WEEK 7: ICU

This week I did my clinical observations with an ICU nurse. She was in charge of two patients at a time. Due to the intensive attention each patient needed she could not exceed more than two. She stayed in the ICU unless she needed to transport a patient to either the MSU or the cath lab.

Things I learned this week-

• The type of patients who come into the ICU.
• Daily tasks of an ICU nurse.
• How the ICU staff works as a team to care for each and every patient

The BEST thing that happened this week was being able to assist with taking a simple blood sugar test. Since we are there only for observation it isn't very often that we are offered to participate. I had gloves on swabbed the area down took out the needle punctured the hand and squeezed the blood onto the strip to put on the machine.

The WORST thing that happened this week was working with a questionable and grumpy patient. He asked me to fetch his bag and check that no one had taken his inhaler and pills. The nurse stopped me and allowed me to search for it myself but told me not to give it to the patient because he wasn't allowed to take anything not authorized by the doctor. He seemed pretty sketchy and complained a lot.

Overall this week was: GOOD

What I Observed...

Mechanical ventilator

Nasal Oxygen tube

 Technology:

•  nasal oxygen tube

• Mechanical ventilator

  

  Blood Tests

• Infusion Pump

Diagnostic Procedures:

• blood sugar level test

• vital signs

• blood tests

 Therapeutic procedures:

• blood transfusion

• injections

• pills

• morphine

•  IVs

 Diseases/Disorders:

• post-op from a tumor removal

• obesity

• gastrointestinal pain

• Renal Kidney Failure

Medical Terminology:

• code blue- pulmonary or cardiac arrest

Other: 

•  When you start a blood transfusion on a patient you must remain with the patient for 10-15 minutes in order to verify that there are no unexpected reactions such as an allergic reaction or quickening of the breath that could potentially be life threatening.

• When taking blood tests another nurse must be present for legal reasons in order to verify the procedure.

   

   

  I. I worked in the ICU unit of the hospital that is upstairs behind the CCU unit that is no longer in service. There were no locked doors or buzzers needed to get into this area. This area was conjoined with the respiratory unit and had about 4 or five rooms on each side. Each room had glass doors so that the nurses and doctors could see in and make sure the patient is fine without having to go in and evaluate them. Each patient was hooked up to quite a few wires that included IVs, antibiotics and blood and or oxygen lines. I remained in this area the entire length of my visit.

  II. The majority of workers were RNs. I saw a couple of doctors overshadowing the nurses. The nurses were each assigned up to two patients and helped the other nurses with simple procedures. At one point there was this obese man who had to have a mat put under him so three RNs and two student nurses worked together to lift and adjust him. This was a prime example of how a lot of the staff in this area comes together to aid one another on each others patients. The patients in the ICU needed constant attention vitals were taken during each procedure to ensure minimal change in the patients health. Although charting took up a lot of the nurses time the most vital part was monitoring their levels.

  III. The first patient I saw needed a blood transfusion due to her renal kidney failure. In order to proceed with the transfusion the nurse contacted her POA in order to verify that they wished to have the procedure done. Before the procedure she was given a blood thinner to avoid clotting and a saline solution to flush the central line before receiving the blood. Once the preparation was done the blood was hooked up to her central line and controlled by an infusion pump.The man with obesity was put on a mechanical ventilator in order to breath for him since his body had already undergone a lot of stress due to his trip to the OR for the removal of a tumor in his abdomen. Another patient had gastrointestinal pain and was constantly asking for more morphine to ease his pain. Each patient needed constant attention and care.

  IV. Overall I had a good experience and learned a lot about patients in the ICU. In the ICU as with many other areas charting takes up most of the nurses time rather than actual patient interaction just because due to the legal aspects of things everything needs to be charted and as I learned the motto in the nursery department last week, "If it's not written down on the charts, it didn't happen." This is a motto I believe the entire hospital abides by.