Reading "Awakening Care" makes people suddenly enlightened. This book points out five major defects of nursing: insufficient number of nursing staff, too much treatment time, unsatisfactory professional skills, frustrated nurses' enthusiasm and so on. As a psychiatric nurse who has just joined the job for a few years, there is no way to change many aspects by her own efforts, but what can be changed is to improve and improve her own problems.
First, strive to improve professional skills. Many professional skills of psychiatric nurses are not as good as those of general hospitals, which is my first feeling when I first entered the hospital. Each has his own strengths. Psychiatry is good at observing the situation of psychiatry, but it also has defects in observing other aspects. Even if he observed the blind spot of knowledge, he didn't know how to care. Strengthening the study of their own theories is what nurses should always do.
Secondly, change the concept of nursing as soon as possible, take the initiative to observe and be good at observing. What is real nursing? This book gives the answer. People-oriented holistic nursing is too important! Figuratively speaking, its significance and function is to make nurses become doctors' sentries. They are like scouts in battle, not the main battle troops, but they can find the enemy's situation and nip in the bud. They are also the patron saint of patients, always taking care of patients and finding problems in time. This shows that it is particularly important to observe the condition, and we can have a forward-looking thinking to prevent and deal with it in time to prevent the aggravation of the condition. There was a patient in the department before, weighing 100 kg. Every night when she goes to bed, she often sits up and breathes by herself from time to time before going to bed. A nurse found that the patient coughed and had sputum discomfort, and reported it to the doctor in time, and then she was given aerosol inhalation and cough treatment according to the doctor's advice. The patient's sleep improved significantly. Assuming that the nurse only routinely checks the patient's sleep dynamics and does not observe the special situation that the patient can't cough up phlegm, it is very likely that the patient will have an accident of sputum suffocation.
Finally, you need to have empathy and compassion. I feel more like self-reflection, self-reflection on my own shortcomings, and self-reflection on whether I have achieved the empathy and compassion mentioned in the book at work. Quote the words in the book: "Love is on the left, sympathy is on the right, walking on both sides of the road of life, sowing at any time, blooming at any time, decorating this road with fragrant flowers, so that pedestrians covered with branches and leaves will not feel pain and tears, but they will not be sad." I once read a news that ICU nurses in a hospital personally asked doctors to give air intubation in order to understand the pain of patients' sputum aspiration and tracheal intubation, in order to put themselves in the patient's shoes and provide better services for patients.
Nursing is facing people, and the career path is bound to have difficulties and changes, and more is testing and commitment. As nurses, we have a lot to learn and change, but I believe that the road to serving patients' health will be bright.
Zhang Zhongnan's Thoughts on Awakening Nursing 2 This book, Awakening Nursing, uses popular language, real cases, detailed data and personal experience to analyze posture nursing and its influence on disease rehabilitation, and introduces in detail how to implement it.
One of the "super girl" cosmetic cases that caused a lot of noise left a particularly deep impression on me. In fact, there is no problem with cosmetic surgery itself, and the amount of postoperative bleeding does not exceed 200ml, which should not lead to death. However, because it was a minor operation, the hospital did not give close monitoring. As a result, the patient's bleeding seeped into his throat, forming oppression and leading to suffocation and death. This case reminds me of postpartum hemorrhage, one of the four major causes of obstetric maternal death.
I still remember that it was a continuous transformation. When I took over, I found that the uterus of the lying-in woman who had just returned to the room after delivery was slightly soft and the umbilical cord at the bottom of the uterus was flat, so I immediately massaged the uterus and saw a big blood clot after a bullet. Seeing that the situation was not good, I quickly adjusted the dropping speed of oxytocin, changed the perineal pad, measured 250ml of blood, and immediately reported to the bed doctor: "Jin Yisheng, 1 Bed parturient has poor uterine contraction. Jin Yisheng replied, "Prepare two misoprostol anal plugs, and I will be there soon. After a while, Jin Yisheng came to the bed and stuffed his anus with prepared misoprostol. I massage the uterus to comfort the mother and her family. The uterus of the parturient gradually hardens, and the vaginal bleeding is only 50 ml. My hanging heart also relaxed, but I didn't let my guard down. 10 minutes later, I came to the bedside again to observe the maternal vital signs: pulse 90 times/minute, blood pressure 89/56mmHg, blood oxygen 97%. As soon as my hand touched the uterus, my brow wrinkled. The lying-in woman's uterus is weak, so she massages the uterus immediately. I saw a big blood clot coming straight at me. My heart jumped into my throat, called Jin Yisheng to the bed again, and measured 300ml of blood. Give oral advice: "There are many blood clots in the uterus of the parturient. Give the parturient a pill of misoprostol, intramuscular injection, routine blood drawing, coagulation picture and 3P experimental test. "I cooperate with the doctor in an orderly way and check it, that's right. I gave the parturient a pill containing misoprostol, injected a muscle of Simupei, opened another vein, collected blood samples, changed the perineal pad, and weighed 400ml of blood. Jin Yisheng once again issued a verbal medical order: "The maternal uterus is weak, and there is a blood clot in the uterus. Get ready for a blood transfusion. "After the implementation of a series of nursing measures, the parturient uterus gradually hardened and vaginal bleeding gradually decreased, which was called blood 100ml, BP96/68mmHg. My hanging little heart gradually put down, and I can't help but sigh that Xin Mupei is really a good helper for postpartum hemorrhage! But my heart has been restless for a long time. In just two hours, the amount of maternal bleeding 1000ml. If you don't observe in time, if you relax your vigilance when the first contraction improves, and if the nursing measures are not accurate enough, will the parturient bleed more and the consequences will be more serious? I really can't imagine!
"When we are old or sick in the hospital, we hope to get the kind of care described in the book", which is not a textbook, but also the soul of a textbook; It is not a system and norm, but the standard and basis of system norm; Do not need to copy mechanically, need to know how to create; It tells us to know why, what to do and how to do it in the process of implementing quality care. I hope I can return to the essence of nursing in my future work.
Zhang Zhongnan's Thoughts on Awakening Nursing 3 Recently, under the recommendation of the leaders of the nursing department, I carefully read the book Awakening Nursing, which was very touching. She is not a textbook, but she has the essence of a textbook; She is not an institutional norm, but the standard and foundation of institutional norms; She can't copy mechanically, she should know before she creates.
Unconsciously, I have been in the emergency department for more than a year. I not only learned the rules and regulations, but also learned professional knowledge and standardized operation. What I learned was how to be a man. When I think of internship, every day is a simple dispensing and injection. Didn't learn much professional knowledge. After eight months of internship, I didn't even know how to operate the indwelling needle, and I didn't realize the importance of three inspections and eight inspections to the core system. I'm just anxious for a sudden emergency, and I'm even more hesitant in the face of patients' inquiries. After coming to the emergency department for nearly half a year, I realized that what I had learned before was not even superficial.
When I first came to the emergency department to work in the infusion room, I realized that it was far from simple injection and dispensing. From the configuration of the most basic skin test solution of various drugs to the calculation of the dosage of children's infusion drugs, from unfamiliar to familiar, from initial fear of getting started to handy now, all the people who were able to get started before were adult infusion. Under the guidance and encouragement of the teacher, I began to try some children's infusion slowly from the correct needle insertion method. Thank you for your tireless and careful guidance.
Later, he was transferred to the emergency rescue class. Under the guidance of the head nurse and the teaching teacher, I used to only know how to seal the tube with indwelling needle, but now I can do it myself. I still clearly remember the first successful puncture of indwelling needle. The patient is an old man in his seventies, and his vascular elasticity is not particularly good. I remember I sweated when I was exhausting. I tried my best to calm myself down. After tying the tourniquet, I remembered the teacher who taught me how to choose blood vessels and how to push the needle core with the indwelling needle. In this way, I successfully stabbed the first indwelling needle in my career, which was relatively smooth and a relief at that time.
After the hospital set up a chest pain center, it really benefited a lot. Before, I simply knew the operation method of ECG machine and the general term of "heart disease". Later, under the guidance of patients, I realized that patients with acute ST-segment elevation myocardial infarction may be in danger at any time. I know how to refine the general term "heart disease" and how to deal with patients with acute ST-segment elevation myocardial infarction. I have been able to handle it from timidity to now. I remember seeing the first patient of this type, and I remember what the teacher taught me. I established a venous passage in the patient's left arm, gave a pack of prepared medicine chewable clothes, and monitored the patient's vital signs at any time according to the doctor's advice. Under the dialogue between the doctor and his family, I agreed to the operation and sent the patient directly to the catheter room. The patient underwent emergency PCI, the operation was successful, and the hanging heart was put down. I remember another visit, and the patient received a phone call saying that it was chest pain. The emergency team came to the local health center. The patient complained of severe chest and back pain. At that time, my first reaction was to think of what the teacher said was a painful symptom of aortic dissection. When I was about to give the patient an electrocardiogram, I found that the patient had a rash similar to herpes on his waist. I remember the teacher said to distinguish herpes zoster from aortic dissection, and sent the patient to the hospital quickly after giving the electrocardiogram. Checked the patient's hospitalization records, and it was indeed herpes zoster. At this time, I really realized what it is to apply what I have learned and the significance of continuous learning and growth.
In the emergency department, I not only learned professional knowledge, but also learned how to be a man. Now the doctor-patient relationship is getting more and more tense. The hospital advocates people-oriented nursing. I always remember what the head nurse said. Always put yourself in others' shoes. I remember the head nurse used a patient with gastric lavage as an example. A finger-thick stomach tube is inserted into your nose. Sometimes patients are impatient and put themselves in others' shoes. How uncomfortable it is for patients to struggle with such a thick stomach tube. Sometimes it is said that patients don't understand nurses. In fact, not all patients' families are unreasonable. Always remember the head nurse's words "Learn to put yourself in others' shoes". Sometimes it is easier to soothe a patient's heart than to heal a patient's wound.
"Love is on the left, sympathy is on the right, walk on both sides of the road of life, sow seeds at any time, blossom at any time, decorate this long journey with fragrant flowers, so that pedestrians covered with branches and leaves will not feel pain and tears, but they will not feel sad." After reading this passage of Bing Xin, I was very moved. If through our efforts, the sick people can be relieved of their pain, the hope of life can be ignited, and their lives can leave with dignity and peace at the last moment, I feel the greatness and loftiness of the nursing career I am engaged in, and I also understand the true essence of the nursing career, that is, to safeguard the dignity of life, protect life and care for life.
Finally, I want to say that "awakening nursing" is like a kind teacher. She patiently taught me how to get along with patients, and gradually made me understand that only by serving patients from the heart can I be happy and really improve the quality of nursing. I realized that "Awakening Care" is like a rising star in Ran Ran, leading me forward. I believe that with her company, I will grow better! Let's work happily, safely and attentively under the guidance of the core essence of awakening and caring. ...
I have read Zhang Zhongnan's Awakening Care and Nightingale's Nursing Notes, the originator of nursing, and I am deeply impressed. I think it's really a good book, but the time in it is far away from us after all, and it doesn't really help much. Now I have the honor to read Awakening Care recommended by the hospital, and I really think it is a better book, which can guide us how to do it.
The first part of this book: nursing deficiency, lists five "symptoms" of nursing deficiency, and finds out the reasons. Some people will say that these reasons are not solved, such as insufficient number of nursing staff, too much treatment time and low nursing expenses. How can we work hard? What's the use of trying again I certainly don't think so. No matter leaders, nursing managers or ordinary nurses, after reading this book, they are doing their best to do what they should and can do. The kind of care described in that book will be realized as soon as possible. And we can do as much as possible for patients in a limited time.
As an ordinary nurse, we should first change our concept and truly understand the importance of nursing in "three-point treatment and seven-point nursing", which is not limited to simply carrying out doctor's orders and taking injections and medicines. However, through people-oriented holistic nursing, the curative effect, safety, benefit and doctor-patient relationship can be significantly improved to ensure the real implementation of quality nursing. It has long been known that all wards in our hospital should carry out high-quality nursing, but I don't know its true significance. All I know is that I just wait on people to help patients wash their faces, feet and urinate. I don't want to do it at all. I feel inferior. Now I finally know its value, just as the book says: Don't blindly carry out it, get the support of the hospital, increase the fees for quality care, carry out training to improve nursing technology, accurately judge what patients can and can't do, guide patients to do what they can, do a good job in nursing, reflect the difference between nurses and ordinary nurses, and let patients really enjoy people-oriented holistic nursing.
Teacher Zhang Zhongnan is an orthopedic expert. There are many cases in the book. As an orthopedic nurse, I think it is particularly helpful to us. Some time ago, a 70-year-old man was admitted to our department, with 4-5 broken ribs on the right side, 6-7 suspected ribs, lumbar fracture and femoral trochanter fracture on the left side. Patients need to lie on a hard bed because of lumbar fracture, but they are old, unable to turn over or even dare to move because of repeated pains, and are prone to a series of complications such as pressure ulcers and lung infections. We warmly received the patient. Under the guidance of the doctor, the patient's right chest rib fracture should not turn to the right as far as possible to avoid fracture and dislocation. Sometimes he can lie on his left side and try to lie flat. It doesn't matter if the bedside of lumbar fracture is slightly raised. Skin traction was performed on the left lower limb. We assessed that the vital signs of the elderly were stable, and the muscle strength of both upper limbs and right lower limbs was normal, so we established a turn-over card for the elderly, regularly urged and instructed patients to hold their hips with their hands, slowly put their hands into the sacrococcygeal region, massage their backs, and assist them to lie on their left side from time to time. At the same time, guide and encourage correct coughing and drink plenty of water. When the patient came back from the operation, he couldn't finish these measures by himself. We helped him finish them. We massage his sacrum with our hands to keep the bed clean and dry. Now the old man has recovered smoothly without any complications. Every time he sees us, he always shakes hands with us, and his words are full of gratitude.
There are many personal experiences, which let us deeply appreciate the gratitude and satisfaction from patients. Although we haven't fully achieved the kind of nursing mentioned in the book, we will work hard for it and truly feel the superiority of people-oriented holistic nursing. For example, the quality control circle that hospitals and departments are doing, the activities of "holding hands with big hands" (providing for the elderly, guiding nurses with doctors) and continuous quality improvement are all aimed at improving the quality of nursing and developing the efforts of high-quality nursing wards.
As an ordinary nurse, we may not be great, but as the book says, we can be warm, serve patients wholeheartedly, build a platform for the future with love, and extend love into a river full of sunshine and flowers, where we can bathe and enjoy. I believe that in the future, not only can we, as Ms. Guo Yanhong said, "When we are old or sick in the hospital, we hope to get the kind of care described in the book", but we can also do this kind of care in person to better serve the patients.
Reflections on Zhang Zhongnan's Awakening Nursing 5 When I first heard the word "Awakening Nursing", what came to my mind was that it was a new nursing model and a new concept. But when I read the book "Awakening Care", I found that this is not the case. The word "awakening" in this book is used as a verb to awaken our nursing workers and managers to understand the essence of nursing work.
"People-oriented", a word we have been saying, has not really been understood and put into action. It is clearly pointed out in the book that we should respect patients, pay attention to their physical and psychological feelings when seeing a doctor, solve their pain as soon as possible, treat and care for patients as a whole, meet their needs from emotional, functional and psychological aspects, pay attention to people, care about people, pay attention to their personality, and truly treat people as people, not as attachments to diseases. Only pay attention to the condition, ignoring the patient's own feelings, ignoring the patient's understanding and expectation of the disease, and poor communication, so some patients will be dissatisfied with the current medical and nursing work, leading to more and more disputes.
Professor Zhang Zhongnan's book says that many things come from our nurses, and there are many things that we can't change, such as the harsh medical environment and the incompetence of many nurses. But as a clinical nurse, I think we must pay attention to the following points in clinical nursing:
First, we should change our ideas.
It is more than just carrying out doctor's orders, giving injections and distributing medicines. I remember when we gave patients "three short and nine clean", we thought that washing their hair, cutting their nails and wiping their bodies, taking care of patients in life was quality care, and life care for patients was to improve their satisfaction. But after reading "Awakening Care", I understand the true meaning of quality care and the author's intention.
The essence of life nursing is professional nursing, focusing on judging patients' self-care ability and observing patients' physical and mental conditions. Through life nursing, we can find the changes of patients' condition, and bring them a sense of comfort, peace of mind and care. Therefore, we should change the concept of nursing, start with details, change passive service into active service, and change active service into touching service.
Second, we must master professional technology and have solid professional knowledge.
With the improvement of people's living standards and the implementation of national medical insurance, the medical cause is also developing constantly, and it is also facing great pressure and challenges. In recent years, many new forces have been injected into the nursing team, but these new forces lack clinical work experience and are often "smelled" by patients in their work. This will reduce our job satisfaction. Only by training nurses in basic knowledge, professional knowledge, communication skills, laws and regulations, etc. So that nurses can know fairly well in nursing work and make a quick judgment on their illness, so as not to delay their illness.
Three, nursing work should be active, serious and responsible.
In the aspect of measuring vital signs every afternoon, ask patients whether they have 24-hour defecation. Some nurses do that. If he doesn't solve it, he will record "0", if he solves it three times, he will record "3". However, some care is different. Patients who have not solved the problem will ask a few more questions, "How many days have you not solved it, how much did you eat, and how was your activity?" After solving it for three times, they will ask, "How did you solve it? What color did you eat?" These two working attitudes are different. You can know the patient's excretion and even other situations by asking.
Fourth, guide patients to participate in nursing correctly.
Nursing is not only for sick people, but also for sub-healthy and healthy people. In our infectious diseases department, it is very important to check the amount of hepatitis B virus regularly. It is also our duty as nurses to correctly guide patients to have a correct understanding of diseases and carry out health education, so as to effectively prevent or find some diseases as soon as possible.
Fifth, nursing should be dynamic.
Dynamic, in fact, runs through nursing work. Real nursing, from health to disease, from disease to rehabilitation, and then to health tracking, is a dynamic process. For a responsible nurse, once she cares about the patient, she is the patient's friend and is always responsible for his health. This is our nurse's duty.
Sixth, "patient-centered" nursing.
Patient-centered refers to thinking about patients everywhere and putting patients first in all activities. Compared with disease-oriented nursing, people-oriented nursing pays more attention to the influence of patients' emotional, psychological, physiological and physical function recovery on patients. When treating patients, we should closely observe the emotional and psychological changes of patients.
"Quality care" includes psychological care, treatment, life care and educational guidance. This nursing model perfectly interprets "love, patience, responsibility and carefulness".
To this end, an excellent nurse should first be able to stand in the patient's position, learn to think for them, care for and understand the patient, and relieve the pain for the patient with skilled technology and quality service. Use your knowledge to help solve patients' doubts, improve your position in patients' minds, and make patients believe that you can help doctors treat their diseases and get respect, thus reducing unnecessary medical disputes.
Really understand Professor Zhang Zhongnan's nursing thought, regain people's respect for nursing workers, let nursing career develop, and let nursing workers work happily, safely and attentively!