How to Prepare for Your Clinical Days Doing Patient Care at Mercy Truxtun 2W Med/Surg

How to prepare for your clinical days doing patient care at Mercy Truxtun 2W Med/Surg :

Come the night before to get your clinical assignment. Assignments will be posted at 1530.

Check the daily assignment sheet for your patients’ room numbers. After that find the patient charts. If you remove the chart from the front nurses station place your sign (student nurse has patient chart) in the rand and tell the ward clerk and RN were you will have it (i.e. back nurses station).

Look for H&P and consultations. Look at MD orders to find all current orders – don’t forget to look at the MRD’s. Orders include: admit to either Med/Surg or Tele, diagnosis, code status, allergies, current meds, current diet, current activity, current labs and other current tests. Look for current MAR, current labs, and radiology reports. (If patient had surgery since admission or transferred from ICU current orders start thereafter)

Always get following labs: CBC, BMP or CMP. Also look for tests specific to your patient: If your patient diagnosis is COPD you need to look for ABG, if patient has liver issues look for LFT’s, if your patient has an infection look for microbiology cultures.

If the patient is not on the unit you can find all this information on the computer in the PCI section: Medical transcribed reports will contain H&P and consultation reports, radiology transcriptions will have all X-rays, CT, and MRI reports. In the laboratory section you will find all kinds of labs and microbiology reports. Further down you can also see current medication orders.

You may make copies of patient reports, but under no circumstances is it acceptable for you to leave the unit and still have patient identification information on the copies!!! This is a major HIPAA violation and could jeopardize you standing in the ADN program.

You need to be prepared to tell me about your patient’s history and why your patient is currently here. Know the meds and why you patient is on them (TACTIS). This includes all meds you give during your shift, including PRN. Know the labs and you need to explain your patients’ results (i.e. why is H&H low).

If your patient was discharged after you received your assignment, please address this with the team leader and you will have another patient assigned to you.

You will not leave the unit until you have given report to someone – bedside hand-off to a fellow student for lunch and report to the RN and CNA at the end of the day. No procedures will be done w/o me and no meds will be past w/o me!!!!

You will only chart for procedures on the computer: ie. IV insertion, taking out a FC.

Be sure you look at the daily clinical assignment sheet as a reminder what I expect of you!

How to prepare for your clinical days as team leader at Mercy Truxtun 2W Med/Surg : Show up at 1530 to.

Look at the H&P & consultations for each patient you are team leading – fill out the “S” and “B” on your paperwork on each patient. Be prepared to follow up to see if the students you are leading have addressed abnormal labs and are on track time wise with the meds. (You will need to keep track of them and me to make sure that a student is ready to pass meds when I am available to them - this way we can pass all 1000 meds in a timely manner). You need to tell me about leadership styles and what leadership style will work for you and why. I also would like you to answer a question on conflict resolution.

There are always 2 team leaders on the unit. The team leaders will each lead half of patient care students. The function of the team leader is that of the CN on the unit. We will get report on the whole unit with the night CN and the day CN. Pay close attention to the patients you are in charge of, but do not neglect to listen to report on all patients. The following should be your focus: is the patient going for a procedure or will have one on the unit? (PICC line, needs NGT, going for EGD, ECCO etc). This could be a learning opportunity for you or your peers!! Is the patient being discharged or will he stay? (This may become important since you might need to assign a new patient).

You are in charge of assigning breaks: half students will go for first lunch at 1100, the other half will go at 1200. The two team leaders will also go on break at different times.

You need to keep your eyes and ears open for learning opportunities: IV insertions, FC insertion, NGT insertion, etc.

Team leaders will lead post conference. Plan to spend 1 hour in post conference:

10 to 15 min debriefing from unit and same amount of time debriefing from OR students.

Be prepared to cover topics of your choice: discuss 4 medications; discuss pathophysiology of a patient in concept map format; give report on patients using SBAR format; discuss procedures, policies. (This can be informal, but needs to be informative, ok to use boards in conference rooms or make 1 page photocopies on unit); TL may delegate some to class mates but needs to present most. – I expect to see a variety of topics throughout the rotation

I hope this will help all of you during this rotation – I look forward to a great rotation!