Erica Glenn

11/14/12

Respiratory

Experience Journal

      I.         Assessment of the Environment

a.    Personnel- On Monday, I worked with Jesus. And on Wednesday, I worked with a woman, who I believe her name was Kim. But there are always two respiratory therapists in the department, and on Monday, it was two men, and on Wednesday, it was two women.

b.    Services Provided-The respiratory therapists are in charge of all of the patients that are in the ICU. They help the patients get off of the ventilators and respiratory machines that they are on after surgery. Also, the respiratory therapists are in charge of responding to all of the code blues in the whole hospital. I also saw an ET tube on the airway of one patient.

c.     Equipment-There is a lot of equipment that is utilized in the respiratory department. Mainly, the ventilators are very important because the patients cannot breathe on their own, and need the help of machines to remain alive. Also, the monitors that show the vital signs are very important to see how the patient is doing. Also, I saw a Mac 500, AirGas machine, VMax machine, a PFT test, etc.

d.    Technology Utilized- There is a lot of technology that is used in the respiratory department. The computers and monitors that show how the patient is doing are very important. Also there are many computers and such that are used. Also, the respiratory therapists need to use the lab to to test blood and such, so there is a lot of technology utilized in the laboratory for respiratory. Also, when doing a PFT test, Kim used some sort of breathing machines to test the air of the patient. Mac 500, AirGas machine, VMax machine, a PFT test, etc.

    II.         Observation

a.    Health Care Professionals- In the respiratory department, there are a few health care professionals. On Monday, there were two males, Jesus and someone else who I did not know his name. And n Wednesday, there were two females, Kim and Pricilla. But when we went into the ICU, there were a lot of nurses, technicians, and doctors helping the patients. Also, there were two nursing students that were in the ICU observing the real nurses.

b.    Teaming Skills-The two respiratory therapists have to work well together when a code blue is called. They must work together well in order to save the patients life. They all work well in teams in order to help the patient.

c.     Communication Skills-The health care professionals that work in the respiratory department, all have to have good communication skills in order to save someone’s life. They also are really nice, and communicate well with each other to have fun during their workday.

d.    Safety Procedures-There are many safety procedures that are used in the respiratory department in order to keep all of the patients and workers safe. Mainly, when I went into an ICU room, I had to put a lot of PPE on, including a gown and gloves. Also, there is a code blue button in every room that is there for when a patient codes, the button is pushed and everybody rushes into the room in order to save their life.

e.    Therapeutic/Diagnostic Procedures-There was a few therapeutic procedures that I observed in the respiratory department. These include the ventilator that was there in order for the patient to breathe. But for a diagnostic procedure, I saw an ABG (arterial blood gas) test that was testing the amount of gasses that are in the blood in order to see if the patient was ready to be taken off of the ventilator after their surgery. I also saw another diagnostic test that was called a PFT (Pulmonary Function Test) that was for a patient to see how well they are breathing and what kind of gasses are being released during their inhalation and exhalation.

  III.         Knowledge

a.    New Information Learned- This week I learned that in the respiratory department, there are two respiratory therapists that have to respond to every single code blue in the whole hospital. Also, I learned that a PFT is a pulmonary function test, and that an AGB is an arterial blood gas test. While talking to one of the respiratory therapists, I learned that you could possibly get your employer to pay for your schooling in order to further your medical degree, which she did. Also, there was a patient in the ICU who had had an open heart surgery many years ago, and during the surgery, the doctor accidentally cut his diaphragm, and since he only had one lung, he is going to have to be on a ventilator for the rest of his life and cannot speak. I thought that that was really sad and depressing, but I still learned something new.

b.    Medical Terminology- I learned a few new medical terms this week.

                                              i.     PFT- Pulmonary function test

                                            ii.     ABG- Arterial blood gas

                                          iii.     Code- Code blue

                                            iv.     Trach- Trachicastomy

                                              v.     COPD- Chronic Obstructive Pulmonary Disease

c.     Skills Learned- I learned how easy it is to do an ABG test. I also learned how to take something out of the fancy machine that like charges the patient whenever you take something out of it.

  IV.         Evaluation

a.    Personal Experience- I had an okay time this week. Monday was kind of eventful and I got to see a few different patients, and Jesus was really nice and trying to teach me a bunch of new things. On Wednesday, it was pretty boring, and I did not do very much. I got to talk a lot with one of the respiratory therapists, and she answered a lot of questions that I had about the department. At the end of Wednesday, it got kind of eventful, and I got to observe the doctor preform a diagnostic test on a patient.

b.    Educational Value- I learned a few new things this week during my time in the respiratory department. I learned a lot about some of the patient stuff on Monday, and a lot of stuff about the career path of a respiratory therapist on Wednesday.

c.     Professional Value- I learned a lot about the professionalism of the respiratory department this year. Mainly, on Wednesday, I got to talk a lot with the doctor, Kim about her career path. She was originally working as a physical therapist, but her employer decided to pay for her to go back to school. So she did, and she became a respiratory therapist. She said she did not like her job. The only thing she liked about it was the amount of freedom that she had. So yes, this week did have some sort of professional value for me.

Learning Report

      I.         What were your responsibilities or duties this week?

a.    I did not have any responsibilities or duties that I had to preform at all this week. It was pretty slow, so the doctors were not asking me to help with anything; they were just trying to teach me.

    II.         What new knowledge or skill did you learn this week?

a.    I learned a few new things this week during my time in the respiratory department. I learned a lot about some of the patient stuff on Monday, and a lot of stuff about the career path of a respiratory therapist on Wednesday.

  III.         What was the best thing that happened at the unpaid work-based learning site this week?

a.    The best thing that happened this week was a lot of different things. Mainly, how nice Jesus was, it really was fun. He was trying to teach me as much as possible, and he was taking me like all over the hospital. And on Wednesday, the best thing that happened to me was that I got to see an actual PFT test being preformed. It wasn’t too interesting, but it was a real diagnostic test that I got to observe, so that was cool.

  IV.         What was the worst thing that happened at the unpaid work-based learning site this week?

a.    The worst thing that happened this week was that on Wednesday, it was pretty slow and quiet. And Kim, the lady who I was observing, was kind of bitter, and not that nice to other people. But it was really funny. And I enjoyed her as a person.

    V.         If the “worst” was a mistake, how was it corrected?

a.    The worst was not a mistake, so there was no way to correct it.

  VI.         This Week was: Fair

Why? This week was fair because Monday was eventful, and Wednesday was not that eventful.

Experience Record

      I.         Technology Observed:

a.    Mac 500

b.    AirGas machine

c.     VMax machine

d.    a PFT test

e.    etc.

    II.         Diagnostic Procedures Observed:

a.    ABG test

b.    PFT test

  III.         Therapeutic Procedures Observed:

a.    Ventilator

b.    Medicine

c.     Trach

  IV.         Diseases/Disorders Observed:

a.    COPD

b.    Apnea

c.     Obesity

    V.         Medical Terminology/Abbreviations Encountered

a.    ABG- Arterial Blood Gas

b.    PFT- Pulmonary function test

c.     Code- Code blue

Learning Experience Journal

This week I was in the respiratory department. On Monday, I first walked in and introduced myself to Jesus and Mark. They were watching TV, but when I came in Jesus decided to go check on a patient to show him to me. So we walking into the patient’s room, and it was an obese 600 pound man. Jesus talked to the family for a while, and then took some blood from the patient. Then we went to the lab, and did a test on the blood, and the test had bad results because he accidently got venous blood instead of arterial blood. Then we went back upstairs and saw another patient who had a ventilator that he relied on to breathe. Then on Wednesday, I walked in and introduced myself to the woman who was in the office, and she said that there was nothing going on for a few minutes, and she asked me to wait outside. So I waited outside sitting in a chair for a while, and worked on my questions. Then Pricilla came in, and she started to talk to me for a bit. Then she left and I was still sitting there. Then finally Kim came out and took me around the ICU, but she didn’t really need to do anything, so she was talking to one of the nurses for a while. Then I started asking her questions, so we sat down and chatted about the job and some of the questions that I had. Then she showed me around the stock room. Then she got a call, so we went down to the radiology department to run a PFT test on a patient who was a walk-in. So Kim started the test, and like halfway through it, it was time for me to go, so I said goodbye and got Kim to sign my task sheet, and then I left. I had a pretty good week. I learned a lot of new things and had a lot of patient contact throughout this week.

Respiratory Therapy Questions

          I.     Explain the difference between a pulmonologist and an RRT

a.    A pulmonologist is an MD and an RRT is a registered respiratory therapist

        II.     Define the following:

a.    Aerosol- a type of gas

b.    Spirometry- a test that measures the forced expiratory volume in one second

c.     Bronchodilator- is a substance that dilates the bronchi and bronchioles, decreasing resistance in the respiratory airway and increasing airflow to the lungs

d.    Apnea- A sleep disorder when you are really overweight and cant breathe

e.    Aspiration- when you choke on our own vomit

f.      Hypoxia- disease in the blood

g.     Croup- coup

h.    Hiccough- mix between a hiccup and a cough

i.      Sneeze- discharging snot through your nostrils

      III.     Describe the components of ABG analysis.

a.    Blood analysis that tests for all of the different gasses in your blood

       IV.     Identify the normal values for PO2 and PCO2.

a.    PO2 and PCO2

         V.     Describe the characteristics of hemoptysis in relation to the potential bleeding site.

a.    When a patient presents with massive hemoptysis, the initial steps are to correctly position the patient, establish a patent airway, insure adequate gas exchange and cardiovascular function, and control the bleeding 

       VI.     Differentiate between PEEP and CHF

a.    CHF is Chronic Heart Failure, and PEEP is positive end-expiratory pressure

     VII.     Describe the purpose of a pulmonary function test.

   VIII.     Describe the procedure for a postural drainage.

a.    Drainage used in bronchiectasis and lung abscess.

       IX.     List the steps for adult one-person CPR

a.    Normal, compressions and breathing.

         X.     What are the benefits of an aerosol treatment?

a.    the use of an aerosol for respiratory care in the treatment of bronchopulmonary disease. 

       XI.     Describe atelectasis

a.    is the collapse of part or (much less commonly) all of a lung. Symptoms: Breathing difficulty; Chest pain; Cough.

     XII.     Describe the signs and symptoms of a spontainious pneumothorax

a.    A collapsed lung, or pneumothorax, is the collection of air in the space around the lungs. This buildup of air puts pressure on the lung, so it cannot expand as much as it normally does when you take a breath

   XIII.     Define tension pneumothorax

a.    Collection of air in the pleural cavity around the lungs that cause a lung to collapse.

    XIV.     Define the following:

a.    Pneumonectomy- removal of a lung

b.    Thoracotomy- removal of the thorax

c.     Trachestomy- removal of the trachea

d.    Lobectomy- removale of the obes

      XV.     Define the signs and symptoms of COPD

a.    Chronic Obstructive Pulmonary Disorder

    XVI.     Draw and label the components of the respiratory system

a.    Lungs, veins, arteries, trachea, blood, etc.

  XVII.     Define the following

a.    Emphysema- Stuff in your lungs

b.    Pneumonia- sickness where there is fluid in your lungs

c.     Bronchitis- inflammation on the bronchi

d.    Tuberculosis-a condition of the tuberculi

e.    Asthma- a shortage of breath, and problem with your lungs and bronchi

f.      ARDS- ARDS

XVIII.     Define the following

a.    Etiology- The study to eti

b.    Prognosis- a diagnosis

c.     Remission- being well for s while

d.    Exacerbation- exacerbation

e.    Relapse- back from remission

f.      Complication- a problem

g.     Sign- a symptom

h.    Symptom- some clue as to what is wrong

    XIX.     Describe the difference between a hemothorax and a pneumothorax

They are practically the same thing