WEEK 2: ER

Emergency Rooms

What Society Thinks Happens:

What Actually Happens:

• This week I did my clinical Observations with a nurse. She was working with several patients and would draw blood from each then move to the next. There weren't a lot of patients being admitted so triage wasn't an issue.
• Things I learned-
• most nurses work together on patients ,but not necessarily at the same time. They each have individual jobs they must complete such as drawing blood, prepping the patient, or filing the patient's information.
• A lot of the ER isn't necessarily intense cases; it could just be a patient with stomach pains.  

• The BEST thing that happened this week was watching a pregnant woman get wheeled into the ER. It  gave you the feeling that things could easily go wrong and everyone would have to rush to save this woman and her baby.
• The WORST thing that happened this week was interacting with a rude nurse. I simply asked a nearby nurse who was about to go into a patient room if I could do my clinical observations with her and she rudely responded by saying, "Uh I don't care." Then later one of the nurses told me to pick up a blue bag and I did then the rude nurse next to me grabbed it out of my hands. 

This week was: GOOD

What I Observed...

Technology

• Catheter
• Butterfly Needle
• Portable Ultrasound
• Cardiac Monitor Display

Diagnostic Procedures

• Blood sampling
• Ultrasound
• Vital Signs
• Triage

Therapeutic Procedures

• IV

Diseases/ Disorders

• Stomach virus

Medical Terminology

• lasix (water pill)- get the fluid off 
• hydrologene (pill)- to regulate blood pressure

Other

• you inject fluids through the same tube used to draw blood
• the general steps for drawing blood

I.  I worked in the ER section, which is blocked off from the rest of the hospital and creates a U of patient rooms. I remained in this area the entire time while shadowing a nurse who was working on 3 patients periodically. She would check their vital signs, assess their medial issues, then draw blood for sampling, send it in a shoot to the lab, then fill out the patients paper work. With the first patient she inserted a catheter through the bladder in order to control the drainage of fluids. She then used butterfly needles to draw blood for testing. In order to monitor the patients blood pressure she constantly checked the cardiac monitor display and when the pregnant woman came in they immediately checked out her baby's heart rate with a portable ultrasound.

II. All of the workers I saw in the back were female nurses or receptionists at the desk. They would work together each performing a specific procedure on each patient. For example, one would do the physical assessment and vital signs and then the other would administer the IV. They communicated through the use of a dry erase board with each patient and the nurse who was supposed to be on duty at that time. There weren't too many patients so triage wasn't really an issue there were enough workers to cover ever patient. For safety they just made sure to follow bio hazardous precautions and disposal when it came to dealing with blood and needles. The diagnostic procedures done on patients included drawing blood, basic vital signs with a physical assessment to conclude triage and an ultrasound on the pregnant woman. For therapeutic procedures all they got to was discussing IV distribution because they hadn't yet received back the results of the blood to assess the medical issue.

III. I learned lasixs are water pills uses to release the fluid in a patient and Hydrologene is used to regulate blood pressure. Before putting in the catheter they lubricate it with a jelly-like substance. When you draw blood you first sterilize the area, then you tie off the section, you insert the needle, open the access to the tube for storing the blood, then you close the needle. When you insert the needles there are two tubes that it is sectioned off into. When you can't find a good vein in the arm you move to the hand.

IV. Overall I had a good experience. I mostly learned about needles and blood drawing. The personnel on the most part were nice. All the information I learned can be used in general most areas in the hospital ,so it was very beneficial.