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Accounting practice content 40 days, 3 essays.
Notes on Teachers' Three-week Internship
Article 1 of the Summary of Inspection Practice Mode:
Time flies, and three years of school life is over. On _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.
_ _ _ _ Hospital is. . The largest national "Class III A" modern general hospital integrating medical treatment, teaching, scientific research, preventive health care and in-hospital and out-patient first aid. The hospital has advanced equipment and good conditions in all aspects, providing a good medical environment for patients. The laboratory teachers have strong professional skills, clear division of labor and serious and responsible work, which sets a good example for students. Teachers are strict with students, and guide them carefully and patiently, which benefits us a lot.
_ _ _ _ _ The clinical laboratory of the hospital is divided into nine departments, and the blood laboratory belongs to hematology. From Year and month. From day to day. . In fact, I went to the body fluid laboratory, blood collection room, luminous immunity room, immunity room, cell room, microbiology, biochemistry, blood routine, ward laboratory and blood laboratory in turn to study.
1. Biochemical
Clinical biochemical examination mainly includes routine examination of liver function, renal function, cardiac function, electrolyte, blood lipid and tumor markers. In the biochemical room, I learned the usage and principle of American Beckman C_9AL automatic biochemical analysis system and Roche P800: photoelectric colorimetric principle. Understand the daily work of quality control, calibration and maintenance of instruments, pay attention to ensuring the dosage of reagents in instruments, and master the collection, preservation and treatment of biochemical test specimens and the cleaning of glassware. Pay attention to the influence of hemolysis and hyperlipidemia on the experimental results. Because biochemistry is a large number of specimens, we should be careful in every job.
2. Blood laboratory
In the blood laboratory, I learned to use four coagulation analyzers, learned the normal reference value and clinical significance of each of the four coagulation items, and the detection method of D- dimer. Blood slides and bone marrow slides are collected, stained and classified by doctors themselves, and there are not many opportunities to see them, but you can basically know granulocytes and erythroid cells, lymphocytes, plasma cells and megakaryocytes.
3. Ward laboratory
The instruments for urine routine and blood routine testing in the ward laboratory are the same as those for urine routine and blood routine. In addition, we also studied the detection of cerebrospinal fluid and serous cavity effusion, and how to use ESR tube to add ESR.
4. Blood collection room
In the blood collection room, I mastered the method of venous blood collection, which vacuum blood collection tube should be used for each test item, and each vacuum blood collection tube contains different anticoagulants. Red blood cell collection tubes do not contain anticoagulants and are generally used for biochemical projects and immune hematology tests; Green blood collection tube contains heparin sodium and heparin lithium anticoagulant, which is generally used for biochemical project detection; Purple blood collection tube contains EDTA-K, which is used for hematology and immune hematology detection. The anticoagulant of light blue blood collection tube is sodium citrate hydrochloride: blood = 1:9, which is used for coagulation test; The anticoagulant of black blood collection tube is citrate: blood = 1:4, which is used for ESR test.
5. Blood routine
In the aspect of blood routine, we have mastered the use of micropipette and the method of peripheral blood collection, learned to use _S-800i blood analyzer and automatic ESR analyzer, and understood the clinical significance of each item.
6. Body fluid laboratory
In a short period of one month, I learned how to use the automatic urine analyzer ULITURIT series and its detection principle, microscopic examination of urine, collection and preservation of urine samples and matters needing attention, and inspection of feces, prostatic fluid and vaginal secretions. Through reading the teaching materials, I have mastered the clinical significance of various inspection items in urine, feces, prostatic fluid and vaginal secretions.
(a) detection principle of urine dry chemical analyzer:
(1) composition: It usually consists of three parts: mechanical system, optical system and circuit system.
(2) Dry urine chemical detection area: the detection items are vitamin C(VC), white blood cells (WBC), ketone bodies (KET), nitrite (NIT), URO, bilirubin (BIL), protein (PRO), glucose, urine specific gravity (SG), occult blood (BLD) and acid-base.
(3) Detection principle: The corresponding chemical components in urine discolor various membrane blocks containing special reagents, and the color depth is directly proportional to the concentration of the corresponding substances in urine. A plurality of test strips are placed in the colorimetric sampling tank of the urine analyzer, and each membrane block is irradiated by the light source of the instrument in turn, generating different reverse colors. After receiving light signals with different intensities, the instrument converts them into corresponding electrical signals, and then calculates the reflectivity of each test item according to the formula through the microprocessor, and then compares it with the standard curve.
(2) Detection principle of urine visible component analyzer: flow cytometry and electrical impedance analysis principle are applied.
7. Microorganisms
During this month, I learned the inoculation methods of various specimens and the bacteria that often appear in various specimens. Basically, I can identify several common bacteria, such as Escherichia coli, Staphylococcus aureus, Streptococcus pneumoniae, Pseudomonas aeruginosa, Klebsiella pneumoniae, Proteus, Streptococcus viridis and fungi. Learned the operation of oxidase test and enzyme contact test. The operation steps of Gram staining, the use of DL-96 bacteria detection system random in vitro diagnostic reagent plate and how to read DL-96 reagent plate with DL-96 bacteria analyzer. In addition, the installation of blood culture bottle, the operation of ink dyeing and Widal reaction test were studied, and the use and detection principle of VersaTREK blood culture instrument were understood. Common drug-resistant bacteria include methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, Gram-negative bacteria producing extended-spectrum β -lactamases (ESBLS are mainly found in Klebsiella pneumoniae and Escherichia coli), pan-resistant and multi-resistant Acinetobacter baumannii, Pseudomonas aeruginosa and fungi.
8. Luminous immunity
In the luminous immunity room, I learned how to use Beckman instrument and understood each item and its clinical significance.
(1) anemia screening: ferritin, folic acid, vitamin B 12.
(2) Down's comprehensive screening: human chorionic gonadotropin (β-HCG), alpha-fetoprotein (AFP) and estriol (E3).
(3) Seven hormones: luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol (E2), progesterone (Prog), prolactin secretion (PRL), testosterone (Testo) and estriol (E3).
(4) pituitary function examination: growth hormone (hGH), follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL) and thyroid stimulating hormone (TSH)
(5) Detection of thyroid function: thyroglobulin (Tg), anti-thyroglobulin antibody (Tg-Ab), thyroid peroxidase antibody (Tpo-Ab), free T3 (FT3), free T4 (FT4) and thyroid stimulating hormone (TSH).
(6) Markers of myocardial injury: myoglobin and troponin.
(7) Other test items: blood β-HCG, cortisol and digoxin.
9. Immune room
The detection of hepatitis A, hepatitis B, hepatitis C, prenatal and postnatal care, human immunodeficiency virus antibody and syphilis spiral antibody are all enzyme-linked immunosorbent assay. Follow the instructions in the kit, and be sure to wash the plate during the operation, otherwise there will be false positives. The Swiss Dicken RMP- 150 automatic enzyme immunoassay system was used for the five quantitative tests of hepatitis B. Hepatitis B surface antigen and HBeAg were detected by double antibody sandwich method, anti -HBs was detected by double antigen sandwich method, and anti -HBe and anti -HBc were detected by competitive inhibition method. The detection of antinuclear antibody (ANA) is indirect immunofluorescence, and the universal detection of ANA is an extremely important screening test in clinical diagnosis and differential diagnosis. Further detection of various subtypes of ANA antibodies in ANA-positive patients is of great significance for definite diagnosis, clinical classification, disease observation, prognosis judgment and treatment evaluation. Western blot is the most commonly used technique to detect anti-ENA antibody spectrum. The positive rate of anti-ENA antibodies with different characteristics in autoimmune diseases is obviously different, which has important clinical significance for the auxiliary diagnosis and differential diagnosis of autoimmune diseases. ELISA is the most commonly used method to detect vasculitis associated autoantibodies (ANCA). Indirect immunofluorescence analysis is often used to detect anti-keratin antibody (AKA), which has important clinical significance for the early diagnosis of rheumatoid arthritis. ELISA is the most commonly used method to detect anti-cyclic citrullinated peptide antibody (CCP), which is a highly specific new index for diagnosing rheumatoid arthritis. In addition, I also learned to detect glycosylated hemoglobin and microalbuminuria.
10. Cell
Beijing Tongfang Shenhuo Reporting System combined with high-power microscope to detect mycoplasma in throat swabs, urethral secretions and vaginal secretions, learned to use sperm quality analyzer to detect sperm, learned to use hemorheology analyzer and precautions in detection.
Internship harvest
The short ten-month internship is over, which means that four years of college life is coming to an end. In this short ten months, I deeply realized the importance of medical laboratory workers and the importance of test results. The report in the patient's hand seems simple, but it is actually obtained through the careful operation of quality control, experiment, detection, inspection and audit, and every step is sloppy. Inspectors should not only keep professional knowledge in mind, but also have a lot of practical experience. As inspectors, we must treat every job seriously, carefully and responsibly. In life, I learned how to communicate with teachers, how to communicate with patients, and how to get along well with interns in other schools. Graduation practice is the last stage of completing all the teaching plans of medical laboratory specialty, and it is an important link to realize the training goal. Students integrate their theoretical knowledge into clinical practice through graduation practice, so as to consolidate their professional knowledge and skills, further cultivate and improve their ability to analyze and solve problems and work independently, and enhance their adaptability to society. During the internship, we should not only learn to integrate theory with practice, but also learn how to communicate with patients, cultivate our good interpersonal skills and lay a solid foundation for independent work after graduation. In a word, I learned a lot from this internship, which will definitely help me in my future work and life.
Thank you speech
Thank you. . . The school provides me with a good learning environment. Thank you for the teachers' earnest instruction in the past four years, the teachers in the laboratory of _ _ _ _ Hospital for their patient guidance, and the friends who accompanied me all the way. I will work harder in the future! Come on together!
Summary of inspection practice mode Article 2:
At the hot end of June, we finally started the long-awaited practice. I am full of expectations when I think that I finally have the opportunity to enter the laboratory and learn about my major from practice. As we are the first batch of students to start internship, we are inevitably a little excited and nervous. We will keep in mind every operation point and precautions introduced by the teacher. In just ten days, I witnessed the busyness of three departments-biochemistry, immunology and clinic, and found that there is a world of difference between work and study.
The first is biochemistry. The work here is basically an assembly line. Here, we should not only master professional knowledge in an all-round way, but also have a certain understanding of inspection instruments, because we don't know when the instruments will break down, so we need to know how to maintain the machines at this time. You need manual operation here, so you have to say blood back. This is for the convenience of patients or doctors when they have questions about the report. It is not only responsible for patients, but also my own responsibility as a medical staff.
The second sector is immunization. Unlike biochemistry, immunization requires a lot of manual operation. Because many of them are micro-experiments, they will be one mile short. The teacher also dare not let us operate easily. Many times, I just do some simple experiments and listen to the explanations of some experiments next to the teacher. With this intuitive learning method, the pale theory and simple pictures and texts in our class become concrete and vivid.
The third department is the clinic, which is actually divided into blood and body fluids. In the blood clinic, I looked at the flow cytometer that automatically analyzed, and then recalled what the teacher explained in class, and I had a deeper understanding. In the clinical examination of body fluids, teachers often let us see samples. These days, we have a better understanding of the just-concluded clinical laboratory foundation, and we have seen more samples, and these samples from different people, whether positive or negative, are what we will face in the future.
It is said that the relationship between doctors and patients is tense now, and I am lucky to practice here at the information desk. Dealing with patients requires more patience. Say hello more, maybe it will narrow the distance between doctors and patients, less suspicion and more trust.
Some people say that the work in the laboratory can be easily started within three months, which is very simple. However, after really coming here to experience it, you will find that the inspection work is not as simple as expected. Just like the report in the patient's hand, it seems simple. In fact, this is through the careful operation of teachers' quality control, experiment, detection, review and re-examination, and every step is sloppy. Although it seems to outsiders that inspectors do the same work every day, when accidents or special symptoms appear, it is meaningful to find the accumulation day by day, which is why inspectors not only need to keep professional knowledge in their minds, but also need a lot of practical experience.
Although this internship lasted only two weeks, I learned a lot about the work of the clinical laboratory and met many teachers. I have some new knowledge about this major and my future, and also make my future goals more clear. In a word, this practice has gained a lot. I am really grateful to the teachers in schools and hospitals for giving us such a good opportunity to have a full understanding of our major.
Summary of inspection practice mode Article 3:
In the summer vacation of _ _ year, our group (the second batch of biochemical practice group) practiced in the laboratory of _ _ hospital. Although the two-week internship is short, we have learned a lot.
I remember on the first day of practice, we stood there looking at the busy teacher and couldn't even help. However, under the guidance of the teacher, we gradually learned to use various instruments and became familiar with the whole operation process ... The next day, we basically started to find something to do by ourselves, and then asked the teacher for advice when we met something we didn't understand. As a result, we gradually accumulated knowledge in our work day after day.
We met many kind and strict teachers during the rotation practice in various departments of immunization I, immunization II, clinical biochemistry, clinical examination (blood routine and urine routine) and exfoliated cells. Their earnest teaching makes us make continuous progress. It can be said that this practice has applied a lot of knowledge in the original textbook to practical operation, but we have also learned a lot of knowledge that books can't learn. For example, many operations need to pay attention to details: 24-hour urine sampling, elisa sampling, operating blood cell analyzer ... When helping teachers do experiments, some teachers often ask us some questions (although sometimes they can't answer them), and then teachers will explain the knowledge points to us, consolidate what they have learned while learning new knowledge, and some teachers will take the time to explain to us the working principles of various instruments, so that we can have a preliminary understanding and understanding of various instruments.
This practice can be successfully concluded. First of all, I would like to thank the department leaders and counselors, Mr. Chen Ruiming and Mr. Ying Yayun, who won this rare opportunity for us. I would also like to thank Mr. Peng from the laboratory for his warm reception. Finally, I would like to thank the teachers who are enthusiastic about teaching during the practice outside. These include Mr. Mao Kezi, Mr. Zhi Liming, Mr. Wang, Mr. Lu Yide, Mr. Shi Hourong, Mr. Wang and Mr. Jin.
In a word, this practice has benefited a lot, and I have learned a lot while enriching my summer vacation life.
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