Internship is an indispensable learning stage for every medical student. As a beginner who is very lacking in clinical experience, in addition to his own teaching teacher, other doctors, nurses and patients in the ward are teachers who should be consulted.. Therefore, I maintain a humble and serious study attitude, actively participate in all the ward's learning, medical treatment, discussion and other activities, starting from the most basic examination, medical records, and gradually sharpen myself.
Before entering the ICU, I brought a teacher to explain the management system and disinfection system in the ICU, and introduced the ICU environment, so that I had an understanding of the monitoring room and worked well. I specially arranged lectures on specialized disease knowledge, which is common for chest and heart surgery.The introduction of the disease has given me a certain understanding of thoracic and cardiac surgery diseases and is conducive to postoperative monitoring. In addition, I also teach basic nursing aspects, such as preoperative education for patients, psychological care and life care.
First, let me understand the significance and importance of central venous manometry. It is an objective standard that directly reflects left ventricular function and measures blood volume, guides the rate of fluid replacement and assesses blood volume. Factors affecting central venous manometry: ① Zero point② The fourth rib of the mid axillary line in the supine position and the fourth rib of the anterior axillary line in the semi-recumbent position; ③ The patient must measure the pressure in silence; ④ The pressure measuring tube must be kept open to ensure that the catheter is in the vena cava or right atrium;When applying the ventilator PEEP, the PEEP value must be subtracted to obtain the true central venous pressure. At the same time, the teacher and I measured the pressure separately to compare the accuracy of my measurement. Pay attention to sterility and avoid injecting vasoactive drugs from the pressure measuring tube, And make sure the pipes are in place.
After entering a clinical internship, I tend to focus my learning on the operation, and relax the training of theoretical learning and clinical thinking, especially in thoracic and cardiac surgery. There are many types of thoracic and cardiac surgery, and there are many operations. IIt is easy to focus all of my attention on the operation. Therefore, I take more surgery and more hands as the main purpose of the internship. The pathophysiology after the operation will change a lot. I must comprehensively and accurately integrate the medical history, signs, and condition.In order to accurately grasp the key points, understand the essence, understand the impact of surgery on patients, and formulate the correct treatment measures, let them know more about the reasons, and then gradually improve their clinical work.Ability to analyze and solve problems.
Through a one-month internship, I have an understanding of postoperative monitoring of thoracic and cardiac surgery. I have basically mastered the clinical applications and precautions of monitors, ventilators, defibrillators, micropumps, and can independently complete central venous pressureTesting skills, suction of sputum in tracheal intubation, writing of nursing record sheet, summary of the amount of access and other monitoring skills. Finally, they can pass the theoretical and operational skills exam.
With the development of medical science, the widespread application of advanced electronic instruments in clinical practice, this has also put forward higher requirements for nurses, not only must have a high sense of responsibility, but also learn the skills of intensive care and intensive care. I am in the chestMastering intensive care and intensive care skills during the internship in the cardiac surgery intensive ward has improved the overall quality and professional level of clinical nursing. During the internship, I understand the purpose, meaning, precautions and harmfulness of improper operation.Secondly, I know that some operations must be experienced first-hand in order to master the skills, and to operate on the patient after mastering the methods and skills.
During the internship. I always insist on myself from the perspective of seeking truth from facts, starting from little by little, because this is responsible to the patient, to myself, to society, and to science.