Saturday, August 22, 2009

First Week of Head Nursing Exposure

I and my other dutymate was assigned in North General Hospital at 3B Station- has the Medical, Surgical, Pedia, and OB wards. Prior to our duty which started last Sunday night ‘coz we were assigned in graveyard/nite shift-10pm to 6am, we were not able to have an orientation because the teacher didn’t want to orient us anymore due to lack of time. Basically, we have no idea of what to do during the duty. This is also our first time to be assigned in NGH, so we were totally clueless.

August 09, 2009 Sunday (10pm-6am), Charge Nurse: Sir Dexter

Since there was no bus later that evening, we decided to meet at Ayala and from there we rode a taxi to NGH. We were so nervous that time because as I’ve said, we had no idea of what to do. We went inside the hospital, looked for the nursing office, and punched in our punch cards. We arrived at 9:30 so we still have time to change in our clinical uniforms. After a few minutes, when all was set, we then carefully headed to 3B Station. Carefully so as not to awaken the patients. As we arrived at the station, all we did was stare at each other, stand in the corner, and totally clueless. We hesitated to greet the staffs because they were very busy, we didn’t want to startle them. When it was time forendorsement-endorsing the previous shift to the next shift, a guy in an all-white uniform who’s eating Chippy, asked if we’re on our 1st day of head nursing and we said yes. The guy’s name is Dexter. He was tha charge nurse that evening, and we didn’t know until he called us for the endorsement. Once the endorsement finished, we had the rounds- going to every patients’ room and checking the IVFs (Intravenous Fluids) for the remaining cc/ml, just like the usual rounds. After which, he then taught us how to do the things the Charge Nurse does- which I will explain later. So basically, that’s all we did on the first day-learning the basics.

August 10, 2009 Monday (10pm-6am), Charge Nurse: Sir Dexter

Another day in head nursing. I was all alone this day because my partner was absent due to unknown cause. I was so nervous, I also planned to be absent, but then my conscience haunted me. I paid a hundred pesos in my taxi fair that night-so sad. Again, as I arrived at the hospital, I punched in my punch card, get dressed, and went to the station. As I saw Sir Dexter, I was so scared. I told him my partner is absent and he gave me a shocking reply which was “Good Luck”. I didn’t know what he meant by that but it made me want to run, pack my things and go home. After the rounds, he then repeated what he taught to me and made me apply what I learned. When I had nothing to do that time, I wrote in my notebook the tasks of a head nurse which includes:

1. Receiving the endorsement from the previous shift.

2. Doing the rounds- checking the remaining IVF solutions.

3. Preparing the Summary Nursing Care Plan for the next shift:

-must refer to the kardex for the room numbers, names of patients and physicians

-copy the from the previous shift’s summary nursing care plan

4. Preparing the Assignment Sheet:

-write the names of patients with their room numbers

5. Solving the previous IVFs for the Time, Parenteral, and Remaining.

-this is the part I hated the most. I really can’t get it right especially when getting the remaining and the time.

6. 3 hours before the shift ends, rounds must be done to check the remaining IVFs again for the next shift.

7. Updating the new Summary Nursing Care Plan for the remaining, IV number, time to be hooked, and the solution.

8. Getting all the charts:

-check for the monitoring like vital signs, then fold

-write the parenteral in the I & O sheet and slash the solved parenteral, then fold

-lastly, check the order if it is carried/noted and crash out the patient’s room numbers in the previous SNCP.

And you are done!

P.S. If there are any new orders, leave your usual work and transcribe the order from the chart to the kardex, and the new prescribed medicines from the kardex to the medicine tickets and medication sheet. When done, fold the kardex, insert it in the chart right where the order is attached, and let the Charge Nurse check it.

August 11, 2009 Tuesday (10pm-6am), Charge Nurse: Ms. Julie

My partner was present again this time. As we arrived at the station, we were surprised to see another charge nurse. It was Ms. Julie since Sir Dexter had his day off that day. We were again scared to death since we don't know the new charge nurse. Many questions were running on our minds-is she okay? Is she strict? Or what? Finally, she spoke to us. She asked if we are for head nursing, and we said yes. She was shocked to see that there were two of us. So she called the Nursing Service Department to ask if there were students for head nursing on the other station-the 3A Station-which has the private rooms. Private rooms are rooms which are more costly than the wards. It is air-conditioned, has TV, couch, private bathroom and toilet, and allows two significant others to stay for the night. Going back, so after calling the Nursing Service Department, she asked one of us to transfer to 3A station since there was no student for head nursing on duty. My partner decided to transfer, so I was left alone again in the 3B Station with the new charge nurse. I just sat quietly in the corner and just wait for her to make instructions. Finally, all went well except for the solving the IVFs part. I was so confused on how to solve it. She and Sir Dexter have different techniques. I didn't know who to follow. Now I know that they (charge nurses) have different styles and I can tell who is right and wrong.

August 12, 2009 Wednesday (10pm-6am), Charge Nurse: Sir Dexter

This was our last day of duty since the next day will be our Midterm Examination. Again, my partner was absent because according to her, she felt tired to go on duty. So I rode the taxi and payed 100php, punched in my DTR, got dressed, and went to the station. I was surprised again to see Sir Dexter-yeah he's back. I know that's a good thing because I know him well enough now. So the usual routine was made and before the shift ends, I gave him my evaluation sheet for him to evaluate me. He brought it home and said he'd return it the week after.

So basically, that ends my first week of head nursing exposure. Another week awaits, and another story to tell.



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