Patient Assessment - Deep trouble

Whisper · Jun 17, 2003

Thanks for the link, it look really interesting, I am on my lunch break so I can not have a proper look at the minute.

The guy was elderly, about seventy five, and had no temp, on admittence. This patient scared me, him and another gentlemen have put me off assessments, I haventcompleted one since! I think I am building a phobia about them,

I think when I go back on a placement on the wards I will be okay as long as I have a good mentor who is willing to catch any mistakes.

BTW the pts rash was NOTHING like the pictures I have seen in books of sepsis, it was nothing remarkable, and looked like little more than heat rash, but I did measure and document i was just lacking the knowledge of what the problem was.

Reading this thread is helpful as I can see things I know, and more importantly the areas which I don't which gives me a chance to correct that. If I manage to qualify it will be in less than a year, which is very worrying and very daunting considering the amount that I don't know.

By the by, the other gentlemen I mentioned earlier we thought was a CVA, but it turned out to be some tropical disease, (which I was not told the name of) So even though we were looking at the wrong cause we were giving him the right treatment.

Whisper

Peeps Mcarthur · Jun 17, 2003

I]From Rachelkieran[/i]

Peeps - how come you know so much!!?? Although I suppose once something grabs my attention I can run with it - just haven't had much opportunity to at this stage in my degree.

15 years ago, in a galaxy far,far away......I was a certified respiratory therapist. That was 5 years of patient care in which I was not expected to know more than how to fill a nebulizer so that each one of the 3-4 patients on them would finish in a series so that I could move on to the next line. I had been trained at an academy where I learned nothing about respiratory care except for what I observed in clinicals. The academy was an accellerated course in which I learned virtualy nothing but time management skills, however I passed the national exam on the first try. At my last job I was as skilled as one could get. I had protocols to intubate. I could draw gasses and confer with the physician. I was completely trusted.

How is it possible for someone with such a crappy education to pass boards when some associate degreed students from well known schools had to retake, then excel at a vocation I was never taught??

I bought books every time I wanted to know something. I took ACLS (although I was not required to) so I could learn what a code was about. It cost me $300 I didn't have but it was knowledge that I couldn't afford not to have. When I came across something I didn't have the answer to (which was often) I found the answer and beyond.

Anyhoo, you get the point.

I'm using the same strategy now that I'm completing prerequisites for BS in physician assistant. In A&P courses, for instance, we learned about renin released from the kidneys as a response to blood pressure. If you then follow renin around some very interesting reactions occur and some always surprise me. The first reaction occurs in the lungs............................One year of school and 5 years as a certified respiratory therapist and I never knew that:chuckle

Look around:idea: The clues for what you will learn next areeverywhere.

kaitlynsmomma · Jun 17, 2003

:roll

Hi guys!! I just wante dto say that I am a student and that I love reading these posts about the Patient Assesments. They are so interesting! I am learning alot just from reading them!! Keep em coming!! Katie

Pediatric Critical Care Columnist · Jun 17, 2003

if i may make a request...

when including a list of drugs given to or taken by a patient, could we please use generic names so all may know what it is we're talking about? every country has different patent names for things and it can be very confusing to puzzle them out.

just my $.02 worth...

epiglottitis is becoming a rare thing and many paeds personnel have never seen it. this is due to the advent of the haemophilus influenzae b immunization that came on the scene about 15 years ago. it is still seen occasionally in the canadian northern aboriginal population and is caused by streptococcus pneumoniae. treatment is the same for both agents: intubation with or without ventilation, antibiotics, steroids and tincture of time. racemic epinephrine isn't much help, nor is heliox.

and on the topic of cases 4 and 5, absolutely the kid with all is the priority. febrile neutropenics are usually the only oncology patients we see in the picu other than post-op cranis. when they crump, they do it in a big way.

Whisper · Jun 17, 2003

I will try and use the generic names in future, sorry

LoFaTrEsS · Feb 8, 2006

patient A

he has angina, frustrated cause he is out of breath, god he only smoked his lungs away , prolly needs an inhaler nitroglycrein patch and some valium to sleep :chuckle

HappyNurse2005, RN · Feb 8, 2006

Yeah, this post is 3 years old.