Nursing Professional Essay Full Sample Essay Part 1: "Trying to Improve Nurses"
1 Materials
1.1 There was once a woman in labor who said: ? When I was in labor, I was in pain and afraid, but the two midwife trainee nurses talked and laughed and chatted endlessly, and I was afraid that they were not concentrating on me, and I said a few words to them, and they were also very angry?
1.1 A woman in labor once said: ?
1.2 About 12.5% of the trainee nurses because of the improper use of language, caused by the habitual use of terminology, so that the patients are confused, communication barriers, and even misunderstanding, affecting the communication and exchange between each other, for the nurse and the patient disputes buried hidden trouble.
1.3 Due to today's China's medical laws and regulations are not sound, resulting in the internship nurses to the laws and regulations of the understanding of the unsound, for medical accidents laid a hidden danger.
2 Problems in nursing
According to the above three materials, reflecting today's internship nurses nursing work is faced with many problems, but also to understand the inadequacy of nurses in nursing.
2.1 Their own overall quality
2.1.1 Lack of empathy, indifference
Compassion is the basis of interpersonal communication, but also one of the basic principles of interpersonal communication, especially in the hospital, the intern nurses good empathy plays a pivotal role in the establishment and development of the relationship between nurses and patients.
2.1.2 The amount of relevant information that needs to be communicated is too little
Patients and their families are the first to contact the nurses, and the patients and their families are in a very anxious mood, and are eager to know a series of issues related to hospitalization, such as the condition, the medication, the treatment measures, the prognosis, the name of the responsible doctor and the responsible nurses and their level of competence, and so on.
2.1.3 Lack of professional skills
Since the nurses just came out of school, they seldom come into contact with patients face to face. Nursing work is more specialized, in nursing work often see such a situation, despite our kind attitude, but the patient's questions due to ambiguous explanations, operating technology is not skilled, etc., but also cause the patient's distrust or even resentment, affecting the relationship between nurses and patients.
2.2 incomplete understanding of laws and regulations
2.2.1 Legal problems of nursing instruments
Intern nurses for the first time using nursing instruments, there are still a lot of incomprehension. For example: medical and nursing records are not the same, nursing handwriting is scribbled, the statement is not detailed, the content of the nursing record is inaccurate, the focus is not prominent as well as poor continuity. Medical prescription time and the nurse execution time is not consistent, random alteration, on behalf of the signature, retrospective records, etc., all make the nursing records lose authenticity, integrity. This phenomenon for medical disputes buried hidden dangers, resulting in the inability to prove and lose.
2.2.2 Malpractice legal issues malpractice
Internship nurses in the work of serious irresponsibility, do not carry out the rules and regulations and nursing routines, violation of operating procedures, resulting in the death of the patient or serious injuries to the illegal behavior. Such as: do not implement the checking system, resulting in patients with improper route of administration, wrong change and leakage of liquid. Do not implement the inspection system, the oxygen catheter does not work, the patient's fluid extravasation caused by limb swelling, the patient's condition changes are not found in time, so that the patient loses the best chance of resuscitation.
2.2.3 Legal issues of infringement
Intern nurses work in the process, due to improper care, low level of technology or work irresponsible, ignoring the rights and interests of the patient, to the patient's health brought about by the damage or even the death of the error of the accident, is the infringement of the patient's right to life and health. At the same time, the patient has the right to know the treatment and care program of the disease suffered, and the medical staff has the obligation to inform the patient. For example, without the consent of patients and their families, unauthorized medical operations and a certain kind of examination, will constitute a violation of the right to informed consent. If the majority of health care workers are not alert to this, the harm will be greatly increased.
3 Improvement measures
3.1 Pre-service training
Through planned, targeted, targeted pre-service training for new nurses. Cultivating a sense of dedication and selfless service can help them adapt to the new environment as soon as possible, guide the new nurses to love the nursing profession and practice nursing in accordance with professional standards and norms, and provide effective clinical care for patients.
3.2 Improve the concept of nursing service
In the daily work, pay attention to shaping the good image of nursing staff, pay attention to instrumentation, aesthetic and other comprehensive ability to cultivate, beautify the nursing staff's speech, behavior, demeanor, and put the ? Patient-centered? The specific measures are really put into practice. At the same time, to improve the observation and problem-solving ability of practical nurses, so that passive nursing into active nursing, and constantly deepen the? Three parts treatment, seven parts nursing? Connotation of understanding [4].
3.3 Strengthen the legal awareness, enhance the legal concept
Organize nursing staff to learn the relevant laws and regulations, please legal professionals to hospital lectures, to learn the knowledge of the law and the combination of specific cases, to increase the management efforts to standardize the nursing behavior, the nursing errors that have arisen to analyze, from the big point of view of the small start, to prevent the faithful in the future, you can prevent or reduce the occurrence of medical accidents. The first step is to make sure that you have the best possible care for your child.
3.4 Strengthen the study, standardize the writing of nursing documents
The Regulations on the Treatment of Medical Accidents stipulate that: ? The nursing record is an important part of the medical record. That is to say, nursing records will also be the same as medical records, as court evidence to be adopted. Nursing staff should be from the height of law enforcement, improve the understanding of nursing records, nursing document writing encountered new problems to take appropriate measures to standardize nursing records.
3.5 Strengthen the study of legal knowledge, enhance the concept of the rule of law
In the clinical work, nurses must be able to understand the law, understand the law, comply with the law, clear their legal responsibility at work, fully aware of the nursing behavior at all times are subject to the constraints of the law, and strictly comply with the laws and regulations and departmental rules and regulations of the operating procedures, to minimize the incidence of medical errors.
3.6 Fulfillment of the obligation to inform
Patient consent is a necessary condition for medical care infringement, and is a prerequisite for the legitimacy of medical care behavior. Therefore, the nurse should inform the patient and family of the purpose of each operation, risk factors, special treatment, care, inspection, should obtain the consent of the patient, if necessary, to fulfill the signature procedure. This is not only respect for the patient's rights, but also the need for nursing self-protection.
4 Summary
Nurses have a long way to go to improve the level of nursing care and reduce nursing disputes is the responsibility and obligation of each of our nurses. It is necessary for nursing staff to improve the quality of care, update the concept, improve the level of business; at the same time, strictly abide by the rules and regulations, operating procedures, and conscientiously fulfill their duties, the relevant laws and regulations, as well as departmental rules and regulations are truly implemented, so as to ensure that the nursing work is standardized and carried out in an orderly manner.
Nursing professional thesis essay two: "Try to talk about the care of postpartum hemorrhage"
First, postpartum hemorrhage cause analysis
Postpartum hemorrhage is one of the important causes of maternal mortality, according to the analysis of the clinical data of our hospital, causing postpartum hemorrhage are mainly the following aspects of the cause:
(a) uterine contraction weakness
Uterine contraction The most important reason for postpartum hemorrhage is the lack of strength of uterine contraction. In normal labor, a little bleeding is common when the placenta is detached from the uterus, but when the placenta is completely detached from the uterus and expelled, the bleeding will decrease rapidly. However, in some cases, large amounts of bleeding may occur due to weak uterine contractions and poor vascular closure caused by excessive mental anxiety or fatigue during labor and delivery. Multiple pregnancies, large fetuses, prolonged labor, various pregnancy complications and comorbidities, as well as multiple abortions resulting in uterine fiber damage, amniotic fluid makes the pressure in the uterine cavity increased uterine muscle fibers overstretched, etc., is also prone to uterine contraction weakness and postpartum hemorrhage.
(2) placental factors
Placental factors caused by postpartum hemorrhage is commonly known as? The first time I saw this is when I was a little girl, and it was a little girl, and it was a little girl. It is also a common cause of postpartum hemorrhage. There are mainly the following situations: the most common is incomplete detachment of the placenta, that is, because part of the placenta is not detached from the wall of the uterus, resulting in the detachment of the surface bleeding; the second is the placenta can not be discharged in time after the detachment of the placenta, that is, the placenta from the wall of the uterus has been completely detached, but due to the lack of uterine contraction of placenta can not be discharged resulting in bleeding; third is the history of scraping the maternal uterine metamorphosis dysplasia, the placenta chorionic implantation of the uterus myometrium, resulting in the placenta adherence, placental implantation. often cause bleeding; four is the use of oxytocin improper, making the uterus spasmodic contraction caused by the stripped placenta embedded in the uterine cavity, can also cause vaginal bleeding.
(C) obstetric laceration
Most of them occur after vaginal surgical delivery, the fetus is too large, the use of forceps birth, the obstetric tract obvious edema or varicose veins, difficult labor, emergency delivery, etc., will increase the possibility of obstetric laceration. Our hospital in the last three years of clinical 8 cases of patients with varying degrees of hyperemesis, due to systemic spasm of small arteries, tissue hypoxia, increased vascular fragility, delivery in the soft birth canal after the tear caused by the vaginal wall hematoma; other there is a rapid delivery, vulvovaginitis, cervical canal toughness and so on, resulting in tissue damage and vascular tear, the improper operation of the midwife is also a non-negligible reason.
(D) coagulation disorders
Mothers with blood disorders such as thrombocytopenia, anemia, lack of coagulation factors, etc., are also prone to cause postpartum hemorrhage, our hospital 23 cases of postpartum hemorrhage in patients, there are 8 cases of varying degrees of anemia.
Second, the prevention of postpartum hemorrhage first aid countermeasures
(a) adhere to the prevention first, symptomatic preventive measures
1, uterine contraction weakness caused by postpartum hemorrhage prevention
First, because postpartum hemorrhage occurs in the abnormal birth of a timely and timely complications in the maternal, so the prenatal period should be carefully screened out of the high-risk pregnant women, to do a good job of monitoring the delivery of a good job in the delivery of a good preparation for postpartum hemorrhage. Postpartum hemorrhage rescue preparations. Secondly, during labor and delivery, we should strengthen the supervision, pay attention to maternal rest and nutritional supplementation, care for mothers, strengthen psychological care, empty the bladder to prevent prolongation of the labor process, maternal failure resulting in postpartum uterine contraction weakness. If it is necessary to use antihypertensive and sedative drugs, the use of drugs should be moderate, to avoid overdose and affect uterine contraction. Third, the combination of twin fetuses, excessive amniotic fluid, stagnant labor, placenta praevia, placenta previa, severe hyperemesis gravidarum, transient mothers who have a history of postpartum hemorrhage and other susceptible to postpartum hemorrhage, in the fetal anterior shoulder after delivery, can be used to promote uterine contraction immediately oxytocin.
2, the prevention of postpartum hemorrhage due to placental factors
One is to catch ? Early? The first step is to make sure that you have a good understanding of the situation, and that you have a good idea of what you are getting into, and what you are getting into. The second is to grasp the importance of the concept of "the right" and "the right" in the context of the right. Quasi? In the course of labor, accurately determine the signs of placental abruption, waiting patiently before the abruption of the placenta, avoiding premature squeezing and rubbing the uterus, pulling the umbilical cord, after the delivery of the fetus can be injected with oxytocin to stimulate uterine contractions, prompting timely abruption of the placenta discharged. Secondly, if the placenta is still not detached half an hour after the delivery of the fetus, firstly, intravenous oxytocin will be given to strengthen the contraction, and if the placenta is still not detached, the perineum can be re-disinfected, the bladder can be emptied, and artificial detachment can be carried out. Fourthly, if the placenta becomes embedded and causes bleeding, anesthesia can be applied to relax the stenotic ring and the placenta can be removed artificially. Special attention should be paid to the fact that, regardless of the above circumstances, after the placenta is discharged or artificially removed, it should be carefully examined to see if there is any placenta, fetal membranes, or parietal placenta residue, if so, the uterus should be cleansed in a timely manner, and the use of antibiotics, to prevent infection, to avoid the bleeding in the later stage.
3, the prevention of postpartum hemorrhage caused by obstetric laceration
Postpartum hemorrhage caused by soft obstetric laceration, effective hemostatic measures are timely and accurate repair suture. After the delivery of the fetus carefully check the soft birth canal, including the cervix, vagina and perineum, especially the cervix, there are cracks timely suture. First, the management of cervical laceration. Severe cervical laceration can extend to the fornix and fissure or even into the adjacent tissues, it should be sterilized first, then expose the cervix, clamp the anterior lip of the cervix side by side with oval forceps and pull it towards the vaginal opening, move the oval forceps in a clockwise direction gradually, and then observe the situation of the cervix under direct vision, and if laceration is found, it will be closed with sutures with intestinal sutures, and the first stitch should be from the tip of the fissure, and the last stitch should be from the lateral cervical end of the cervix, and the last stitch should stop at the outer cervix, and if the suture is closed to the outer end, it should be closed at the outer end. The last stitch should be 0.5cm from the lateral end of the cervix. If the suture reaches the outer edge, cervical stenosis may occur in the future. Secondly, the treatment of vaginal laceration. Vaginal laceration need to pay attention to the suture to the bottom, to avoid leaving a dead space, pay attention to the suture to achieve good tissue alignment and hemostasis, suture process to avoid the suture line through the rectum, and take the perpendicular to the direction of the blood vessels can be more effective hemostasis. Third, the treatment of perineal laceration. According to the anatomical part of the suture muscle layer and submucosa, and finally suture the vaginal mucosa and perineal skin.
4, prevention of postpartum hemorrhage due to coagulation dysfunction
First, the prenatal period should be promptly asked about the medical history, if there is an early admission to the hospital for labor, platelets, bleeding time, clotting time and other laboratory tests. Second, coagulation dysfunction is a relatively rare cause of postpartum hemorrhage. Once postpartum hemorrhage occurs, suspected coagulation dysfunction can be identified after ruling out lack of uterine contraction, placental factors, and soft birth canal laceration. After the diagnosis is clear, fresh whole blood, platelets, fibrinogen or prothrombinogen complex, coagulation factors, etc. should be actively transfused. Thirdly, because coagulation dysfunction postpartum hemorrhage is the most difficult to treat the special type of postpartum hemorrhage treatment, in addition to the conventional postpartum hemorrhage treatment steps and methods, we should pay attention to the protection of the important organ function, in order to improve the success rate of resuscitation, and reduce the maternal mortality rate.
(B) adhere to the principles of nursing, timely nursing measures
Postpartum hemorrhage, especially the outbreak of hemorrhage, is very likely to cause maternal shock, so once the occurrence of postpartum hemorrhage, the nursing staff must be calm and cool, and effectively take warmth, oxygen, and actively promote the uterus back to the measures, while the report of physicians to implement the resuscitation work. First, quickly assist the doctor to implement rescue, timely and effective hemostasis, start to find the cause of bleeding, blood sampling, blood type, cross-matching, ready for blood transfusion and surgery if necessary, to keep the airway open, the loss of blood in a timely manner to give oxygen, to prevent hypoxia. In case of emergency, establish double venous channel quickly to replenish blood loss to the mother effectively in a short period of time. Secondly, closely observe the maternal pulse, blood pressure, respiration and uterine recovery, accurately measure the bleeding, and make a detailed record of special nursing care. Third, after the shock is corrected, the mother should be comforted to rest quietly, encouraged and assisted to eat, and at the same time, the mother's blood pressure, pulse, uterine fundus height, uterine recovery and vaginal bleeding should be closely observed, especially in the first two hours after the delivery, and the mother should be sent back to the ward only after her condition is normal. Fourthly, after returning to the ward, the mother should be instructed to empty her bladder in time to prevent bladder distension from affecting uterine contraction and recovery. Within one day after delivery, the general condition of the mother should still be closely monitored, and the mother should be instructed to keep the vulva clean, prevent infection, maintain a nutritious diet, and prevent anemia symptoms caused by postpartum hemorrhage.
Nursing professional thesis sample article three: "Talk about the reasons why the teaching effect of psychiatric nursing is not good"
Nursing profession is an important part of our country's health care system, accompanied by the transformation of the modern way of life, the improvement of people's health consciousness and the trend of population aging is increasingly aggravated, the demand for nurses is increasing, China's current nurse resources are still partially rely on the five-year nursing students to supplement, students, students, and the nursing profession, and the nursing profession, and the nursing profession, and the nursing profession. Nursing students to supplement, students in the school learning process is the basis for becoming a good nurse, psychiatric nursing is a specialized course in nursing, so how to learn this course is not only related to the teaching expectations of the school, but also more importantly, to provide a theoretical basis for the students' clinical work.
According to the spirit of the Nursing Regulations, the Administrative Measures for the Registration of Nursing Practice, and the Measures for the Examination of Nursing Practice Qualifications, an access system is implemented for the position of nurse, and nurses must pass the examination for the qualification of nursing practice in order to apply for the registration of practice. Since 2011, the licensing examination for nurses has been changed from four subjects to two subjects, professional practice and practical ability, and the examination involves the early stages of clinical work in the care of a variety of common illnesses that nurses may encounter, including mental disorders, which is a new type of illness. However, in the results of the professional qualification examination for nurses, it was found that most of the five-year students did not score any points in the test related to mental disorders. This phenomenon forced educators to think y about what causes students to learn psychiatric nursing poorly. The author combined years of teaching experience and clinical practice, analyze the reasons are as follows:
First, the student foundation of good and bad
Five-year nursing students are junior high school graduates after entering the vocational colleges and universities to study the group. Some students choose to study in vocational schools on their own, hoping to learn vocational skills to earn a living. Some students follow their parents' wishes to study in vocational colleges in the hope that they can enter the society as soon as possible through school education. As far as the general situation of the society is concerned, the academic performance of students studying in vocational colleges may not be satisfactory. In the process of teaching, the students' basic problems will emerge. Nursing students are also required to study all the basic medical courses, such as biochemistry, physiology, histoembryology, microbiology and immunology. In the junior high school curriculum, students are initially exposed to chemistry, physics, biology and other courses, which are still helpful for the study of basic medical courses. If the foundation is not solid, then the learning of specialized courses built on the basic subjects will also have some problems. Psychiatric Nursing is also one of the specialized courses, which also requires biochemistry and physiology as the basis to master the knowledge of mental illness.
Although there is a difference in the basis of students, in the process of teaching, each teacher should take into account the needs of all students, and constantly improve the teaching methods, teaching methods, to help each student to understand and master the knowledge needed in the work, and improve the quality of teaching.
Second, the relatively single means of teaching
Modern life is changing rapidly, technology is also advancing. Whether it is basic education or college education, multimedia teaching methods are commonplace. Through the multimedia PPT, image data display, can be the focus of each lesson, the difficulty of the teaching of the precise narrative to the students, as a means of explaining to the students the relevant knowledge of the disease, but the current reality is only a single traditional teaching methods can not meet the requirements of modern nursing. The study of mental illness nursing not only requires theoretical knowledge, but also requires certain practical training and apprenticeship courses like other professional courses such as internal medicine, surgery, pediatrics, obstetrics and gynecology nursing, through which classroom knowledge is combined with practical operation to improve students' comprehensive vocational skills. As a relatively special type of mental illness, the practical training course can teach the nursing skills of some common mental illnesses and ways to deal with emergencies, so as to avoid being at a loss when encountering such illnesses at work in the future. The apprenticeship course can let students really contact with mental illnesses, visualize mental illnesses, and deepen their learning and mastery of mental illnesses. In addition, students have a variety of ideas, and teachers can also set up some teaching scenarios for students to learn the process of caring for people with mental illness in the form of skits. In order to help students continue to learn about mental illness after school, some advanced teaching tools can be added to keep pace with the times, such as uploading teaching courseware or micro-lesson videos on the school's website to show the knowledge gained in the process of learning for the convenience of all. In addition, the condition of the teacher can establish a personal WeChat public platform, the use of the current widespread smart phones at any time and place to help students to solve the problem of learning.
As society continues to progress, the teaching methods of Psychiatric Nursing should be constantly updated to meet the needs of students' learning, and really bring out the advantages of vocational education.
Third, the teacher's level is uneven
The development of modern science has led to the continuous innovation of biomedical technology, which has enabled us to have a more comprehensive and deeper understanding of the biology of many diseases. Insightful people have proposed that the medical model should move toward ? biopsychosocial? This new medical model seems to be the most appropriate, applicable and needed in psychiatry. At the same time, more and more people advocate that psychiatry should not only study mental illnesses in the traditional sense, but also (or more) pay attention to a variety of psychological and behavioral problems; psychiatry should not only serve in psychiatric hospitals, but also (or more) focus on the mental health of society as a whole. However, the knowledge of mental diseases under our curriculum system is relatively outdated, with fewer opportunities for outside training, relatively slow updating of library books, and even the negligence of some teachers in pursuing further studies has resulted in the level of faculty members related to psychiatric nursing remaining unchanged over the years. What's more, many of the teachers who teach Psychiatric Nursing have never really been exposed to mental illness, and can only rely on book knowledge to explain the relevant knowledge of mental illness, lacking certain experience and practical skills.
For every teacher, if the knowledge structure is not updated and the teaching method is not improved, it is like a pool of stagnant water that is never alive. Then the students' enthusiasm for learning may also be gradually worn out because of the teachers' lack of progress. I hope that every teacher will not stagnate and watch the sky, but to continue to improve the quality of self to achieve the purpose of improving the quality of teaching.
Fourth, the backwardness of the school management system
Five-year nursing students enter the school at a relatively young age, the time of learning in the school is relatively long. In this process is also their important growth and metamorphosis process. The school believes that five-year students do not have a mature mind and the ability to exercise self-discipline, and even the ability to recognize right and wrong is relatively weak. For the sake of students and parents, the school sometimes manages the five-year nursing students in a strict and even rigid manner. Basically still according to the management mode of compulsory education, on time to the morning self-study, evening self-study, no space to go to the library, reading room or electronic reading room to expand their knowledge, and even stifle the students to develop the ability of self-study. In life, perhaps the five-year students still need to learn from the teacher and the school's supervision and oversight, but in the study of students should be given a certain amount of space. Psychiatric Nursing" is also a relatively difficult course, just rely on the teacher to teach the knowledge is not a good way to grasp the knowledge related to mental illness, which requires students to consciously go to the relevant information to solve some of the problems. As the old saying goes? Teaching a man to fish is better than teaching him to fish. , the teacher's duty is to teach, the purpose of students is to learn. But how to learn is also a teacher in the teaching process should penetrate to the students, which is the main thrust of education.
At this stage of the educational background, the concept of "60 points" is outdated. The concept of "60 points" has been outdated, all the knowledge learned in vocational colleges and universities need to be transformed into skills to be used in practical work. How to improve the five-year nursing students learning psychiatric nursing learning effect is also an important part of teaching. Helping students to enhance their basic knowledge, enriching teaching methods, improving teachers' strength, and improving the school management system are effective ways to improve the effect of improving Psychiatric Nursing for five-year nursing students. We hope that it will help to improve the learning situation of five-year students in Psychiatric Nursing, and we expect that it will inspire educators' teaching reform.
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