Nursery/ NICU

 Responsibilities:

·        Observe what nurses in the NICU and nursery do

·        Be familiar with what procedures the babies needs, depending on what their needs are

 Knowledge/ Skills

·        Care for premature babies

·        When to identify when baby is too hot

·        What the monitors tell you about the baby

·        Understanding when baby needs to be discharged are stay longer

·        Understanding the procedures needed to be done when a baby is circumcised

Best thing that happened on this unit:

·        Observing the first few minutes of a baby’s life

·        Watching other people, other than the baby’s parents, care for newborn  

-        protocols  they take to discharge a baby

Worst thing that happened:

·        When the babies cried

·        Almost was a code pink

·        They couldn’t find a instrument they needed to tend to a baby

1.      The technology I observed in the NICU was very helpful for the babies there. Since they needed care the most. The babies that were healthy and born on time weren’t hooked up to any monitors. The technology observed while in the NICU were incubators, oxygenation machines, ventilator, feeding tube machine, iv machine, and phototherapy light to help with yellowish skin of the baby.

2.      Some diagnostic procedures included placing baby under a special light to help with the yellowing of their skin and if mom had diabetes they had to give baby a different type of formula due to a low sugar level

3.      Therapy in the nursery/ NICU were feeding tactics, cooling of their bodies, and treating there sugar levels.

4.      Diseases/ Disorders I observed was anemia, which was a blood disorders, and jaundice which is a high level of bilirubin in the blood

5.      BBT – baby’s blood type, BM- bowl movement, C/S – cesarean section, L+D labor and delivery, were all the abbreviations I heard in the nursery and NICU.

  The NICU / Nursery could be one of two things; either very quite or a room of crying babies. If any monitors would go off the nurses made sure to silent them so they wouldn't wake up any of the babies. On the door of the NICU, there was a sign that read ''I'm trying to sleep", this was to insure that when a guest would walk in they were influenced to stay as quiet as the could. The service provided from the nurse to baby was excellent and the service provided from nurse to parents was great as well because the were sure to inform and make good attraction between each other. The equipment there was very helpful for the NICU area, because those were the babies that needed the care the most.
  The team on the unit was very helpful toward each other. If one nurse was busy charting babies information then she would ask another nurse to feed the baby for her. If a nurse needed something to care for the baby the other would realize the problem and give the nurse what she needed. There were many safety procedures on this unit. Before you even were allowed on this unit you had to call for a nurse to let you in. You also had to wash your hands  before entering. Also each baby had a ankle bracelet to keep track of them and make sure they were  accounted for and didn't wonder off with a stranger. If they were close to an elevator entrance, or in the wrong hallway, it set off alarms and everyone was to be aware and check on the baby. Diagnostic procedures included giving baby medications they needed through an iv. Some babies had yellowing of the skin which caused them to be placed under a blue light. Some of the babies needed to be on ventilators to help their respiratory system. Some Therapeutic procedures  for the babies included placing them on a heating blanket to keep the warm.
  While on this unit I learned lots off new knowledge such as how long baby will be in the nursery or NICU, what vital signs are taken, what test the baby must pass in order to be discharge, what different formula are to be given, what the baby schedule is like, and what was done when a baby boy was circumcised. There wasn't much medical terminology I head but I did here the most common things said on this unit including   BBT – baby’s blood type, BM- bowl movement, C/S – cesarean section, L+D labor and delivery. Some skills I learned was how to tend to a  baby once they are born and exactly how to bottle fed baby and how to burp them. I also learned how patient you have to be with the baby.
   This was great personal experience, from this unit I could take a lot for the future. Maybe one day when I want to start a family once I get much older it would prepare me just a little bit about a new born. This unit was a great educational experience because most of the other units dealt with the care of older patients but in this case we were able to care for babies.


GRACE CARE:  Dinning
 Lentigines can come from size range of  .2 to 2 cm. Lentiginnes is flat to the skin and  dark area in color. Most of them are irregular in shape. Lentigines are caused by a increase in the number of pigment cells. They generally take a biopsy when there is a change in pigment or if its not flat with the skin. This is done to rule out cancer. Lentigines is benign and therefor doesn't need treatment. Some can choose to get it bleached, or removed.
  Osteoporosis is a condition the make your bones weak and more likely to break. Osteoporosis usually is more common in older women. Osteoporosis is a silent disease. Some times you might not know you have it tell you break a bone. In order to check you may want to get a mineral density test. To keep bones strong it is recommended to east a rich diet in calcium and vitamin D.
  Arthritis is a joint disorder with inflammation. Arthritis causes joint pain. There are many types of arthritis. Causes of Arthritis depends on the type of arthritis you have. Cause can include injury, metabolic abnormalities, hereditary factors, direct and indirect effect of infections, and a misdirected immune system. Treatment for arthritis include physical therapy, splinting, cold pack, paraffin wax dips, anti-inflammatory medications, pain medication, and surgical operations.
 
 

Responsibilities

•Observed nurse and patients in PACU

•Be familiar with the procedures they take once with patient

 

Knowledge or skills:

• vital signs that are taken

•How long they are in the PACU

•What instructions to give patient

•Good communication with patient

 

Best thing that happened in the PACU:

•Patient did well during surgery

•Patient did well after surgery

•Patients was aware of what was happening once awake

 

Worst thing that happened in PACU:

•Tension between staff members

•Bad communication with staff members

1. This week in the PACU was very good with a great experience.

2. In the PACU there is lots of technology around. Since the patient is taken here right after surgery they hook them up to many monitors. This include cardiac monitor, blood pressure cuff, and pulse oximetry.

3. The Diagnostic procedure included surgery on the foot to remove a screw in patient left leg. Patient had therapeutic before surgery was considered an option. Doctor recommended her to attend therapy, which she did but without any luck they went ahead and completed the surgery.

4.  When I asked the nurse treating the patient in the PACU she informed she didn't know the disorder the patient had. She only knew she had surgery on her left foot due to pain over many months.

5. There wasn't much complex medical terminology because the nurse to patient vocab can’t be much abbreviated. Nurses have to try to explain the best they can on a level in which patient can understand.

 

 

  The PACU was pretty calm for the most part. When I was present there were only about three patients. Once the surgery nurses came to transfer the patient to PACU there was a bet of commotion. And this was because the PACU nurses were trying to get all the information the needed on the patient to be able to chart. There were about 4 different types of nurses once the patient was brought back to the PACU. The service provided in the PACU, I believe was pretty good. They took great care of their patient. At many times the nurse would ask the patient questions and monitor vital signs. In the PACU there were lots of equipment and many monitors. They would take vital signs every 10 minutes and this was done by the equipment they had there. In the PACU I got to observe the care the patient received and how and what they charted. The nurses there were not communicating well together. You could tell the tension in the area. At one point they did start to raise their voices at each other because they were not happy at what was happening or how things were being ran.

   The patients that came in went into surgery due to pain in her left leg, after failure of therapy the doctors resulted to perform surgery to place a screw in her foot, after having the screw in her foot for a period of time she then went back to get it removed (which was this day). While in the PACU I got to experience everything you would do and tell a patient right after surgery. Such as their level of pain they were in, if they were comfortable, and if they had any concerns. The nurse informed me on what to look for in a patient if they weren't doing well; and who to report it to. Right out of surgery the patient has an oxygen mask and after about 20 minutes the patient was able to spit it out.  25 min after that the patient was feeling good and was able to see her family. While the patient was recovering the nurse charted all her information and all her vital signs. The nurse also made sure to chart how her foot looked after surgery, how it felt, and if there was anything out of the ordinary. The nurse had to also make sure she had all her medication ready that she was supposed to take. When the nurse and patient were ready the nurse called the doctor over to release her to day stay where she would then be reunited with her family and be discharged. Throughout the whole time the patient was very calm because she was used to surgery and what to expect once home. This personal experience was great because i got to experience what it’s like to be there as soon a patient came out of surgery.

  This week at grace care I was in activities and watched a speech therapist assist with a resident. While in activists we were able to do some arm exercises with the patients by using a parachute. We had them raise it up and down. I noticed this time around the residents was more involved and they seemed happier. I thought it was pretty cool that one of the residents in garden bridged remembered a conversation we had previous weeks ago and she had continued telling me what she had wanted to tell me. When i did go to garden bridge this week I tried to get some residents to remember what they did in high school or college. I did come across some that could tell me what they did or at least tell me some information on what they did. I feel as we go to garden bridge we think that these residents don't have much to tell us or don't have much to do with us but in reality these are some of the best people we can meet and when you’re able to sit down and have a conversation with them it makes this whole experience a experience of a lifetime. While I was in rehab with the speech therapist she was helping a resident. Her task with this resident was to help a resident to be able to drink regular liquids. Up to that point she had her on thicken liquids. It was hard for the therapist to get her to do to throat and mouth exercise but after telling and explain to the resident over and over the resident was able to finish.