Day 7 Clinical Placement

Just finished day 2 of my second week of placement. This week I am on the ENT (ear, nose, throat) and Plastics ward, and I'm also doing evenings instead of mornings. I'm finding the shift goes quicker even though I feel less busy, and I also don't get as hungry as I did on the morning shift. I like saying 'good night' and seeing the patients go to sleep at the end of the shift.

I'm enjoying the mix of patients, all ages, and learning about and caring for their conditions which are all very different. I have been looking after a room of boys (last week I was looking after a women's room). Two of them are very low maintenance (only have to do something for them twice in a shift, usually towards the end of the shift) and the others have been more high maintenance with lots of things to do and lots of checking up.

Today I had my first post-op patient which was good because that's one of the things we've been learning in this subject. We brought him up from recovery and then had to do half hourly observations of vital signs and pain level and the circulation to his fingers and check that the wound (on his hand) wasn't bleeding.

The other high maintenance patient has a tracheostomy (breathing through a hole in his throat) and needs continuous oxygen therapy. He also has a naso-gastric tube. He can only communicate through body language or a notepad because he can't talk due to the trachy. I haven't learned tracheostomy care yet so for that I've just been observing my nurse buddy but I've been able to do everything else. We also took him for a chest x-ray after the naso-gastric tube got dislodged.



I've had more opportunities to give drugs via different routes - several by IV port injection, crushed up pills via naso-gastric tube, mouth drops, and eye drops.

I've also chosen the patient I am going to use for my assignment which is a 2000 word nursing care plan due 2 weeks after this placement and it's worth 50% of my grade. The challenge was finding something not too complicated and not too simple and something that I find interesting. The patient I've chosen is a 20 year old male with a condition call arteriovenous malformation (AVM) which is a bleeding disorder for which he has needed major facial reconstructive surgery and has lost vision in one eye and also has only one ear. I looked after him on Monday and tomorrow I've arranged to do an interview with him. Since I haven't been too busy I've had the chance to read through his entire file and look at all the history and treatment he's had, and also do a bit of research on the internet about it.