Reflective Journal Med Surg, Ridge Meadows, Maple Ridge.

Student Name Dermot Connolly Stenberg College April 1st 2013

Monday April 1st 2013 I was assigned a new patient today Ms Berndt, a 72 year old Caucasian woman with right lower lobe pneumonia admitted on March 29th after she felt weak while having lunch with friends. When I was initially assigned Ms Berndt, I was happy to learn that I would get to practice my lung auscultations as she also has a history of COPD and asthma. I found Ms Berndt to be a very co-operative woman on 2 liter of O2 with no continuous IV line except to administer her Levofloxacin antibiotic at noon. I felt that this week, I was able to equate a lot of what I had learnt in theory to my clinical experience in that many of Ms Berndts vitals equated quite well with a person suffering from pneumonia and COPD. Ms Berndts pulse for example was quite high at 109 as was her initial blood pressure, which has since being reduced following her admittance. Her O2 sat was a little low at 92% considering she was on 2 liters of O2. Ms Berndt is an obese woman which means her body mass index is quite high, again another contributing factor to COPD. I learnt this week that I need to be more assertive when requesting my patients to complete tasks. For example, I was reluctant to ask Ms Berndt to sit up in her bed so I could listen to her lung auscultations as I did not wish to cause her any discomfort. I opted instead to complete her front lung auscultations and due to Ms Berndts size, I was unable to hear anything. Having spoken with Don, I realized that I was going to have to ask Ms Berndt to sit up so I could complete a complete lung auscultation. I was glad I had spoken with Don as I could clearly hear crackles throughout her right lung when I completed her lung auscultations from the back. Ms

Berndt was very keen to get some exercise by going for short walks which left here feeling breathless. Again this is a classic symptom of COPD. I felt very fortunate this week to be working with Marie, the day shift nurse also assigned to Ms Berndt. Marie was happy to answer any questions I had and more than willing to let me get my hands dirty and help her with her other patients. Marie was especially helpful in helping me develop a routine around collecting vitals, charting and when to chart. I also got some wonderful experience with Marie, helping her use 2 person lifts, personal care, wandering patients and the importance of giving patients like Ms Berndt the opportunity to sit up in their chair allowing them to breathe more freely and easily. Another new technique I learned this week was the maintaining of an IV line for the administration of antibiotics. One of the other nurses, Alana, helped me maintain the line by completing a saline flush and administering the IV medication which was a little nerve racking but Im glad I had the opportunity to do it. While it was great to maintain the IV line, I would still like to practice the technique several more times to ensure I have perfected it. I would especially like to help set up a new IV line if I have the opportunity. Overall, I felt the day went really well, it was nice and steady pace and I felt I learnt a lot while still feeling I contributed to the team as well.