PACU (Post Anesthesia Care Unit)

PACU Responsibilities:

• Observe a registered nurse helping patients recover from surgery

New knowledge or skills:

• Information must be repeated to patients is crucial because they are sometimes not aware of what is happening after surgery.
• Monitoring the level of pain from the patient is important in the PACU to determine if additional medication is needed.
• Encourage patients to cough and take deep breaths after surgery is needed to help the patients get back to normal.

Best thing that happened:

• The nurse monitored my heart using a heart monitor and performed an EKG to show me what the machine did. 

Worst thing that happened

• I was not ready to leave when my time was done. I really enjoyed PACU.

This week was: Good

I was able to observe a pediatric patient coming out of surgery which is rare since we are not allowed to interact with pediatric patients. 

Technology Experience Record:

Computer charting

EKG
Heart Monitor
Vital Signs

Diagnostic Procedures Observed:

No diagnostic procedures were observed. 

Therapeutic Procedures Observed:

Pain medication was given to patients after surgery.

Medical Terminology Abbreviations Encountered:

EKG- Electrocardiogram

Appendectomy- Surgical removal of the appendix

PACU Journal:
When I went to the PACU I thought it would be boring since other students had told me that it was not busy. I was surprised to find more than half of the beds were occupied during my rotation. It was going to be a busy day.

The Charge Nurse asked me if I wanted to be hooked up to a heart monitor and she wanted to run an EKG.  It was a training heart monitor and EKG. The nurse was trying to show me how the use the machines. At first I was confused, but it was like a training session. I even received a print out of my heart activity.

The first patient I observed was an older lady. It looked like she had surgery on her foot. Her foot was in a big boot. The nurse that was watching her and was asking her about her level of pain from 1-10. The nurses were dispensing medication. The patient's throat was scratchy and the nurse gave her ice, which should help relieve the scratchy throat.

The charge nurse told me that a pediatric patient was coming out of an appendectomy. The patient came into the room and was hooked up to all of the machines. The nurse was waiting for the doctor's orders for the pain medication. Fifteen minutes went by and she did not receive any orders from the doctor. The nurse seemed confused. She told the Anesthesiologist that she needed orders for pain medication because if the patient woke up, they would be in a lot of pain. Finally after another ten minutes she was able to talk to the doctor. The nurse was glad she received the pain medication orders. The child's parents came into the PACU and I was able to see their reaction. I could tell they were worried but relieved that everything seemed good for their child.

This rotation was great. I would love to go back and observe more. The overall experience was good because I shadowed another good nurse. Every single person in the PACU was passionate about what they did. They were more than willing to teach me about what they were doing.

Medical Surgery 6th Floor Unit

Medical Surgery Unit Responsibilities:

• Observe a registered nurse dealing with patients in medical surgery

New knowledge or skills:

• Repeating information to patients in this unit is important because they are sometimes not aware of what is going on.
• When a patient is a fall risk, they must be checked on constantly for their safety.
• Family requests are accommodated for the comfort of the patients. 

Best thing that happened:

• I observed the nurse dealing with a patient that was suffering from possibly Dementia. The nurse was very willing to help the patient even though they were not aware of what was going on.

Worst thing that happened

• I was disappointed that I could not go into a isolation room. 

This week was: Good

I observed sympathy and empathy by the nurse in the hospital. I was fortunate to have a really good nurse to observe. 

Technology Experience Record:

Computer charting

Patient monitor that alerts the nurse if a patient gets out of the bed

Diagnostic Procedures Observed:

No diagnostic procedures were observed. 

Therapeutic Procedures Observed:

One of the patients received a shot to prevent clotting. 

Medical Terminology Abbreviations Encountered:

IV- intravenous

ABG- arterial blood gas

Medical Surgery Journal:

I went to the 6th floor of the hospital. I was familiar with this unit because I had already observed the 5th floor medical surgery area.  I was assigned a registered nurse to shadow this time. 

I waited outside the patients room because the nurse was already helping the patient drink some chocolate milk. The nurse did some charting and went to assess the patient's mental state. This patient seemed confused and did not know that they were in the hospital. The nurse must have told the patient several times. 

I was surprised that the nurse was so patient in dealing with them.  The nurse told me that the patient had fallen and hit her head. The patient was not acting the same since the fall. The patient was lethargic and unaware of her surroundings. I think the fall might have contributed to her confusion. The IV needed to be replaced because it was leaking. The patient received a shot in the stomach to prevent blood clots. We tried to give the patient her medicine but she kept falling asleep and did not want to take her medicine. 

The next patient was in isolation with the flu. I was disappointed that I could not go into the room. But I understood the reasons why. I noticed on the door there was a droplet precaution. The nurse was putting on gloves and a mask. Even though I did not get to go into the room. I was able to listen to what was going on in the room. 

This rotation was not boring. I was able to observe many things during my time with the nurse. I feel I observed the toughest part of being a nurse, dealing with a patient that was not cooperative. I think this will help me become a better medical physician in the future.