1. Self-identity of emergency department
During the internship in the emergency department, I should abide by the rules and regulations of hospitals and departments, have a correct internship attitude, clear internship motivation and strong work initiative. Under the guidance and guidance of the teacher, strict "three checks and seven pairs" and aseptic operation were carried out. Now, the pre-hospital examination and pre-hospital emergency procedures have been solved, and I am familiar with the nursing of common diseases in emergency and the rescue cooperation of critically ill patients, and master the first-aid professional skills such as gastric lavage, cardiopulmonary resuscitation and defibrillation and the operation and maintenance of xx first-aid instruments. During my internship in the emergency department for one month, I learned a lot, whether it was pre-hospital emergency or post-hospital emergency. The work of emergency department is the first line of patients' lives, especially the emergency room. When the patient was sent to the emergency room from the car of 120, his spirit improved by 10,000 times120, and I devoted myself to the rescue of the patient. Here, I witnessed the rescue of many dying patients, such as cardiac arrest, ventricular fibrillation and cerebral hemorrhage. In short, to sum up, the work of the emergency department is urgent, and your agility means the life of the patient!
Similarly, in the work of the pre-examination desk, I initially learned what kind of patients to triage. When I was in the intensive care unit, I followed Mr. Chen to learn how to extract blood gas and practice distinguishing venous blood from arterial blood. In the work of emergency department, I also mastered the most basic measures to rescue patients, the process of gastric lavage technology, and ECG. The use of various instruments, such as defibrillators, ventilators, sputum aspiration techniques, artificial respiration machines, chest compressions, etc.
There are only four months before the end of the internship. I will try my best to leave a better impression on teachers and patients. I hope I can get my wish.
2. Self-identity of emergency department
During the internship in the emergency department, I should abide by the rules and regulations of hospitals and departments, have a correct internship attitude, clear internship motivation and strong work initiative. Under the guidance and guidance of the teacher, strict "three checks and seven pairs" and aseptic operation were carried out. Now I have understood the process of pre-hospital examination and pre-hospital first aid, and I am familiar with the nursing of common diseases in emergency and the rescue cooperation of critically ill patients! Being affirmed by the emergency department teacher, I will work harder in the future ... First of all, the emergency practice nurse can't enter the rescue role in time, and the problem of assisting the teacher to rescue has become the main contradiction in the rescue work. In order to give full play to the role of practical nurses in the rescue and improve the examination results, we adopt the method of scene simulation to teach. By changing the teaching method, the qualified rate of nurses' out-of-surgery examination has been improved obviously. Therefore, the adoption of new teaching methods can enhance teachers' learning motivation, improve the overall level of nurses, and make practice nurses adapt to the role of rescue as soon as possible, so as to give full play to their greater potential.
The emergency department is a comprehensive department, which is characterized by the coexistence of many diseases. Therefore, emergency nurses must be all-round nurses who fully understand the characteristics of various diseases. However, due to the lack of first-aid experience, poor nursing skills, improper teaching methods and lack of first-aid experience, emergency nurses can not quickly enter the rescue role and share the rescue task. In order to shorten the teaching period, improve the teaching effect and adapt to the emergency work as soon as possible, we analyze their behavior and formulate reasonable measures for scientific teaching. The teaching method should not be that after the intern nurses report for duty, they will be taught by teachers who have worked for more than 2 years. What students learn depends on the teacher's personal experience, the workload of the class and the strength of the teacher's explanation skills. If the teacher's explanation skills are poor, his personal experience is not rich, he sees few diseases in class, and the contents learned by the nurse interns are not comprehensive. In practical work, most patients in emergency department are urgent, critical and severe, and patients and their families are very anxious. Because of the poor ability to evaluate and judge the condition, the intern nurses also ask patients to register and wait for treatment as usual, instead of doing some nursing work before diagnosis immediately, which will make patients and their families feel disgusted and have contradictions. Not familiar with the first aid process. Most nurse interns are not familiar with the rescue procedures and do not know the nurses' coping measures. Therefore, I'm afraid I can't enter the rescue role as soon as possible and finish the rescue task earlier. Not familiar with the usage of various drugs and the performance of instruments. In the process of first aid, because I am not familiar with the dosage, usage and function of first aid drugs, and I don't know the placement and operation procedures of various first aid instruments, it is easy to make mistakes in the busy process, thus delaying time and losing the opportunity of rescue. Poor first aid knowledge and operation skills. Whether the first aid is appropriate or not directly affects the safety of patients and their first impression of the hospital. At work, it often happens that patients do not trust the hospital, ask for transfer or cause disputes because of the poor first-aid knowledge and operation skills of intern nurses. Psychological quality is not too hard. Emergency patients panic as soon as an accident happens, with various conditions and shocking scenes. If you encounter an unfamiliar disease or unbearable situation, the intern nurse will be nervous, deformed and forgetful, which will affect the smooth development of first aid work. Stiff attitude, lack of patience, improper use of words can not give scientific, reasonable, patient and comprehensive explanations to patients' questions, and rude attitude and blunt words cause unnecessary disputes.
I have learned too much in emergency science, which is not available in other specialized wards. ECG and ECG monitoring vital signs are the most basic principles of nursing every patient. Organophosphorus poisoning and other pesticide poisoning, cardiopulmonary resuscitation and defibrillation. I've seen them all, and they're all miscellaneous diseases. A month's harvest is good.
The emergency department internship is over. Once again:
One end means another beginning, and I will start a new internship journey!
The future is bright, wish me luck!
3. Self-identity of emergency department
Once upon a time, I heard an old nurse say, "It is difficult to be a nurse, it is difficult to be a good nurse, and it is even more difficult to be an emergency nurse." Only then did I understand the real meaning. I was deeply impressed in the emergency department for just one month. Arriving at the emergency department on Monday, the head nurse enthusiastically introduced us to the nature, rules and regulations and workflow of emergency work, which gave us a preliminary understanding of emergency, such as the requirements of emergency window service, the rigor of checking system, the necessity of accompanying, the importance of ensuring safe transportation, the daily inventory of rescue equipment and emergency articles, and the importance of ensuring good condition. It was not until the night shift that the head nurse really realized the importance of explaining all this.
When I was on the night shift, several patients came one after another, and I was immediately stunned. I had no choice but to ask the teacher for help, watching the teacher make an orderly, rapid and accurate triage of acute abdomen, contacting the orthopedic surgeon by phone, and arranging to escort the patient with nosebleeds to the otolaryngology department; At the same time, he instructed me to push the patients with cerebral hemorrhage to the emergency room, and asked me to call a pediatrician to see a doctor when I was sucking sputum and infusing mannitol with indwelling needle ... After about half an hour, the emergency department was temporarily calm again, and my envy came from my heart. In case of emergency, we should not only "lay a solid foundation", but also have skilled operation skills and keen observation. Dispose of emergency ability, be calm when something happens, and cooperate with doctors to complete the rescue accurately and quickly; In the emergency department, time is life, and it is our duty to strive for every bit of time for patients. Later, a patient with supraventricular tachycardia was sent to the emergency room. In just a few minutes, he recovered his electrocardiogram, ECG monitoring, oxygen inhalation and intravenous propafenone. The teachers are flowing, and the emergency room is orderly and busy, which makes me look forward to it.
Nightingale said: "Nursing needs not only exquisite skills, but also art". It takes courage and confidence to work in the emergency department. At first, I was afraid of emergency work, so I should be "not afraid of danger". As a window unit, medical staff do not have enough time to communicate with patients and their families, and their families are impatient and sensitive to every detail of medical staff, which requires us to say, do and make sense of everything and do everything in place. I remember a child with epilepsy, grand mal, who lasted for 40 minutes. We give children intravenous drugs, enema, defecation cleaning, health education, and go to the accompanying ward for hospitalization. Everyone is anxious that the child's persistent brain hypoxia cannot be alleviated, and at the same time, they are constantly comforting the parents of the children who are at a loss. Afterwards, we sincerely thanked our families, which made me realize the true meaning of emergency first aid again and understood that loftiness and trust come from sincere dedication.
In such a department that is constantly learning, willing to pay, full of promises and challenges, I have been sublimated from theory to practice to thought. In the future work and study, the professionalism of "knowledge, action, sadness and love" in the emergency department will lead me to go further and fly higher.
4. Self-identity of emergency department
First, strengthen service awareness, improve service quality, adhere to the patient-centered, patient's interests and needs as the starting point. If the nurse is required to quickly push the car to the emergency room door after hearing the sound of the ambulance, the patient will be admitted. Provide patients with facial tissues, paper cups and boiled water. Register for the unaccompanied elderly, the weak, the sick and the disabled to take medicine. Every emergency inpatient is escorted to the hospital by a nurse or nurse. In order to solve the problem that there are many transfusion patients at night in summer, flexible scheduling is implemented to increase the number of people going to work at night. These measures have been welcomed by patients. Especially in disputes between doctors and patients, even when we beat and scold medical staff, our nursing staff tried their best to explain reasonably, and they didn't fight back or scold, which was praised by the hospital.
Second, strengthen learning and cultivate high-quality teams.
The emergency department formulates a learning system and plans to strengthen the professional knowledge learning of nursing staff. To carry out emergency professional training and send nurses to anesthesiology department and operating room to learn tracheal intubation requires everyone to pass eight emergency operations. Learn the new progress of cardiopulmonary resuscitation, acute coronary syndrome first aid and trauma first aid with doctors. Improve the level of emergency treatment and the speed of rescue response. General practitioners consciously learn from Wei Ran. At present, there are 8 nurses taking the national higher education nursing junior college classes and undergraduate self-study exams. Two nurses who worked for one year passed the nurse's practice examination. Assign senior nurses to study the new concept of emergency nursing and emergency simulated first aid training.
Third, do a good job in teaching new nurses and interns.
According to the working characteristics of the emergency department, a three-month training plan for new nurses was formulated, requiring new nurses to master the first aid procedures, pre-hospital first aid, how to answer emergency calls, master the use of all instruments in the emergency department, and strengthen theoretical study and assessment within three months. In the first year of training, good results have been achieved. For interns, let go of their eyes and give small lectures every week.
Fourth, care for life and race against time.
It is the direction of emergency department's efforts, and we should also do a good job of "urgent" articles. For example, on October 7th, 20xx165438+/kloc-0, the patient who was sent to the emergency department due to falling from a height was unconscious, restless, unresponsive, with bloody fluid overflowing from his mouth and open fractures of both lower limbs. As soon as the nurse on duty saw it, she was given oxygen and intravenous injection, and decisively took tracheal intubation, sputum aspiration and oxygen inhalation, and at the same time opened a green channel to win valuable time for rescuing patients.
Five, do a good job in the management of first-aid drugs and first-aid equipment.
The preparation of first-aid drugs and the debugging of various first-aid equipment are the basis of first-aid work. Now there is a special person in charge of every job, and the responsibility is carried out to people, so that the class can check regularly. During this year, there was no influence on the rescue work because of first-aid drugs and first-aid equipment.
5. Self-identity of emergency department
I believe you have a new understanding of the emergency department. Facing the first diagnosis and rescue of critical emergency patients, emergency patients often have unclear diagnosis, unclear condition and rapid changes. If it is not handled properly, it is easy to have medical disputes. However, patients and their families are prone to impatience, anxiety and fear. The emergency room is different from the ward. Medical staff have enough time to communicate with patients and their families, understand the needs of patients in time, and establish a good nurse-patient relationship. In the emergency department, patients and their families have not yet established a good sense of trust in their brief contact with medical staff, and they are very sensitive to every nuance of medical staff. The speech and behavior of medical staff will have a great influence on patients' psychology. As a result, the rescue behavior of medical staff is not understood, leaving patients and their families with the illusion that they are not taken seriously and the emergency is not urgent. Therefore, the more I feel that communication is the most easily overlooked and important thing in an emergency. Nightingale said: Nursing needs not only exquisite skills, but also art. First, you must learn to observe, so that you can be good at discovering the existence of problems, including observing the patient's condition, psychology, needs and family members. For example, some patients' families are critical of nurses' behavior, but they don't fully understand patients' fluids. For such family members, we should patiently remind them where to call a nurse when changing fluids. At the same time, we should also patrol the ward on time to observe the progress of the liquid, so as to avoid conflicts with the patients' families to a great extent because the liquid was not replaced in time. Second, learn to communicate. Mutual respect and trust between people is based on communication. For patients who come to the emergency department, we should actively ask and guide them enthusiastically. For example, we can help patients with mobility difficulties, or help them take them to the clinic with carts, measure their vital signs and give them to the nurses in the clinic; For patients who need and can go to the ward for treatment, the location of the ward can be pointed out in detail to prevent patients from running the wrong way. For patients who have been ill for a long time but their condition is not critical, we can advise them to go to the outpatient clinic for medical treatment, and patiently and carefully inform them of the location and time of medical treatment, so as to facilitate patients' arrangements. A smiling expression and a hand gesture can not solve the physical pain of patients, but can quickly shorten the distance between nurses and patients, effectively meet the psychological needs of patients who need care, thus facilitating our follow-up nursing work. Finally, through observation and communication, learn to judge, and have an accurate understanding and judgment of the patient's condition and needs, which is conducive to the rescue work of medical staff and buys time for patients. For example, trauma patients can know the location and severity of their injuries through observation and general inquiry, and seek medical treatment at the first time. Registration procedures can also be prepared. The above is just a brief talk about my work in the emergency department, and there are still many things to learn.
Of course, being a good emergency nurse is not enough. It also needs a solid theoretical foundation, rich rescue experience, quick response and quick action. This is a guarantee to stand the test in an emergency. During my internship in the operating room, I strengthened the concept of sterility and increased my understanding of the principle of sterility, which made me have a deep understanding and understanding of the work tasks of hand-washing nurses and visiting nurses, and also made me have a better understanding of the cooperation between nurses and doctors.