Summary of internship of nurses in cardiology department
Diseases such as internal medicine, respiratory system, circulatory system and digestive system are common. Because most diseases have sudden onset, complex symptoms and rapid changes, it is very important to master skilled coping measures.
What impressed me the most was the whole process of rescuing a patient with cor pulmonale in respiratory medicine. The patient was temporarily deprived of oxygen because he went to the toilet on the ground. Hearing the alarm, the teacher, the doctor on duty and I immediately ran to the ward. The teacher quickly let the patient lie flat, put on a breathing mask and monitor, and pay attention to his blood pressure and oxygen saturation. At the same time, several doctors also rushed to the ward to start consultations. The condition is constantly changing and developing, and the rescue plan is also changing flexibly with the condition, and everyone's nerves are tense. I stared at the expression of the ECG monitor for a while, and looked at the expression of the patient for a while, worrying about the patient. The drug entered the patient's body, and everyone was watching the further development of the disease. Doctors and nurses are very focused at this time. The doctor made a cautious judgment, the nurse was skilled, nervous but not flustered, and the ward was extremely quiet except for the sound of the ventilator. The patients' families put their lives in the hands of doctors and nurses and pinned their hopes on them. I'm afraid only doctors and nurses know how much pressure they have on their shoulders at this moment. After more than an hour of rescue, breathing, heartbeat and blood oxygen saturation gradually returned to normal, pulling the patient back from the death line. Everyone is relieved.
From this, I deeply realized that as a nursing staff, we must have exquisite nursing operation skills, as well as agile thinking and calm mind, and skillfully cooperate with doctors. Cooperation between doctors and nurses is very important. The responsibilities of doctors and nurses are highly unified, and the goal is to alleviate or alleviate the physical and psychological pain of patients. Only the close cooperation between doctors and nurses can bring the greatest benefits to patients.
The occurrence of medical diseases is closely related to patients' psychological state and behavior. Therefore, in the treatment and nursing in contact with patients, I used my knowledge to encourage patients to mediate their psychology, establish a good lifestyle, and give corresponding health education and guidance for different diseases, which won the recognition of patients and their families.
Practice summary of nurses in the second department of cardiology
Through more than half a year's nursing practice, under the careful guidance and patient teaching of the teaching teacher, I have carefully studied the Regulations on Handling Medical Accidents and its laws and regulations. Through study, I realize that the concept of modern nursing quality is to satisfy patients in all directions and in the whole process, which makes people put forward higher and newer requirements for medical nursing service, and the theoretical level and practical level have been improved to a certain extent. During my internship, I strictly abide by the rules and regulations of the hospital. Conscientiously perform the duties of nurse interns, be strict with self-discipline, respect teachers, unite with classmates, care for patients, never be late, never leave early, work hard, and strive to achieve standardized nursing work, high-quality skills and services, flexible basic nursing, regular love activities, combination of theory and practice, planned theoretical study, focused, measured and recorded nursing work. During the internship, I always take "love, care and care" as my hand, foot and mouth, think about what patients think and worry about what patients are anxious about, provide quality services to patients wholeheartedly, and establish a good medical ethics. In the practice of each department, we can standardize the writing of various nursing documents, complete the handover records in time, do a good job in patient evaluation and health education, do a good job in nursing common diseases and frequently-occurring diseases in each department, conscientiously implement aseptic operation procedures, and do a good job in preoperative preparation and guidance. Postoperative care and observation, during work, problems found can be carefully analyzed and solved in time, and various nursing operations (writing down gymnastics movements) can be skillfully carried out, and at the same time, I actively participate in various case discussions and academic lectures to continuously enrich my professional knowledge. Have a more comprehensive understanding of holistic nursing technology and ward management knowledge. Through more than half a year's practice, my theoretical level and practical level have been improved. In the future work, I will continue to work hard, keep in mind the responsibilities of nurses, constantly strengthen ideological study and professional study, comprehensively improve my comprehensive level and provide quality services for patients.
Students who have studied neurology may find that the clinical manifestations of different parts of the nervous system damaged by the same cause are very different. On the contrary, although different causes damage the same part of the nervous system, their clinical manifestations are almost the same, which also determines the different ways of thinking in the diagnosis of nervous system diseases. In the process of understanding nervous system diseases, it is particularly emphasized to understand the "location" of the disease first, and then to understand the "nature". Learning and mastering this way of thinking is of great significance for correctly understanding nervous system diseases. Neurology is considered as a highly logical and theoretical clinical discipline. We say that the nervous system is complex, which is aimed at human cognitive ability of the nervous system. In fact, the nervous system is like a huge and very orderly information transportation network. Through this network, the surrounding organs and centers are organically combined to form a complex life. If any part of this network or center has problems or is destroyed, it will be manifested in various forms. Faced with this complex and orderly network and center, it is impossible to judge it without strict logical thinking and understanding of its structure.
The second is the practice method. Students find it "difficult" to learn the anatomy, physiology and pathophysiology of the nervous system, or to learn the diseases of the nervous system. The reason why it is "difficult" is that its anatomical and physiological functions are complex, its content is abstract and its learning time is relatively short. Obviously, it is unrealistic to ask students to fully understand nervous system diseases in just a few weeks of practice. The key is to learn how to understand nervous system diseases. It will be very easy to understand each specific disease after mastering the methods of understanding nervous system diseases. So, what is the way to understand nervous system diseases? As mentioned above, the nervous system is like a huge network system. Its basic unit is nerve conduction pathway, which is usually composed of receptor, afferent nerve, center and effervescence. The organic combination of conduction pathways constitutes the nervous system network. With the concept of network, we can better grasp the methods and points of practice, so as to achieve the purpose of understanding nervous system diseases. Let's talk about how to master the practice methods from the perspective of network, so as to do a good job. Because the nervous system is a huge network system, we must first understand the composition and function of the nervous system, which is what we call the anatomy and physiology of the nervous system. Therefore, to do a good internship, we must first review and master the anatomy and physiology of the nervous system, which is the premise and basis for understanding and understanding the diseases of the nervous system. We know that the basic unit of nervous system network is conduction pathway, so our review and study should start from these basic units and review the related anatomical and physiological functions with conduction pathway as the main clue. Due to the limitation of students' study time, it is impossible to have a comprehensive understanding of this network during their study and internship. Therefore, students should grasp the key points when reviewing, that is to say, they should grasp the main trunk roads that constitute the network, such as the distribution and function of each pair of cranial nerves, and the parts that enter and exit the skull; Internal structure and function of brain stem; The position, start-stop and function of the main conduction bundle of spinal cord; Composition and significance of common deep and shallow reflex arcs; Distribution area of each skin segment of spinal nerve, etc. These contents are briefly described in the form of tables in the teaching materials and related reference materials, and you can refer to these books when reviewing. Mastering the "main road" of the network can better grasp the main body of the network, which is very important for understanding nervous system diseases. It can be said that the more comprehensive the understanding of the composition and function of the network, the greater the help to understand the nervous system diseases. Therefore, students should master as much knowledge of anatomy and physiology as possible. The occurrence of nervous system diseases is essentially a failure of a certain link or part of the network. In order to find out the location and causes of these faults, we must take corresponding methods to obtain relevant information, that is, asking medical history, physical examination and auxiliary examination. In inquiring about medical history, we should not only master the general methods of inquiring about medical history, but also pay special attention to: ① The object of knowing medical history is not only the patient, but also the relatives or insiders of the patient. This is because, on the one hand, patients with consciousness disorder can't describe their medical history, on the other hand, patients' feelings at the time of onset may be different from the actual condition. For example, epileptic patients are not aware of their own performance when they have an attack. ② Pay attention to judge the difference between the patient's feelings and the actual situation. Among the patients with nervous system diseases, there are more patients who deliberately exaggerate or narrow their condition than patients with other system diseases. Therefore, when analyzing the medical history, we should pay attention to whether the patient's chief complaint is consistent with the actual signs and the general situation of the patient, otherwise it will easily lead to improper narration, misunderstanding and mistakes in diagnosis and treatment.
Summary of nurses' practice in three departments of cardiology
This is the last department of this internship. I was supposed to go to the emergency room, but my plan was suddenly disrupted. We came to the respiratory department. Because we don't know much about medical knowledge, we all think that respiratory department is for patients with serious respiratory problems. Frankly speaking, we were afraid of infection, so we came to the respiratory ward with a nervous heart.
The first morning, I attended the morning medical class. I'm surprised that all respiratory doctors work in shifts in English. Listening and teaching Mr. Zhang, this kind of English change has been going on for more than five years. This is to better promote our medical staff to study English hard, because English is an indispensable key to the development of medicine. In the respiratory department, we also know that another purpose of morning shift is to rectify the spirit of medical staff, change the role of medical staff and enter the working state as soon as possible. At the same time, it is also the time for patients' illness transfer in the whole ward and information communication between hospitals and departments.
We saw the operation of placing a closed thoracic drainage tube in the respiratory department. I feel the same way when I see the tension and pain of patients with pneumothorax, because I have suffered from spontaneous pneumothorax because of trauma, so I see patients with spontaneous pneumothorax here and know a little about their treatment and nursing. Then we see that many patients use air cushion beds, which is an effective measure to prevent bedsores for patients who are unconscious, fractured, limited in turning over and breathing while sitting.
Teacher Zhang also taught us about various monitoring indicators on the ECG monitor: (electrocardiogram) ECG-heart rate, when the waveforms of ECG are unequal (excluding (interference factors), it means that the patient's heart rate is irregular (HR60-100//min is normal); SPO2 monitoring and alarm system; Respiration rate (RESP) Normal breathing (16-20 beats/min); Blood pressure (NIBP).
Coma patients are forbidden to drink water-it is easy to suffocate, and the restraint belt must be approved by the family. Nurses patrol the wards once every half an hour for patients with primary care. Patients with secondary care and tertiary care are not seriously ill, and patients with self-care ability patrol every two hours.
Sputum suction machine is divided into electric sputum suction machine and central sputum suction machine, which are widely used in respiratory department. The sputum suction bottle of the electric sputum suction machine should be filled with water for easy cleaning, and the negative pressure tube is directly connected to the patient's bedside by the central sputum suction machine.
On Wednesday, we went to the intensive care unit and saw the expression of grandpa's breathing pain after tracheotomy. Some of them are filled with tubes, and some use restraint belts ... I feel terrible. One of them, Grandpa Zhou, looks pale, his eyelids are bloodless and his abdomen is swollen. Although he couldn't speak, he tried to point his finger at his stomach. Teacher Zhang told us that his stomach was obviously swollen than yesterday, so he invited a general surgery consultation, made a diagnostic puncture of the abdominal cavity, and pulled it out. The doctor said it was a sign of critical illness, and his family knew that he might not make it, so they all came to see him. Seeing his groaning in pain, I couldn't help crying several times. I don't know if he can survive the medical education network. I sincerely pray that Grandpa Zhou can persist and survive the crisis. Bless you, Grandpa Zhou! I hope to see you recover.
In the respiratory department, we saw the vulva cleaning care, oral care and bed bath of critically ill patients, and learned that the ventilator should be strictly disinfected regularly and kept in a good standby state at any time. Glutaraldehyde disinfectant has a strong smell, and long-term exposure may lead to gene mutation, which is harmful to human body. Therefore, the use should be standardized, and attention should be paid to the airtight cover of the disinfection barrel to achieve the disinfection effect and protect the medical staff and patients. Finally, I went to the outpatient endoscopy room to see the fiberoptic bronchoscope and gastroscope. During the endoscopic examination, the patient will feel very uncomfortable. Before operation, he can be anesthetized-intravenous anesthesia and atomized inhalation anesthesia (lidocaine with water), and fiberoptic bronchoscopy can be inserted through the nasal cavity. After 2 hours, you can drink water without choking, and you can eat soft food and liquid food. Gastroscope and fiberoptic bronchoscope can clearly see the internal views of gastrointestinal tract, trachea and bronchus. Hey! The development of modern scientific instruments is so advanced that we must study medical knowledge hard and keep pace with the times.
This internship in respiratory department has completely changed our wrong ideas and selfish psychology, not only let us know how to be an excellent nurse and cultivate the concept of caring for patients, but also let us learn some operations, such as measuring vital signs, inhaling oxygen and installing an air cushion bed. , and the harvest is great. Practice has laid a solid foundation for our theoretical class. I believe we will learn better under the learning mode of combining theory with practice.
Practice summary of nurses in cardiology department;
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