Wow!! I have had two very exciting and educational days in practice this week and getting a chance to see different areas of nursing that I have not yet been exposed to. I am hopeful that the remainder of this rotation will continue to provide me with great learning opportunities. I am appreciating the feedback that has been provided by yourself. You come from a different nursing back ground than my previous instructors and I'm enjoying your knowledge and insight. Thursday was my first time in the OR, to be honest I was excited to have this opportunity but, I was pretty nervous at the same time. I was unsure if I was going to be able to handle watching a surgery. Once I was in the OR the scrub nurse explained everyone's roles in
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We weren't finished drawing up the medication yet, so I was kind of just waiting for the return of my instructor. I however, realized the amount of pain my patient was in and was able to ask his primary nurse to give the medication for me if my instructor did not return within the next five minutes. My instructor did return and I was able to draw up the medication and work though my confusion around the administration of this medication. The need for a second check was definitely validated for me. Before giving the Dilaudid I noted that the patients pulse, blood pressure and respiration rate were within rage to give the medication. I gave the medication over a 5 minute time period as per the IH monograph. When flushing after giving the medication, I made a small error and forgot to flush at the same rate I had give the medication. I returned to the patients room about 15 minutes later to see if he was experience any pain relief and get another set of vitals from him and discovered his heart rate was down to 53 bpm. He was able to report that his pain level had decreased to a 6/10. His respirations were difficult to count but they were still normal. I was concerned about his low heart rate and let his primary nurse know. After his pain level had decreased some I went with my instructor to complete my head to toe. I have always worked from the feet up during my head to toe, but I received some constructive feedback from the instructor suggesting that it would be much more effective if I were to start with the respiratory system. Reflection on our conversation I am going to take the feedback and change how I conduct my assessments. During my assessment the patient became very nauseous. I decided to discontinue my assessment until, I was able to manage is nausea. The patient had a PRN for Ondansetron. Starting this IV infusion I got
We weren't finished drawing up the medication yet, so I was kind of just waiting for the return of my instructor. I however, realized the amount of pain my patient was in and was able to ask his primary nurse to give the medication for me if my instructor did not return within the next five minutes. My instructor did return and I was able to draw up the medication and work though my confusion around the administration of this medication. The need for a second check was definitely validated for me. Before giving the Dilaudid I noted that the patients pulse, blood pressure and respiration rate were within rage to give the medication. I gave the medication over a 5 minute time period as per the IH monograph. When flushing after giving the medication, I made a small error and forgot to flush at the same rate I had give the medication. I returned to the patients room about 15 minutes later to see if he was experience any pain relief and get another set of vitals from him and discovered his heart rate was down to 53 bpm. He was able to report that his pain level had decreased to a 6/10. His respirations were difficult to count but they were still normal. I was concerned about his low heart rate and let his primary nurse know. After his pain level had decreased some I went with my instructor to complete my head to toe. I have always worked from the feet up during my head to toe, but I received some constructive feedback from the instructor suggesting that it would be much more effective if I were to start with the respiratory system. Reflection on our conversation I am going to take the feedback and change how I conduct my assessments. During my assessment the patient became very nauseous. I decided to discontinue my assessment until, I was able to manage is nausea. The patient had a PRN for Ondansetron. Starting this IV infusion I got