Otolaryngology self-identification 1 Only 2 weeks in Otolaryngology, the time is long and short. The tutor is Dr. xx, the supervisor is Mr. xx, and the director is Mr. xx. Follow the value once and teach xxx teacher.
I just entered the hospital and am not familiar with the operating system. I am not as agile as other students, but I still study hard. Otolaryngology is a highly operational subject, and the correction of nasal septum deviation in books is very important in clinic. We won't know until we get in. It turns out that ENT is also surgery, and the teachers in it are all good surgeons. I didn't know until I started my internship. It turns out that in my internship line, the first four departments are all surgery (otolaryngology, ophthalmology, surgery, orthopedics). Hehe, at the beginning, my senior said it was surgery, which was not very cost-effective, because I was very tired just now.
The most important examination in otolaryngology department is admission examination, which is the key to give patients a targeted examination. Including: ear examination (auricle, external auditory canal, tympanic membrane), nasal examination (nasal appearance, nasal vestibule, inferior turbinate, middle turbinate, observation of mucosa, drainage, polyps, etc.). ), throat examination (tonsil ring, tonsil enlargement, uvula deviation, congestion of pharynx and palatopharyngeal arch, lymphoid follicular hyperplasia, etc.). These simple external examinations are basically necessary when you are admitted to the hospital. I often do some special tests, such as tuning fork test and laryngoscope observation in listening test. In the aspect of instrument examination, I learned to look at pure tone hearing threshold test and middle ear acoustic impedance curve, and became familiar with a series of operations of nasopharyngeal laryngoscope.
During my two weeks in the Department of Otolaryngology, I have seen several common diseases: sudden deafness (including neurological and conductive), unexplained epistaxis, radiotherapy and chemotherapy for nasopharyngeal carcinoma, pharyngeal tonsil abscess, nasal polyps and sinusitis, mastoiditis and otitis media. After I went to the emergency department at night, I learned how to deal with acute massive hemorrhage in a small area and how to solve the problem of fishbone stuck. Problems (including barium meal examination with cotton wool), blood bubbles in the upper jaw and so on. In the operating room, I visited the total resection of parotid mixed tumor, double Fess+ nasal septum correction and epiglottic cyst resection.
Below I listed some very detailed knowledge points:
1, in the relationship between otolaryngology and endocrinology, i query literature found that under the stimulation of estrogen, nasal mucosa will grow like endometrium, and at the same time, mucosal secretion will increase, which is why pregnant women are prone to rhinitis, and why menopausal women are prone to atrophic rhinitis and nosebleeds.
2. The causes of facial paralysis can also be parotid gland tumor compression and mastoid lesions. And after parotidectomy, there will be symptoms of swelling and sweating of the mandible (it is a normal phenomenon that will occur during the process of nerve growth and will relieve itself).
3. Sudden deafness is an unexplained hearing loss in the inner ear for up to 3 days, and most of the reasons are related to cochlear vestibular vascular stasis. Clinical use of erigeron breviscapus needle or erigeron breviscapus powder injection, oral sibelium dilate blood vessels to improve blood flow. At the same time, cerebral Doppler blood flow will be routinely checked to rule out the factors of cervical vascular limitation.
4. Acoustic impedance test is specially used to measure middle ear function. The normal curve belongs to the peak type. The curve of ossicular chain fixation is low peak, which indicates that the rigidity of ossicular chain increases. When the eardrum shrinks or the ossicular chain is interrupted, the compliance is abnormally increased and the curve is beyond the limit. Tympanic effusion or adhesion lesions, limited tympanic membrane activity, flat curve. When the pressure of external auditory canal and tympanic cavity is equal, the compliance is the largest, forming a peak, which can show the degree of tympanic cavity negative pressure.
5. If there are drugs related to coagulation in the doctor's advice, whole blood analysis and coagulation must be set to st! .
In fact, when I first arrived here, I still made many mistakes, such as giving the wrong doctor's advice when I was on duty at night, grabbing the line in the morning shift and saying the wrong thing, such as wearing my clothes backwards when I entered the operating room ... But the teacher was very tolerant, didn't say how to scold me, and didn't blame me too much. I was slowly becoming conspicuous.
These two weeks are just in time for project application. I have no experience and poor design. I was scolded several times, and I was in a bad mood. ....
However, we must continue to work hard.
After more than half a year's nursing practice, under the careful guidance and patient teaching of the teaching teachers, I studied hard and implemented the spirit of the 16th National Congress of the Communist Party of China, studied the Regulations on Handling Medical Accidents and its laws and regulations, actively participated in the training of medical accident nursing regulations organized by hospitals, and participated in the study of nursing staff for many times. Through the study, I realized the establishment of the socialist market economic system and the improvement of the legal system. People's awareness of the legal system has been continuously enhanced, and it has become people's awareness to act according to law and safeguard legitimate rights and interests. The concept of modern nursing quality is to satisfy patients in all directions and in the whole process, which is the demand for higher and newer medical care services, thus enriching legal knowledge, enhancing safety protection awareness, making nurses know the law and usage according to law, and reducing the occurrence of medical accidents. Both the theoretical level and the practical level have been improved to some extent.
During the internship, I will strictly abide by the rules and regulations of the hospital, earnestly perform the duties of the intern nurse, take Marxism-Leninism, Mao Zedong Thought and Deng Xiaoping Theory as the guidance, be strict with myself, respect teachers, unite classmates, care for patients, be late and leave early, work hard, strive to standardize nursing work, improve skills and services, make basic nursing flexible, make love activities regular, combine theory with practice, and study theory in a planned way. The nursing work is focused, with measures and records. During the internship, I always take "love, care and patience" as the foundation, strive to achieve "eye diligence, hand diligence, foot diligence and mouth diligence", think about the patient's thoughts, worry about the patient's urgency, and provide quality services wholeheartedly, thus establishing a good medical ethics.
In the practice of Otolaryngology, we should strictly abide by the department system, attend nursing rounds on time, be familiar with patients' condition, correctly answer teachers' questions, standardize and skillfully carry out all kinds of basic nursing operations and specialized nursing operations, correctly implement doctor's orders, strictly implement three checks and seven pairs, standardize and write all kinds of nursing documents, complete the handover records in time, and do a good job in patient admission evaluation, nursing and health education. Can do a good job in the nursing of common diseases and frequently-occurring diseases in various departments, and seriously implement aseptic operation.
At work, problems found can be carefully analyzed and solved in time, and various nursing operations such as internal and external nursing, maternal and infant nursing and intensive care can be skillfully carried out. Be able to get familiar with the illness quickly and deal with acute, dangerous, old and serious patients in various departments. In the rescue work, I was meticulous and methodical, and won the trust and praise of patients. At the same time, actively participate in various case discussions and academic lectures, and constantly enrich their business knowledge.
Through more than half a year's internship, my theoretical level and practical level have been improved. In the future work, I will continue to work hard, keep in mind the responsibilities of nurses, constantly strengthen ideological study and professional study, comprehensively improve my comprehensive level and provide quality services for patients.
Three years of otolaryngology self-appraisal passed quickly, and ten months of internship ended in a blink of an eye. Practice is the first step for us to apply theory to practice and clinic. In this process, I have gained a lot and learned a lot. The following is my self-evaluation of this practice:
I am an intern in xx City Hospital of Traditional Chinese Medicine. According to the requirements and regulations of schools and hospitals, I went to seven departments to study, including internal medicine, internal medicine, gynecology, pediatrics, ENT, emergency and orthopedics. During the internship, I will abide by the laws and regulations of the hospital and all departments of the hospital, respect teachers, unite with comrades, be strict with myself, and strive not to be late, not to leave early, not to be absent from work without reason, and not to leave my post without permission.
I am kind to patients and have a good attitude. I try my best to apply the theoretical knowledge and basic skills I have learned to practice. In this process, I constantly sum up my learning methods and clinical experience, strive to improve my ability to think independently, solve problems independently and work independently, and strive to cultivate my lofty thoughts and good professional ethics of serving the people wholeheartedly. After ten months of 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 normal values and clinical significance of common examinations and the preliminary treatment of various dangerous, serious and urgent patients. The learning tasks of all departments were successfully completed, and no medical errors and medical accidents occurred.
In addition, as a preparatory party member, I got in touch with the Party branch of the internship hospital, which ensured that I could continue to study the Party's education after leaving school and keep moving closer to the Party organization, making my internship life more substantial and meaningful.
In a word, I am satisfied with my performance during my internship and full of confidence in my future work. I sincerely hope that you will give me more valuable opinions and suggestions to help me make greater progress!