Emergency Room Rotation Week

Learning Report

What were your responsibilities or duties this week?
My duties this week were to observe and shadow an Emergency Room Tech and learn how the ER functions. I was to ask questions as well as observe diagnosis, treatment and triage. I had to shadow the nurses and techs of the ER and learn how the process of triage and assessment work. I was to interact with the employees and learn more about the careers associated with the ER and the technology and procedures that are used within the department.

What new knowledge or skill did you learn this week?
This week I learned how unexpected and important the Emergency Room can be. By observing, I learned that diagnosing a patient is a time consuming and, sometimes, difficult task. Some patients can be serious where as other might not be. I also learned that there is much more than diagnosing and treating a patient by observing behind the scenes when the nurses were away from their patients. A lot of paperwork and research is necessary for each patient that is omitted. The ER must remain organized and proficient in order to insure triage is maintain properly and successfully. Within this hospital, the ER can become chaotic at any time or be slow other times, which means the employees must always be ready for the unexpected. 

What was the best thing that happened at the unpaid work-based learning site this week?
The best thing that happened in the ER was when the EMS brought a patient in to be treated. I was able to observe the procedure while the EMS entered and the actions necessary once the patient arrived. Despite the strong urine spell, I was able to see the nurses and employees react to an emergency and treat the patient accordingly.

What was the worst thing that happened at the unpaid work-based learning site this week?
The worst thing that happened this week was during the first day when it was very slow and the tech who I was shadowing was on the phone and talking to her fellow employees which made it difficult for me to interact and ask questions. 

If the "worst" was a mistake, how was it corrected?
I went in the second day determined to ask more questions and talk to other employees and avoid any awkwardness. I did not want to miss any opportunities to learn whether the ER was busy or slow. 

This week was: Fair
Why?
The second day made up for the first day because I was able to see more patients and more of the department as well as ask questions about the ER. However the first day, my nervousness did not allow me to ask many questions and resulted in an awkward day.

Experience Record 

Technology observed:

• Vital Sign Monitors
• CAT Scan                
• Cardiac Monitor
• Stethoscope/Blood Pressure Cuff/Thermometer 
• Defibrillator
• Oxygen Tanks/Oxygen Masks 
• Crash Cart

Diagnostic procedures observed:

• Questioning the patient
• Vital Signs
• CT Scan
• Radiology
• Laboratory
• History questioning
• Urine Test
• Blood Tests (for infection, etc.)

Therapeutic procedures observed:

• Morphine
• Medication
• Upright Position (Orthopnea) /Decubitus Position
• Oxygen Mask

Disease/disorders observed:

  

• Allergic reaction -  immune response or reaction to substances
• Dementia - loss of memory and brain function
• Respiratory Distress / Dyspnea - difficult or labored breathing
• Chronic Headache - head pain which lasts for a long time
• Orthopnea - difficult breathing that is relieved in the upright position
• Angina - chest pain

Medical terminology/abbreviations encountered:

• Trauma -  injury to the body
• MRI - Magnetic Resonance Imaging
• CT Scan - Computed Tomography Scan
• Triage - process of determining the priority of patients' treatments based on the severity of their condition
• Diagnosis - Determining what's wrong with a patient 
• Central Line - central location of the vein used to help fluids enter the body
• Assessment - evaluating the patient and thier condition
• Allergic Reaction - overreaction of the body's natural defense system
• ER/LAB/Radio/Tech/BP/CPR/EMS/EMT
• ABG - Arterial Blood Gas
• Dementia - loss of memory and brain function
• CBC - Complete Blood Count
• IV - IntraVenous
• Palpations - the pressure felt of the heart
• ECG - electrocardiogram

Other Observed:

• 
  
• Psychiatric Patient
• Employee relationships (negative & positive)
• Peg Tube (Percutaneous endoscopic gastrostomy 
• Downtime
• Teamwork to diagnose patients

Experience Journal

1. The ER was much smaller and more compact than I expected however it was functional and easy to move about. It was very technical with all the equipment and technology throughout the department. There are several nurses and ER techs as well as officers and cleaners. The employees we laid back and talkative with one another and also very helpful to their patients. Each day is unpredictable and different from the each other, however the process and procedures that are used are common each day. The department determines the patients disorder or reason they are in the ER and helps each patient get healthy and treat them accordingly as well as prevent further complications. The employees we laid back and talkative with one another. The ER is located near an MRI and CT machine that is used often and efficiently in helping patients. Vital sign monitor are essential for every patient and the nurses take pulse and blood pressure to monitor their patients health. The ER, though slow, should always expect the unexpected and react with prompted care and services. 
2. The employees that I observed were friendly with each other as well as their patients and very talkative. They worked well with each other and were successful in patient care and treatment as the consoled with each other regarding patients. I did observe an employee argument with their superior and saw the superior handle to situation successfully and accordingly. I also witnessed triage miscommunication that was quickly resolved and fixed. All employees were appropriate with patients and followed rules and safety procedures, such as using gloves and disposing items correctly. They were aware of their surroundings and did not let their personal issues affect the care of the patients, within each patient room they were professional and helpful. They are intelligent health care providers and know how to handle each unique situations and react with appropriate therapeutic and diagnostic procedures. 
3. Through my observation in the ER I learned how the department function and what is needed to be successful. I learned that communication and teamwork is essential to providing care for patients and being professional is important  when treating patients. There are many procedures that are used to help diagnose and treat patients, such as blood/urine tests, MRI or CT Scan, asking the patient question about their symptoms and history, and vital signs. The ER employees must be prompt and reactive to any situation and be ready for anything. The have to face barriers such as language and psychiatric patients, but still be able to provide the best health care possible. I learned new procedures and terminology used in the ER which are commonly used daily. The ER sees patients of various conditions, some severe, others not as much, however the employees must treat the patients and use triage to keep the ER functioning successfully.
4. Throughout this week I learned that I need to become more talkative and interactive and not be shy or quiet. I learned that it is essential to communicate in order to learn more.  This experience has taught me that I need to ask more questions and interact more in order to learn and I will remember this when I go to other departments. The ER is very unpredictable, which is something I learned that I enjoy. I enjoy the diversity of each patient's condition and the various ways to handle each situation. I learned a lot of terminology and medical knowledge that is sure to help me in the future. I enjoyed the ER most of the time, however I have learned that if I want to work in trauma, I would rather enjoy a fast and busy ER.