A bit about brain tumors that I learned while on clinical placement:
Symptoms:
• headache
• vomiting
• dizziness
• strabismus (uneven eyes)
• meningismus (three symptoms occurring together - neck stiffness, sensitivity to light, and headache)
The most common type of brain tumour is a meningioma, a benign tumor that grows out of the meninges. 8/10 are treatable with surgery, steroid drugs, and/or anti-seizure drugs.
Goals of brain tumour treatment:
• decompression to relieve intracranial pressure (surgery)
• diagnose the type of tumour (histopathology)
• management plan (radiotherapy, rehab or palliative care)
• peritoneal shunt (if there is hydrocephalus)
This week I did two aged care shifts (paid work) and have been going to class three days a week. Next week I have a group presentation worth 20% and an assignment worth 40% to do.
Videos
• Nurse TV: Nursing Makes a Difference http://www.youtube.com/watch?v=TOiK5Cbz97U&feature=related
• Nurse TV: No lift policy http://www.youtube.com/watch?v=xQTJd_-QSXE
• Safe Needles Save Lives
Reading
• Reflective Practice: A Guide for Nurses and Midwives
• Neurologic Assessment Skills for the Acute Medical Surgical Nurse
• Neurovascular Observation
Lectures
• Adverse events and root cause analysis
• Quality and risk management
• Implementing Change
• Leadership in nursing
• Clinical leadership and management
Monday, April 4, 2011
Sunday, April 3, 2011
Third and final week of placement
Had six shifts in a row this week and most of them were earlies so I've been very sleep deprived and tired. But the placement has been great. I have one more day to go (tomorrow). Also starting tomorrow I have two weeks of classes for my Professional Transitions in Nursing subject.
Here are some of the things I did this week:
• Had the flu vaccine (for free)
• Observed and assisted with the fitting of a halo brace. Involves full spinal care manual handling (five people) and the doctor put the brace on, screwing it into the skull (with local anaesthetic). My role besides the manual handling was to hold the patient’s hand and tell her she is being so brave. They needed her to stay really still and she squeezed my hand really hard when they were injecting all around her head with the anaesthetic. I put a picture of a halo brace a couple of blog posts ago.
• Administered intravenous drugs via a PICC line (directly into the heart), using sterile technique.
• Looked after five separate patients that were IV drug users and had head injuries due to either a fall or a car accident while intoxicated. Two of them were in nappies and had to be spoon fed all their meals. Another had to be shackled to his bed because he was non compliant and would put his head drains out IV lines if his hands weren’t tied up.
• Planned and carried out all the care and documentation for two patients each shift. Some things, like give drugs, I had to do under supervision but everything else I did myself.
• Got a really good final assessment and feedback from my clinical educator and successfully passed the placement.
Here are some of the things I did this week:
• Had the flu vaccine (for free)
• Observed and assisted with the fitting of a halo brace. Involves full spinal care manual handling (five people) and the doctor put the brace on, screwing it into the skull (with local anaesthetic). My role besides the manual handling was to hold the patient’s hand and tell her she is being so brave. They needed her to stay really still and she squeezed my hand really hard when they were injecting all around her head with the anaesthetic. I put a picture of a halo brace a couple of blog posts ago.
• Administered intravenous drugs via a PICC line (directly into the heart), using sterile technique.
• Looked after five separate patients that were IV drug users and had head injuries due to either a fall or a car accident while intoxicated. Two of them were in nappies and had to be spoon fed all their meals. Another had to be shackled to his bed because he was non compliant and would put his head drains out IV lines if his hands weren’t tied up.
• Planned and carried out all the care and documentation for two patients each shift. Some things, like give drugs, I had to do under supervision but everything else I did myself.
• Got a really good final assessment and feedback from my clinical educator and successfully passed the placement.
Friday, April 1, 2011
Understanding the nursing handover and patient notes
Acronyms from ONE SHIFT:
ABX - antibiotics
NAD - nil abnormalities
CP - chest pain
THR - total hip replacement
OSA - obstructive sleep apnoea
HOB - head of bed
BOS - base of skull
TTE - trans thoracic echogram
AXR - abdominal xray
TOV - trial of void
VSS - vital signs stable
IVDU - intravenous drug user
ORIF - open reduction internal fixation
MVA - motor vehicle accident
ABX - antibiotics
NAD - nil abnormalities
CP - chest pain
THR - total hip replacement
OSA - obstructive sleep apnoea
HOB - head of bed
BOS - base of skull
TTE - trans thoracic echogram
AXR - abdominal xray
TOV - trial of void
VSS - vital signs stable
IVDU - intravenous drug user
ORIF - open reduction internal fixation
MVA - motor vehicle accident
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