Hypertension, arrhythmia, coronary heart disease and heart failure are the most common diseases in cardiology. Common diseases include coronary heart disease, hypertension, arrhythmia, atrial fibrillation, paroxysmal supraventricular tachycardia, heart failure, myocarditis, congenital heart disease, cardiomyopathy, atrial septal defect, rheumatic heart disease, myocardial infarction, angina pectoris, acute infective endocarditis, myocardial ischemia and other symptoms. During my internship, under the guidance of my teacher, I basically mastered some common diagnostic methods, such as the determination and significance of troponin and myoglobin, the meaning represented by the data on the report of cardiac color Doppler ultrasound, and the change and significance of electrocardiogram. Treatment measures, commonly used drugs to rescue patients with heart failure, commonly used instruments. Learn to use defibrillators and master the working principle of temporary pacemakers.
Every morning, we interns go to the department early to take the blood pressure of each patient. Blood pressure is often used as a very important basis for patients' response to drug treatment, so the accuracy of measurement is very important. I put two fingers on my elbow, put a stethoscope on the brachial artery pulse, and then measure it. Because the arterial pulse of some critically ill patients is very weak, and the blood pressure can't be measured by nonstandard measurement methods, there was a patient in my internship: heart failure, and the pulse was very weak, so I went to measure the blood pressure.
Then I learned more about the fragility of life in cardiology. During this month in the Department of Cardiology, I experienced three major rescues. Once when I was on duty with my teacher, my ventricle escaped. First, pump dopamine continuously and push adrenaline. All medical staff take turns to perform external cardiac compressions, seize the time to defibrillation and install temporary pacemakers. This process is directly a process of fighting. When the patient stabilized a little, it was already past 1 o'clock in the morning. Another time, a patient had a massive myocardial infarction. When the nurse arranges the bed, the patient has myocardial infarction, rescue, defibrillation, intubation, continuous pumping of dopamine and adrenaline. All the medical staff took turns to perform external cardiac compression, defibrillation and temporary pacemaker installation, but the patient just left. Arriving at the ward at eleven o'clock, a life ended at one o'clock. The child's sad cry is really distressing.
I left school, but I have a lot to give up. I feel that I haven't learned enough, and I still have a lot to learn. But the internship arrangement and weekly internship arrangement are also orderly, so let's learn and grow step by step. At the same time, it also made me know more about professionalism. In this month, I strictly abide by the rules and regulations of hospitals and departments, earnestly perform the duties of interns, be strict with myself, respect teachers, unite with classmates, work hard and care for patients. Don't be late, don't leave early, and strive to be standardized in work, integrate theory with practice, study theory in a planned and focused way, and have measures and records in work. I will constantly improve my professional knowledge, keep in mind the teacher's teaching and internship experience, and keep learning and making progress. At the same time, I will apply these experiences and teachings to the next internship department and strive to do better.
Summary of Cardiology 2 A short month is coming, and the internship of Cardiology is coming to an end. In this month, under the hard guidance of teachers, I have benefited a lot through constant practice. Among them, there are bitterness and joy, and there are sour and sweet. I believe that everyone has their own taste in their hearts and is about to leave the department, but there are also many disappointments. I feel that I haven't learned enough, and I still have a lot to learn. But here, teachers in Cory attach great importance to it, and the weekly internship arrangement is also very orderly, so let us learn and grow step by step. At the same time, it also let us know the professionalism.
During my internship, I will strictly abide by the rules and regulations of hospitals and departments, earnestly perform my duties as a nurse, be strict with myself, respect teachers, unite my classmates, work hard and care for patients. Don't be late, don't leave early, and strive to achieve standardized nursing work, high-quality skill service, flexible basic nursing, regular love activities, combination of theory and practice, planned and focused theoretical study, and measured and recorded nursing work.
Hypertension, arrhythmia, coronary heart disease and heart failure are common diseases in cardiology. Common diseases include coronary heart disease, hypertension, arrhythmia, atrial fibrillation, paroxysmal supraventricular tachycardia, heart failure, myocarditis, congenital heart disease, cardiomyopathy, atrial septal defect, rheumatic heart disease, myocardial infarction, angina pectoris, acute infective endocarditis, myocardial ischemia and other symptoms. During the internship, under the guidance of the teacher, I basically mastered the nursing and basic operation of some common diseases. Attend the shifts arranged by the hospital and the teaching rounds of departments on time; Welcome the new patient with a smile. Actively cooperate with doctors, take the initiative to understand the patient's situation, solve problems for patients in time, and try our best to help them.
After nearly a month's internship in cardiology, I have re-recognized and improved the diagnosis and treatment of common and frequently-occurring diseases in internal medicine, and learned the knowledge and skills to deal with sudden diseases. In a word, I benefited a lot from my internship in cardiology. Although I am only a student with limited ability, I will continue to explore, warm patients' hearts with smiles and enrich my knowledge and skills with efforts. Review the old and learn the new, and consolidate what you have learned with practice. At the same time, I constantly improve my professional level and enrich my professional knowledge.
In a word, although I have only experienced for a month, there may still be many things I haven't really realized, but I respect all the medical staff in the Department of Cardiology very much and like their superb technology and professionalism. I think, now is the beginning of internship, which is both a challenge and an opportunity. I will constantly improve my professional knowledge, keep in mind the teacher's teaching and internship experience, keep learning and making progress, and apply these experiences and teachings to the next internship department to do better.
Summary of Cardiology Chapter III During my three months in Cardiology, I always feel that I have not learned as much as I expected.
I just arrived at the Department of Cardiology, and I am catching up with the professional doctor exam. After listening to Mr. Zhang Mingguo's electrophysiology picture, I feel that I hate being late for the meeting. I feel that if I had listened to these pictures a month earlier, the pharmacological effects of various drugs for controlling arrhythmia would not have been so painful, and the ECG changes corresponding to infarctions in various parts of the heart could also be clearly seen through deduction.
But soon I was assigned to another senior who just decided to study, and the next day was an all-out exam. After the exam, it seems that I no longer have the motivation to study. Because of the limited skills and the relatively limited things taught by the seniors, I stayed in the Department of Cardiology for more than two months. If you leave the department, you will only have hypertension and coronary heart disease. It's really a heart attack. I haven't figured out when to thrombolysis and when to be conservative!
In the department of cardiology, my biggest exercise is working at night. Generally, nurses only call the rotating doctor at night when patients have problems. Therefore, patients must learn to judge the severity of their illness, know what to do and when to call undergraduate doctors when they have an emergency at night.
In the department of cardiology, I also had my first illness since I joined the work-"upper sensation". It's strange to be sick. It is worth remembering that I didn't catch a cold after a night shift. I felt uncomfortable in my throat the next day, and started to have a runny nose, fever and sore throat on the third day. The most terrible thing is that the exam is only a week away, and only desperate people will use antibiotics immediately. Fortunately, the infection was suppressed during the exam, and there was no fever and stuffy nose, just a sore throat.
Summary of Cardiology 4 In a blink of an eye, I have finished my study life for one year. I reluctantly left Anhui Provincial Hospital of Traditional Chinese Medicine, but I returned to work in Anhui Provincial Hospital of Integrated Traditional Chinese and Western Medicine with more confidence. First of all, I am very grateful to the leaders of Anhui Hospital of Integrated Traditional Chinese and Western Medicine for giving me this opportunity for further study and holding the idea of cultivating talents. At the same time, I also thank the teachers of Cardiovascular Department of Anhui Provincial Hospital of Traditional Chinese Medicine for their tireless teaching. The intense and substantial study time always flies. During my study, I studied with an open mind and worked hard, which was praised by the teachers in the learning department. Through this year's further study, I have gained a lot, not only improving my clinical professional and technical level, but also broadening my horizons and ideas. Take this opportunity for further study and talk about some of my own experiences.
Cardiovascular medicine consists of outpatient department, ward, ECG workstation, cardiac intensive care unit and cardiac catheterization room. At present, it has advanced multi-functional intensive care system, 24-hour ambulatory ECG blood pressure monitor, electrocardiograph, defibrillation pacemaker and other equipment, which can carry out invasive and non-invasive series of monitoring, examination and treatment, and has carried out permanent and temporary pacemaker installation, coronary angiography, percutaneous coronary intervention (PCI) and aortic balloon counterpulsation. It has reached the domestic advanced level in the prevention and treatment of angina pectoris, acute myocardial infarction, chronic cardiac insufficiency, arrhythmia, hypertension, dyslipidemia, viral myocarditis and cardiomyopathy. In particular, the application of self-developed hospital preparations such as "Gan Yang Yishui Granule", "Tiaopi Huxin Formula" and "Yishui Huoxue Decoction" has given full play to the characteristics and advantages of traditional Chinese medicine, treating both the symptoms and root causes with few side effects, and is favored by the majority of patients.
In the process of further study, under the guidance of teachers, I have mastered the diagnosis and treatment of common cardiovascular diseases such as coronary heart disease, angina pectoris, acute myocardial infarction, chronic heart failure, arrhythmia, hypertension, viral myocarditis and cardiomyopathy, and improved the application of traditional Chinese medicine in cardiovascular diseases. The level of diagnosis and treatment of acute, dangerous and difficult cases has been improved; Familiar with the routine drugs and use of cardiovascular diseases; Be able to use ECG independently and master the key points of ECG reading and writing; Understand the process of coronary intervention; Standardize the writing of clinical electronic medical records and the treatment of newly diagnosed patients. Improve the theoretical knowledge and clinical skills of cardiology.
In the further study, I realize that the development of the department needs excellent professional skills, good service attitude, the consciousness of unity and cooperation of the department staff and the strong support of the hospital leaders.
Although the study time is limited, there are still many deficiencies in medical theoretical knowledge and clinical professional skills, which need to be further improved. However, this further study has made me fully understand myself and has had a great impact on my future work. I will make full use of this knowledge in my future work, strengthen my study and progress in my own shortcomings, play my role in the clinical work of our hospital and contribute my strength to the development of our hospital.
Summary of Cardiology Department From July 20xx to July 20xx, I was very lucky to get the training opportunity of clinical pharmacy for cardiovascular specialty in Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology. After a year of intensive training, I have some humble opinions on clinical pharmacy of cardiovascular specialty. Now I will make a summary of my study experience in the past year and share it with my colleagues.
1 Difficulties and problems faced
1. 1 Lack of basic medical knowledge
Clinical pharmacists are clinical professional technicians who are based on the professional knowledge of systematic pharmacy, have certain clinical medical knowledge, are familiar with the nature and function of drugs, understand the requirements and characteristics of disease treatment, participate in designing rational drug use schemes, and ensure rational drug use. I graduated from a pharmaceutical college, majoring in pharmacy. Since joining the work, I have been engaged in the preparation of drugs, as well as prescription analysis, adverse reaction report collection, drug publicity and so on. Although I have participated in the clinical pharmacy work of cardiovascular internal medicine in our hospital for a short time, I lack basic medical knowledge and theoretical knowledge of clinical medicine. Therefore, as a new clinical cardiologist with strong professional knowledge, many professional terms are unfamiliar, and some diseases are only known by their names, which is very stressful.
1.2 has a pharmaceutical foundation, but lacks clinical experience in comprehensive application of pharmaceutical knowledge.
After graduation, I am mainly engaged in routine work in pharmacy, and there are few opportunities for further study and further study. However, the new progress and new technology in the field of pharmacy are changing with each passing day, and my knowledge of pharmacy is gradually aging. As a pharmacist, I should be very familiar with the current situation and progress of my professional knowledge, but when I entered the clinic, I found that a lot of knowledge about drug application needed to be obtained from doctors. For example, clinical treatment guidelines for various diseases and experts' latest knowledge of drugs. I deeply feel the professional crisis as a pharmacist.
1.3 Lack of communication skills with doctors, nurses and patients.
I didn't know how to communicate with doctors, nurses and patients when I first started to participate in clinical pharmacy work in cardiovascular medicine. I lack self-confidence, I am at a loss, I don't know what information to get, and I don't even know the way to communicate with patients. I learned a lot from clinicians.
2 Countermeasures to solve the problem
2. 1 Enrich clinical medical knowledge
Before the training, I carefully read the document "Training Outline for Clinical Pharmacists in Cardiovascular Department", which has certain requirements for mastering clinical medical knowledge. In order to make up for the lack of clinical medical knowledge as soon as possible, I first read the ECG chapter of Diseases and Diagnostics of Internal Circulation System by myself, and then reviewed the book with emphasis and pertinence, so that I could systematically understand the concept, pathogenesis, principles of drug treatment and the best choice.
2.2 Update the knowledge of clinical pharmacy
Pharmaceutical knowledge is the content that clinical pharmacists must focus on and study deeply. Only when clinical pharmacists are proficient in pharmacology and skillfully use these pharmaceutical knowledge can they provide needed pharmaceutical services for clinicians and patients and reflect their clinical responsibilities and values. There are many kinds of drugs used in Union Medical College Hospital. Therefore, firstly, we should carefully understand the drug use of circulatory system diseases in Union Medical College Hospital, and then review and update the mechanism, contraindications, pharmacokinetics and precautions of commonly used antihypertensive drugs, hypolipidemic drugs, antiplatelet drugs and drugs for heart failure, so as to learn to choose and use drugs according to the condition. Meet new and old knowledge points, often discuss with teachers or students, and be good at summing up in learning.
2.3 Training clinical practice skills
Participate in daily rounds, consultations and case discussions in the ward in charge; Participate in the discussion of drug treatment plan; Pharmacist rounds, pharmaceutical care, writing medicine calendar for key patients; Participate in the treatment and consultation of critically ill patients; Participate in weekly hospital quality rounds; Educate and guide patients to use drugs rationally, and improve patients' compliance with drugs. Special attention is paid to the skills training of cardiovascular specialty, such as the skills of collecting medical history in detail, simple physical examination in specialty, learning to measure blood pressure correctly, learning simple heart auscultation and lung auscultation, and cultivating ECG reading skills.
2.4 Expand clinical thinking
Clinical thinking refers to the thinking activity of using medical and other related disciplines, taking patients as the center, collecting medical history, physical examination and necessary laboratory examination through full communication, obtaining first-hand information, and making judgmental analysis, synthesis, analogy, judgment and differential diagnosis of all kinds of information with the help of all available best evidence and information, thus forming an individualized diagnosis, treatment, rehabilitation and prevention plan, and implementing and correcting it. Pharmacists' consideration is often limited to the drug itself and rarely combined with clinical practice. A qualified clinical pharmacist must make a drug treatment plan under the condition of fully grasping the patient's clinical data and detailed medication information, monitor the curative effect and adverse reactions during the treatment, analyze the reasons for the poor curative effect and the methods to improve the curative effect. In order to update clinical knowledge and know the latest drug information, he actively participated in various academic lectures and conferences within one year, and * * * attended more than 50 conferences and lectures.
2.5 Develop effective communication skills with doctors, nurses and patients.
The working mode of clinical pharmacists is doctor-oriented, nurse-oriented and patient-oriented. The most important thing in clinical pharmacy is communication. I believe many clinical pharmacists have a deep understanding. Communication skills are very important for the work of clinical pharmacists to be recognized by doctors and nurses. Although communication is very important, we still need to explore slowly and find ways to make doctors or nurses accept it. The author believes that as clinical pharmacists, we have the responsibility to make reasonable suggestions, because this is our job, but we must never communicate with doctors by preaching or criticizing, but we should discuss or learn modestly, which may achieve better results. For potential or actual medication problems found in clinical practice, in clinical departments, talk to doctors first; For senior doctors, participate in their work with a consulting attitude. Moreover, you need to consult relevant documents and books before communication, and you can't ask for advice without thinking.
3 Experience and experience
3. 1 Correct learning attitude
Learning theoretical knowledge is rather boring. First of all, we should correct our study attitude and ensure sufficient study time. Cardiovascular English, especially the abbreviations of various diseases, is also very important for clinical pharmacists, because doctors often use professional English abbreviations when writing medical records, such as electrocardiogram, UCG, coronary heart disease, ACS, PCI, NT-proBNP, LVEF, AVNRT, ICD, AMI, etc. Therefore, the teaching teacher has made a strict study plan for cardiovascular English, which will let patients come to the hospital for daily English conversation.
3.2 Pay attention to learning methods
Learning should also pay attention to methods. For example, when learning textbooks of internal medicine and diagnostics, don't skip reading, but try to understand word by word, because the knowledge points in the book echo each other step by step. If you skip the part that is considered unimportant and read a page, a certain concept will appear, which is time-consuming and incoherent.
When learning the diagnosis and treatment of cardiovascular diseases, we should firmly grasp the concepts of various diseases, because often the concepts contain information related to the diagnosis and treatment of this disease. In addition, ECG is the most important non-invasive examination technique for diagnosing circulatory diseases. When studying, we should pay special attention to the waveform characteristics and normal values of each lead of normal ECG, and it is best to firmly remember the waveform characteristics and normal values of each lead of normal ECG; As long as you look at the patient's ECG, you can immediately reflect the difference between the waveforms of each lead and the normal ECG waveform, which is conducive to the correct diagnosis of the disease. In addition, teachers should listen more, remember more and ask more questions every morning to strengthen their perceptual knowledge of diseases. Listening more means that the knowledge points mentioned by doctors during rounds are aimed at patients, but they are chaotic for pharmacists. No matter how difficult it is, as long as you pay attention and repeat it, your understanding will be enhanced. Remember more, refers to the technical terms you don't understand and the meaning of the patient's test results to the disease. When doctors and patients ask questions about drugs, if they can't give explanations, they should also record them in time for future investigation. Ask more questions, that is, when you are in ward rounds or reading a book, you will encounter unfamiliar clinical medical problems and ask them carefully. After all, the majors are different, and the interlacing is like a mountain.
3.3 Participate in clinical medication practice
Clinical pharmacists are the bridge between doctors, nurses and patients and a member of the treatment team. In the treatment, we should not only give full play to professional knowledge to ensure the safety and effectiveness of patients' medication, but also help doctors and nurses improve their medical level and help patients improve their medication compliance. Clinical pharmacy has just started in China. As pioneers and practitioners, we have a long way to go. As a clinical pharmacist, only by constantly strengthening professional study and improving their own quality can they meet the clinical needs. Only in this way can we provide comprehensive and high-quality pharmaceutical services for patients, doctors and nurses.
Cardiology 6 Summary In the past two months, with the care and patience of the teacher, I have learned a lot of things that I didn't know in class. In the days of practical study, I learned the general process of treating patients: for example, measuring vital signs; Ask about the patient's medical history, allergy history, etc. Write nursing records carefully, observe the patient's condition at the same time, cooperate with the teacher's guidance, and understand the basic application of antibiotics to each digestive system.
In the process of practical study, we should strictly abide by the rules and regulations of the hospital and various departments, earnestly perform the duties of nurses, be strict with ourselves, respect teachers, unite with classmates, work hard and think of patients wholeheartedly. At the same time, we can understand family members, correctly handle the relationship between nurses and patients, do a good job of explanation and comfort, say "I'm sorry" more, let family members understand the work of nurses, and reduce unnecessary misunderstandings or excessive behaviors.
Hypertension, arrhythmia, coronary heart disease and heart failure are common diseases in cardiology. Under the guidance of the teacher, I have basically mastered the nursing and basic exercises of some common diseases. Welcome new patients with a smile and do a good job in admission evaluation; Closely monitor vital signs and standardize records; Collect blood and urine samples correctly; Actively cooperate with doctors for treatment; Strictly implement three checks and seven pairs; Seriously carry out intravenous infusion ... while constantly learning and summing up experience, I can be diligent in observation, be good at observing the patient's condition, grasp the changes of the condition in time, and make accurate judgments. Although the time is not long these days, I have been exposed to a lot of professional knowledge and skills that I didn't know before, and I have picked up a lot of operating techniques again, such as aseptic principle, oxygen application and five settings of rescue vehicle.
In a word, I think I have learned a lot from my practical study during this period. Although I am only a student, maybe my ability is limited, I use my efforts to enrich my knowledge and skills, hoping to send patients away with my smile and desire for success in learning. This is only the beginning of practical learning, a challenge and an opportunity. I must apply what I have learned to the next practical learning department, keep in mind the teacher's teaching, keep learning and make progress. At the same time, I would like to thank the patients in our department for their cooperation in my treatment. As the saying goes, patients are teachers. I hope everything goes well at the next stop.
Summary of Cardiology Section 7 Cardiology Practice is coming to an end. During this period, I strictly abide by the rules and regulations of hospitals and departments, strictly demand myself, unite with classmates, respect teachers, be strict with myself, have a correct attitude towards learning, have a rigorous work style, listen carefully to teachers' teachings, and always integrate theory with practice. Under the patient guidance of the teaching teacher, I successfully completed the internship tasks and requirements of the undergraduate course, and basically mastered the nursing and basic knowledge of some common diseases in the undergraduate course. Cardiology is mainly some circulatory diseases with the highest mortality. Because of the complex diseases in cardiology, the symptoms are often atypical. If you don't observe carefully, ask patiently and give feedback to the doctor in time, you will delay your illness and must follow strict medication guidelines. Patients with heart disease should strictly control the number of drops and monitor their blood pressure and pulse according to the doctor's advice. Because the therapeutic dose of some drugs in cardiology is quite close to the toxic dose, we should pay close attention to the patients' reactions before and after taking the drugs. Because of the short practice time, the teacher first introduced me to the normal electrocardiogram, and then explained the common abnormal electrocardiogram in clinic. Combined with the actual ECG of clinical patients, I deepened my impression and explained it repeatedly until I could correctly identify some common ECG and teach me the common sense of monitoring instruments.
During this month's internship, I have been practicing and studying in the inpatient department, but I have seen many diseases and all kinds of cardiovascular diseases. The teacher's psychological teaching of patients has always made me unforgettable. The treatment and medication nursing of heart failure, coronary heart disease, congenital heart disease, pulmonary heart disease and supraventricular tachycardia are still fresh in my memory. Through my combination with book theoretical knowledge, I consolidated this point. Can accurately and timely detect the changes of blood sugar and blood pressure, and timely feedback to the teaching teacher.
Tired and busy, I have been exhausted this month, but my physical difficulties make me feel particularly comfortable, because I feel full. I am very busy in the department, and everything I do seems to increase my knowledge. So I am happy to do what every teacher needs me to do.
Summary of Cardiology 8 The practice of Cardiology is coming to an end, and the study of Cardiology is the focus of clinical practice. We need to know the causes and inducing factors of common diseases in internal medicine, the application of special instruments in various specialties, and special detection and treatment methods, such as pulmonary function measurement, ECG monitoring, pacemaker defibrillator, cardiac catheter, various endoscopes, peritoneal dialysis, various punctures, etc. Familiar with the clinical manifestations, treatment principles and side effects of common diseases in internal medicine, the normal values and clinical significance of clinical tests, and be able to identify common abnormal ECG, functional tests and disease inspection methods in various systems.
During my internship in this department, I will abide by labor discipline, work hard, study hard, and be able to apply what I have learned from books to practice. Under the guidance of the teacher, I have basically mastered the nursing and some basic operations of some common diseases in cardiology, which made me realize the particularity and necessity of clinical work from an intern to a nurse. What I learned in school before was all theoretical, but now I find that what I saw in my actual work is not as simple as I thought, nor as typical as what I wrote in the book. At work, I often rely on my usual experience. Only by practicing and having good experience can I gradually accumulate experience.