The society's demand for nurses has been increasing, and the requirements for nurses have been improving, but the turnover rate of the nursing team has been high, resulting in a serious shortage of nursing human resources. The following is my nursing undergraduate thesis for your reference.
Nursing undergraduate thesis sample 1: Clinical observation and psychological care of elderly fracture patientsKeywords : Elderly fracture, psychological care
Abstract of the paper Purpose: To explore the clinical characteristics of elderly fracture patients and psychological care interventions. Methods: 116 cases of elderly fracture patients admitted from January 2006 to December 2007 were retrospectively analyzed. RESULTS: The patients' primary conditions were stable, no nursing complications occurred, their psychological status was good, and their anxiety and depression were improved. CONCLUSION: Understanding the psychological needs and characteristics of elderly fracture, and doing a good job of perfect psychological care and rehabilitation guidance is an effective guarantee of comprehensive rehabilitation of elderly fracture in physiological, psychological and social activities.
With the improvement of medical level and the prolongation of human life span, the proportion of elderly patients treated in orthopedics and traumatology has gradually increased. Due to the long treatment time of elderly orthopedic patients, activity restrictions, in bed treatment period is prone to a series of complications, the majority of patients are worried about limb crippling, and often show different emotional responses and psychological needs, therefore, we in the clinical care, we should be in response to the characteristics of the elderly bone fracture and the psychological situation, to strengthen the psychological care, as much as possible to give the patient care and comfort, patiently explain the long term bedridden patient's We will try to give more care and comfort to the patients, patiently explain the precautions for the long-term bedridden patients, and enhance the patients' confidence and courage to overcome the disease. The report is as follows.
Data and methods
From January 2006 to December 2007, 116 cases of elderly fracture patients were admitted to our department, of which 49 cases were male and 67 cases were female; their ages ranged from 66 to 98 years old, with an average of 73 years old. The average age was 73 years old. Fracture site: femoral neck and intertrochanteric fracture accounted for 81%, and forearm fracture accounted for 19%. The patients were accompanied by different degrees of hypertension, heart disease, cerebral thrombosis and other medical history.
Psychological care: Because the elderly fracture patients are hospitalized, leaving their families and work units, and are unfamiliar with their surroundings, most of the patients have a sense of loneliness, and show nervousness, anxiety, depression and pain, worrying about the pain, not being able to take care of themselves, and accidents, etc. For this reason, we caregivers have to create a good environment for the elderly patients, and the nurses have to pay attention to their own words and deeds. One word and behavior, to treat patients with enthusiasm, concern and serious attitude, patiently and carefully do a good job of explaining the work, tell patients about various treatments as well as the significance of nursing care, reminding patients that they must cooperate with the precautions taken in treatment. To be through the treatment and care of the opportunity, the nurse should be open to the patient to make self-introduction, keep the instrument elegant, natural expression, guide the patient to produce a positive psychological response and related optimistic behavior, in order to obtain the trust of the patient and his family, to establish confidence in overcoming the disease.
Caress and care: the new hospital for elderly patients, nurses are to high nursing morals and good psychological state, to meet and care for the elderly patients, the elderly can be smiled at, talk to, massage, rehabilitation guidance and assistance to the patient to carry out the necessary functional exercise, etc., so that it feels happy and satisfied.
Establishing a good social support system: for elderly hospitalized patients, in addition to the care of medical staff, but also need the support of family, friends, colleagues and society, to give more positive guidance, persuasion, encouragement and comfort, etc., to help patients get through the most difficult period, and really experience the love and warmth of society and loved ones, so that it will be conducive to the early recovery of patients. The company's website has been updated with the latest information about the company's products and services, as well as the latest information about the company's products and services, and the company's website.
Patient explanation, careful observation: the experience of the elderly on the disease, often can not tell a very clear and specific, so the nurse can not wait for the patient's active response, we must carefully check the patient's series of physiological and pathological changes, and detailed collection of information about the condition of the elderly patients, so as to facilitate the correct estimation of the condition, to make the correct nursing judgments and take the correct nursing measures.
Strengthen training, mastering nursing skills: nurses should actively participate in a variety of nursing special learning exchanges, receive training in nursing knowledge, and constantly improve the nursing ability to make the elderly fracture patients fully trust in business technology. Nursing staff's every move, word and deed will have a great influence on the elderly patients, if in a certain nursing technology operation, the action is sloppy, it will be considered in taking them to do the test, thus causing some changes in the psychology of the elderly patients, so the nurse should be demeanor is steady, skillful, gentle operation, responsive, caring for and pay attention to their various treatments and inspections. For example, if the post-surgery patients need intravenous injection, due to the elderly blood vessels hard, slippery, to puncture to bring some difficulties, coupled with the psychological effect of the elderly, always worried about the new nurse can not ? A needle to see blood? , in this case, it is best to let the new nurse first to the other patients in the same ward operation, so that the elderly patients from the side of the new nurse to understand the hard intravenous injection technology, so that it produces a sense of trust and a sense of security. Results
The patients' original condition was more stable, no complications occurred in nursing, the patients' psychological state was good, and they could actively cooperate with the clinical treatment and nursing care, and the vast majority of the patients' anxiety, depression, loneliness, and dependence mentality were improved accordingly, and they were very satisfied with the nursing work. Discussion
Due to the poor physical quality of elderly patients, coupled with the characteristics of the fracture will generally be a longer course of disease, poor efficacy, fracture is not easy to heal, metabolic function slows down, osteoporosis, as well as decalcification, etc., so the healing time of the elderly fracture patients, generally is the healing time of the young patients 1 or longer, and prone to comorbidities. Fractures in elderly patients are usually neck of femur and intertrochanteric fractures, which require traction for treatment, and the patients need to be bedridden for 2-3 months before they can leave the bed, which increases the chances of comorbidities in most of the elderly patients. In the data of this group, most of the elderly patients suffer from hypertension, heart disease, diabetes and other chronic diseases, which undoubtedly bring a lot of difficulties to orthopedic treatment and care in the clinic, often due to the pain after the fracture, mental stress, long-term bedridden and so on, thus leading to the recurrence and aggravation of these chronic diseases. For this reason, nurses should master the psychological needs and characteristics of elderly fracture patients, and do a good job of perfect psychological care and rehabilitation guidance, which is an effective guarantee for the comprehensive rehabilitation of elderly fracture patients, physiologically, psychologically, and socially, and which is also essential for the extensive development of systematic holistic nursing. Only by doing a good job of psychological and rehabilitative care can holistic care be implemented.
Nursing undergraduate graduation thesis sample 2: community hospital rescue nursing work of the hidden dangers and strategiesResuscitation room to receive are emergency critical patients and physical and mental anxious family members, and the rescue room is also a high incidence of medical disputes, in the first aid work, often due to the lack of nurses' technical level, service is not in place, the failure of the rescue instrument, lack of communication art; the patient's legal awareness increased, while some patients are also the high incidence of medical disputes. Patients' legal awareness has increased, and some patients' own quality is poor, demanding; dissatisfaction with some services in the hospital will be vented on the nurses, thus triggering doctor-patient conflicts and medical disputes. In order to make the primary hospital rescue nursing work to adapt to the needs of modern social development, so that the rescue nursing work towards standardization, institutionalization and standardization of the management track, in view of the above realities, to take a series of precautions, so that the hospital in the rescue nursing work to receive a satisfactory result, significantly reduce the error, the incidence of disputes. Now for the hidden dangers and countermeasures to discuss the following.
1 nursing difficulties and pitfalls
1.1 Section division of labor is not clear, the responsibility is not in place due to the grass-roots community hospitals are smaller, and even the department is not sound, the clinical department of outpatient and emergency is not divided, so that many patients with emergencies in the outpatient clinic, so that the real emergency resuscitation of the patient can not be timely and rapid treatment.
1.2 A considerable portion of patients with low comprehensive quality, poor nurse-patient communication grassroots hospitals rescue patients are mostly car accidents, fights, pesticide poisoning, alcoholism, drowning, etc.; the age of small, language communication barriers. In the process of resuscitation, it is difficult to cooperate with the nurses, they often put the grievances of those who caused the accident, the patient's pain, family conflicts, spiritual loss, will be inflicted on the nurses, resulting in nurse-patient tensions, nurses work under pressure, nursing work carried out difficult.
1.3 Nursing staff emergency response ability is low, safety precautionary awareness is not enough nursing staff in the high-quality integrated talent less. Professional basic knowledge is not solid, the nursing technical operation is not standardized, the assessment of critical patients is poor, the lack of patients and their families to publicize the obligation to inform the fulfillment of the promise to sign less, safety precautionary awareness is insufficient.
1.4 Nursing staff shortage, insecurity and hidden danger with the full implementation of the new rural cooperative medical system, the patient increased, and nursing staff is not enough; supernumerary nurses are more nurses, nurses mobility; young nurses work initiative is not enough, the work of the ability to adapt to the poor; these are the factors that cause insecurity and hidden danger. Due to the rescue of patients when nursing highlights a? urgent? The word, need to rescue personnel skilled, adequate personnel, in order to ensure the quality of rescue. However, due to personnel constraints in primary hospitals, most of the time is a nurse on duty, not only to participate in the rescue of critical patients, but also to take care of outpatient injections and other routine treatment work. Sometimes due to being injected and can not guarantee the timely arrival and delayed rescue of critical patients, so that the patient's family and nurses have unnecessary quarrels, and even family members hit; at the same time, the outpatient injection room no one to take care of (eg, skin test time to the end of the intravenous injection), busy nurses go round and round; coupled with, due to the work of the busy, fewer nurses, it is easy to overlook the other patient's condition observation, the record of the condition of the untimely, comprehensive, these are left unsafe medical care. These are to the medical care left unsafe hidden trouble.
1.5 Inadequate infrastructure, affecting the efficiency of the rescue measure of a hospital's emergency work in place. The first is to have a skilled medical team, the second is to have a series of advanced medical rescue equipment, so as to ensure the quality and rescue success rate. The working environment of the emergency department of primary hospitals is poor, and the lack of instruments and equipment required for the work and the aging of the personnel are a source of stress for the nurses in the emergency department? Some resuscitation equipment is not commonly used, and when encountering critical patients, there are failures of resuscitation equipment, such as suction powerlessness, gastric pump failure, cardiac monitor is not easy to start, etc. Not only does it delay the resuscitation time, but it also makes the patient's life easier. Not only delay the rescue time, but also bring unnecessary medical disputes.
1.6 Obstructive, lost the principle of grass-roots hospitals due to the rescue room and infusion hall is not far away, individual nurses in the way not according to the rules and regulations of the work, usually do not have to rescue the patient in and out of the hospital, some acquaintances, friends, in the rescue room on the empty beds, accompanied by a large group of family members, so that rescue beds can not be readily available in the state of emergency and the indoor environment and the application of equipment has an impact on the infusion once the patient appears abnormal, or suddenly, the patient is not in a state of emergency, the patient's condition. Patients with abnormal conditions, or suddenly came to the rescue patients, it may cause conflicts between doctors and patients, resulting in unnecessary disputes.
1.7 Subject to the constraints of the bonus distribution system, the relationship between doctors and nurses is not coordinated In recent years, due to the principle of bonus distribution of doctors is to pay according to the work, more work, more pay, the humanitarian awareness of saving lives and helping the wounded has been weakened. Emergency patients first to the rescue room, nurses and then go to ask the doctor's situation occurs from time to time. Existing doctors only care to give outpatients prescriptions, check, rarely immediately take the initiative to cooperate with nurses to participate in emergency treatment, but also rarely for the patient psychological counseling and conflict resolution work. As a result, nurses in primary hospitals are often subjected to verbal abuse by patients' families and even unfair accusations. Nurses work, psychological pressure gradually increased.
2 Resuscitation nursing countermeasures
The work of the resuscitation room is characterized by: emergency, critical, serious patients, fast-paced work, patients and their families are impatient. Therefore, the rescue room nurses must have strong emergency response ability, rescue technology skilled, agile, efficient, good communication good quality. In many cases, it is necessary to make preliminary treatment before the doctor arrives, such as the establishment of intravenous access, oxygen, sputum, hemostasis and so on. At the same time, it is also necessary to do a good job of resuscitation records and checking. In order to protect the lives of patients, to avoid medical disputes, timely detection of nursing hazards, and effectively strengthen the safety of medical, now summarize the years of practical experience in the work of the undergraduate, for the rescue of emergency nursing hazards to make the following precautions.
2.1 Improve the hardware facilities to ensure safe medical care department attention, hospital leadership support, equipped with and improve a variety of rescue facilities. The replacement of the rescue facilities must be replaced to achieve standardization, standardization, and conscientiously do a good job in the handover and management of rescue equipment, equipment by a person responsible for the class inventory, found that the problem of timely maintenance to ensure that the first aid equipment intact rate of 100%. First aid so that nurses can operate with ease, so as to improve the quality of rescue, reduce medical hazards and disputes, and win the popularity of the hospital.
2.2 Transform the service mode, standardize the service behavior with the transformation of the modern medical model, the patient's care is not only rely on superior professional skills, should pay more attention to psychological, social and emotional factors such as integrated care, advocate humane care, carry out humane service, to do? Medical patient's heart, cure the patient's disease? Improve the understanding and trust of patients and their families in nursing. Put? People-oriented? The service concept and practice throughout the clinical nursing work, with love and responsibility to care for each patient, the implementation of humane, humane nursing services, and constantly promote and improve the overall quality of care.
2.3 Strengthen the standardized training of emergency department nurses, comprehensively improve the overall quality of nurses for emergency nurses to carry out specialized, standardized training, so that they master the use of a variety of instruments, the observation of common diseases and methods, critical patient resuscitation techniques, etc., senior nurses to do a good job of transmission, help, bring work, the nursing department from time to time to organize nurses to learn new knowledge, new technologies, regular theoretical knowledge, emergency response capabilities of the nurses, they have to carry out a regular training program for the nurses. The nursing department organizes nurses to learn new knowledge and technology from time to time, and regularly assesses their theoretical knowledge and emergency response ability. Such as cardiopulmonary resuscitation, oxygen, gastric lavage, etc., in order to improve the emergency nurses emergency response, resilience, to do the brain spirit, quick reaction, in case of panic, calm response, in order to complete the high-quality nursing tasks.
2.4 Strengthen the legal concept of education, improve the legal awareness of nurses require nursing staff to learn the law, understand the law, use the law, and strictly follow the legal norms, in the conduct of various nursing activities, should be strictly limited to the scope of the law, to improve the sense of responsibility for the work, and to reduce the occurrence of nursing errors and accidents. Such as alcoholism, drug suicide and other emergency work with legal disputes, requiring nurses to observe and record the condition in a timely and accurate manner. Vomit or wash out the stomach contents of patients taking drugs are preserved and sent for examination. All kinds of dangerous nursing operations, in the case of strict operating procedures, must be explained to the patient and his family, explaining the necessity and danger of the operation, and strive for their understanding, and sign support. This is not only for the rescue of patients to lift concerns, but also to protect themselves and maintain their legitimate rights and interests.
2.5 Strengthen the nurse's sense of responsibility, strict fulfillment of the nurse's duties Stick to your workstation, at any time in a state of readiness, whenever you encounter the rescue patients adhere to the principle of first urgent and then light, the first rescue after the payment of the fee, do not due to the non-payment of the fee for delayed resuscitation and treatment, and accurately, timely and complete writing of all the rescue nursing record sheet. Do not give up the principle because of acquaintances and friends, resulting in medical disputes.
2.6 Telling the language art, good nurse-patient communication should be set up in the nursing work? The first thing you need to do is to take a look at the situation in the room and see if you can find a solution. The service concept, warm reception of each patient, sincere attitude, language civilization. Avoid raw, cold, hard. When the patient or family members show impatience, to patiently do a good job of explaining and pacifying work, truly reflecting the clinical nursing work to? Patient-centered? The patient is the center of the clinical nursing work, and the quality of care is the core. To the quality of care as the core? The nursing management, strict implementation of the nursing operation procedures and nursing rules and regulations, and gradually solve the problem of insufficient nursing human resources, so that each caregiver can start from the patient's personal interests, think differently, improve communication, change the passive service to active service, win the praise and trust of the patient, nursing disputes will be reduced.
2.7 Handle the relationship between health care and nursing, enhance the collective cohesion in the hospital work, medical, nursing, although independent of each other's systems, but the same object of service, doctors, nurses in different jobs, should be established to exchange a collaborative and complementary type of relationship. Patient information should be exchanged with each other, especially in the emergence of doctor-patient, nurse-patient conflicts and even disputes, should communicate with each other to find out the reasons, and timely research, take measures to resolve the conflict as far as possible, not to blame each other, shirking responsibilities, picking fights.
Set up a good teamwork spirit, nip in the bud the hidden dangers of insecurity.