medsurg reflective clinical journal angel...

Running head: MEDSURG REFLECTIVE CLINICAL JOURNAL ANGEL ST.DENIS 1

MedSurg Reflective Clinical Journal Angel St.Denis

Angel St.Denis

Stenberg College

MEDSURG REFLECTIVE CLINICAL JOURNAL ANGEL ST.DENIS 2

MedSurg Reflective Clinical Journal Angel St.Denis

Week of June 16 th and June 17 th , 2014

This was our first week on the floor in MedSurg and wow was it ever a fast ride! I had an

amazing nurse on my team that basically through me right into the thick of things and I

immediately got hands on experience right off the bat! The following were highlights that stood

out for me this week:

-Had 2 patients in isolation, preformed isolation procedures (gowned up, gloved up,

everything stays in room including vital machine, paper & pen to write on, and CAVI wipes used

to wipe everything down.

-Did wound care on two wounds for isolation patient that has sepsis. Pt. had constipation

and was given stool softners that started working as we were doing the dressing change and

wound care! Sterilization protocols were used and we had to keep re-setting up our sterilized

field between each BM.

-Was able to do BGM on isolation pts.

-Did vitals, temp, O2 Sat on all of my patients.

-Got to do head to toe 12 hour assessment on my patient including auscultation of her

lungs (she has pericarditis and pneumonia), and Bowel sounds.

- Established a therapeutic relationship with my patient and she confided in me regarding

her depression and recent losses.

-I got to do a subque injection of Heparin on my patient (she was so nice and told me I

did a great job, which really helped!).


-Was present when doctor came to assess my patient and I was able to take information

from the doctor and the patient and give that information in report!! That was an awesome

feeling!!

-I also collected a urine sample from my patient and sent it down to the lab for urinalysis

to find out if she has a UTI.

-I also had the opportunity to write in my patient’s chart at the end of my shift.

I was literally blown away with all of the amazing opportunities that I had, and all of the

nursing skills that I performed in just two short days! It was exhilarating, stressful at times, but

overall an amazing experience and I loved being a nurse!! Donna our instructor was fabulous!

She is very supportive and is readily available if I need any help with anything. Thanks Donna!!

Something I need to work on is not being so overly anxious when giving medications.

Right now because I am such a newbee, I am slow, and feel really stressed about ensuring I do it

properly. I hope to get much better at administering medications as the weeks progress.

Thought you had a great two days. Each week you will gain more confidence and become

proficient at doing the skills and the head to toe.

Donna

Week of June 23 rd and June 24 th , 2014

It really is incredible how much I am learning in such a short amount of time! My clinical

shifts are always jam packed with new opportunities to embrace, new skills, and I am loving

every minute of it.

This week I had the following opportunities:


-Booked a MIBI with nuclear medicine for my patient. Charted it in the chart, noted it in

the cardex, gave the information for the unit clerk to input and also changed my patient’s diet

accordingly. I also discussed the procedure and MIBI NPO protocol with my patient.

-Administered medications with a lot more confidence this week than last week! I also

gave my patient a SC injection that was new to me. Another exciting thing was that I learned

how to flush his IV lock with saline both days.

- I was happy with the way I was able to complete my patient’s vitals, medication

administration, 12 hour assessment (head to toe), charting and fill out the cardex in an efficient

timeframe.

-I asked Theresa to teach me how to use the stretcher, and then after she taught me, I

taught Bing how to use that same stretcher. Funny enough a nurse came out and asked us to

bring a new mattress into isolation on that stretcher, so I had the opportunity to put all I learned

into action on the floor.

I find the staff, my classmates, and my instructor all very encouraging and supportive,

which makes it a wonderful learning environment.

Week of June 30th 2014

I had another great week in medsurg this week. I was able to do my patient vitals,

medications, head to toe assessment, and chart all in an efficient timeframe. I was also able to

speak in the nurse’s report again this week about the condition of my patient.

My patient was an incredibly sweet little lady who was 84years old and was in for chest

pain and irregular heart beats. I was able to notice and make a pertinent observation that she had

pitting edema in her left foot area. Donna showed me in the textbook about the different degrees

of it, and we noted that she was likely at a minus one stage. I was able to have many


conversations with her throughout the day and she shared her past history of major events in her

life that she has been through. I noted that she seemed to really enjoy our visit and it lead me to

ask her if she lived alone (as she seemed lonely). I discovered that she did live alone and so I

noted that in the 12hr assessment under psychosocial concerns. She was very humorous and

patient with me as a student nurse. At the end of my time with her she looked me in the eyes, and

said you are my angel and I will never forget you! I was deeply touched, and I know that I had

established a therapeutic relationship with her.

This week we also got to tour the ICU and Pieds to go over the crash carts. It made me

feel a bit uncomfortable just thinking of someone needing that type of intervention, but it was

great to learn all of the available tools and interventions that staff can use and perform when

someone is in that situation. We also learned from another nurse that students should only

participate in code blue if they are the first on scene, otherwise they are to stand in the hall and

get equipment as needed (as asked by others).

All in all it was a great week and I learned so much in such a short time!!

WEEK of JULY 7 th , 2014

- Research teaching on discharge planning, diabetes and lifestyle teaching, and MIBI

patient teaching. I then taught patients all of the above and was also able to go to a

MIBI with my patient. Great experience!

WEEK of JULY 14th, 2014

This week I had a complex patient (in his thirties) had triple bypass heart surgery with

complications that were being documented for legal purposes, had serious diabetes type 1 and

was brittle, has only one kidney, and was on isolation. He had a hypoglycemic event and I was in

charge of getting his BGM stabilized asap. I also charted everything for court purposes. Was a


unique and great experience. Stressful after I debriefed it and it took awhile to stress down

afterward.

WEEK of JULY 21 st , 2014

Psychosocial needs-

Had patient with history of schizophrenia, talking to himself, and was admitted from

hyponatremia. Was part of the team with the psychiatrist Dr. Boler, the physician, the

community mental health nurse (Shaha), Nicole the social worker, the life skills worker and was

able to give my pertinent observations to the psychiatrist, in rounds, to community health nurse,

for them to use in their team meeting the next day. I also charted and recorded that I did not feel

he was able to live independently on his own as he was not able to follow through with ADLs, he

said he would but he couldn’t even follow through with the shower or brushing teeth. Neat

experience! Love being part of the team!!

WEEK of JULY 28 th , 2014 ……EVALS….we are done!! Great experience! I love being

a nurse!

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