How to Function at Night on the Job - Essay Example

It was on my first day that I began to observe the unit and follow my preceptor who was entrusted with 3 patients who were under orthopedic service, the other was a child in weighted halo traction. I found it difficult to work with the child in that situation because I have an inborn knack for empathizing with people, most especially my young patients. I began to work with the patient by starting the child on 10 lbs. weights and then slowly increasing the weights until we reached the goal of 45 lbs. The child was obviously uncomfortable and in pain but I needed to continue with the task, offering the child words of encouragement and appeasement along the way in order to prod the child not to give up on the task. I also had an opportunity at this point to observe the nurses who were assigned to the group and bedside reports. The nurse on duty for the night was quite helpful and did not mind having to teach me how to perform a head assessment on a patient. We spent the night with her teaching and me learning about how to calculate pediatric medication dosages, how to check the link for formulary medication, and other related tasks. I made sure to question her about the diagnosis of patients but every time I asked about a patient, she would simply tell me to run a Google search.

One of the patients was admitted with Jarcho-Levin syndrome, Vacterl syndrome, and severe congenital scoliosis with a history of fused ribs, spinal bifida, and club feet. His VEPTR (Vertical Expandable Prosthetic Titanium Rib) was removed that day. I found his case quite interesting so I ran a Google inquiry on his illness and then asked my preceptor to clarify certain points pertaining to his case for me. What I did find out on my own however was quite interesting. I learned that the illness also went by other names such as costovertebral segmentation anomalies, spondylocostal dysostosis, spondylocostal dysplasia, spondylothoracic dysostosis, spondylothoracic dysplasia, were all very rare genetic disorders that are characterized by malformation of bones in the spinal column, vertebrae and the ribs which affect the respiratory system. Any infant born with the jarcho-levin syndrome would have short necks and limited neck motion because of abnormalities in the cervical vertebrae and stature. Surgery is the only treatment for this type of disease with the patient placed on halo traction to stabilize his spine by pulling the vertebrae and the neck together.

September 9, 2013

We admitted and discharged 2 patients respectively. I learned about the admission process and the need to properly communicate with the family, ensure the accuracy of my documentation, and other back office procedures. I administered to the medical and palliative needs of post-operative patients while also checking in with the doctor in order to confirm medication orders and IV fluid administration. This was a highly challenging clinical experience for me. Each stage was filled with a sense of worry and self-doubt because I knew that I could not control what was going to happen on the floor. But as I gained confidence in my skills and learned about procedures, I found myself becoming more comfortable taking care of and communicating with children. I also become more acquainted with performing assessments on admitted patients, post-surgical skin assessments, medication control, and other day-to-day related activities. Going forward, I am looking forward to being given an opportunity to concentrate more on documentation, assessment, wound care, and more.