The emergency department is one of the most important windows in the hospital. My hospital is one of the best comprehensive tertiary hospitals in the province. It not only receives normal acute and severe patients, but also receives critically ill patients transferred from prefectures and counties. It is anxious, busy and complicated. 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 treatment behavior of medical staff is not understood, leaving patients and their families with the illusion of "being ignored" and "being urgent and 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 wrong". 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 short work in the emergency department, and there are still many things to learn. Everyone is my teacher in the emergency department, and everything is my experience, which has taught me a lot, whether it is being a person or doing things. 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.
Emergency department internship experience II
The emergency department, as its name implies, is the department that rescues critical patients. It is very exciting, full of mystery, and it is thrilling to feel the fragility of life and the strong willpower of human beings. It was a department of death and struggle for existence, where medical staff raced and struggled with death for a chance of survival. This is my understanding of the emergency department when I was studying critical illness.
Because of the defects in the emergency department of the internship hospital, I didn't see the busy and tense atmosphere, and I was disappointed at once. The emergency department has completely become a comprehensive internal medicine department, with many patients with heart failure, coronary heart disease, diabetes, pyelonephritis and pneumonia. The drugs used in the department are varied, almost all of which are chronic diseases. In a few critical cases, gastric lavage, defibrillation, cardiopulmonary resuscitation, simple ventilator and ventilator are useless at all, and those infusion pumps and ECG monitors have become furnishings. The working environment is very simple, the sanitary conditions are poor, the instruments and equipment are outdated, and the working conditions are equally difficult. The case is still in the doctor's handwriting stage, and the blue oxygen bottle is still in use. In short, it makes people feel poor. Although the working conditions and environment are not satisfactory, the patient's understanding attitude towards disease knowledge and eager eyes make us feel how happy we are, and we have no regrets in choosing this career. The patient's strong cooperation has greatly improved my venipuncture technique. No matter who in the department can guide us interns to do some physical work such as cleaning, I feel quite wronged. Considering the patient's good rest environment, I put up with it for the sake of the patient's face. I'm here to study, not to be a free laborer. I am deeply unwilling and angry. The arm can't twist the thigh, who let people be leaders? We have no position! Laugh despite reluctance, it's so painful! Through my two-week internship in the emergency department, I witnessed their work style, attitude and ability to interact with people. I really dare not compliment them! Doctors and nurses have a weak sense of responsibility, and when they encounter problems, they will push from pillar to post, and laziness and laziness will become obstacles in their work. This is probably because the outpatient department is too far away from the hospital and the inspection and supervision are not strict, which has caused such a situation. Quick hands and feet, not keeping up with the joneses, and a harmonious relationship between doctors and nurses are the basis for doing a good job in medical and health services. Hospital hardware equipment is on the one hand, and soft power is as important as the rules and regulations of interpersonal relationships. Good equipment also needs to be maintained and cherished by everyone. It is unclean and unclean, and good things are just like old ones.
I admit that I didn't study hard in this department, and I complained a lot. I think a person who can really learn and know how to make progress is not influenced by others' teaching, but is good at finding problems, asking questions, and then collecting, sorting out and analyzing information to achieve the ability to solve problems independently. There is a famous saying that there is no road in the world, and people who walk a lot will become roads. We should be brave enough to open up new roads and strive to be the first person to open up new ones.
This experience is entirely my personal feeling, others' feelings are not necessarily like this, and I can't judge others casually. Please forgive me if I have offended anyone.
Practice experience in emergency department III
The emergency department is the department with the most concentrated acute and critical patients, the most complicated diseases, the most urgent time, the most emergencies and the heaviest rescue task. It is a window to reflect the comprehensive level of a hospital. In order to adapt to the development of modern emergency medicine and improve the success rate of patient rescue. How to cultivate the ability of pre-examination, triage, condition observation and first aid coordination of nursing students in emergency department and realize the teaching goal is the direction of our efforts. My teaching experience in the emergency department is summarized as follows.
1 There is a problem:
1. 1 Disharmony between teaching and learning Due to the timeliness of emergency work, the success rate of various nursing operations is required, resulting in many tasks that are not allowed to be completed by nursing students, such as sputum aspiration and gastric lavage. In practice, nursing students lose their internship opportunities for fear of being accused by patients and their families, or the rescue is not in place, which makes them far from meeting the requirements of the internship plan.
1.2 The quality of teaching staff is mixed. In clinical practice, there are few teachers with solid professional foundation and high professional quality, and there are many nursing students, and some teachers are unwilling to teach. Some teachers have dogmatic teaching methods and cannot teach students in accordance with their aptitude. Students with poor foundation work hard, while students with good foundation can't exert their potential and better mobilize their enthusiasm.
1.3 There are many and complicated rescue instruments in the emergency department, and there are also many nursing operations that need to be mastered, such as cardiopulmonary resuscitation, gastric lavage, and the use of ventilator. However, the practice time of nursing students in emergency department is short, so it is really difficult to ask them to be familiar with and master these operation techniques. Some nursing students are often at a loss in a tense working environment because of their strict requirements and fear of operation, and even lose confidence in their studies.
1.4 Lack of communication Some teachers have a strong sense of responsibility and mission. They are strict with nursing students, standardize management teaching, follow a certain order and proceed in an orderly way. Although such teachers have certain dignity, they lack human feelings, which leads to the lack of communication between teachers and students.
2 teaching methods
2. 1 while teaching nursing students, we should strengthen the basic operation of first aid and practice on simulated people. When you meet a patient, you should read more books, ask more questions, then read more books, and combine theory afterwards. When you encounter the same disease again, you should be aware of it. Give examples to guide nursing students to practice and operate more. For example, when emergency patients see a doctor, they will instruct nursing students how to receive it, the wound treatment process of trauma patients, and the rescue process of critically ill patients. , explained by the teacher, students operate, and complete the disposal of emergency patients under the guidance of the teacher.
2.2 Improve the overall quality of teachers. In the process of clinical practice teaching, teachers are selected by departments, and they also learn to think from different directions and different sides by excavating teaching materials and combining themes, resulting in multi-angle and multi-level thinking activities, improving the ability to solve problems and achieving the expected results of teaching.
2.3 Strengthen the cultivation of first aid skills in practical work. For catheterization, gastric intubation, sputum aspiration, gastric lavage and other operations, we should "let go without looking." While providing practical opportunities for nursing students, we should strengthen the guidance, supervision and help for nursing students, so that nursing students can be encouraged in such difficult operations, thus gradually overcoming the situation of being helpless at the rescue site and improving the rescue cooperation ability.
2.4 Learning to communicate is a process of transferring and feeding back thoughts and feelings between people and groups, so as to achieve ideological consistency and emotional smoothness. Teaching teachers should understand the active thinking of modern young people, and the teaching forms should be eclectic, so that learning forms can be diversified and effective communication can be applied to teaching work.
In a word, by standardizing teaching and combining the characteristics of emergency department, nursing students mastered the first aid theory and operation skills required by the teaching syllabus during their internship in emergency department, and the first aid operation and theoretical assessment reached the standard, which achieved our expected results.