Model essay on nursing specialty of medical students: analysis of emergency nursing care of coma patients with cerebral hemorrhage 1 method
1. 1 basic nursing
By observing whether the patient has consciousness disorder, we can know the degree of the patient's illness. The change of pupil can reflect the patient's bleeding. Narrow pupil indicates that the patient has cerebral hemisphere bleeding, while dilated pupil indicates that the patient has severe and critical bleeding. By observing the patient's breathing frequency and depth, it is decided whether to provide ventilation support to the patient. Under normal circumstances, a ventilator is needed for ventilation. Patients are prone to nausea and vomiting. For patients with severe symptoms, you can keep lying on your side and guide the correct methods of expectoration and vomiting. When necessary, mechanical sputum aspiration can be performed to clean the mouth in time to reduce the occurrence of pneumonia. If the patient is in a deep coma and has weak spontaneous breathing ability, oxygen support can be given.
1.2 Nursing care of complications
Coma patients with cerebral hemorrhage often have complications, such as pneumonia, bedsore and urinary tract infection. In order to prevent such complications, corresponding nursing can be carried out in emergency nursing. Patients with unconsciousness can't swallow and cough normally, which leads to the accumulation of oral secretions in the mouth. In order to prevent aspiration pneumonia, patients can be given corresponding sputum suction nursing. In order to prevent the occurrence of bedsore, it is necessary to turn over the patient regularly and pay attention to keeping the patient's oral hygiene and the mattress clean and dry. If the patient's condition is serious, many nurses are needed to help him turn over and move lightly, and pay attention to the fixation of the catheter. The catheter is kept because the patient excretes urinary incontinence, and the catheter is placed to prevent urinary tract infection. Observe the color of patients' vomit and stool. If the color of vomit turns dark and the color of stool turns black, it means that the patient has serious gastric bleeding and should take corresponding measures in time.
1.3 Nursing care of intracranial hypertension
The increase of intracranial blood volume will lead to intracranial hypertension. When increased intracranial pressure reaches a certain level, some brain tissues of patients will be displaced, which will further oppress nerves or brain stem and cause a series of symptoms, which is also the manifestation of cerebral hernia. Drugs should be given in time to reduce intracranial pressure, and diuretics and mannitol should be used more. In this group, 0.25g/kg mannitol was injected intravenously for about 25 minutes, and then injected again after 7 hours. If the patient has cardiopulmonary insufficiency, the infusion speed can be slowed down.
1.4 Diet recuperates the brain
Patients with hemorrhagic coma can't eat normally. In order to avoid malnutrition, it is necessary to provide nutritional support to patients in time. For patients without symptoms of upper gastrointestinal bleeding, liquid food can be fed by nose, and the food is mainly light and high in protein. Observe the nutritional status and gastric juice color of patients to prevent gastric bleeding.
1.5 Other nursing care
In addition to basic nursing and complications nursing, nursing staff should strictly implement the shift-over system, and must be supervised at all times to keep abreast of the patient's condition changes and ensure the complete effectiveness of nursing. Pay attention to the body movements of coma patients with cerebral hemorrhage in the process of visiting wards to see if they have emotional instability and obstacles. In order to prevent patients' involuntary actions from aggravating their illness, protective belts can be applied appropriately, and nurses can be instructed to pay attention to patients' emotions and actions when patrolling the room. Keep patients' skin clean and comfortable. In order to prevent patients in deep coma from bedsore because they have been in the same posture for a long time, we can provide patients with turn-over massage nursing regularly, promote the recovery of blood circulation and limb function, and pay attention to gentle movements to prevent patients from being injured again because of overexert.
Two results
After effective first-aid care for 30 patients with cerebral hemorrhage coma, 24 patients' clinical symptoms were relieved, and the success rate of rescue was 80%. Among them, 14 patients were cured and discharged, and 7 patients could not be cured because of their serious condition.
3 discussion
Cerebral hemorrhage is a common and serious clinical complication in patients with intracranial vascular malformation, middle-aged and elderly hypertension and cerebral arteriosclerosis. The disease develops rapidly and it is difficult to rescue. In emergency nursing, besides observing the patient's vital signs and routine nursing, we should also pay special attention to whether the patient's respiratory tract is unobstructed, whether there is bleeding in the digestive tract and the prevention of complications. If patients are found to have abnormal symptoms in the observation records, they should promptly notify doctors to check and deal with them, and actively communicate with patients and their families to help them build up their confidence in fighting the disease, strive for their cooperation, and create positive conditions for the next treatment.
Abstract: In medical education, nursing education is a very important part, and its duty is to cultivate talents for medical and health undertakings. The cultivation of nursing talents needs the attention of nursing education to ensure the quality level of nursing professionals.
Keywords: medical education; Cultivation; Nursing education
Nowadays, with the progress of society, economy and health, there is an increasing demand for nursing talents in China. According to the statistics of the World Health Organization, the proportion of doctors in China's population has exceeded the world average, but there are few nurses, so the proportion of doctors and nurses is seriously out of balance. It is urgent to find a way to match medical education with hospital development needs, cultivate nursing professionals needed by hospitals and improve the employment rate of health college graduates. This paper mainly analyzes the present situation and development of nursing education, and makes some contributions to the development of nursing education in China.
First of all, train a group of excellent nursing staff for the country.
At present, the way of nursing education in China has become a multi-level and multi-channel system. For example, professional courses and master's degrees represent the advanced level of nursing education in China, and education at this level has basically been on the right track. However, primary care needs more primary staff. Intermediate nursing education aims at cultivating primary nursing talents, so that graduated medical students can choose medical institutions at all levels to engage in nursing work when they are employed. In nursing education, we should pay attention to the combination of practice and theory, especially to cultivate students' practical ability. Education should not only attach importance to technology, but also educate students' moral quality. On the one hand, the nurses in our country are not as good as the advanced countries in terms of service consciousness and service concept, and there is still much room for improvement. On the other hand, the current source of students has a certain influence on education, and a large number of nurses are accustomed to being an only child, so moral education is more important than theoretical teaching and skill improvement. Whether a person's career is successful or not has a lot to do with his ideology and morality. The cultivation of good moral character is a slow process, and students should be cultivated in education, so that nurses in China can have excellent qualities such as sincerity, respect and care.
Second, attach importance to the development of medical nursing education.
1. Add humanities education courses. Modern medicine needs to better reflect humanistic care. Humanistic care is simply? Care about others. More reflected in the vulnerable groups. In hospitals, humanistic care lies in serving patients. Under the current competitive trend, many hospitals have improved the original system, requiring doctors and nurses to treat and care for patients with respect and guidance in their duties. Think from the patient's point of view and consider the patient's sick mood. This is a great progress. In order to keep up with the transformation of modern medical model faster and better, nursing specialty needs to add more humanities courses in the education process to increase its proportion. For students studying at school, cultivate their awareness of medical care, so that they can provide more humanized medical services for patients when they take up their posts. Pave the way for building a harmonious hospital. Hospitals serve people, medical staff are the core personnel of employees, and they are also the creators and transmitters of hospital nursing culture. Therefore, the training of nurses should start from medical college, that is, pay more attention to humanistic education for students.
2. Male nurses have more advantages in nursing field. In the field of nursing education, male nurses have their unique advantages and become a new bright spot in nursing education. With the development of society and the progress of science and technology, more and more medical instruments and equipment are put into use, and nursing is no longer just health guidance and disease observation. In the past, only women's clinical nursing work is slowly being replaced by men. Male nurses have broken the situation that most hospital nurses are basically women with their unique advantages. To cultivate distinctive male nurses, we should pay attention to accumulate experience in the process of training, cultivate excellent male nurses, let them show advantages that women do not have in their work, and let male nurses have more advantages in employment.
Third, changing the thinking of nursing students begins with the concept of choosing a job.
Science and technology are progressing and society is developing. With the change of medical model, the problem of aging population has become increasingly prominent, and the reform of medical and health system has been carried out, people are paying more and more attention to health problems. The current nursing mode is no longer the traditional nursing mode. The content and scope of nursing work of nurses have begun to expand, and the roles and tasks of nurses have also changed greatly. These changes pose a challenge to the schools that carry out nursing education to cultivate talents who can adapt to social development. Therefore, nursing education still has a long way to go. China has a large population, and the proportion of rural population accounts for more than half of our country. Because China's development is still relatively backward, the allocation of medical resources in urban and rural areas is not reasonable enough, and students' employment concept is not perfect enough. Due to economic conditions, many students are willing to live in big cities and want to find jobs in big hospitals. With the progress of medical technology, the development of society and the improvement of people's living standards, residents' health awareness is constantly improving, and the number of nursing staff can not meet the needs of society at present. Therefore, while cultivating talents, we should pay attention to the ideological guidance of students, so that students can have a correct outlook on employment. In the usual educational activities, the school should educate students to have the concept of employment and nursing work in the community. Students should have the idea of actively responding to the call of the country and making their own contributions to the development of the country. The state should support the idea that nursing students should go to the grassroots level and enter the community after graduation. Nursing students should apply their knowledge and skills to grass-roots units and communities. Provide health care services for the grassroots, improve their physical fitness, and benefit the people, the grassroots and the people. Contribute to the progress of nursing technology and the development of human society.
To sum up, the situation of nursing education is still grim. Nursing educators should strengthen the professional emotion education for nursing students, set up reasonable nursing curriculum education, strengthen the education of nursing concepts for nursing students, and strengthen the education of nursing professional attitudes and concepts for nursing students. As a nurse, carrying forward the nightingale spirit is not just talk. While maintaining systematic theoretical education, China should learn from advanced western teaching methods, strengthen students' innovative ability, scientific research ability and practical ability, and cultivate comprehensive nursing talents to adapt to social development. Nursing colleges should pay attention to the cultivation of students' psychological quality, strengthen the cultivation of students' personal ability on the basis of clinical nursing and technical training, and cultivate nursing talents in the new era.
References:
[1] Study on the mode of higher nursing education [D]. East China Normal University, 2008.
[2] Jiang Ying. Research on curriculum reform of school-based higher vocational education for nursing majors [D]. Shanghai Normal University, 20 1 1.