As far as its research scope is concerned, the main research object of neurosurgery is the central nervous system. Because the anatomical structure of the central nervous system is complex, the understanding of human brain function is not very clear, and the clinical symptoms and signs of patients vary widely. Diseases in the same species and the same part may have different clinical manifestations, and different clinical manifestations may also be diseases in the same species or the same part. This brings some difficulties to the diagnosis of neurosurgical diseases, especially intracranial neurosurgical diseases. For example, for coma patients, it may be caused by intracranial diseases (such as tumors and bleeding) or extracranial diseases (such as electrolyte disorders and cardiovascular diseases), and its research scope may belong to neurosurgery or internal medicine diseases. Therefore, for neurosurgeons, the first problem is to determine the neurological symptoms of patients. Then consider the treatment plan.
As far as its treatment is concerned, neurosurgery involves the brain and its lesions. Facing the brain which is not very clear, complex in structure and life center, neurosurgeons must decide where and how to operate before operation, which can not only achieve the therapeutic purpose, but also minimize the damage to normal brain tissue. We must be very familiar with the local anatomy of the brain and perform the operation with skillful operation skills in order to achieve the purpose of surgical treatment of minor injuries. What effective methods should be taken to promote patients' recovery after operation, which all put forward higher requirements for neurosurgeons' theoretical level and operational skills.
For patients with craniocerebral injury, time is life, which requires neurosurgeons to keep up with the crisis, analyze and judge the patient's condition quickly and accurately, and take effective rescue and treatment measures in time. Therefore, it is one of the characteristics of neurosurgery to be prepared for emergencies at any time, and the ability to deal with emergencies is also the basic quality that neurosurgeons must have.
Second, the practice method
Because neurosurgery is a specialized subject, interns often feel that the disease is complex and the operation is difficult after entering the department, which leads to fear of difficulties, but the harvest of internship cannot be directly proportional to the time spent. How can we learn more knowledge in a limited time? How to do neurosurgery practice well? This requires students to master the practice methods of neurosurgery before and during the practice.
First of all, being familiar with and mastering the relevant theoretical basic knowledge is the key to the success of this subject practice. Therefore, before entering neurosurgery practice, we should review the anatomy of the central nervous system, and after entering the department, we should review according to the clinical manifestations of specific diseases, so as to combine theory with practice, so as to realize a correct understanding of diseases.
Secondly, we should choose the foothold of our own internship and make clear the focus of the internship. Because neurosurgery is specialized, it is impossible to reach the level of specialized subject in a relatively short time. Therefore, the diseases that teachers and specialists are keen on are not necessarily the key diseases that students need to master. Students should make clear the key contents they need to master according to the requirements of the syllabus, and then make an internship plan that suits them, instead of being ambitious and unilaterally pursuing too professional related knowledge and content.
Thirdly, the purpose of clinical practice is to apply the theoretical knowledge learned to clinical practice and realize the combination of theory and practice. Therefore, we should focus on the diagnosis, treatment methods and clinical work procedures of neurosurgical diseases, especially neurosurgical emergencies (such as scalp trauma, various craniocerebral injuries, cerebral hernia, etc.). ), in order to timely and correctly judge the patient's condition and take effective treatment measures.
Fourth, don't just focus on the operation. Students who practice in neurosurgery often attach too much importance to surgery, and unilaterally emphasize the "big", "difficult" and "new" of surgery, while ignoring the study and training of basic skills in neurosurgery. This understanding is wrong. For interns, the purpose of surgery is not only to learn the operation method of a certain operation, but to master the relevant basic techniques and skills through surgical exercise. Without skilled and solid basic skills in neurosurgery,
In short, if you want to do a good job in neurosurgery practice, you need to master and apply relevant theoretical knowledge, make clear your own practice content and key points, and practice the basic skills of neurosurgery.
Neurosurgery self-summary II. Three weeks of spiritual practice passed quickly, and I gained a lot in these three weeks. Although I am very busy every day, I feel full and have learned a lot.
There are many complicated diseases, including various brain injuries caused by car accidents, brain stem injuries, spinal injuries and so on. Many patients have unconsciousness, restlessness and coma. So unlike other neurosurgery, there is a special ECU to treat those critically ill patients. There are many operations outside the gods, and most of them are major operations, so postoperative nursing is particularly important. It is very important to closely observe vital signs, keep the drainage tube unobstructed, keep the patient's correct posture and strictly record the amount of entry and exit. We can't ignore anything.
During these three weeks, I mainly studied urethral orifice nursing, atomizing inhalation, bladder irrigation and so on. In a short time, I felt the warmth of the department and treated the patients like relatives. Taking sweeping the bed in the morning as an example, carefully observe whether the patient is unwell and whether the bed is clean, and change the contaminated sheets in time to help the patient turn over and maintain a comfortable position. I think many times, our service to patients is reflected in these small things. In addition, I found that my theoretical knowledge still has many shortcomings. Sometimes I feel ashamed and can't answer all kinds of questions raised by patients' families in detail. I also want to strengthen the review of theoretical knowledge. In addition, I want to know more about the commonly used drugs and indications, adverse reactions and precautions in our department in order to help patients better.
In addition, thanks to the guidance and help of the head nurse and teachers in our department, I have made greater progress. In the future, I will study harder and constantly enrich myself. Please supervise me.
The one-month neurosurgery internship has ended. I still remember when I first arrived at the hospital, I felt that everything was so strange and there was a sense of loss. I reported to the hospital, and after training, the teacher took me to my first internship department: neurosurgery, where there were basically various head injuries, brain stem injuries, spinal injuries and so on. Many patients have unconsciousness, restlessness and coma. I feel that this department still has a lot of feelings, after all, it is the first department!
At the beginning, Xie Jing, the head nurse, taught us different classes. Because my name is the first, I am still a little nervous. Who knows the teacher directly said: Ren Xinyi, just follow Ren Hui. You two happen to have the same surname. This legitimate reason suddenly dispersed my nervous mood. Teacher Ren Hui probably asks me questions about nursing exams every day, saying that theory and practice should be combined. If I don't answer the question, the teacher will let me go back to study hard and recite it for her the next morning. She is also very strict about all kinds of operations. Sometimes she will ask me if I am too strict with me, but I still like her. Before the teacher taught me something, I always thought it was time to leave the department, but in fact, my gluteus maximus was injected intravenously. So thank you, teacher. I have learned a lot this month!
Teacher Zhang Pei also taught us the operation and theory of inserting stomach tube and inhaling oxygen, which is really textbook-style; Teacher Gawain is like an encyclopedia. She can remember all the functions of drugs. She knows everything I ask. She gave me the drug instructions so that I could order them together, which was easy to remember. Teacher Wang Yufei taught us to measure vital signs and GCS scoring standard. Although Miss Xie Jing is the head nurse, she can still lay the sheets with us every morning, which taught me not to forget my original intention and be consistent.
Practice for nearly a month, learned to measure vital signs, intravenous infusion, changing medicine bottles, and sealing tubes with indwelling needles. I found that these seemingly simple operations will still be in a hurry when I first do them. Every operation, the teacher will give us a sentence: change the name, bed number, liquid (three checks and seven pairs) ... but I forgot it at first, and I was reminded by the teacher several times before I got used to it. There are still many deficiencies in my theoretical knowledge. Sometimes I feel very ashamed and embarrassed because I can't answer all kinds of questions raised by patients' families, so I use my notebook to record all the commonly used drugs and indications to avoid the phenomenon that I don't know if I ask.
I'm leaving school soon, but I have a lot to give up. In the big family outside God, every teacher is very approachable and teaches me a lot of things that I can't learn in textbooks carefully and patiently. Here, I would like to express my heartfelt thanks to all the teachers.
A long time ago, when I was not on the road of nursing, I watched a TV series "Mind". The background of the TV series is neurosurgery, so the department where I started my internship is outside the gods. I feel very honored.
For those of us who have no clinical experience and only theoretical knowledge, we are unprepared when we first come to the internship department. Fortunately, the patient guidance of the head nurse and the teaching teacher helped us clear the clouds and lead us into clinical work. On the first day of practice, I didn't dare to do anything, but with expectation and excitement, Mr. Chen Xue wouldn't let me operate the treatment at first. She asked me to observe her every move carefully and ask me about my theoretical knowledge at any time. After making sure to demonstrate it several times in person, let me start the operation under her guidance. Of course, I am not a very clever student, but fortunately I met a very attentive teacher. In case there is a mistake, the teacher will criticize me and let me sum it up myself. After trying to make progress, the teacher will also encourage and praise me and recognize myself, so that I can find the direction of progress and stick to my goal in just a few weeks.
During the two-week internship, I have clearly known what different classes should do and what to do at each time. Of course, this is closely related to the teacher's standardized teaching and experiential teaching, so I get a lot of gains every day.
The clinic is not like a university campus. In the center of school teachers are our students, and in the center of hospital nursing are clinical patients. In school, we are faced with models and books, while in hospital, we are faced with fresh life. In the first week outside of God, I experienced the death of a patient. I have no time to think and grieve. We must take good care of other patients, and we must continue to perform our nursing duties.
Life with clinical patients is happy and intimate. Over time, I will remember which beds have special needs and try my best to help them. Every day when I go to work, I will feel a warm current when I see familiar patients and their families say hello.
As a family member of the patient, my relatives are also admitted to hospital in a distant hometown, and I also hope that the medical staff will try their best to treat them. As a medical staff, I should work diligently and diligently now. The doctor's benevolence is second, and the road to practice is long. I will grow up bit by bit, hoping that with the joint efforts of medical care, more people will recover healthily.
Neurosurgery self-summary 5 Time flies. In a blink of an eye, I will bid farewell to my one-month internship. I will never forget the first day I left God. I was late that day because of an incident and was criticized by the head nurse. While accepting criticism with an open mind, I feel the importance of the concept of time.
This is an ordinary department, but there are a group of medical workers who are not doing their jobs, a group of worried patients, and the signs outside the gods have frozen the laughter of many relatives and friends. "A handsome young man and her mother took care of her dying father day and night in front of the hospital bed. Every time I have an intravenous drip in the ward, I can feel the selflessness and greatness of my loved ones. Watching the patient get better day by day until he is discharged from the hospital, I think it is worthwhile to be bitter and tired again, because this is what we hope to see and what we gain.
I go to work at 7: 30 as usual. At this time, the street outside is particularly deserted, but it is already crowded here, and the treatment room is particularly narrow, because every teacher is busy giving patients morning care, oral care, urethral orifice care, atomized inhalation, intramuscular injection, intravenous injection, and measuring vital signs ... The work here can only be described as "busy" in one word. "Nurse, my dad's phlegm came up. Come and suck. " "Ok, coming right away!" "Nurse, my mother is going to cook from the stomach tube!" "Please wait a moment!" "Nurse, my old man has a bowel movement. Help us change the sheets." Nurses ... their steps are light, healthy and agile, and they are busy but not chaotic. The needles and water bells rang one after another, and they still adhered to the strict "three checks and eight pairs". Ask the same patient "What's your name" countless times every day. Walking through one ward after another, their patrol eyes are like beating flames, burning with care, care, warmth and responsibility!
The patients here seem to be slightly different from other general departments. The people who live here are patients with more critical conditions, such as cerebral hemorrhage, intracranial space occupation, brain tumor, cerebrovascular malformation and so on. They are not only seriously ill, but also have more complicated pathophysiology. Therefore, we should be very careful when nursing, and carefully observe the indicators of patients in order to better judge the condition. Therefore, we should not only have skilled skills, but also have a pair of eyes to observe the disease. The doctors here are skilled and can pull many patients back from death. Their handsome appearance can not only penetrate into the hearts of patients, but also have an inexplicable sense of worship. It's always nice to follow them around. Each group has different styles and gains.
Our post may be ordinary, our story may be ordinary, but our labor is respect for life, responsibility to society and love for life. Finally, thank you to every teacher present, thank you for your enthusiasm, thank you for your careful teaching, be a teacher for one day and be a teacher for life. "The road is long, Xiu Yuan, Xiu Yuan, and I will go up and down." . In the days to come, I will continue to consult and learn from my teachers and classmates, and strive to become an excellent angels in white.
In clinical teaching, we implement the principle of integrating theory with practice. Our department not only pays attention to cultivating the practical ability of nursing students, but also encourages them to give full play to their subjective initiative. We also carry out targeted teaching and training programs to cultivate their keen observation and innovative thinking, and ensure that nursing students can practice smoothly and safely, so that nursing students can complete their practice with high quality in our department. With the joint efforts of all the teaching teachers and other nursing staff, the teaching work has made certain achievements and progress. Looking back on this year's teaching work, there are still some shortcomings in our department that need to be continuously improved and improved.
First, the problems existing in the teaching process of our department
1, insufficient supervision, weak sense of responsibility of teachers, imperfect clinical teaching system and ineffective supervision measures. For example, some teachers are indifferent to teaching, lack a sense of responsibility, unilaterally think that teaching is a burden, and are afraid that teachers will be responsible for the problems arising from nursing. Individuals do not attach importance to teaching, only let students run errands and do odd jobs, and do not impart knowledge; However, some teaching teachers think that nursing students in the later stage of practice have certain operational ability, so they are allowed to operate independently and no longer supervise and guide themselves, which increases the incidence of errors and lays a hidden danger for the occurrence of medical disputes.
2. Inexperience of teaching teachers: Because of the age gap between nursing students and teaching teachers, teaching teachers don't understand the psychological status of young nursing students. In addition, due to insufficient understanding of educational psychology and rigid teaching methods and means, it is difficult to stimulate nursing students' interest in learning.
3. Lack of professional quality of teaching teachers: The lack of professional quality of clinical teaching teachers is mainly reflected in: talking and laughing loudly with colleagues at work, sleeping at night, treating nursing students as labor, ordering them to do this and that, but sitting still, etc.
4. Nursing students' operating skills are stiff and their sense of responsibility is poor. It is difficult for patients to accept because of the blunt and unskilled operation skills of nursing students. Even if it is reluctantly accepted, it will cause dissatisfaction of patients and easily lead to medical disputes. Some nursing students have poor sense of responsibility and patience and are impatient with patients' inquiries. Don't ask yourself,
5. The theoretical knowledge of nursing students is weak: practice is the necessary stage for nursing students to transition to competent nursing students. In practice, they can't make good use of theoretical knowledge, their thinking is still in the primary stage in school, and their independent thinking ability and observation ability need to be improved.
6. Nursing students have weak legal awareness: nursing students enter the clinic and know little about some legal problems faced by medical care. Some nursing students think that the mistake has nothing to do with the teacher and the legal responsibility is not clear. Therefore, in practice, we don't pay attention to the relationship between nursing and law, we can't look at our own nursing work from the legal point of view, and our words and deeds are not rigorous enough, which may easily lead to medical disputes. There are also some nursing students who are too confident, especially in the later period of internship, who will break away from the supervision of the teaching teacher and carry out the doctor's advice without authorization, resulting in nursing errors and medical disputes.
Second, our department has taken corresponding measures to solve the above problems.
1. Enhance teaching awareness and sense of responsibility, strengthen the organization and management of teaching work, and implement one-on-one teaching. Teachers must be strict in teaching, adhere to the "One Belt, One Belt", broaden their horizons in clinical nursing teaching, highlight key points, clarify difficulties, and teach nursing students new progress and new technologies in nursing and related disciplines, so as to care and educate students with serious and responsible spirit, so that nursing students can gain love, respect and understanding while gaining knowledge. Adopt a variety of teaching methods, and closely combine theory with practice. We have been practicing for many years.
The principle of problem-centered, problem-oriented teaching and supplemented by indoctrination; Give priority to argumentation, supplemented by theory. Teachers should guide and inspire students to try their best to see, ask and do with their hands, so as to improve students' cognitive ability and observation ability.
2. Constantly improve their teaching quality: Clinical teaching teachers should actively participate in various teaching trainings and learn to actively explore and improve teaching methods. It is necessary to grasp the psychological characteristics and state of nursing students, teach students in accordance with their aptitude and be flexible. Pay attention to the combination of theory and operation in teaching, so that nursing students can not only know why, but also know why. At the same time, we should pay attention to combining various teaching methods to create suitable clinical operation opportunities for nursing students. We should answer their questions promptly and accurately, adopt inspiring teaching methods, encourage more and criticize less. We should strive to improve their interest in learning and fully mobilize their enthusiasm in order to achieve the goal of continuously improving their professional quality.
Teachers and students should establish a relationship of mutual trust and learning.
Our department has changed the traditional concept that nursing students are the accessories of nurses. From the beginning of nursing students entering the department, the department encourages nursing students to show their personal advantages and strengths according to their basic situation and personality characteristics, so as to give full play to them at an appropriate time. And mobilize the subjective initiative of nursing students, encourage teachers to ask questions frequently, learn from each other and make progress together in the process of answering questions. And care about the living conditions and psychological state of nursing students, share the joys and sorrows in the internship process, and let nursing students feel like teachers and friends.
4. Pay attention to nursing teaching rounds and encourage nursing students to actively participate.
Our department can strictly follow the teaching requirements of the nursing department and conscientiously implement the teaching plan of the department, organize nursing teaching rounds regularly as required, arrange nursing students to preview the relevant knowledge of rounds in advance, let them make rounds according to the new nursing rounds mode, change the habit of moving books in the past and formulate practical nursing measures. In the whole process of teaching rounds, teachers guide nursing students to find problems and learn to solve them by asking questions and letting students judge right and wrong.
5. Improve the work order and practical ability of nursing students.
First of all, let them make an internship plan in the pre-internship stage, study with goals, let them understand the nurse's work flow, clarify the work tasks of each class, get rid of the rigid learning method blindly arranged by the teaching teacher, think more, flexibly arrange work tasks, and improve work efficiency and organization; Secondly, the cultivation of practical ability of nursing students is a long-term and gradual process. At first, as a teaching teacher, I divided some complicated operation techniques into simple and easy operation procedures to promote memory and operation, and encouraged and affirmed them, so that students were willing and interested in learning, gradually became familiar with the operation procedures, and then applied them in practice to be proficient, and guided them to operate according to the formal operation procedures to avoid forming wrong habits from the beginning; Thirdly, cultivate a serious and responsible attitude towards work, form good habits, and point out shortcomings and bad habits in work at any time.
6. Strengthen the cultivation of legal awareness of teachers and nursing students.
Organize teachers to study relevant legal knowledge seriously, find out the hidden dangers that are easy to cause medical disputes and medical errors in nursing teaching in time, and correct them immediately once found. In the teaching process, we always respect patients, safeguard their rights and protect their privacy. Organize practical nursing students to study relevant laws and regulations seriously, strictly implement various rules and regulations, guide nursing students to clarify their legal responsibilities in clinical work, and require strict care of patients under the guidance of teaching teachers, and cannot operate independently to avoid disputes and mistakes.