Teacher's comments: During the surgical practice, students strictly abide by the rules and regulations of the hospital, master the preoperative nursing and nursing education of common surgical diseases, understand ECG monitoring and the use of various instruments, and can complete various technical operations under the guidance of teachers, as well as intravenous infusion, oxygen supply and intramuscular injection.
During my internship in general surgery, I fully understood the nursing work of general surgery. Master common nursing techniques in general surgery, such as gastrointestinal decompression, indwelling catheter, indwelling needle in peripheral vein, enema, etc. At the same time, I also learned the postoperative care of appendicitis, hernia and thyroid. Mastered the contents that should be observed after major operations such as gastric cancer, gallstones, colon cancer and rectal cancer. Can independently undertake the preoperative preparation and postoperative care of appendicitis, a common acute abdomen in general surgery. In this internship, I learned that general surgery is a surgical department, which requires nurses to have the emergency ability and strong technical level to deal with a large number of problems in a short time.
In a blink of an eye, more than a month of surgical practice has ended. During the internship, I strictly abide by the rules and regulations of the hospital, earnestly perform my duties as an intern nurse, take Marxism, Mao Zedong Thought and Deng Xiaoping Theory as the guidance, be strict with myself, respect teachers, unite my classmates, care for patients, work hard, and strive to achieve standardized nursing work, high-quality skills service, and flexible basic nursing and caring activities. During my internship, I always take "love, care and patience" as the foundation, and strive to be diligent in eyes, hands, feet and mouth, think about patients' thoughts, worry about patients' urgent needs, and wholeheartedly provide quality services to patients, thus establishing a good medical ethics.
In surgical practice, strictly abide by the department system, attend nursing rounds on time, and be familiar with the patient's condition. Can correctly answer the questions of the teachers, standardize and skillfully carry out various basic nursing operations and specialist nursing operations, correctly carry out the doctor's orders, strictly carry out three checks and seven pairs, and complete the handover records in time. Can do a good job of preoperative preparation and guidance, and complete postoperative care and observation. Problems found in work can be carefully analyzed and solved in time, and various nursing operations can be skillfully performed. For the acute, dangerous, old and serious patients in the department, they can quickly get familiar with the condition and respond. Through study, my theoretical level and practical level have been improved. In the future work, I will continue to work hard, keep in mind the responsibilities of nurses, constantly strengthen ideological and professional study, comprehensively improve my comprehensive level and become a qualified nurse.
Fourth, general surgery internship for three weeks. The first thing to do at the department is to be "busy". Seeing the high medical records on the desk, I know that the internship work in these three weeks must be very busy, but it will also give me more opportunities.
Coming here means often dealing with the operating room, because surgery is the most important thing, and the first day I came, of course, I knew the workflow and my task first. After the first day in a hurry, I understand that being a surgeon is not simple, it requires a solid theoretical foundation and skilled operation. There is a saying that can describe a surgeon well, and that is "bold but cautious, with a solid foundation". There must be a very strict concept here, that is, "sterility", which is responsible for patients and themselves, because there are often places for invasive treatment.
For me, I like being a surgeon from the beginning, so I like this busy job very much. These three weeks have enriched me and let me know what I want, so the first step in doing things is to be interested.
Gastrointestinal Surgery Self-Summary 4 It is a great honor to assign a major surgical internship to Gastrointestinal Surgery. Here, teachers regard us as their sisters, and nurses care about our interns, which makes us feel the warmth of this big family. Let's not talk about it. Let's sum up what we have learned in gastrointestinal surgery in the past two months.
Surgery, mainly surgery. I remember that I was not very busy when I first arrived at gastrointestinal surgery. I may have one or two operations every day, which is basically not a major operation. Under the patient guidance of the teaching teacher, I am trying to cope with it every day. Slowly, the number of operations gradually increased, except for the rest time at noon, from work to work every day. Although busy, I learned a lot. I have practiced a lot from basic operation to specialized operation. Through the correct demonstration and guidance of teachers, many operations have also been standardized. There are mainly CVP measurement, intravenous infusion, intramuscular injection, enema, the use of intravenous indwelling needle, artificial anus nursing and so on. Gastrointestinal surgery is mostly for stomach, intestine, hernia, anal fistula and other operations, and many of them are hospitalized because they are found to be cancer. In this department, we can feel that cancer is getting younger and younger now, and some people only find it as intestinal cancer when they are twenty years old. Life is really precious and should be cherished.
In this department, there are also many family members who ask to keep their illness confidential, which also shows that psychological care of patients is very important. Gastrointestinal surgery is mainly for surgical patients, so special attention should be paid to skin care and drainage tube care. Health education for patients before and after operation also needs our earnest implementation. Especially in diet. Because most operations are gastrointestinal operations, it is generally necessary to wait until the gastrointestinal function is restored. Some family members don't understand, they start eating on the day of operation, or they have been afraid to eat. Therefore, diet health education is very important. In addition, it is necessary to teach patients and their families how to properly care for the drainage tube, prevent the drainage tube from coming out, and observe the color, quantity and nature of the drainage fluid. Observe the patient's condition changes in time.
Surgery is a dynamic department; The teachers in the department are extroverted and treat people well. I hope my future job can be in surgery.
Since joining our hospital in July this year, I have grown from a vague intern to a responsible nurse. Through this period of practical study, I think that if we want to combine the theoretical knowledge we have learned before with clinical practice, on the one hand, we should strictly ask ourselves to consult modestly in our usual work, on the other hand, we should study hard in our spare time to enrich ourselves.
It is still rotating, and there is no fixed department. So I need to study and master the characteristics of each department and its business knowledge more seriously. Now I'm in gastrointestinal surgery, and I've learned something about the stomach. Knowledge of intestinal surgery. I know that preoperative preparation includes psychological counseling, intestinal preparation and dietary guidance. Postoperative vital signs monitoring, incision observation, assistance in coughing and expectoration, observation of infusion volume and infusion speed, nursing of various drainage tubes, nursing of catheter, diet nursing, observation and nursing of postoperative complications, etc. Due to the particularity of patients undergoing gastrointestinal surgery, we are required to communicate with them more patiently in our daily work. Only in this way can we better improve the quality of nursing and make patients trust our work. Although I also had an extragastric internship, the internship and work are really different. Now I feel that what I learned at that time was really not solid enough and systematic enough. Many problems come out after real work. Fortunately, Cory's teacher is very kind to me. They have been patiently helping me and taught me a lot! In the days when I get along with them, every day's work is carried out in an orderly way in coordination.
In recent months, apart from being familiar with the professional knowledge of departments, I also learned how to better maintain the professional image of nurses. Pay attention to polite service in daily work, adhere to civilized language, be dignified, dress neatly, don't wear heavy makeup, don't wear high heels and loud shoes, be polite to patients, have a kind attitude and have standardized language. Seriously study the Regulations on Handling Medical Accidents and its laws and regulations, and actively participate in the learning activities of the Regulations on Handling Medical Accidents organized by the hospital, which enriched the legal knowledge and enhanced the awareness of safety protection. Under the active and serious guidance of the head nurse, I have made great progress and improvement in many aspects. At ordinary times, I insist on participating in the monthly business study of the department, the morning meeting every Monday, the nursing rounds of critically ill patients, and the three-basic training of nursing staff ... In one year's work, I always insist on continuous learning and strive to improve my own quality and emergency ability.
Of course, I also have some shortcomings that need to be improved. For example, in study, sometimes I feel impetuous, I feel that I have too much to learn, and I am impetuous, especially when I encounter setbacks, and I can't handle it calmly. At work, sometimes the standards are very low. Although I can basically perform my duties and obligations, my initiative needs to be further improved. These are all local medicine that I need to improve and improve in the future.
People are always maturing and growing. If I was so impetuous and shaky yesterday, I am more mature and steady today, with a new interpretation of nursing work, a clearer understanding of my responsibilities and burdens, and a better and more focused service for every patient. In the new year, I would like to thank the head nurse and the teaching teacher for their education, guidance, criticism and help, thank everyone who has worked with me, thank you for your kindness, thank you for meeting and knowing each other like this, thank you for your kindness and beauty, and thank you for letting me live in such a warm family! I hope that in the new year, we can still feel the beauty of life and create a better future with * * *!
The summer vacation in another university is coming. I usually like reading quietly. I am not in the school in the resort center, nor in the dormitory. Although the textbook is in my eyes, people have rushed to the building opposite the school, which makes patients feel scared and grateful, and also makes medical students admire and fear.
As we all know, the affiliated hospital of our school is a third-class first-class hospital with high prestige. There are many doctors with excellent medical skills and noble medical ethics in various departments, and gastrointestinal surgery is no exception. Under the guidance of Dr. Tian, the treatments of gastrointestinal surgery are proceeding in an orderly way. For surgery, surgery is the most distinctive and arduous task, and the preparation before operation, careful examination during operation and careful nursing after operation are extremely critical.
Patients in this department are generally admitted to the inpatient department of gastrointestinal surgery by outpatient rough diagnosis, or they can be transferred to other departments for symptomatic treatment because of their complex diseases involving the scope of gastrointestinal surgery. No matter what the source of the disease is, doctors will be serious and responsible for those who stay outside the stomach.
Every time a new patient is admitted to the hospital, the relevant doctor will lead us to do a biopsy. According to the patient's summary, the teacher gave the patient a corresponding examination. For example, the patient complained of abdominal metastatic pain for one year. If the doctor suspects that he has appendicitis, he will deeply press the patient's right lower abdomen to see if there is tenderness and rebound pain in his right lower abdomen. If the patient complains of abdominal pain on one side and can feel a protrusion after standing for half a year, and the doctor suspects that it is an oblique inguinal hernia on one side, he can ask the patient to take the supine position, press the position of superficial inguinal ring by hand, probably above the pubic tubercle of the aponeurosis of the external oblique abdomen, then manually press his abdomen or make the patient cough to increase the abdominal pressure, then release the hand pressing the superficial inguinal ring, increase the abdominal pressure again, and observe the change of the position of the abdominal cavity device; You can also let the patient stand, let him jump, and tell the doctor whether there is a feeling of falling in the abdomen after jumping. These two items can be used as the preliminary diagnostic criteria for indirect inguinal hernia. If the lesion occurs in the front of the neck, the doctor can consider the lymph node metastasis of thyroid tumor or cancer by touching the size, location and quantity of the neck tumor. In order to make a further diagnosis, doctors can perform local anesthesia, biopsy and send samples to the pathology department for examination.
After the doctor's examination, a consultation will be held, and the internship seniors will organize the patient's onset process, current medical history and family genetic history to ask again. After knowing the patient's relevant information, it is necessary to input the patient's information into the computer and file it, and then carry out some routine examinations such as blood, urine, stool routine, electrocardiogram, ct and so on. According to patients of different ages and sexes, the attending doctor will decide whether to perform surgery. If yes, it will be decided whether to operate immediately, selectively or restrict the operation according to the sex, age, physique and severity of the patient's illness.
It is the pride of every surgeon to do every operation beautifully and perfectly. It is the dream of every clinical intern to enter the operating room, and I am one of them. When you arrive at the operating room on the seventh floor with the elevator, you need to change your shoes, socks and clothes, put on sterile surgical clothes, put on a mask and hat, and wash your hands before entering the operating room. The surgeon's sense of responsibility for patients in the affiliated hospital is manifested in the ward, but it is more vividly reflected in the subtle operation.
There was a 5 1 year-old female patient who was suspected to be an abdominal tumor in gastrointestinal surgery, so the doctor in this department operated on her. However, the scene after laparotomy shocked all the doctors present. She does have a tumor the size of a balloon in her abdomen. After careful search and observation, according to the adjacent organs of the tumor, such as bladder, ovary, rectum, vagina, etc., no uterus was found, and it was suspected to be a uterine tumor. Contact immediately at this time. Experts from other departments were also invited to assist in the diagnosis. Finally, after expert consultation, it was diagnosed as hysteromyoma, and the related surgical countermeasures were put forward. The operation time was 10 hour, and the swollen uterus was completely removed. It is admirable that the doctor is so responsible.
After the operation, the staff will count the number of surgical instruments and gauze, then close the abdomen, suture the skin, relieve the anesthesia and send the patient back to the ward.
The operation process is very important, and careful postoperative care is also crucial. In order to avoid postoperative wound infection, patients should be changed once a day, and once every other day or two when the wound heals well. After seven days, stitches can be removed at intervals, and stitches can be removed completely in ten days. According to the amount of negative pressure drainage fluid in the patient's body, when to pull out the negative pressure drainage tube is decided. No matter dressing change, thread removal and extubation, aseptic operation and strict disinfection are needed. After the operation, doctors make rounds every day to observe the condition, and go through the discharge formalities for patients with good wound healing and stable condition, so that they can go home to rest and not be followed up.