Howdy all. It’s been a while. This week has been nuts. I had a midterm on Tuesday and a paper due tonight. Aside from all of that, today was my 4th Clinical at BC Children’s Hospital. I definitely feel my confidence is getting stronger in this setting and love it MORE and MORE. Since the beginning, I’ve had the privilege to take care of a 2 month old, 5 year old and 3 month old.
Today was a little different. The mom of my patient had to leave at 1200 to go be with her other children, so I got the chance to hang out with this little man for the majority of the day. With a 3 month old baby in with bronchiolitis, who was quiet sick kept me on my toes. There were times I’d go into the room to do a q1hr check, thinking I’d be in there for 5-10 minutes but ended up staying for over an hour. I’d end up taking vitals, feed him a bottle, change his diaper and settle him down if he’s was agitated. Time definitely passed by fast. This really showed me the importance to time management, especially if you have other patients.
Having this patient has given me the chance to really listen to a crackly and congested chest. I’ve also seen the effect that a NS (normal saline) nebulizer or Ventolin can have with the loosening of mucous. Within 15 minutes of the first ventolin was given my patient got into a coughing fit, which had definitely been a result from the neb. Over all, I feel like I know what a crackly and wheezy chest sounds like.
Aside from this I felt my communication with my nurses was great! I was reporting off every so often on my patient’s status and working alongside. I felt like I learned a lot and had some great conversations with them. I finally feel that I am a part of a team and it’s great.
There were two aspects I felt I covered under this objective today. Today, I especially felt like I applied my “critical thinking to clinical decision-making” aspect. There were times during the day where my patient would have coughing fits and the mucous would move up around in his lungs. At times his O2 sats would drop to the low 80s and I was worried that he could go into a state where we’d have to call a code. I was in a situation, which I had no control of and yet I managed to apply my knowledge in regards to my care for this child. I believe I was able to provide adequate care to this infant when using my critical thinking in the spur of the moment.
I also felt I used “evidence-based knowledge in practice today” by demonstrating the needed knowledge to deal with the drop of O2 sats during his coughing fits. He was on 1/8L NP, so when this happened, I increased his rate and attempted to calm him down by bouncing him up and down. Once settled, the O2 was brought down to 1/8L again and O2 sats were high 90’s. Knowing the O2 would help with his sats, as well as calming him down during his fit was evidence-based knowledge I have gained and learned from my education at Trinity.
Anyways, thought I should fill you in. I’m exhausted and about to pass out! Have a wonderful weekend ya’ll. I’ve got another paper to start! xox
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