Summary of the experience of emergency doctors (selected 6 articles) After my internship in the emergency department during this period, I deeply realized the importance of emergency work. Not only ordinary patients are treated here, but also critically ill patients are treated through 120 emergency. These patients are often anxious, busy and complicated, which makes the work in the emergency room extremely challenging. There are many uncertain factors in the first diagnosis and rescue of critical emergency patients, such as unclear diagnosis, unknown condition, rapid change, etc .............................................................................................................................................
The emergency room is different from the ward. In the ward, medical staff have enough time to communicate with patients and their families, understand the needs of patients in time, and establish a good nurse-patient relationship. In the emergency department, in this unfamiliar environment for patients, it is difficult for patients and their families to establish a good trust relationship with medical staff in a short time, so every subtle move or even talk of medical staff in the treatment process will have a great impact on patients' psychology. Therefore, it is particularly important for emergency medical staff to actively communicate with patients.
During my internship in the emergency department, I learned many ways to establish a good trust relationship with patients:
1, for patients who are not familiar with the hospital environment, we actively ask and enthusiastically guide;
2. For patients with mobility difficulties, we will help them take them to the clinic in wheelchairs, measure their vital signs and give them to the nurses in the clinic;
3. For patients who need to go to the ward for treatment, we carefully mark the location of the ward to prevent patients from running the wrong way;
4. For patients who have been ill for a long time but their condition is not critical, we suggest that they go to the outpatient clinic for medical treatment, and patiently inform them of the location and time of medical treatment, so as to facilitate patients' arrangements.
A smiling expression and a helping hand can not solve the physical pain of patients, but can quickly shorten the distance between nurses and patients, effectively meet the psychological needs of patients who need care, thus facilitating our next nursing work.
The emergency room is the core of the emergency department, and the work of the emergency room is also quite heavy. Working in the emergency room requires skilled rescue skills, rational analysis ability in emergency situations, and good ability to cooperate with doctors to rescue. Whenever we receive a patient to the emergency room, we should immediately carry out ECG monitoring, oxygen inhalation, blood pressure monitoring, venous access establishment, blood test and other work to prepare for the follow-up drug treatment. It is worth noting that the patient's condition should be recorded and observed at any time when using first-aid drugs, and the role, side effects, routine dosage and safety value of first-aid drugs should be mastered. Moreover, working in the rescue room, the use of rescue equipment should be skilled and correct to ensure that patients can get the most effective treatment during the rescue process. After the rescue, nursing rescue records should be supplemented, the condition should be closely monitored, and the problems should be dealt with in time. In addition, working in the emergency room should be familiar with the clinical manifestations of each acute disease, the monitoring of disease changes and the rescue plan. Only by constantly summing up in the usual work can we grow rapidly.
I am very grateful to the doctors and nurses in the emergency department for teaching me nursing knowledge and skills these days. In the big family of emergency department, everyone is my teacher, and every experience is my life wealth. I still have a lot to learn to be an excellent emergency nurse. I will continue to improve the quality of nursing and better serve patients.
I have seen many cases of cardiac arrest and respiratory arrest in the emergency department these days. Fatigue, quarreling with family members and too much pressure in life are all indirect factors. Men, women and children chat one second and disappear in this world the next. This phenomenon let me know that career, money, love and so on are all in this world. ......
The emergency department is a department with rapid turnover of personnel. The patients who come here are complex and diverse, and it is necessary to determine the cause and treatment of the patients in a short time. I believe this is the result of years of experience. I remember a patient with cardiac arrest once came. Soon, the doctor gave a verbal order firmly and quickly, while the nurses gave the ventilator, pacemaker and medicine in an orderly way, as if the patient in the hospital bed were like his relatives. Until I saw that the ECG changed from a straight line to a straight line, everyone's hearts seemed to be tied together. Everyone's smile at that moment, I think, is the happiest smile from the heart!
Tiredness seems to be synonymous with emergency nurses, but even so, teachers have never complained. They face patients in a constant state every day. When they don't eat on time and work overtime, it has become the norm, but fatigue has become the main theme. But when patients say thank you from the heart, they can get satisfaction and happiness!
These days, I think there are really too many. I saw the teacher writing nursing records while infusion. I don't care if I see a wound on my hand during the rescue; Seeing the patient's knowing smile when he leaves the hospital! Let me feel that a nurse is so ordinary and so extraordinary! Thank you for taking care of me during this time!
In this society, the status of career love is of course important, and various pressures are normal. However, take care of yourself anyway. No life, nothing. I hope everyone has a healthy body! I can take care of myself.
Clinical practice is the deepening and continuation of school education and teaching, and the nature of nursing work in emergency department is more complicated, emphasizing "urgency, quickness, accuracy and liveliness", and the illness is urgent and serious. The patient's condition changes rapidly, and the number of patients is large, especially in case of sudden disasters, and it is necessary to undertake the rescue and nursing work of a large number of wounded people. Therefore, the emergency nursing work is very busy and arduous, and it must be busy and orderly. According to the working characteristics of the emergency department, the problems existing in clinical nursing teaching and the improvement measures are summarized as follows:
As far as student nurses are concerned,
1, the theoretical knowledge is not firmly grasped, the basic theoretical knowledge and skills are lacking, and the sense of responsibility is not strong. Before entering clinical practice, nursing students lack solid theoretical foundation, technical operation experience and due sense of responsibility.
2. The role of nursing students is vague, and some nursing students are not clear about their roles when they first enter clinical practice. Most nursing students rely too much on their "student" role, fearing that the operation will fail and the patients will be dissatisfied, and they are unwilling to start nursing practice. A few students over-emphasize their role as nurses and dare to try all kinds of operations, whether they have done it or not.
3. Nursing students have weak legal awareness and weak safety awareness. Nursing students seldom receive legal knowledge education at school, and their legal responsibilities are unclear. Therefore, in practice, they do not pay attention to the relationship between nursing and law, can't look at their own nursing work from the legal point of view, and their words and deeds are not rigorous enough, which may easily lead to medical disputes.
Instructor: 1. Teachers' own quality problems, lack of comprehensive knowledge accumulation and improvement of their own quality, and the unstable professional thinking of some staff directly affect students' enthusiasm, creativity and initiative. 2. Lack of teaching time and energy. Since the implementation of performance appraisal in our hospital, the establishment of nurses has been tightened, the workload of basic nursing in neurology department has been heavy, and various new businesses and technologies have been continuously developed.
Improvement measures in future teaching work;
1. Strengthen pre-job training of nursing students and cultivate legal safety awareness.
The nursing department conducts training in nursing technical operation, professional quality, psychological knowledge and legal knowledge. In the process of clinical practice, teachers should guide students to put themselves in the other's shoes, respect patients' rights, make nursing students establish legal concepts as soon as possible, be serious and independent, and enhance their sense of responsibility.
2. After entering the department, nursing students will be familiar with the ward environment, observation room, injection room,
Do a good job in health education, consultation and guidance, do a good job in three inspections and eight pairs of veins, muscles and intradermal areas for patients in injection room, guide nursing students to practice hand-in-hand, and teach teachers to open their eyes. After each work, help nursing students recall what they learned that day, encourage them to take clinical notes, and deepen their understanding and mastery of knowledge.
3. Make a detailed teaching plan for clinical teaching combining theory with practice. According to the requirements of the internship program and the characteristics of the emergency department, the internship teaching plan and nursing teaching rounds are arranged to provide as many internship opportunities as possible, so that nursing students can gradually complete the process from unfamiliar to familiar and then to accurate.
4. Explain common diseases, frequently-occurring diseases, emergencies and nursing knowledge to the emergency department every week.
Know small lectures, and guide the use and precautions of commonly used first-aid drugs.
5. Combining theoretical knowledge with clinical practice, teachers should guide nursing students from the moment they enter the department.
They are integrated into emergency nursing work, and they observe patients and emergency patients for outpatient service together.
Summary of the experience of emergency doctors (selected 6 articles) 4 I used to like to watch the stories about the emergency department in film and television programs, and I felt that the doctors and nurses in the stories were so decisive, capable and attractive that I envied them. The emergency department is the fourth department of my internship. When I came to this department, I was in a hurry from the beginning to gradually find a rule. It's not easy to be a good nurse in the emergency department! The emergency department is one of the most important windows in the hospital. I spent two weeks in the clinic and two weeks in the intensive care unit.
The first stop is the clinic. My hospital is one of the top comprehensive tertiary hospitals in the province. It not only receives normal acute and severe patients, but also receives critically ill patients transferred from prefectures and counties. It is anxious, busy and complicated. Facing the first diagnosis and rescue of critical emergency patients, emergency patients often have unclear diagnosis, unclear condition and rapid changes. If it is not handled properly, it is easy to have medical disputes. However, patients and their families are prone to impatience, anxiety and fear. The emergency room is different from the ward. Medical staff have enough time to communicate with patients and their families, understand the needs of patients in time, and establish a good nurse-patient relationship. In the emergency department, patients and their families have not yet established a good sense of trust in their brief contact with medical staff, and they are very sensitive to every nuance of medical staff. The speech and behavior of medical staff will have a great influence on patients' psychology. As a result, the treatment behavior of medical staff can not be understood, so I think communication is the most easily overlooked and important thing in emergency. Nightingale said: Nursing needs not only exquisite skills, but also art.
Only by learning to observe can we be good at discovering problems, including observing the patient's condition, psychology, needs and family members. For example, some patients' families are critical of nurses' behavior, but they don't fully understand patients' fluids. For such family members, we should patiently remind them where to call a nurse when changing fluids. At the same time, we should also patrol the ward on time to observe the progress of the liquid, so as to avoid conflicts with the patients' families to a great extent because the liquid was not replaced in time. Second, learn to communicate. Mutual respect and trust between people is based on communication. For patients who come to the emergency department, we should actively ask and guide them enthusiastically. For example, we can help patients with mobility difficulties, or help them take them to the clinic with carts, measure their vital signs and give them to the nurses in the clinic; For patients who need and can go to the ward for treatment, the location of the ward can be pointed out in detail to prevent patients from "running wrong". A smiling expression and a hand gesture can not solve the physical pain of patients, but can quickly shorten the distance between nurses and patients, effectively meet the psychological needs of patients who need care, thus facilitating our follow-up nursing work. Finally, through observation and communication, learn to judge, and have an accurate understanding and judgment of the patient's condition and needs, which is conducive to the rescue work of medical staff and buys time for patients.
In the third week, I came to ICU, and the rotation of ICU had passed. In these two weeks, I saw the rescue and death scenes that are difficult to see in the general ward; Learn how to use various instruments, such as electrocardiogram, ventilator, noninvasive cardiac function monitoring, defibrillator, etc. The commonly used rescue drugs are: atropine, adrenaline, diuretics, and constant heart rate; Rescue cooperation: tracheotomy, tracheal intubation, chest compression, etc. Operations that can be practiced in ICU include: morning care, intravenous medication, intravenous drip, intravenous injection, sputum aspiration, blood gas analysis, noninvasive cardiac function monitoring, gas switching, deep vein dressing change, perineal scrubbing, oral care, blood sugar measurement, etc. Since I learned to care for patients independently, I have witnessed my hands-on ability to operate independently, making my theoretical knowledge more solid and my operational skills more skilled.
There is still a lot to learn. Everyone is my teacher in the emergency department, and everything is my experience, which has taught me a lot, whether it is being a person or doing things. Of course, being a good emergency nurse is not enough. It also needs a solid theoretical foundation, rich rescue experience, quick response and quick action. This is a guarantee to stand the test in an emergency.
In my opinion, I feel that the doctors and nurses in the story are so decisive and capable, full of beauty, which makes me envious.
When I grew up, I became a nurse. From the initial hurry-scurry to gradually finding the law, I really realized that it is not easy to be a good nurse in the emergency department!
My hospital is one of the best hospitals in the province. It not only receives normal acute and severe patients, but also receives critically ill patients transferred from prefectures and counties. It has the characteristics of anxiety, busyness and complexity. Facing the first diagnosis and rescue of critical emergency patients, emergency patients often have unclear diagnosis, unclear condition and rapid changes. If it is not handled properly, it is easy to have medical disputes. However, patients and their families are prone to impatience, anxiety and fear. The emergency room is different from the ward. Medical staff have enough time to communicate with patients and their families, understand the needs of patients in time, and establish a good nurse-patient relationship. In the emergency department, patients and their families have not yet established a good sense of trust in their brief contact with medical staff, and they are very sensitive to every nuance of medical staff. The speech and behavior of medical staff will have a great influence on patients' psychology. As a result, the treatment behavior of medical staff is not understood, leaving patients and their families with the illusion of "being ignored" and "being urgent and not urgent". Therefore, the more I feel that communication is the most easily overlooked and important thing in an emergency.
At the same time, we should also patrol the ward on time to observe the progress of the liquid, so as to avoid conflicts with the patients' families to a great extent because the liquid is not replaced in time. Second, learn to communicate. Mutual respect and trust between people is based on communication. For patients who come to the emergency department, we should actively ask and guide them enthusiastically. For example, we can help patients with mobility difficulties, or help them take them to the clinic with carts, measure their vital signs and give them to the nurses in the clinic; For patients who need and can go to the ward for treatment, the location of the ward can be pointed out in detail to prevent patients from "running wrong". For patients who have been ill for a long time but their condition is not critical, we can advise them to go to the outpatient clinic for medical treatment, and patiently and carefully inform them of the location and time of medical treatment, so as to facilitate patients' arrangements. A smiling expression and a hand gesture can not solve the physical pain of patients, but can quickly shorten the distance between nurses and patients, effectively meet the psychological needs of patients who need care, thus facilitating our follow-up nursing work. Finally, through observation and communication, learn to judge, and have an accurate understanding and judgment of the patient's condition and needs, which is conducive to the rescue work of medical staff and buys time for patients. For example, trauma patients can know the location and severity of their injuries through observation and general inquiry, and seek medical treatment at the first time. Registration procedures can also be prepared.
The above is my emergency department summary report, in fact, there are still many things to learn. Everyone is my teacher in the emergency department, and everything is my experience, which has taught me a lot, whether it is being a person or doing things. Of course, to be an excellent emergency nurse, communication is not enough. You also need a solid theoretical foundation, rich rescue experience, quick response and quick action. This is a guarantee to stand the test in an emergency.
Experience summary of emergency doctors (selected 6 articles) Six articles have been internship in three departments, and they came to the emergency department, which is completely different from other departments. I'm a little excited and a little stressed. The emergency department is the most important window in the hospital. Not only receive critically ill patients who come to the hospital, but also receive critically ill patients transferred from other hospitals. It has the characteristics of anxiety, busyness and complexity. Be careful at every step for fear of doing something wrong.
The first week I came to your department, I studied separately with teacher xx. I thought the diversion would be simple, but it's not. Every job has its own characteristics and skills. The triage is responsible for triage of patients, making preliminary assessment, analysis, judgment, planning and implementation of patients' condition, and evaluating the results of triage. Because many patients who come to see a doctor are in emergency, patients and their families are prone to impatience, anxiety, fear and other emotions, which requires us to have good communication skills and keen insight in addition to skilled triage skills to relieve patients' concerns. In case of emergency, be responsible for transporting patients to the emergency room and contacting doctors for first aid. The triage work is very scattered, and we need to have a strong sense of responsibility from the liaison work of the whole department to the item management of the triage desk. There is something special about triage, that is, the differentiation of abdominal pain triage requires asking the patient's position and symptoms in detail;
Facial trauma should also pay attention to the difference between going to stomatology or ophthalmology.
The second week was in the emergency room and infusion room. In my opinion, the emergency room is the core of emergency, and the work is quite heavy. You need to have quite skilled rescue skills, be able to analyze rationally in an emergency, and be able to cooperate well with doctors in rescue. Whenever we take a patient to the emergency room, we should immediately carry out ECG monitoring, oxygen inhalation, blood pressure monitoring, venous access establishment, blood test, and prepare for the subsequent drug treatment. When using first-aid drugs, you should always record and observe the patient's situation. It is necessary to master the function, side effects, routine dosage and safety value of first-aid drugs. We should not blindly follow the doctor's advice, but look at everything with critical thinking. The use of rescue equipment should be mastered and applied correctly to ensure that the most effective treatment can be given to patients during rescue and save lives. After the rescue, the nursing rescue record should be written in time, the condition should be closely monitored, and the problems should be dealt with in time. Working in the emergency room should also be familiar with the clinical manifestations, monitoring and rescue of each acute disease, and pay attention to summing up in the work.
In the next two weeks, I studied in the observation room, which was divided into observation patients and inpatients. The observation room is basically equivalent to a ward, but it has the characteristics of messy personnel, large flow and many diseases. Observation mainly provides daily nursing routine, infusion, treatment and observation of patients' condition, ensuring that patients are within the observation range and giving timely rescue when their condition changes. As a sickbed nurse, you need to know the condition and treatment of sickbeds, understand the needs of patients and deal with them in time.
In the face of the first diagnosis and rescue of critical emergency patients, emergency patients often have unclear diagnosis, unknown condition and rapid changes. Patients and their families have not yet established a good sense of trust in short-term contact with medical staff, and they are very sensitive to every subtle link of medical staff. The speech and behavior of medical staff will have a great influence on patients' psychology. As a result, the treatment behavior of medical staff is not understood, leaving patients and their families with the illusion of "not being taken seriously" and "emergency is not urgent". If it is not handled properly, it is easy to have medical disputes. So learn to communicate and learn to be patient.
During my internship in the emergency department for one month, I got a detailed understanding of the emergency department and learned a lot of common sense, knowledge, the use of instruments and the handling of emergencies. However, there is still much room for improvement. From master xx, I learned that everything should be traced back to the source. Mastering knowledge requires systematic understanding and memory, never letting go of any small hidden danger that may cause accidents, and being strict with yourself. Thank the teachers for their care and help in their study and life this month. In the future study, I will follow the example of teachers, continue to arm myself with knowledge, and train myself to become a qualified nursing worker.
I started a one-month clinical internship in the emergency department with hesitation and nervousness on xx. A month passed quietly, and I calmed down to find that I had learned a lot. At least, I gradually found the law from the initial chaotic diagnostic thinking, and I also realized that it is not easy to be a good emergency doctor!
I have just entered the clinic for a month, and I am not familiar with all aspects. I always feel at a loss, and I am also a strange state to emergency work, and I have no formed concept of what I can do in such a new environment. So when I entered the emergency department, I was so hesitant and nervous. Fortunately, my teacher, Mr. xx, is kind, responsible and enthusiastic about teaching. He explained in detail some vital signs and clinical manifestations of common diseases in emergency department, and also taught me how to do physical examination, how to ask medical history and what kind of examination to open. With rich teaching experience, I quickly adapted to the work in the department. Therefore, being able to adapt to the environment of the emergency department as soon as possible and lay a good foundation for future internship and work in the hospital should be regarded as the first harvest in the emergency internship stage!
In this extremely short month, the biggest experience is the working characteristics of the emergency department: "urgent", "busy" and "miscellaneous". Emergency patients have rapid onset and great changes. So we must race against time, deal with it quickly, and strive for rescue time. I think my numerous haste during my internship fully embodies this point. The time, number and severity of emergency patients are unpredictable, random and controllable, especially when accidents, accidents, acute poisoning and syncope occur, the work is more busy. Therefore, it is necessary to have a division of labor and usual cooperation, so as to keep the work busy and not chaotic. Once I rescued a patient with high-voltage electrical burns. As soon as the patient entered the emergency room, I saw all the doctors and nurses around me rushing to the emergency room. Qi Xin made concerted efforts to immediately implement routine rescue procedures for patients: oxygen inhalation, airway opening, venous access opening, blood preparation, ECG monitoring, etc. , are very detailed, fully embodies the teamwork! In these processes, I will also learn the application of ventilator, cardiopulmonary resuscitation and other out-of-hospital emergency operations. This is my second harvest in the emergency room.
The sentence "I don't hate books even more" will always be the summary of my internship. What are the clinical manifestations of each new disease and what measures should be taken? What kind of medicine should I use? I can't think completely, so the first thing to do when I get back to my dormitory is to turn over the books. Clinical practice is the consolidation and strengthening of theoretical learning stage, the cultivation and exercise of one's own diagnostic thinking, and the best training before employment. Although this time is short, it is very important to me. I will cherish this period of time, cherish the opportunity that the teacher gives me to exercise and improve myself every day, and cherish this rare mentoring relationship with the teacher. This is the third harvest!
Under the guidance of Teacher xx, actively strive for every exercise opportunity, learn the process of ECG monitoring, defibrillator and ventilator, and also understand various nursing operations such as intravenous infusion, skin test and intramuscular injection, as well as the unique triage process and importance of emergency room. At the same time, I constantly enrich my clinical theoretical knowledge, actively think about various problems, and humbly ask xx or other teachers for advice if I don't understand them, and take knowledge notes. When the teacher has no time to answer, I will read emergency publicity materials after work and learn a lot of clinical knowledge in the publicity materials.
Consult teachers and more people to better strengthen the combination of theoretical knowledge and clinical practice. Generally speaking, this is the fourth harvest and the biggest harvest during the short internship.
Of course, there are many problems besides harvest. During my one-month stay in the emergency department, I found that I had too much knowledge to learn or strengthen, and my theoretical foundation was poor, which led to my indecision and indecision in diagnosing my illness.
My communication skills need to be improved. During the internship, I often meet patients who don't want me to give her a physical examination or bedside electrocardiogram. I will strengthen these in the future.
Time is too short. I'm just familiar with the environmental structure and job responsibilities of the emergency room. I have to go. I am a little reluctant to part with you. The above is just a brief talk about my short work in the emergency department. There is still a lot to learn. Everyone is my teacher in the emergency department, and everything is my experience, which has taught me a lot, whether it is being a person or doing things. Of course, being a good doctor in the emergency department is not enough. You also need a solid theoretical foundation, rich rescue experience, quick response and quick action. This is your guarantee that you can stand the test in an emergency.
In a word, I would like to thank Mr. xx for his careful teaching and the patient guidance of other teachers. I will go into the next department with a more positive working attitude, more solid operational skills and deeper theoretical knowledge, improve the theoretical basis of medicine, enhance my clinical work ability and go all out to treat internship!