patient on the COVID unit – Savvy Essay Writers | savvyessaywriters.net
patient on the COVID unit – Savvy Essay Writers | savvyessaywriters.net
CAPSTONE
1) A few days ago, I had patient on the COVID unit at my hospital who was desaturating to 68%, despite wearing a non-rebreather and receiving 15 L/min oxygen. This patient is a gentleman in his late 80’s who was a long-time smoker and now COVID-19 positive. I called a rapid response because we could not stabilize him on our unit and he was moved to our CCU, where was eventually intubated because BiPAP treatment was not enough to stabilize him, either. According to Healthy People 2020, smoking is a determinant of health and helping those to stop smoking can improve their quality of life, no matter what their age (Office of Disease Prevention and Health Promotion, 2020) Had I been a nurse to this patient prior to his visit for COVID-19, I would have spoke with him on the importance of smoking cessation and the benefits it can bring, no matter what age the person quits. I would also provide the patient with smoking cessation information, as well as, resources for him to use to help him to stop smoking, since 1-9 months after quitting, the lungs begin to regain normal function, which includes their ability to clear out mucus, which helps to reduce infection (American Cancer Society, 2020) Unfortunately, this patient was not in my care before, and now intubated, I am unable to provide him the information he could use to quit smoking. —- Shelley
2) I work in the downtown Los Angeles area and there is a lot of homelessness. Homeless people have come to the emergency department for dressing changes, pain management, or just to stay warm. We have had to remove people from the emergency area because after discharge, they cannot just hang around begging outside the hospital. Some of them have slept on the bench at the emergency entrance many do not require care that would justify a visit. Homelessness is a determinant to a patient’s health. Without housing, people do not get enough sleep, have excessive sun exposure or cold weather, very little to no hygiene routine, more skin abrasions and skin breakdown, higher risk of substance abuse, higher risk of attacks and injury, physical, mental, emotional stress, and malnourishment. (Brown-Yung, 2016) I have seen roaches crawl out of bandages, patients who have no family or patients who don’t know where their family is at. I have given clothing, blankets, food, food coupons. I have sat and talked to some of them, reminding them that they have a name and an identity. There are some homeless people who choose to be homeless, some who are transitionally homeless, some who fell into hardship and can not physically work anymore, some who are chemically addicted, etc.
I do not know if I, anyone, or any governing entity can “cure” homelessness. It takes an individual’s desire to take control over their life, or a personal caregiver for each or groups of these people. Even if you give them access to housing, addresses to free health care, locations to food pantries, and bus vouchers there is no guarantee they will follow through. I cannot say all, but many. —- Suanne
PUBLIC HEALTH
1) Immunizations are important and can save lives. “Immunizations that protect children and adults from the dangers of vaccine-preventable disease are one of the genuine triumphs of basic medical science and the health care delivery system within the United States” (Zuanna, et al., 2018). There are vulnerable populations that may not have access to immunizations. The immigrant and refugee are vulnerable populations that may not have access to health care services that will enable them to get immunizations. In planning and implementing programs to provide immunizations to refugee and immigrant populations, I would partner with schools, community centers, faith-based organizations, and homeless shelters in the community. Creating these partnerships will allow the opportunity to reach out to the target population. In addition, engaging the community will help provide access to get vaccinated where the target population congregates. Furthermore, offering these types of programs can help decrease preventable diseases. —- Oldine
2) Building immunity to a disease takes time. It requires that a person gets exposed to a specific antigen for the immune system to produce antibodies against it for future exposure. Immunization plays an important part in building immunity or protection from diseases caused by bacteria or viruses. Not only that it is beneficial for the person receiving the immunization, it is also beneficial for the people within the community. Strategies to increase immunization rate have been used such as school entry laws, which has effectively increased the demand for vaccines. One key to a successful strategy to increase immunization rate is matching the proposed solution to the current problem (CDC, 2015). Providing targeted population group with easier access to immunization services along with giving them the resources to educational materials will aid in promoting compliance. To do this, partnering up with local health clinics, schools, recreational centers like YMCA, and non-profit organizations will be beneficial in its implementation. Non-profit organizations can provide preventative measures to address health problems in the community. These organizations help strengthen the community by giving the residents affordable/free access to preventative care, promote wellness, and provide some services that the government can’t fully provide. —- Sheryll
CLINICAL
1) This week I won’t be able to assist to clinical rotations due to high work volume, fortunately I have several hours accumulated. At work the first two weeks of the months are always the busiest and I planned ahead so I could be away of clinicals for a week or two. I wanted to share an experience I had performing a straight catheterization procedure. We had this male patient, who advised to the nurse preceptor that he was feeling an urgency to urinate, a swelling in his belly and a feeling of fullness. The nurse allowed the patient to lay in bed and we rushed to wash our hands to start the procedure. I was instructed to gather the equipment and to explained the procedure to the patient even though he was very familiar with it. We both assisted the patients into supine position with legs spread and feet together. The nurse preceptor then assisted me with cleaning the patient’s urethra and then I proceeded to open the catheterization kit following my preceptor’s instructions. I prepared the sterile field and put on sterile gloves, the catheter had lubricant applied because we were using a self- catheterization kit. This procedure is very basic for a nurse, but since nursing school I didn’t have an opportunity to practice it again. I hold the penis straight from the body and squeezed gently the tip to open the urethra, the catheter was inserted very slowly until we saw the urine coming out. It was a very refreshing experience for me and gave me the opportunity to practice this basic task for us as nurses.
At the pediatric clinic every day is unique, because we don’t know how many techniques we will have to implement, I am lucky to have an experience nurse preceptor who guide me and teach me as the cases arrive. —- Olga
2) Safety is a big issue at Adult Day Care Centers. This week my Preceptor Mrs. Richardson and I met 0800 at the facility to update all the clients’ medication in the infirmary. This area is located in the nurse’s office. It is several cabinets that are locked at all times along with the nurses’ office. The only people with the keys to the nurses’ office and these cabinets are Mrs. Richardson herself and her nursing staff. Today my assignment was to check all the medications that was assigned to the clients and check the expiration dates and call the clients doctors for any changes of medications. This was done for the 50 clients that come to the daycare on a daily basis. The clients that attendance daycare have special needs such as monitoring their blood sugars, artisan and mild cognitive deficits. And because of this the nurses manage their medication at the daycare. Each client continue to have a regular chart with a special sheet that is located under medication in these charts with the medications name, time of administration, what the medication is given for and side effects. After calling doctors on the clients that needed updates for their medications this information was put in the chart and updated in the computers for easy assets when needed. Mrs. Richardson continue to keep paper charts on each client in case of computer goes down and information is needed.(New Generations, 2020). Just by reviewing the medication update in Adult Day Care if there was no continuous communication about medications with family, caregivers and doctors there could become a gap in continuity of care were clients and have a change in medications. Medication alone can lead to a safety issue. —- Olga
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