Physical Therapy Rotation

Journal 

Assessment of the environment 

PT is located away from the hospital and works as it's own medical business. It is similar to most PTs where it has a large space, multiple benches, workout equipment, therapy equipment and other necessities. However it also has a room for speech therapy and a pool. It is very quiet and organized. I noticed that each employee tended to have a specialization in therapy, such as one man helped mainly back patients, a women helped hands, one helped legs, and one helped upper body. The purpose of this area is the restore patients after accidents or surgery and help relieve pain. I was unable to see the speech therapist but they help people improve their speech. Most of the equipment is used daily and it all is a main source of rehabilitation. Each patient has individual requirements depending on their needs and they use different equipment. Counting, taking a break, and ice/heat is used almost all the time. This area is crucial for a patients recovery and it was nice and friendly place to visit.

Observation

At PT there are several people, receptionists, therapists, each specializing in different types of therapy, and others who help the patients. The area is relaxing and friendly as they all get along and help each other. I saw many employees give a hand or some advise. They often laugh a lot which I found was good because the patients felt more comfortable. They all followed cleaning procedures as they wiped down all equipment between use and did not reuse certain equipment on patients. The therapists I found, have the best bond with their patients compared to the rest of the hospital and they seemed more relaxed. They utilized their time, environment, and resources. They were all talented and skill in helping patients. Also they enjoyed helping their patients which I find is an important part in ones career. 

Knowledge 

This week I saw many therapeutic techniques various times with different patients. It was interesting to see how each patients responded differently and how common certain things are. Many of the hospital patients are at PT which shows how important it is. I saw one therapist remove ditches and analyze a patients hand. I saw multiple times the use of the ultrasound which explained how helpful it is. I was able to learn many patients stories and see how the therapists engage with their patients. Each patients had their own level as I saw healthy and young patients but also older, unfit patients. It was also interesting to realize that the majority of the patients with back or leg problems tended to be overweight. I learned the importance of therapy and how helpful it is to patients.

Evaluation

I fell that this week I did not do as we'll as I could have, I didn't not interact enough nor did I ask many questions. I felt a little awkward and did not know what questions to ask. I did not want to interrupt the conversations and felt intrusive. However I did learn a lot and took advantage of my time. The importance of PT was brought to my attention and in the future in my medical career I will always keep it in mind. I learned I need to feel more comfortable and try to engage more. I am proud of how I have changed throughout clinical rotations but this week was not a good representation of how I have grown. I hope that my future is influenced by this week. I learned about the different careers and how each patient needs their own treatment. I am grateful for what I have learned. 

Lab Rotation Week

Journal

Assessment of the Environment

The lab is divided into several areas all having various jobs. The entrance is where the rest of the hospital sends items to the lab with the tube machine. Past the entrance is an area split into two sides, one for blood and urine tests and another for drug testing or further tests needed. The technician receive the items from the rest of the hospital and test is accordingly and verify the results on the computers. CBC's and urine analysis are performed with high-tech machines but often the result must be check using old techniques by the employee using a microscope. There was two of every machine because if one breaks the hospital can keep smoothly running or if the other one needs cleaning there is another one to do the job. The machines are very large and impressive. They are usually quick and easy to use depending on the test needed. To the right of this area are smaller labs including a blood bank and a pathology lab. The pathology lab is equipped with several machines used for different tests, many microscopes with slides, and a work area for slicing and measuring the items brought in. The entire lab is well organized and highly technical. 

Observation

At first many of the employee were not busy, but eventually they had tasks to do. One employee would bring the blood or urine to the techs and they would follow with the appropriate test. They are all very efficient in communication and seem to be happy and have fun. Everyone I saw wore gloves and avoid touching any of the items, they used proper safety procedures as well as cleaning procedures. The tests they provide are vital for patients and can help save lives. The tests from the ER are almost always STAT and are important for the doctors to treat patients accordingly. The lab employee understand this and do their job very well and efficiently.

Knowledge

I saw a lot this rotation and learn a lot of new knowledge. I was able to see a CBC test and a urine analysis and see the tech use a microscope to confirm the test, which she let me look. She also showed me how to properly make a slide for a blood test and how the dye helps the test see the different cells. She explained very well the different cells and the normal ranges. Another tech showed me a drug test and how the machines work and the different tests that they can perform. He explained his job and his career and gave me a lot of insight in the careers in a lab. My favorite part, where I learned the most, was the pathology lab where I saw the pathologist slice and examine various organs and tissues. He showed me the different stitches surgeons use and how they remove certain organs during surgery. A patient had her uterus removed after delivery and I was able to see how the pathologist examines it to see the cause behind the excessive bleeding and cuts certain areas to create slides to be further examined in the future. I also saw various placentas and umbilical cords and compared healthy and unhealthy ones which I learned a lot as he explained the different components of placenta and how there are three vessels that connects to the baby. He specializes in human development and share a lot of the information he knows and also showed me many very interesting pictures of fetuses and the development stages. Before I left he showed me a colon that was removed and showed me in detail the pain that was caused because of the problems within the colon. I learned a lot by observing as well as the pathologist explaining his actions and giving me a lot of insight in different organs as well as his career and his colleagues. I really enjoyed this area and learned so much that I have became more interested in pathology.

Evaluation

When I first arrived nothing was going on and everyone said there was nothing for me to see. As I was about to leave, blood and urine samples started arriving and a very nice technician allowed be to observe her. Then she sent me to another technician where I saw drug testing and learned a lot and he eventually sent me to the pathology lab where I had an amazing time. Through this, I learned not to jump to conclusions and give up. I eventually became for comfortable and began to ask questions and interact better. I was shy at first but after a while I loosened up and learned a lot. Once I got into the pathology lab I was amazed and so interested that I wasn't shy at all and learned a lot. This rotation I would say has been one of the best I have had and the most influential in my future. I have for a long time been interested in pathology but have been changing my mind lately; this week has shown me why I enjoy pathology and allowed me to see a future in the career. 

ICU Rotation Week

Journal

Assessment of the Environment

The ICU is very quiet, clean and organized. It is identical to any other area with patient rooms however the rooms are more isolated. There are many machines in every place and there are many different types of professionals working in the unit. There are several RN with a charge nurse, respiratory therapists, and many different doctors depending on the patient. In the unit they closely monitor patients, both conscious and unconscious, and provide appropriate care for each patient depending on their medical situation. It is very eye opening as many of the cases are intense and extreme. All types of machines are used such as ones to help the patient breath, many monitoring systems and any other necessary equipment. It is a very important area and all the employees work hard to provide the best care possible to their patients. 

Observation

The nurses in this area all seemed very nice and friendly. The one nurse I worked with in particular was very informative and nice which made for a enjoyable time in the area. She answered all questions from family members, despite some of them being irrelevant. She was brutally honest which I found was good in a nurse and she knew what she was doing and what she had to do. All of the employees worked extremely well with one another and took care of all the patient's needs. They were not afraid to ask for help as I saw the charge nurse help a regular nurse for assistance which I felt made for a relaxing and tense-free environment. I think the employees in the ICU is what makes is so successful and fun despite the heartbreaking events that take place day to day. Once again the area had multiple hand sanitizers and sinks to keep the area safe and sterile. The nurses washed everything they used with alcohol swabs and they followed all safety procedures. I saw multiple medicines and drugs be given to patients and other procedures to help the patient. Blood tests were often and repetitive as they are a important diagnosis technique. The ICU was better that I expected and I enjoyed the employees and saw how they keep it running smoothly.

Knowledge

The nurse I followed had two patients; one in heart failure and one in kidney failure. Through those to patients I learned a lot about their condition, the specific treatment and prognosis. The heart failure was most likely a cause from the patients diet and I learned that each patient reacts different and recovers form their comas in different ways. The nurse took multiple blood samples, listened to their heart, gave them potassium, antibiotics and pain relievers. The other patient was experiencing trouble with producing urine and I was able to see a bladder scan. Through listening to the nurse explain the situation I learn a lot about the condition. I also was able to observe a specialist doctor and learned about her job. The nurse explained how each day was different and how patients families are always impatient. She taught me a lot about her responsibilities and her career. I learned a lot in the ICU and surprised myself by how much I enjoyed it. 

Evaluation

I feel that this week I did my best yet with asking questions and engaging with the employees as well as patients. I observed very well and was able to even help the nurse with some information. I wasn't as shy as I usually am and I wasn't nervous. I was able to have fun and feel as though I was not in the way. I learned a lot about the functions of the ICU and how each patient is different and will react differently which I something that is true in all areas on the medical field. I was uncertain entering the area but was shocked to realize that it was much more interesting that I expected which taught me not to assume. I was happy to be with a friendly nurse and made the best of my time. The ICU was not something I was ever interesting but my time proved me wrong as it has so many different medical conditions and is a very important part of a hospital. It taught me not to underestimate a certain area and I feel that my experience will help me in the future both medically and socially.