Alexander Hobbs – Independent Project

Alexander Hobbs – Independent Project

Class of 2017

Introduction to Topic

If you or your loved one has ever been in a hospital setting, you were most likely cared for by a medical- surgical nurse. Medical-surgical nursing is the largest specialty of nursing currently in the United States. (Nurses, 2017). There are approximately 3.1 million registered and in training medical-surgical nurses. (Nurses, 2017). A medical-surgical nurse is constantly on their feet as they have to care for up to six patients at a time, administer various medications, send different patients to labs and testing, and document all vital signs and health care plans on the computer in a reasonable time during a specific shift. In a hospital setting, medical-surgical nurses offer top of the line care to save lives on the daily which spared my interest and they never know what they are walking into when a new shift begins.

Project Description

For my project, I shadowed in a Medical Surgical Unit at Greater Baltimore Medical Center. My project focuses on the communication struggles on a floor of the hospital and how doctors, nurses, and patients interact during a stay at the hospital. While completing 80 hours of shadowing with Samantha King, a registered nurse, I was able to work hands on with the patient and use a variety of equipment along with understand the daily struggles nurses face dealing with hospital protocol and elderly patients. Through the weeks that I shadowed, I learned the importance of positive nurse interactions with the patients. Once a patient is admitted into the hospital, they get placed under the hands of doctors and nurses and it is their job to revive the patient and do everything they can to improve the poor health conditions.  It was stressed over and over again about the communication systems because a patient’s health conditions could deteriorate at any moment and a rapid response team could need to rush over and save the patient. My innovation provides quick, easy access to the nurse and doctor on call and allows the nurse to check the patient’s condition at any time.

Experience Description

I completed my shadowing experience through the Greater Baltimore Medical Center (GBMC) in the Kaiser/ Ace department. I worked with Samantha A. King who is a registered nurse in this department. On my first day, I was given a tour of the department in which there are twenty-four patient rooms and six of the rooms have the ability to monitor patient’s EKGS and look for signs of arrhythmias. Many of the patients on this floor are elderly individuals and often are being treated for more than one medical issue. There is the medicine dispenser room which has a cabinet with labeled drawers for pills and then a refrigerated section for IV fluid bags or a serum that needs to be kept cold until use. There is also a general storage cabinet for IV tubes, syringes, cups, blankets, and different size needles. Each nurse has their own computer on wheels and a stethoscope.

One of the most interesting patients I got to work with hands on was a women who was in her upper 60’s to mid-70’s and was having extreme respiratory discomfort and was unable to breathe. The patient had been on three liters of oxygen at home but felt like it was not working and felt like she was gasping for air. The patient was in the ICU at St. Joe’s Medical Center but was then downgraded and sent the Greater Baltimore Medical Center because she was a Kaiser patient. The woman had been seen by the respiratory therapist and was given multiple inhalers and a masked treatment but the women complained that it was not working well enough. The doctor ordered a blood gas test in which the amount of oxygen and carbon dioxide in the blood is measured. The blood gas requires a small sample of blood to be drawn for an artery usually in the wrist. The blood gas sample will be drawn by the phlebotomist and it must be analyzed within 10 minutes of the procedure taking place in order to be read accurately. This woman seemed to have pretty normal results other than a few carbon dioxide levels. The women was gasping for air so they put her on continuous pulse oximetry which means her pulse and oxygen level were constantly being measured and being displayed on the nursing station. The woman’s oxygen level dropped to 73 even though she was on 5 liters of oxygen and her pulse was dropping below 60 beats per minute consistently. The doctor immediately knew something was wrong because a patient should be breathing almost perfectly if they are on 5 liters of oxygen. There are not allowed to be any patients on continuous pulse oximetry for more than a few hours on the floor so the nurse and doctor decided the patient was going to need to be upgraded to the intensive care floor. The doctor contacted the admitting doctor on the intensive care floor and they said they would have a bed ready for her within the next thirty minutes. The doctor had ordered Heparin for the patient with is a shot that prevents blood clotting but a lot of people develop bleeding with it. This patient refused the shots but the doctor explained to her that since she is just lying in a hospital bed, she really did need it to prevent blood clots. It was decided the patient was going to be upgraded to the SICU unit which is the Surgical Intensive Care Unit and is designed to provide impatient care for critically ill patients on surgical devices. The nurse and I helped gather the patient’s belongings together and the admitting resource nurse in the intensive care unit came down and hooked the patient up to a more intense vital sign and EKG monitor. The nurse I was shadowing then finished the documentation for morning medicine before the patient left the floor because once the patient was gone; it would then be the intensive care nurse’s job to document progress. I then helped the nurse disconnect the bed and begin to transport the patient up to the Surgical Intensive Care Unit. We went into the patient elevator which is large enough to fit the stretcher and we went up to the third floor. We then entered the Surgical Intensive Care Unit which is a locked unit in the hospital and pushed her stretcher into the room. I had never seen an intensive care unit before but these patients are much more ill then in regular rooms and the rooms are fully equipped with computers, sofas, sinks, tubing, and multiple monitors. We met the new nurses and we helped our patient get cleaned up, change into new scrubs, and get transferred from the Unit 35 bed to the intensive care unit bed. The nurse I shadowed then gave the intensive care in-charge nurse a bedside report which consists of the conditions the patient came in with, actions the unit 35 nurses and doctors took and the current conditions of the patient. Compared to other patients on the floor, she seemed to be much more alert but she had to be upgraded again due to the fact that no patient can be on continuous pulse oximetry. On the way up to the Surgical Intensive Care Unit, the patient’s husband was complaining that he could not walk down the long hallway so the nurse I was shadowing asked if I could push him in a wheelchair, so I went down to the second floor, got the wheelchair, and then dropped him off at the waiting room in the intensive care unit. This was a memorable moment for me because it was a situation in which the nurses and doctors were contemplating calling a rapid response team for and the patient was sent to an Intensive Care Unit which allowed me to see another unit of the hospital and a different perspective of nursing because those patients are much more critical.

I have had my heart set on becoming a nurse after the death of my grandmother because she was a nurse and saved so many patients’ lives. I was so grateful to be able to shadow a registered nurse and see firsthand what the job is like and if it was something I truly wanted to do for the rest of my life. It was amazing to see young and older women and men saving patients’ lives and recommending medication that healed a patient within days. I was not sure how I would do with needles and bodily fluid but I honestly had no problems at all and the nurse I shadowed allowed me to be hands on with the equipment taking vital signs and using the computer software. I definitely want to become a registered nurse and I am also interested in investigating the life of a pediatric nurse.

Innovation Description

Going off my other journals and shadowing experience, I came to an innovation idea. One of the issues I noticed throughout my time shadowing was how the hospital communicates with one another and with other teams of doctors and departments. Each nurse, therapist, and doctor has a phone type device that has other numbers on it to places throughout the hospital and allows for text messages. However, these devices are extremely outdated, need to be charged often, and don’t always connect to the signals throughout the hospital based on what floor you are on and if you are in a closed room or not. (King, 2017). This is a problem because nurses try and call doctors when new symptoms arise or call the pharmacy when they quickly need medicine delivered to a room. Also it is extremely unsanitary because the workers hold the device up to their ear or text while in the patient’s room and then do not wipe them off and then out them in their pocket which with apps these days may not be able to be avoided but it would be better if the systems were updated and they didn’t have to touch buttons as often or the devices could have less areas where germs and bacteria could build up and become extremely unsanitary. My innovation is an app that can connect the patient to the nurses and doctors easier because currently they have big white phones in the room that barely work and stretch like a foot from the wall. It will allow the patient to message the nurse and tell them what they need such as pain medication or food even if the nurse is in a different room and can even call the nurse’s station if there is an immediate emergency. It will also allow the patient’s family to schedule future doctor appointments at outpatient care facilities along with ordering food directly from the room instead of having to call because some patients cannot communicate that well. This will hopefully allow communication to run smoothly since there are so many patients needing different things at once and there is only one nurse per so many patients so they cannot be taking care of everyone at once.

To create my innovation, I used Microsoft PowerPoint to create a slideshow that would mimic an app and that could then be presented on an iPad. I spent the first five hours creating the baseline of the app which consisted of choosing a background color that would appeal to different audiences and also choosing colors that would not cause pain to a patient’s eyes, deciding how many subpages would be included in my app, choosing a layout that would be easy to use for an ill patient along with their family, and including accurate hospital information such as nurse contact information missions for the hospital, and a pain scale that could be managed by all. I then got my app reviewed by peers and my mentor for 2 hours and I was given specific advice such as the order of the slides, different ways to add hyperlinks, and updating certain information. The last 3 hours has been me going back and revising my slides, adding hyperlinks to make it flow like an app, getting advice from family and neighbors, and creating an app that looks professional along with doing research that shows my app is better and innovative then anything that currently exists.

+ Project Topic

Introduction to Topic

If you or your loved one has ever been in a hospital setting, you were most likely cared for by a medical- surgical nurse. Medical-surgical nursing is the largest specialty of nursing currently in the United States. (Nurses, 2017). There are approximately 3.1 million registered and in training medical-surgical nurses. (Nurses, 2017). A medical-surgical nurse is constantly on their feet as they have to care for up to six patients at a time, administer various medications, send different patients to labs and testing, and document all vital signs and health care plans on the computer in a reasonable time during a specific shift. In a hospital setting, medical-surgical nurses offer top of the line care to save lives on the daily which spared my interest and they never know what they are walking into when a new shift begins.

+ Project Overview

Project Description

For my project, I shadowed in a Medical Surgical Unit at Greater Baltimore Medical Center. My project focuses on the communication struggles on a floor of the hospital and how doctors, nurses, and patients interact during a stay at the hospital. While completing 80 hours of shadowing with Samantha King, a registered nurse, I was able to work hands on with the patient and use a variety of equipment along with understand the daily struggles nurses face dealing with hospital protocol and elderly patients. Through the weeks that I shadowed, I learned the importance of positive nurse interactions with the patients. Once a patient is admitted into the hospital, they get placed under the hands of doctors and nurses and it is their job to revive the patient and do everything they can to improve the poor health conditions.  It was stressed over and over again about the communication systems because a patient’s health conditions could deteriorate at any moment and a rapid response team could need to rush over and save the patient. My innovation provides quick, easy access to the nurse and doctor on call and allows the nurse to check the patient’s condition at any time.

+ Experience

Experience Description

I completed my shadowing experience through the Greater Baltimore Medical Center (GBMC) in the Kaiser/ Ace department. I worked with Samantha A. King who is a registered nurse in this department. On my first day, I was given a tour of the department in which there are twenty-four patient rooms and six of the rooms have the ability to monitor patient’s EKGS and look for signs of arrhythmias. Many of the patients on this floor are elderly individuals and often are being treated for more than one medical issue. There is the medicine dispenser room which has a cabinet with labeled drawers for pills and then a refrigerated section for IV fluid bags or a serum that needs to be kept cold until use. There is also a general storage cabinet for IV tubes, syringes, cups, blankets, and different size needles. Each nurse has their own computer on wheels and a stethoscope.

One of the most interesting patients I got to work with hands on was a women who was in her upper 60’s to mid-70’s and was having extreme respiratory discomfort and was unable to breathe. The patient had been on three liters of oxygen at home but felt like it was not working and felt like she was gasping for air. The patient was in the ICU at St. Joe’s Medical Center but was then downgraded and sent the Greater Baltimore Medical Center because she was a Kaiser patient. The woman had been seen by the respiratory therapist and was given multiple inhalers and a masked treatment but the women complained that it was not working well enough. The doctor ordered a blood gas test in which the amount of oxygen and carbon dioxide in the blood is measured. The blood gas requires a small sample of blood to be drawn for an artery usually in the wrist. The blood gas sample will be drawn by the phlebotomist and it must be analyzed within 10 minutes of the procedure taking place in order to be read accurately. This woman seemed to have pretty normal results other than a few carbon dioxide levels. The women was gasping for air so they put her on continuous pulse oximetry which means her pulse and oxygen level were constantly being measured and being displayed on the nursing station. The woman’s oxygen level dropped to 73 even though she was on 5 liters of oxygen and her pulse was dropping below 60 beats per minute consistently. The doctor immediately knew something was wrong because a patient should be breathing almost perfectly if they are on 5 liters of oxygen. There are not allowed to be any patients on continuous pulse oximetry for more than a few hours on the floor so the nurse and doctor decided the patient was going to need to be upgraded to the intensive care floor. The doctor contacted the admitting doctor on the intensive care floor and they said they would have a bed ready for her within the next thirty minutes. The doctor had ordered Heparin for the patient with is a shot that prevents blood clotting but a lot of people develop bleeding with it. This patient refused the shots but the doctor explained to her that since she is just lying in a hospital bed, she really did need it to prevent blood clots. It was decided the patient was going to be upgraded to the SICU unit which is the Surgical Intensive Care Unit and is designed to provide impatient care for critically ill patients on surgical devices. The nurse and I helped gather the patient’s belongings together and the admitting resource nurse in the intensive care unit came down and hooked the patient up to a more intense vital sign and EKG monitor. The nurse I was shadowing then finished the documentation for morning medicine before the patient left the floor because once the patient was gone; it would then be the intensive care nurse’s job to document progress. I then helped the nurse disconnect the bed and begin to transport the patient up to the Surgical Intensive Care Unit. We went into the patient elevator which is large enough to fit the stretcher and we went up to the third floor. We then entered the Surgical Intensive Care Unit which is a locked unit in the hospital and pushed her stretcher into the room. I had never seen an intensive care unit before but these patients are much more ill then in regular rooms and the rooms are fully equipped with computers, sofas, sinks, tubing, and multiple monitors. We met the new nurses and we helped our patient get cleaned up, change into new scrubs, and get transferred from the Unit 35 bed to the intensive care unit bed. The nurse I shadowed then gave the intensive care in-charge nurse a bedside report which consists of the conditions the patient came in with, actions the unit 35 nurses and doctors took and the current conditions of the patient. Compared to other patients on the floor, she seemed to be much more alert but she had to be upgraded again due to the fact that no patient can be on continuous pulse oximetry. On the way up to the Surgical Intensive Care Unit, the patient’s husband was complaining that he could not walk down the long hallway so the nurse I was shadowing asked if I could push him in a wheelchair, so I went down to the second floor, got the wheelchair, and then dropped him off at the waiting room in the intensive care unit. This was a memorable moment for me because it was a situation in which the nurses and doctors were contemplating calling a rapid response team for and the patient was sent to an Intensive Care Unit which allowed me to see another unit of the hospital and a different perspective of nursing because those patients are much more critical.

I have had my heart set on becoming a nurse after the death of my grandmother because she was a nurse and saved so many patients’ lives. I was so grateful to be able to shadow a registered nurse and see firsthand what the job is like and if it was something I truly wanted to do for the rest of my life. It was amazing to see young and older women and men saving patients’ lives and recommending medication that healed a patient within days. I was not sure how I would do with needles and bodily fluid but I honestly had no problems at all and the nurse I shadowed allowed me to be hands on with the equipment taking vital signs and using the computer software. I definitely want to become a registered nurse and I am also interested in investigating the life of a pediatric nurse.

+ Innovation

Innovation Description

Going off my other journals and shadowing experience, I came to an innovation idea. One of the issues I noticed throughout my time shadowing was how the hospital communicates with one another and with other teams of doctors and departments. Each nurse, therapist, and doctor has a phone type device that has other numbers on it to places throughout the hospital and allows for text messages. However, these devices are extremely outdated, need to be charged often, and don’t always connect to the signals throughout the hospital based on what floor you are on and if you are in a closed room or not. (King, 2017). This is a problem because nurses try and call doctors when new symptoms arise or call the pharmacy when they quickly need medicine delivered to a room. Also it is extremely unsanitary because the workers hold the device up to their ear or text while in the patient’s room and then do not wipe them off and then out them in their pocket which with apps these days may not be able to be avoided but it would be better if the systems were updated and they didn’t have to touch buttons as often or the devices could have less areas where germs and bacteria could build up and become extremely unsanitary. My innovation is an app that can connect the patient to the nurses and doctors easier because currently they have big white phones in the room that barely work and stretch like a foot from the wall. It will allow the patient to message the nurse and tell them what they need such as pain medication or food even if the nurse is in a different room and can even call the nurse’s station if there is an immediate emergency. It will also allow the patient’s family to schedule future doctor appointments at outpatient care facilities along with ordering food directly from the room instead of having to call because some patients cannot communicate that well. This will hopefully allow communication to run smoothly since there are so many patients needing different things at once and there is only one nurse per so many patients so they cannot be taking care of everyone at once.

To create my innovation, I used Microsoft PowerPoint to create a slideshow that would mimic an app and that could then be presented on an iPad. I spent the first five hours creating the baseline of the app which consisted of choosing a background color that would appeal to different audiences and also choosing colors that would not cause pain to a patient’s eyes, deciding how many subpages would be included in my app, choosing a layout that would be easy to use for an ill patient along with their family, and including accurate hospital information such as nurse contact information missions for the hospital, and a pain scale that could be managed by all. I then got my app reviewed by peers and my mentor for 2 hours and I was given specific advice such as the order of the slides, different ways to add hyperlinks, and updating certain information. The last 3 hours has been me going back and revising my slides, adding hyperlinks to make it flow like an app, getting advice from family and neighbors, and creating an app that looks professional along with doing research that shows my app is better and innovative then anything that currently exists.

By | 2017-05-15T15:41:41+00:00 May 15th, 2017|Biomed Capstone Project 2017|0 Comments

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