Summary of hepatobiliary surgery In a blink of an eye, I have been working in hepatobiliary for half a year. I have gained a lot in the past six months. I feel that I have grown a lot, not only in work, study, but also in communication with my colleagues. Looking back on the past six months, I have some very profound experiences: 1, everything is general surgery, and the workload is naturally very heavy. If you want to finish your work smoothly on duty, you must be familiar with the workflow of each work, from the handling of patients when they are admitted to hospital, to how to take over when they return to the ward after surgery, how to care for patients, from the emergency treatment plan when the patient's condition changes, to which aunt should be called to clean the floor when it is dirty ... You must be aware of this before you can finish your work smoothly on duty. The head nurse arranged for me to engage in different levels of nursing work: assistant nurse, treatment class, class 8-3, 12-7, two shifts, night shift, responsibility class, etc. And introduced the job responsibilities of the nursing aunt, which made me basically familiar with the responsibilities of each class and understood that the work of the whole department is like a chain. Although the responsibilities are different, the nature and content of the work are different. If 2. Strict implementation of the check system is an important measure to ensure patient safety and prevent errors and accidents. The person who handles the doctor's advice and checks it correctly must sign his full name. The executor of temporary medical orders shall record the execution time and sign the full name. In order to avoid repeating the doctor's advice and causing harm to patients. If there is any doubt about the doctor's advice, you must ask the relevant doctor before executing it. When rescuing a patient, the doctor gives a verbal order, and the executor must repeat it, then execute it, and keep the used empty ampoule, and then discard it after checking. The work of liver and gallbladder is really busy. Sometimes doctors will take in more than a dozen patients at once, and then start to transfer beds, some to ICU, some to ICU, and some even to the same ward. Sometimes nurses forget to turn bedside tables when transferring beds. In this case, mistakes are really easy to happen. Therefore, when carrying out the doctor's advice to transfer beds, you must do it yourself, and you must not be too troublesome. We must ensure that patients, bedside cards and checklists are improved. When executing other doctor's orders, you must check the patient's "name" and strictly implement the system of "three checks and seven pairs" before taking medicine, injection and disposal (that is, check after placing medicine, check before and after taking medicine and injection; Check the bed number, name, drug name, dosage, concentration, time and usage). 3. Unity is the strength in courage, and I work overtime almost every day. Because there are many operations, I am busy with life care and all kinds of pipeline care in the morning, and turn over and pat the patient's back before operation to prevent various complications (such as bedsore, wound infection and falling pneumonia). ), observe the patient's condition changes and inform the doctor in time. We should be busy with health education for newly admitted patients and discharged patients. For example, patients who leave the hospital with tubes should be taught how to care for them, and patients who are about to undergo surgery should be prepared before operation. I didn't come back from surgery this afternoon. It is necessary to start accepting patients, do a good job in postoperative care of patients, and at the same time implement various postoperative doctor's orders. At this time, the doctor just got off the operating table, and the patients who come back to see the ward will have a lot of doctor's orders that we need to carry out, so the time will be delayed and overtime will be formed. Every nurse in the hepatobiliary department is fine. In addition to completing their duties in this class in an orderly way every day, they also take the initiative to help other nurses. No matter how busy and tired the work is, everyone has no complaints and often works overtime to do the work well together. Although they are busy every day, what they see is their laughter after work, not their sadness and complaints. I deeply feel the spirit of unity, friendship, mutual care and help. Working here can be said to be tired and happy! 4. Holistic nursing here, I want to talk about my feelings of working independently at night and being in an independent duty class. When I first started the night shift, I was very worried about the change of my condition at night. Will I handle it and how to handle it? I pay attention to the emergency plan, without considering the overall nursing, so sometimes I have a little knowledge of the patient's situation. When I was in charge of the class, to be honest, I didn't use my brain much, because I was very dependent and had teachers to rely on. If not, give it to the teacher. When Mr. Zhang Huiling started to let me be the supervisor, I realized what holistic nursing was, and I also felt my lack of knowledge. From the moment the patient is admitted to the hospital, it is necessary to introduce the hospital environment, relevant systems, how to deal with diet, and introduce the relevant knowledge of diseases, preoperative preparation, preoperative education, patients' perception of surgery and their psychological state of surgery. After operation, we should assist in life care, make patients clean and comfortable, promote blood circulation, prevent complications, and do a good job in nursing all kinds of pipes. At the same time, pay attention to observe the condition, grasp the changes of the condition in time, and make records when necessary, so as to provide scientific basis for diagnosis, treatment, making nursing plans and improving nursing quality. Patients should be encouraged to get out of bed early after operation, which has the following effects: ① reducing pulmonary complications; ② Improve the blood circulation of the body and promote the early healing of the incision; ③ Prevention of postoperative adhesion; ④ It is beneficial to the recovery of gastrointestinal function. After the patient recovers, he is ready to leave the hospital, and he should be given health education ... I remember that once a new patient with mesenteric artery bleeding was admitted to the ward, because of mesenteric artery embolism, and after selective arteriography in the interventional department, he was treated with interventional thrombolysis. As soon as I took over, I was immediately blinded, "mesenteric artery bleeding?" These words are so strange to me that I seldom hear them, let alone care about patients. Suddenly I found that I knew too little. No, I'm responsible for the patient. While consulting with experienced nurses, I came back to read books and look up relevant information online ... Hehe, these have become my motivation to study. I am very grateful to Nurse Wang Xuehua for giving me such an opportunity to participate in the supervision class independently. It is a very good exercise opportunity for me and the best way to know myself. Through the supervision class last month, I exercised my working ability, made me more aware of the benefits of holistic nursing to patients, and improved my expression ability in the process of communication and cooperation with doctors and other nurses. Hehe, this is the most fulfilling and happy time after work. 5. My suggestions to the ward: ① Standardize the admission guidance, hospitalization guidance and perioperative guidance of departments, and bind them into pamphlets to facilitate the consultation of inpatients and the guidance of nurses, so as to effectively improve the quality of nursing; (2) Establish a "notebook" to record what every nurse should know and pay attention to, and put it in the nurse station, which will be signed by the reader to ensure effective communication. ③ Health education has a lot of room to complete. For example, there should be corresponding information on specialties and professional knowledge for nurses to learn and guide their daily work or health education or student teaching. ④ A folder of "Instructions for Commonly Used Drugs" can be established, which can be consulted if you don't understand it at ordinary times. 6, my shortcomings need to be improved, my language organization ability needs to be strengthened, and there are many things. If I do it seriously, I believe I will do it well, but I always give up halfway. My future requirements: master the theory and operation skills of specialized nursing systematically, be able to predict nursing and reach the service level of specialized nursing.