Sunday, December 9, 2012


Erica Glenn
12/5/12
Emergency Room 

Learning Experience Journal 
1. Assessment of the Environment
  • Personnel- The majority of the ER is women. But the main doctor is a man. The personnel is all very nice and have to be good with patients and stuff. 
  • Services Provided- The ER provides emergency care to patients that are ill or have just been in a car accident (trauma) or something along those lines. They draw blood and then send it to the lab to be tested. They also insert catheters into patients. They also check vital signs and help the patient in anyway they can to find out what is wrong. They preform many tasks along these lines in the ER. 
  • Equipment- There are many pieces of equipment in the ER including, vials, IV's, catheters, thermometers, computers, ultrasound machines, xray screens, sinks, needles, tourniquets, and many other supplies and equipment. 
  • Technology Utilized- Computers that were monitoring vital signs. Also, the main piece of technology is the machine that holds all of the medicines and stuff that the doctors need to help the patients It is like a vending machine that charges the patient for everything they use. 
2. Observation
  • Health Care Professionals- When we first walked in, all of the women were sitting around talking because there were no emergencies going on at the time. But then later, when patients came in, they became rushed and running around. They all seemed nice and professional, but Monday wasn't there, and that is who Marcela and Dorian suggested we observe. 
  • Teaming Skills- All of the heath care professionals seemed to work well in teams. When the pregnant woman came in, three or four doctors had to work together to help her. It was pretty crowded in the room with all of the people in there, but they were all working together, so it went smoothly.
  • Communication Skills- All of the doctors know what to do and how to communicate it in an affective manner. When they were working with a patient, they spoke in a manner that they would understand, and were very nice to the patient. 
  • Safety Procedures- When taking blood or touching the patient at all, everybody was wearing gloves. Also, when taking blood, when the needle was taken out, it had the cap put back on it and disposed of in the sharps container. There was also multiple trash containers for different waste disposal types. Also, the sink had to be turned on with your foot, so your contaminated hands didn't touch it. 
  • Therapeutic/Diagnostic Procedures- Mi and I saw an old woman get a catheter put in, as well as a lot of blood drawn (one from IV, and another from the hand). Also, there was a pregnant patient who came in, and we saw an ultrasound, her temperature taken, and more. There was also another patient who came in and threw up, and we saw him get some meds.
3. Knowledge
  • New Information Learned- I learned that when putting a catheter in, the patient should be laying as far back as possible. I also learned that there is like a portable little machine that is just like a little only sound ultrasound machine that listens to the heartbeat of the baby. I also learned that some people come into the ER for very minor things. 
  • Medical Terminology- When Mi and I were in the ER, there was not a lot of medical terminology used.. But there was a few. IV= Intravenous Therapy.
  • Skills Learned- I learned to stand out of the way when the nurses are running around trying to help a patient. I also learned the steps on how to put in a catheter. I also learned that if you come into the ER with abdominal pain and you throw up, you cannot drink any water. 
4. Evaluation
  • Personal Experience- I enjoyed going to the ER, but i definitely do not want a career in that field. I would not be able to handle the trauma or disgusting aspects of the ER. (Vomit, etc.) 
  • Educational Value- I did learn some valuable information while i was in the ER, and I enjoyed my time seeing new things and seeing the difference between a real life ER and the TV show's ER. 
  • Professional Value- I got some professional value experience while i was in the ER by observing the health care professionals and such. I also know that i do not want my professional career to have anything to do with the ER. 
Learning Report
1. What were your responsibilities or duties this week?
  • This week , when the pregnant woman came in with shortness of breath and chest pain, one of the doctors asked me to go get the thermometer. I left the room and was like frantically looking for the thermometer and i was like asking the person behind the desk and she said it was on the wall. I was like looking everywhere for that thermometer and i kept saying "Where is the thermometer?!?!" and finally she pointed to a wall very far away and i like ran over and got it and ran back to the room and gave it to the doctor. That was pretty much the only thing i was asked to do this week. 
2. What new knowledge or skill did you learn this week?
  • I learned that in the ER, they keep a thermometer in a special place on the wall for some reason instead of one in each individual room.. I also learned the steps on how to put a catheter in. I was also talking to another older student in college and i learned how not difficult it is to become an ER nurse. 
3. What was the best thing that happened at the ER this week?
  • The best thing that happened in the ER this week was the pregnant woman coming into the ER with chest pains and shortness of breath, because she was the only actual emergency we saw the whole time. 
4. What was the worst thing that happened in the ER this week?
  • The worst thing that happened in the ER this week was the fact that when we first got there, it was really quiet and we had nothing to do but talk to the women, who were talking amongst themselves, so it was pretty hard to interject into the conversation. 
5. The "worst" was not really a personal mistake, so there was no way to correct it.
6. This week was fair because neither Mi or I got to do like anything, and we were just standing there not knowing what to do for a pretty long time. It was fairly awkward because the person we were observing had another college student that she was trying to teach, so we didn't get any of her attention, and she kept leaving without us. 

Experiene Record
  • Technology Observed: 
    • IV
    • Thermometer
    • Computer
    • XRay machine screen
    • Needles
    • Catheter
    • Etc.
  • Diagnostic Procedures Observed
    • Inserting a Catheter
    • Listing to an ultrasound machine
    • Temperature taken
    • Nurse asking questions to see what was wrong with the patient
  • Therapeutic Procedures Observed
    • The catheter was inserted to help the patient, so i guess that could be considered as a therapeutic procedure.
    • No other therapeutic things occurred while we were in the ER 
  • Diseases/disorders Observed
    • There was one patient with abdominal pains and was throwing up with stomach-bug- like symptoms
    • There was another patient who came in with shortness of breath, dizziness  and chest pains. 
  • Medical Terminology encountered
    • IV- Intravenous Therapy
    • Cultures- Bloos cultures
    • There were not very many other med terms that i encountered
Experience Journal
This week i was in the ER with Mi. When we fist got to the ER section, we had a woman joking with us that it cost $2.50 to get into the ER, and we all had a little laugh. Then we both entered into the ER and walked up to the desk where there were a bunch of women sitting around, and we introduced ourselves, and someone told us to go observe Jennifer, so we found her and introduced ourselves to her. THen she went into a patients room, so we followed, and the college student girl came in with us too. Then Jennifer put a catheter into an old woman, took blood and then took some more blood. After that, Jennifer went into another patient's room where the guy had just thrown up, and she was asking him a whole bunch of questions and stuff. Then she left that room, and like had to go somewhere, so she ditched us. So Mi and I asked to observe someone else, and so we did. Then a patient came in with shortness of breath and was about to throw up and she was really dizzy and pregnant. So her whole room got very crowed full of people, and Mi and i were just trying to stay out of the way. Then one of the doctors asked me to go get the thermometer, so i was frantically searching for it, and found it and ran back to the room. The doctor was asking the girl tons of questions while the other doctors were putting all sorts of stuff on the patient. Then they did an ultrasound to listen to the babies heart beat, and everything was okay. Then it was time to go, so Mi and I left the room and thanked the pople for letting us observe. Then we left, and made our way back to the cafeteria. 

Sunday, December 2, 2012


Erica Glenn
11-30-12
Day Surgery

Experience Journal
      I.         Assessment of the Environment
a.    Personnel-The majority of the personnel in the day surgery were females. Actually, all females, I didn’t see a single male. But they were all very nice people.
b.    Services Provided- Day surgery provides many outpatients care surgeries. Meaning that you check in, have your surgery, and then leave later that day.
c.     Equipment- There is not a whole lot of equipment used in day surgery.. There were a lot of beds and such. Also, there were computers and screens that monitored the vital signs of the patients after the surgery.
d.    Technology Utilized- Computers were used to look at the vital signs of the patient. Other technology was used to observe and help the patient.
    II.         Observation
a.    Health Care Professionals- All of the health care professionals in day surgery were females. But the majority of the doctors that were preforming the surgery were males. But they were all very nice, and happy to be working there.
b.    Teaming Skills- All of the people in day surgery had very good teaming skills. While I was in there, they were putting up Christmas decorations, and they were all working together to finish the project.
c.     Communication Skills- They were all good at communicating. Once, someone had misplaced something, and everyone was communication and trying to find it. So overall, they all had good communication skills. Also, when one of the  nurses was talking to a patient about all of the discharge stuff, she was very good at communicating all of the information.
d.    Safety Procedures- I only saw a few safety features while I was in day surgery. These included wearing gloves while taking the IV out of the patient. Also, when the patient was lying in bed, the rails on the side of the bed had to be kept up at all times in order to keep the patient safe.
e.    Therapeutic/Diagnostic Procedures- I did not actually observe or see any therapeutic or diagnostic procedures preformed, but I know that a few patients had gotten a colonoscopy. Also, they had been administered anesthesia during their surgery.
  III.         Knowledge
a.    New Information Learned- When I was in day surgery, I learned that when a patient is being discharged, two ladies come with a wheelchair to escort them out. That is the only thing I learned while I was in day surgery…literally.
b.    Medical Terminology-
                                              i.     CNP
                                            ii.     PRBC- Packed red blood cells
                                          iii.     EGD- Esophagogastroduodenoscopy
                                            iv.     LAVH vs. TAH- Laparoscopic Assisted Vaginal Hysterectomy
c.     Skills Learned- I learned how to take out an IV. You take off the tape, first, and then gently pull it out, and cover it with pressure and then a band aid.
  IV.         Evaluation
a.    Personal Experience- I had a pretty awful and boring time while I was in day surgery. It was extremely boring and uneventful. Literally nothing happened. It was just like chitchat time for all the ladies working there.
b.    Educational Value- I did not learn anything useful while I was in day surgery. It was extremely boring and uneventful. Literally nothing happened. It was just like chitchat time for all the ladies working there.
c.     Professional Value- I guess it could kind of be considered as being kind of professionally valuable. I saw how boring their job was. It was pretty much all paperwork and nothing cool. I definitely would not want to work in day surgery.

Learning Report
      I.         What were your responsibilities or duties this week?
a.    I literally had no responsibilities or duties at all. I did nothing the whole time. They were just talking and filling out paperwork and on the computers the whole time both days, so I literally did nothing.
    II.         What new knowledge or skill did you learn this week?
a.    I learned how to take out an IV. You take off the tape, first, and then gently pull it out, and cover it with pressure and then a band aid.
b.    That is the ONLY thing I learned at all.
  III.         What was the best thing that happened at the unpaid work-based learning site this week?
a.    The best thing that happened to me this week was on Monday, I walked in, and the nurse said there was nothing to do, so she let me sit in the chair. As apposed to me standing for an hour on Wednesday not doing anything.
  IV.         What was the worst thing that happened at the unpaid work-based learning site this week?
a.    The worst thing that happened to me this week was having to stand awkwardly by the desk for the full hour and a half on Wednesday, it would have been much more convenient if I could have sat down, but nobody asked me if I wanted to sit, so I didn’t. I had to stand there forever doing nothing.
    V.         If the “worst” was a mistake, how was it corrected?
a.    The worst was not a mistake, so there was no way for me to correct it.
  VI.         This Week was: Bad
a.    Why?- because literally NOTHING happened the whole time. There were no patients on Monday and it was the most boring thing ever.

Experience Record
      I.         Technology Observed:
a.    Computer
b.    Refridgerator
c.     Freezer
d.    Coffee machine
e.    Scanner
f.      Vital signs machine
g.     Nothing else or cool
    II.         Diagnostic Procedures Observed:
a.    Nothing
  III.         Therapeutic Procedures Observed:
a.    Water was given to a patient
  IV.         Diseases/Disorders Observed:
a.    Colonoscopy
    V.         Medical Terminology/Abbreviations Encountered
                                              i.     CNP
                                            ii.     PRBC- Packed red blood cells
                                          iii.     EGD- Esophagogastroduodenoscopy
                                            iv.     LAVH vs. TAH- Laparoscopic Assisted Vaginal Hysterectomy


Learning Experience Journal
            When I walked in on Monday, I introduced myself to the nurse, and she said there was nothing going on, and that I should take a seat. So I sat and she went back into the break room, so I was out there all alone. Then a few of the other nurses came out and they were just chatting forever, doing nothing. And I couldn’t interrupt their conversation because they were talking about their kids and stuff. So that was really boring. There was not a single patient the whole time, and nothing happened. So I left. And on Wednesday, there were more nurses, but they were all sitting at the computers charting and working doing paperwork and stuff. I stood by the desk practically the whole time doing nothing but staring at the clock. But then one of the nurses was going to discharge a patient, so she let me observe her talk to the patient, sign papers, and take the IV out. That was all I did, and it was very boring. And then it was time to leave. So I did. I did not have a good time, and I don’t really want to go back to day surgery because it was so boring.

Day Surgery Questions
Describe the purpose of a surgical consent form: so the patient consents and knows what is going on.
Describe how the patient identity is verified during the surgical experience: bracelets and name tags or something.
Describe the purpose of pulse oximetry: a pulse oximetry is something that takes your pulse.
What risk factors are associated with anesthesia: not waking up or dying, etc. 
What are the components of a patient assessment: assessing the patient
Explain how the patient’s right to dignity, privacy, and confidentiality are maintained: no information is released without patient consent
Identify the members of the intraoperative health care team: during the surgery, the people that help. 
Who is ultimately responsible for patient discharge: the nurses that are responsible for the discharge. 
Identify the criteria for patient discharge: paperwork and telling a lot of stuff to the patient to make sure they understand. 
What is the PACU: post anesthetic care unit
Identify the five most common surgical procedures performed in day surgery: colonoscopy, etc. 
What are nosocomial infections: infections that are noscomial
What infection control procedures are done to reduce the spread of infection in hospitals: washing hands, and other sanitary measures. 
Differentiate between intubation and extubation: one is in and one is out.