Emergency Room 01/30/15

Report

1. In the emergency room, the nurse was responsible for taking vital signs, keeping the patient comfortable, telling the patient what she/he was doing, drawing blood for testing (if necessary) and checking up on the patient. 
2. This week I learned that ER and Imaging staff work together often. One of the patients needed a chest x-ray done, so the imaging staff came in to do that.
3. The best thing that happened in the ER was observing blood being drawn. 
4. The worst thing that happened in the ER was watching two nurses hold down a young, autistic girl because they needed to draw blood, and she would not stop moving.

This week was:  Fair

The ER was not very busy in the morning, and I was not able to see much. The nurses were not very responsive to the questions I had.

Record

Technology Observed:

In the ER, I observed basic technology. There were vital sign machines, and EKG machines. I also observed a machine that was brought in by the imaging staff that took x-rays.

Diagnostic Procedures Observed:

I observed two diagnostic procedures while in the ER. One was the x-ray machine that took an x-ray of the patient's chest, and the other was drawing blood to take several different tests. These tests included checking liver/kidney, dehydration, seeing if the patient is anemic and white blood cell count.

Therapeutic Procedures

I can only think of one therapeutic procedure that I observed. The nurses gave the elderly patient some medication to help with his cough.

Diseases/Disorders Observed:

One disorder I observed very briefly was autism through the little girl. It was evident that she did not really know what was going on which made her very scared and caused her to act out. She screamed and cried the whole time while the nurses tried to hold her down in order to draw blood or put in an IV.

Medical Term/Abbreviations:

In the ER I encountered one term and one abbreviation. On a paper I saw the medical abbreviation "ASA" which stands for aspirin. I also overheard the nurses talking about a laceration which was a medical term we learned about which is a wound that is produced by tearing of soft body tissue.

Journal

    The Emergency Room was very calm and quiet when I first walked in. After being there for about 20 minutes things began to get louder. The personnel were very calm and patient as well which did not surprise me because I feel like working in the ER requires someone with those characteristics. When needed, the nurses would take vital signs and assess the patient. They would look for wounds and ask the patient how they're feeling. 

    I observed the nurses using the vital sign machines and drawing blood on two patients. The nurses would work together to record things and if they needed help with one of the patients who would not cooperate well. They also worked with the Imaging staff to take x-rays. The nurses would administer IVs and draw blood to take tests that for the elderly patient in particular, determined kidney/liver levels, dehydration and white blood cell count. 

    Going into the ER, I did not have much previous knowledge about how the staff worked. I knew that they dealt with many different patients and many different situations. I learned that they work together a lot. There can be two nurses to one patient, and they can help each other out. I came across the medical abbreviation "ASA" which stands for aspirin, and the medical term "laceration" which is a wound produced by tearing of soft body tissue. I also learned that the nurses check the patients for the Flu by putting a long swab up their nose.

    Overall my experience in the ER was fair. I was only able to observe two patients, and the nurses did the same thing for both patients which included taking vital signs and drawing blood. The experience was somewhat educational. It allowed me to see how the staff in the Emergency Room operates, and the different types of patients that they see. 

Clinical Report/Record/Journal - Physical Therapy 01/23/15

Clinical Report

1. In Physical Therapy I did not have any responsibilities. I asked about some questions about the exercise equipment, and talked to the patients.
2. I learned that the physical therapist will usually see two patients at once, and about 16 per day. At this hospital they usually have older adults come in, and most of the patients there were in to work on their knee(s). 
3. The best thing that happened was being able to observe the different exercises they had the patients doing and talking to the patients. 
4. One thing I did not enjoy was seeing the patients do their workouts and being in pain. That was probably the worst part; however, I know they have to do it to get better.

This week was: Fair

I was not able to do many hands-on duties this week, so I really just observed the exercises and talked to the patients. 

Experience Record

Technology Observed: 

In physical therapy I observed a lot of exercise equipment. They had many bicycle machines that would work on your legs, a total gym that also worked on your legs (it could do a lot more, but they just used it for the lower body). They also had weights and exercise balls. 

Diagnostic Procedures: 

In physical therapy they do not really diagnose patients. Physical therapy is usually where patients go after being diagnosed.

Therapeutic Procedures:

Physical therapy is all about therapeutic procedures. They use various amounts of work out equipment and exercises. I observed a patient who have a full knee replacement done, and she used the bicycle machine, the total gym, and she had to lift her leg high to walk over cones. 

Diseases/Disorders Observed:

I was not able to observed any diseases or disorders, for the patients I observed did not have any. However, I asked the therapist what diseases or disorders he has seen while working, and he said he mostly just sees patients with knee problems. Sometimes there are patients who come in who have had cancer.

Medical Terminology/Abbreviations:

The therapist I was shadowing said one medical abbreviation that we just learned. He talked about ADL (activities of daily living) with one of the patients. 

Journal

  Walking into physical therapy was similar to walking into a gym just not as many work out machines. There was even a little hint of nice sweat smell. In the room were probably about six therapists, and they all had patients with them. They were all working with their patients, and they were helping them exercise. One lady was lifting weights, some were stretching, and a couple were using the bike machines.
  Scattered around the room were medical beds, and around the walls there was work out equipment. The therapists all had black shirts on and khaki pants. They would work together, and they would share the work out equipment. I saw some simple safety procedures such as putting a pillow under the patients head while they used the total gym, so they wouldn't hurt their neck. I observed therapeutic procedures the entire time I was there from stretching, to exercise and balance. 
  In physical therapy I went in with knowledge about what they do. I knew that they stretched their patients, and they would give them exercises to do; however, I learned some things too. I learned that the therapist usually has two patients at a time, but not more than two. I did not encounter any medical terminology, but I did encounter a medical abbreviation which was ADL.
  I enjoyed observing the physical therapy area. Physical therapy is something I have been thinking about doing as a career, so it was really interesting to observe. I think seeing some of the exercises done can also benefit me personally because I have an injured knee. Maybe I can do some exercises and strengthen my knee! 

Clinical Report/Record/Journal - Pharmacy 01/09/2015

Clinical Report

1. In the pharmacy, my duties included reading off a list of medication, finding the specific medicine and pulling out the correct number of pills to put in a baggy. After doing so, I had to put labels on each bag, and set them on the counter for inspection by the pharmacist.
2. This week I learned how to look at a paper and figure out what medication (including the mg) is needed, and where to locate that medicine. 
3. The best thing that happened in pharmacy was being able to actually perform hands-on duties. 
4. The worst thing that happened was probably the fact that it was really difficult for me to understand the pharmacy technician. She had a very strong accent and talked very quietly. 

This week was: GOOD

I really enjoyed pharmacy, and I believe it was the first time I was actually able to learn a lot. I did the most hands-on duties in this rotation than I have in any other. 

Experience Record

Technology Observed:
In the pharmacy I was able to observe some of the technology used. I was able to make labels myself using the computer, and print them out of the label printer. Also, when an IV bag is taken out of the package, it is only good for a certain amount of weeks, so I had to make my own sticker with an expiration date on it. Lastly, I observed the technician put pills into a machine, and the machine packaged the pills.

Diagnostic/ Therapeutic Procedures:
I believe the pharmacy in itself is the diagnostic and therapeutic procedure. When somebody is diagnosed with a certain illness, nurses or doctors go to the pharmacy in order to give that person some medication(s) that will help them. 

Diseases/Disorders Observed:
In the pharmacy there were not any diseases or disorders that I observed. However, some of the medication in the pharmacy are used to treat illnesses that may deprive from diseases or disorders.

Experience Journal

   Walking into the pharmacy was messy but organized. It was not as loud as other places I have been to. For example the PACU, which is just a ton of random beeping noises that can probably drive a person crazy. There were probably 3-5 technicians working in the pharmacy, and each one was pulling medicine off of the shelves and making neat piles of pills, only stopping to put a label on a bag or to input information into the computer. There were computers along the wall, and some on the counters with label printers as their neighbors, and I was able to utilize both. 

   After completing the duties given to me, much like the duties explained above, the pharmacy technicians had the pharmacist come in. They were a team. The pharmacy techs would grab all of the necessary medications and baggage them, and then the pharmacist would come in, and he/she would communicate with them if they forgot something or had everything correct. The pharmacist and the tech. both performed the safety procedure of double checking every medication that was pulled out. They could not stress how important it was to make sure you had the right medication. After the checking process was complete, the pharmacist left. 

   I gained quite a bit of knowledge about what workers in the pharmacy do. I was taught how to read a paper that determined what medication to pull out, and how many pills were needed of each medication. I was also able to learn how to input certain information into the computer to make labels specific to the medication that was pulled. I utilized much of the equipment they had, and was able to learn a lot.

   The pharmacy was my best experience yet. The technicians were kind, and Hahn (the tech I shadowed) had a lot of important information to share with me. I never really thought working in the pharmacy would be to interesting, but I really enjoyed my time there. I could definitely use what I learned there in the future if I ever wanted to go into pharmacy.