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Practice summary of nurses in hepatobiliary department 1
I'm used to starting a day's work in shifts, but when I came to hepatobiliary surgery, I just let us start with hot water and greeting patients. I was a little embarrassed at first, and I often couldn't arrive thirty minutes early. Being lectured by the head nurse is probably not as good as getting acquainted with the patients, but I think it will gradually become a habit. Because sincere efforts seem to see a response-patients can remember our names, understand and cooperate with our work.
When I first arrived, I was in a hurry, which was in sharp contrast with the orderly pace now. Review the work during this period and summarize the work process. Take the intensive care unit as an example, patrol the ward-participate in the morning shift (pick up the patient's condition)-pick up items (ambulance, monitor, infusion pump, etc.). )-Check the doctor's advice-Prepare the operating table (welcome the operation and transport the patients from SICU)-Routine treatment-Write nursing records and visit the ward frequently. If you are familiar with it, you will not be like a headless fly. It is impossible to guarantee efficiency by working hard every day.
It is simple and trivial to take temperature, blood pressure, blood sugar, drainage fluid, make bed and change fluid. In contrast, we may prefer blood drawing, stomach tube insertion, puncture and subcutaneous muscle injection, which are slightly higher in technical content. At this time, the division of labor and cooperation is particularly important. It's okay to do it yourself first, and it will always move other students to share it, so that we can have more time to do treatment together and learn from each other's strengths.
Maybe every teacher likes children who are self-conscious and diligent. They will not delay, nor will they reassure people. They are called "good students" by the teacher, and we also want to be good students in the eyes of that teacher. At night, I always help the teacher in the big ward to change the liquid, but only if two people check it; The teacher did not ask to get up consciously in the morning to test vital signs and blood sugar; Prepare the items to be operated in advance and wait for the teacher's inspection and guidance; Respond to patients' doubts, and you can also answer them truthfully; Teachers can also make nursing records when they are busy; Always prepare for treatment in an orderly way, even when changing shifts, and so on. I didn't expect to be moved by myself with so many things to worry about. Although there are many things, sometimes it will be very tiring, but if you do more, the teacher will have more time to answer our questions and correct the shortcomings in our work.
The most unforgettable lecture every Wednesday afternoon is not only the common diseases of hepatobiliary surgery, but also the operating instructions. Such a small lecture not only enabled us to master the operation process and daily nursing points of hepatobiliary diseases, but also reviewed some operation points. The use of indwelling needle has improved my hit rate a lot, and I no longer worry about why I always have to push the blood vessel when sending the needle core; The patient's cooperation is very important when placing the gastric tube. Before the operation, many seemingly nonsense words were well-founded. I have to say that this is also very helpful for our recruitment and examination, and I feel the careful arrangement of the teachers of hepatobiliary surgery.
Time is really a strange thing. Seemingly long two months, in a daze "little follower life" fleeting. It seems that yesterday, I was still quietly complaining about the busy and tired negative energy smog in the intensive care unit, leaving early and returning late step by step, and my heart lacked the affirmation and praise of others. I'm going to wave goodbye to hepatobiliary surgery today, and I really don't want to leave. The scenes of getting along with teachers, patients and classmates flashed in my mind like movie clips, recording my ignorance, confusion, distress and calm joy. If you ask me what my greatest achievement is, I will say, "There is less and less expression of frustration and helplessness at work".
I don't know if I will meet another subject like hepatobiliary surgery, which makes us physically and mentally exhausted but grows rapidly. In a word, I thank the hepatobiliary surgery for giving us an environment to grow up against the wind, the hard-working teachers for escorting us, the small partners who have worked together to help each other in the past two months, and myself for understanding the good intentions of hepatobiliary surgery.
Summary of practice of nurses in hepatobiliary department
In a blink of an eye, more than a month's surgical internship life has ended. During the internship, I will strictly abide by the rules and regulations of the hospital, earnestly perform my duties as an intern nurse, adhere to Marxism, be strict with myself, respect teachers, unite with classmates, care for patients, never be late, never leave early, work hard, and strive to achieve standardized nursing work, high-quality skills and services, motorized basic nursing, regular love movement, and the combination of theory and practice. 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 illness and deal with it. I have improved my theoretical level and practical level. 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.
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 carefully 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.
How time flies! The one-month internship has stopped. Practice is the first step for us to apply theory to practice and clinic. In this process, I benefited a lot and learned a lot. According to the requirements of the school and the hospital, I have divided departments such as-subject and-subject to study. During the internship, I will observe discipline, the rules and regulations of hospitals and hospital departments, respect teachers and unite with * * *. Treat patients with a pleasant attitude and strive to apply the theoretical knowledge and basic skills learned to practice. In this process, I constantly sum up my learning methods and clinical experience and lessons, strive to improve my ability of independent thinking, independent problem solving and independent work, and cultivate my noble thoughts and good professional ethics of serving the people wholeheartedly. After a month's practice, I have mastered the writing of medical documents such as course records, consultation records and discharge records. Master the characteristics of clinical departments and the diagnosis and treatment of common and frequent patients in various departments; Master the abnormal values and clinical significance of common examinations and the preliminary treatment of various dangerous, serious and urgent patients. The learning obligations of all departments have been well realized. Through more than half a year's internship, my theoretical water temperature 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 thinking study and business study, comprehensively improve the comprehensive level, and provide quality services for patients!
Summary of internship of nurses in hepatobiliary department 3
During the internship around the liver and gallbladder, I learned a lot of knowledge that I didn't learn in the last department, and I also got to know more excellent teachers. Have a certain understanding and mastery of specialized diseases and their nursing in hepatobiliary surgery, especially perioperative nursing.
During the operation, I can better understand the meaning of "three-point treatment and seven-point care". Surgical nursing work is quite heavy, with many classes of nurses and more detailed division of labor. Follow the teacher to the main class, Du class, mobile class, morning and evening class, middle and evening class, etc. I got about eight or nine points in general working procedures, among which basic nursing accounts for a large proportion, as well as specialized nursing, such as T-tube nursing, changing drainage bags, dietary guidance and education, as well as various examinations before and after surgery or nursing preparation observation. Nursing plays an important role in operation, especially before and after examination and operation. It is the best reward and encouragement for us to watch the patients go home safely after receiving high-quality treatment and care in the ward.
Moved by the patient guidance given by the teacher, whether it is knowledge or skills, depression or work habits. Here, not only my teaching teacher, but also all the nurses and teachers in hepatobiliary department. Even though I have been in the clinic for two months, I am still a freshman in hepatobiliary department, and I am not familiar with many aspects. Whether the theoretical knowledge is not solid enough to answer questions or the nursing operation skills are not skilled, the teachers smile and encourage, seriously comment on the shortcomings, without any anger or impatience, and all the bits and pieces are branded in their hearts. Even after the small process of measuring blood sugar can be skillfully operated, the teacher said, "Everything will only get better and better." Such a short and simple sentence gave me great encouragement and will be realized together with my later internship life.
What you have gained is not only the knowledge and experience you have learned from your work. I also benefited a lot from the weekly teaching rounds. For example, as the head nurse said, pancreatic diseases, operation and nursing of three cavities and two bladders, special examination and nursing of gallbladder diseases, and nursing of patients with biliary diseases. These are the consolidation and supplement of my theoretical knowledge, and let me better master the basic knowledge of specialized diseases and nursing.
Thank you, I am about to leave the department, and I would like to extend my deep thanks and blessings to all the medical staff and aunts in Hepatobiliary Area B! The new year is coming. I wish you all good health and new breakthroughs and progress in all aspects in the new year!
Summary of internship of nurses in hepatobiliary department 4
Tomorrow is Friday, and the practice of hepatobiliary department is coming to an end. This is my long-lost fatigue, and I haven't found the passion and feeling of working for a long time. Maybe I like being busy. If I like being tired, I don't have to think about anything. Summary of three-week internship in hepatobiliary department. When I first went there for a week, I followed Mr. Yi, and everyone called him "Brother Mao", which probably means don't mess with him, or you will suffer. He brought a high flyers (Mr Mo). I prefer to work with senior students at this stage of internship, because they are generally not as famous as teachers, they will teach me many small details, and they are much more skilled than us interns, so we can learn slowly. I am a slow learner, and my efforts can make them give me more patience.
Teacher Mo told me that day, "When you go back, you should study for at least an hour every day, take a good postgraduate entrance examination and get a certificate." When looking in the mirror, I walked hand in hand for a long time, talking about anatomical structure one after another. But by the second week, my life had undergone earth-shaking changes. There was another advanced student, and I had to follow Mr. Yi. So there were four of us, and some of their teachers took care of 20 patients alone. I was tortured and assigned to Mr. Long's staff, and I cried for it. I didn't like the way he spoke at first, so I felt uncomfortable when I heard that I was going to his place, and then I got along. But I have been tired and comfortable since then, and I have had a hard time every day. I am used to taking a nap, but recently I go back to the ward after lunch every day, and my eyes seem to be hard to open every day. I finally came back to sleep at noon today. I really don't want to get up.
1, the characteristics of biliary colic: right epigastric pain, back pain, related to fat meal, no relief after vomiting.
2. When the liquid drained by the peritoneal drainage tube is gone, don't pull out the peritoneal drainage tube immediately to avoid being blocked by the omentum. You can take a short-term withdrawal observation for one day and then pull it out the next day when there is no drainage.
3. When changing the medicine, the cotton swab iodophor should not only remove the du on the skin, but also squeeze around the incision to see if there is exudate.
4. Test tube:
(1) Before pulling out the T tube, choledochoscope should be done, and the oil gauze should be folded into triangular rows to prevent the dressing from getting damp quickly.
(2) It is written in the book that laparoscopic surgery for T tube removal takes 2 weeks and laparotomy 10 day, but laparoscopic surgery takes 3 months and laparotomy takes 2 months.
(3) before extubation, clamp the tube before and after meals 1 hour, and clamp the tube all day for 1-2 days before extubation. If there is no abdominal distension, abdominal pain, fever, jaundice and other symptoms, it means that the common bile duct is unobstructed and can be extubated.
5.Mirizzi syndrome refers to the clinical syndrome of obstructive jaundice, biliary colic and cholangitis caused by stones incarcerated in the neck of gallbladder or cystic duct and/or other benign lesions pressing the common hepatic duct. It is a rare complication of chronic cholecystitis and cholelithiasis. 6. Upper gastrointestinal bleeding "400ml does not cause hematemesis, but this does not mean that upper gastrointestinal bleeding does not occur, but if hematemesis occurs, it must be upper gastrointestinal bleeding. 7.
(1) Blood clots will form under the common bile duct, and blocking the common bile duct will cause jaundice.
(2) Now the intra-abdominal pressure should be greater than when the T tube was just pulled out, and the bleeding will be more serious.
Summary of internship of nurses in hepatobiliary department 5
In a blink of an eye, the one-month surgical internship has ended. Although this internship is a little tired and bitter, it is quite enjoyable. Hand-over rounds, dressing change, vital signs measurement, intravenous infusion, intramuscular injection, blood sugar measurement, and observation of various nursing operations with teachers. Everyday life is spent in this repetitive busyness. Hepatobiliary surgery, rounds at 7: 30 in the morning, and then dressing changes. Of course, the most bitter thing in the operation is the nursing of the patients after operation.
After staying in a department for a long time, I feel that everyone really feels like a family. The care and instruction of teachers and the cooperation of the whole department make the busy work full and happy. Surgeons are mostly temperamental, no matter how good they are at ordinary times. Once they do something wrong, they criticize others and don't give you any face. Nothing seems to have happened since. Doctors are under great pressure when they operate, especially when the operation is not smooth. All we can do is try not to make mistakes. Otherwise, if you really want to cry, you will only be scolded. My tutor is very kind and strict, and has taught me a lot. Patient demonstration and explanation are convenient for young people to communicate. I learned a lot in hepatobiliary surgery, such as changing bile drainage bags and urethral drainage bags. In fact, their operation steps are similar. In this surgical practice, I deeply realized that some patients are unreasonable, but I am also very pleased that most patients and their families are reasonable, and they understand our hard work and difficulty. That kind of complex taste, perhaps only people have experienced, ups and downs, no matter what the taste, it is worth remembering. Of course, more importantly, I learned a lot that books can't.
In hepatobiliary surgery, the biggest feature is the large flow of patients, which also means that our writing workload is greatly increased, and we fall asleep when we are tired in the dormitory. This is the taste of surgery like a five-flavor bottle. The contents of each student's five-flavor bottle in surgery practice are different, either sour, spicy or sweet, but one thing is the same. No matter what the smell is, it is a smell worthy of my life, belonging to surgery and belonging to myself.
This month is a process of adaptation, and many shortcomings need to be improved. This is an internship process, and many concepts have been revised. Although I am very tired, I can overcome it. This is just the beginning of the internship, and we need to explore it in the future. At the same time, I must make demands on myself in order to gain something. I think the next challenge is also an opportunity, and I must seize this opportunity.
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