Reflective Journal Entry #2 clinical experience icc PDF

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clinical experience icc notes and reflections questions answered in full...

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Reflective Journal Entry #2 Dakota Carter 12/11/21 ORMC - 3C South ICC Something I did (skills I practiced): I preformed assessments of patients, lines, tubes, and drains. I preformed oral care using the CHG and suctioned the oral airways. I used the bladder scanner to identify how much urine was being retained for one of our patients. Practiced more injections of Heparin and Enoxaparin, this also entailed drawing up medications in the case of Heparin. I set up a tube feed to be administered through a G tube. Preformed trach care using Venelex ointment, dressed wounds and maintained a closed system drain. Something I experienced that made an impression (good or bad) and what I learned from the experience: One thing I saw that I was not impressed by was when the suction came undone from a Primafit and left a mark on one of my patients. This occurred during the transfer of patient care and may have occurred because the patient was confused and restless. The takeaway is to not overlook the “little things” and assess all the systems because you never know what you will find and stick to the basics unless more advances care is necessary. Similarly, there was an alarm going off on one of the IV pumps that said line occlusion. A lot of the time what I’ve seen nurses do is position the arm differently and the alarm will go off. My nurse did that but also flushed to make sure that the IV was good. The IV started to leak when she did that and a new one had to be placed.

Something new I learned: Something new I learned was the Deterioration Index and how to document it. It is a score that will alert providers when a patient's condition begins to deteriorate. The index includes factors such as GCS, age, RR, O2, Potassium, Hct, Sodium, systolic BP, WBC, and temperature. The score ranges from 0 to 100, in which the higher numbers signify a greater risk of resuscitation or calling a rapid response. I also learned more about vents and their settings including specific ranges for FiO2, PaCO2 and PaO2. I’m glad that I’m becoming more familiar with trachs and vents because they seemed very foreign when I first started in the ICC. Turns out they are not as scary as I thought and respiratory is always close on the floor if you can’t figure it out.

Something I wish I had done differently or something I would like to improve:

I would like to practice back flowing a secondary to prime the line. I think that is a helpful skill to have and I am not as comfortable as I’d like to be. I would also like to become more familiar with the messaging system to contact a provider and improve on the clarity of what I am presenting to them.

My thoughtful take-away for these shifts: My thoughtful take away from is that there I always going to be different situations relating to patients and you can’t possibly know everything. What is important is acknowledging what you don’t know and being comfortable with your resources to ensure that your patient is receiving adequate care....