what is jessica's clinical summary?
Clinical Summary C N A Name: Jessica Hickingbottom Weeks of October 8-24, 2007 Clinical Assignment Area Brookhaven Nursing Home 1.What type of surrounding do most patients have in their rooms? Does it have anything to do with any of the disorders? List specific examples. (10 points) When I first walked into Brookhaven Nursing Home I felt very warm and welcome, but upon arriving in the first patients’ room I felt a sense of loneliness and despair. This man had no photos and no belongings, just machines all around him, including an oxygen machine by which his every breath depended on. I had a fear that every other resident was just the same. By the time my shift was over I had a totally different view. The second resident that I met was so happy to see me she just kept talking and talking. All around her room there were so many pictures. She was a diehard Elvis Presley fan and her room had every bit to show of it. On her night stand she had a framed picture of her and an Elvis impersonator signed by the man himself. She is a very lively lady and all she needed from me was a helping hand in the morning to get out of bed so she could grab her walker, which sat right next to the edge of her chair, just so she could move on with her day. Every time I walked into a residents room the first thing I would do was look around and see all of their things. One resident even had her very own motorized scooter ;I had been so used to pushing around wheelchairs that it was nice to see someone do it on there own. I noticed that most of the residents had a water jug in there room that was located on their bedside table. Some residents were not allowed to have water, I knew this because some of them had signs posted above their beds warning the CNA’s of certain things. Some signs would tell you not to give the resident water or to be gentle when lifting certain parts of their bodies, while other signs warned us where to put the laundry because their family does it for them. Other miscellaneous items such as night creams, extra pillows, special foot wraps, arm bandages, and denture cups led me to the obvious conclusion s of their needs. I really enjoyed rooms that were filled with things that represented where the resident had been or where they were from. One man had a wall filled with postcards and letters from pen pals of extraordinary trips he had taken in the past and friends that he had met along the way. Another resident that I had come across was originally from china. In her room she had sweet pictures of her grandchildren surrounded by paper fans and ancient Chinese quotes. Many of the residents had equipment in their rooms like walkers, wheelchairs, and lifts that aided them with their disabilities, but the residents that looked past that and decorated their rooms with pictures and memories of their younger years were the one’s I really enjoyed spending time with. 2.Name/identify (trade and generic) two drugs you observed being given. what method was used to give the drug? (Oral, IV, IV Push, etc.) What is the classification of the drug? Why was it given to the patient? (pain, antibiotic,etc) How often is the drug given? (10 points) Trade nameGeneric NameMethod UsedClassificationWhy it was given?How often it was given? Lantus Insulin GlarginIMInsulinDiabetes Every four hours GlucagonGlucagonIMInsulinSevere hypoglycemiaFour times every shift 3.Name as well as describe one procedure you preformed this week. (10 points) This week seemed to be a great time for me to give showers. I was just cleaning bodies from one patient to the next. By the time I had done my third shower I felt like it was the easiest task on hand. Showers started to change for me when I gained a new resident from moving to hall 300. To me it was a typical day, wake the resident, put them in the chair and roll them down to the shower room, all was fine until we started the actual shower. I uncovered the resident, started the shower, checking the temperature while the resident washed her face. I sprayed the water all around her body then I drenched the washcloth in soap and starting washing through the steps. During a normal routine cleansing of the perennial area the certain resident I was working on had a bowel movement and it took me by surprise. In the back of my mind I knew that this very thing could have happened at any time but I suppose I just didn’t expect it. The resident realized what she had done and knowing that she didn’t have any more control over what had happened than I did, I reassured her that everything was just fine. I continued on with perennial care and finished the shower. I knew that my resident was embarrassed and I felt bad about what had happened. I picked up the specimen with a used washcloth as the CNA had instructed to placing it at the bottom of the shower chair making it easier to dispose of. While back in the residents’ room, I gathered her clean clothes and a diaper. I dried off the rest of her body, particularly the hard to reach areas, armpits, peri, and underneath the breast. I started to apply her deodorant when I noticed something on the floor. She had accidently had another bowel movement when I had be drying her off. Just as before I grabbed another washcloth and covered the specimen placing it at the bottom of the chair. I wasn’t grossed out about what she was doing; it was all out of her control. I just wanted to let her know that everything was going to be ok since she was feeling so bad about it. It is part of my job to do these things, but more importantly my job is to comfort the residents and make them feel as positive as they should. 4.What affected you the most in your clinical area this week? (10 points) While working at the nursing home I really started to see how the residents feel. Most people avoid going to nursing homes because they dislike the smell or they think it is just a sad place to be, but all of this is not necessarily truthful. When I was working and connecting with the residents, listening to what they had to say it really affected me. So many people missed their families, which is what it all seemed to be about. Almost every conversation I had was about someone’s grandchild or a family Christmas photo that was on their nightstand. The resident’s felt that they were put in a home waiting to die while the one’s they loved went on. It made me sad when residents would say things like, “When I get better and I get out of this place, I’m going to go visit my sister in Colorado, or my grandkids in California.†I know as well as they do that they won’t be going, but somehow I believe when they tell themselves things like that it makes them feel better. Everyone needs a reason to live you can’t just sit around waiting to die. Some residents would take their feeling s out in anger, yelling at the CNA’s or refusing to eat .While others took it out in sorrow crying their eyes out at every memory of a passed loved one. While on hall 200 I met an amazing lady who was so happy and giggly everyday I worked with her. She would always tell my CNA of the dreams she had the previous night about her husband, and they would always be so sweet and lovely. I felt so sorry that her husband had passed ,but she is one the nicest people I’ve ever met, and when she spoke of her dreams she always had a smile on her face, almost as if her husband were sitting right next to her. She has come to terms of what her life has given her and that made me respect her even more. Some residents made it difficult and sad to work with them but knowing one day that they will all return back to be with the one’s they love make my job so much easier, 5.Copy below from the patient's chart a Doctor's Order and interpret the order. (10 points) Flu vacc 0.5 ml IM x 1 dose Give the resident 0.5 milliliters of the Flu vaccine intra muscular only one dose Check temp. Q shift x 72̊ Check the residents temperature every shift for 72 hours (3 days) 6.Copy below from a patient's chart a Nurses Notes and interpret the order. (10 points) Cont. on flu fall-no delayed injury The resident is continuing to come off of the flu and there is no delayed injury Noted- denies any pain or discomfort The resident denies having any pain or discomfort 7.What do you feel that you need to improve on (skills, etc)? (10 points) When making beds at the nursing home I noticed that residents liked it done differently then the way we were taught. I got really nervous the first time my CNA had me make a residents bed , it was like I had forgotten all of the steps, I think I was just so nervous that my mind went blank. She had to show me all of the steps again like she was teaching me for the first time. I didn’t know that some of the residents liked their sheets folded in half because it makes the bed warmer and it took me a while to get used to that. Each resident seemed to prefer their beds made differently and it took me some time to memorize just the way they liked it. But the majority of the beds that I made were not like the skills we practiced in class. I just don’t feel like my bed making skills are up to par. I have been making so many beds by the residents request that I have forgotten how to make them the way I need to for my CNA test. I know that everything will be fine though, I have my procedural guidelines at home and a bed to practice on. As far as all of the other tasks go I think I have had enough practice and reading to excel. 8.Name two diets that different patients have. Describe. (10 points) Mechanical soft was one of the diets that I came across while working in the cafeteria. This diet consisted of foods that were all soft like eggs, juice, oatmeal, soft sausage, and gravy. A normal diet at the nursing home consisted of pancakes, syrup, eggs, cereal, oat meal, toast, or bacon. This is for residents who can eat easily or with the help of dentures. 9.Name some similar traits that most patients share. (10 points) When it was just the resident and I that were left to converse I felt like I got to know them more as a person than just a room number at Brookhaven Nursing Home. As I mentioned earlier many of the residents were similar in the fact that they were crazy in love with their families. Most of the time I wouldn’t talk much because I would ask a resident about a family member in a picture and they would go on and on .Some residents would just tell me before I even got a the chance to ask. What I love the most about the residents though is that they are all on a schedule, and many of them have the same schedule. Things like going to the bathroom in the mornings or watching a certain television program. This made it so much easier for me because I became accustom to their needs and we could both work together harmoniously, for instance while working on hall 200 there were two ladies who shared a room and also shared the same schedule. I loved seeing them because they made my day so much easier. They both woke up, went to the bathroom and ate at around the same time. They even had certain television shows that they would watch together, it’s almost like they were best friends roomed together. I also met some couples that were in the same room, and I thought that was one of the sweetest things. Most of them act quite similar because they are so used to being by each other side and that helped me out . 10. What is the most difficult thing that you had to do this week? (10 points) I would have to say that the most arduous task I performed this week was when I was assigned to feed a particular resident. Monday morning I was taking breakfast trays to the rooms as I usually do and occasionally I will have to feed residents their meal which is no problem. So when the CNA told me to feed this man I thought alright and headed back to his room. Upon entering I noticed that he was still sleeping so I woke him and raised his bed to a proper eating level. While setting up his tray I tried to start casual conversation with him and I noticed he wasn’t saying anything back so I spoke louder. After my attempts I assumed he was deaf so I began sign language and again no response. Knowing that not every deaf person knows signs I just began to point at breakfast items and show him what I was going to give to him. I took a spoonful of oatmeal and lead it toward his mouth, when all of a sudden he swats his hand at me yelling in Chinese and not wanting any part of what I was doing. It took me back a little because he hadn’t said a word and now he just wouldn’t stop. I pulled the spoon away and calmed him down. After he was settled I pointed at some more of the food items to see if he wanted them or not. Any time I tried to feed him something he would seal his lips and shake his head, after fifteen minutes he knew I wasn’t giving in and he finally ate his food. I just had a really hard time and I felt bad because, I didn’t know what he wanted or didn’t want. The communication barrier between us was so great that I felt lost. Even a persons body language is international and I still feel like he didn’t understand. I’m just so glad that he finally ate and everything worked out nicely.
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Well...I don't understand the question at all. But when I read the summary, I think, this gal is going to be really good at working with these patients. Keep up the good work!
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