Internship Site: Tuality Hospital Hospital Location: 335 SE 8th Ave, Hillsboro, OR 97123 Dates: March 16th, 17th, 19th, 20th Time: 7pm-1am every day
Day one: March 16, 2018
6 hrs Today was the first day of my internship at Tuality Hospital. When I arrived, I was fifteen minutes early so I took the elevator up to Medical/Surgery to meet with Jayesh, the nurse I was shadowing for the next four nights. It was approximately 7:05pm when I had gotten an email that Jayesh was working in the emergency department tonight. I had rushed down there and met Jayesh, alongside a few of the ED nurses and the lead nurse for the night, Christina. Jayesh and I were doing breaks for other nurses, and so we had time to tour the ED. I was shown around to all of the different rooms including the supply room, the nutrition room, and where they kept patients who are a danger to themselves or others. I was solely intrigued by the supply room, and so we went in there and he showed me all the different types of bandages, tapes, reusable stethoscope, suturing kits, saline bags, water cups, etc. At about 8:45 pm is when our first nurse went on her break, it was my first time ever assessing a patient. Jayesh introduced himself and asked if it was okay if I stood by and observed. I watched Jayesh take the patient’s vital signs and assessed the patient of his wounds. The patient had fallen and hurt his arm pretty badly so he was bandaged up and asked to stay overnight. After the first patient, we headed over to room two and assessed a patient with an abscess between his legs. I watched as Jayesh introduced himself and asked the patient if it was okay that I stood by and watched. He assessed the patient, prescribed some pain medication, and discharged him to go home. After we took care of the abscess patient, I overheard the call from the nurses station coming in about a man with bad chest pains and labored breathing. I watched as Christina wrote down his vital signs and the symptoms. Then Jayesh pointed to a monitor above the nurses station and explained to me how the nurses computers. The monitor had symbols on it that showed whether a patient was ready to be discharged, what kind of injuries they have, and what room they were in. It was about 9:37 pm and another nurse was ready to break. We went and assessed the patient’s for about 30 minutes or so. Around 11:15 pm Jayesh and I took our break, during our down time I was able to ask him questions about policies and rules. Around 11:37 pm we went back and made our last rounds of the night. Around 12:45 we were finished and Jayesh called security to walk me back to my car. Day 2: March 17, 2018 6 hrs Today was the second day and Jayesh and I were up in Med/Surg, his true home. I walked up and all of the nurses were so welcoming and were very nice. Jayesh and I started with a tour of the 5th floor Med/Surg East wing. I was shown around to the supply room, nutrition room, and the storage room where they keep gowns, gloves, and wheelchairs. Jayesh and I started our rounds on two patients. One had come in for pneumonia and had precautions on the door so I needed to gown and glove. Another patient had come in for an abscess of the lip, and didn’t seem too upset about the fact she was in a hospital. Jayesh checked in with them, took their vitals (blood pressure, oxygen/pulse, temperature). It was interesting watching the way he had such personal interactions with his patients and keeping them smiling, all while doing his job. Soon after we made our rounds, we were able to sit at the nurses station while Jayesh filled out his logs on his computer and I was bombarding him with questions about our patient’s symptoms and diagnosis. Jayesh was very prompt and alert when I was asking my questions. I learned a lot about the medical supplies and how they are used. I also noticed that Jayesh clips his surgical scissors to his vest in case he needs to clamp an IV for a patient. Around 11:45/12, we made our round of meds to the patient’s. I was lucky enough to watch medicine be mixed and hung, I have never gotten that close to real life hospital administered medication before. I watched Jayesh hang an IV of saline and manipulate the monitor to give a certain drip an hour. It was approximately 12:52 am and I had forgotten what time I was supposed to be done, and we were using a tourniquet and a band-aid and Jayesh was showing me the difference between their biggest needle, and their smallest needle. It was time for me to leave, and security walked me back to my car.
Day 3: March 19, 2018
6 hrs Third day and everything is just the same. I arrived about fiftten minutes early, and waited in the break room until it was time for the night shift nurses meeting. When everyone arrived it was jam packed in the room, and Marley handed us our patient list and Jayesh and I were on our way to do rounds. I remember our first patient because we had her the night before, and she was still in the thick of pneumonia with a terrible cough, and precautions on the door. Our second patient was an elderly man with mittens on his hands to prevent him from pulling out his IV and feeding tube. I remember this patient was hard to understand due to slurd speech and bad hearing. He was a very nice man and was cooperative with Jayesh and I. Our third patient of the night had come in for a kidney infection, and was stubborn but cooperative in the end. I learned a lot from this patient because Jayesh had to have a lot of patience to be able to administer medication to the patient effciently even though the patient may not have wanted to cooperate. The time was about 10 pm and we had some down time to find new learning oportunities. *side note: I was pleased to know that hospital food isn’t as bad as everyone says it is.* I asked Jayesh about nursing programs for colleges, and he and I researched community colleges, and universities graduation rates. I found that the community college that I chose was where he had gone to get his prerequisits and had finished the nursing program. I was relieved to know that I had made the right decision. The time was now 11:45 pm and it was time to do another set of rounds on our patient’s. We administered medicine and IV’s, everything was calm and quiet in the hospital. Most of the patient’s were asleep while the nurses were working away. After our rounds I was sitting down next to Jayesh watching him chart, and I noticed myself falling asleep (which had never happend yet) and I kept dosing in and out. I was amazed at how these nurses can do twelve hour shifts and not sleep a wink (maybe) throughout the shift. The time was 1 am and security walked me to my car.
Day 4: March 20, 2018
6 hrs The last day was bittersweet. I was so confident in where to get supplies, where to get gloves or a gown, and to even open up a cot or grab a wheelchair. I was finally getting the hang of how the hospital works from a smaller perspective. At the beginning of the shift, we went to the nurses meeting around 7 pm, then we got our chart and started our rounds. The rounds were the same, we had a different patient from the last two nights, but we still had the elderly man with the mittens on his hands. I was saddened to find out that no family had come to visit him, and things weren’t looking good. I asked Jayesh why no one had come to visit him since he’d been in here, and none of us knew. Around 9:30 Jayesh and I were giving dinner to patient’s, and I had learned that the elderly man was being fed through a drip. I read the ingredients on the bottle and realized that although it gives you all of the nutrients it just didn’t seem logical to feed someone brown goop. After everyone was fed, Jayesh and I walked into the supply room and I was asking all of these questions about band aids. Why band aids? Because I’ve ever seen so many and of all different variety. Earlier that evening our elderly patient had busted a blister open and it was bleeding. I ran into the supply room and got a band aid that was all clear and was able to clot the bleeding from the surface. It was fascinating to watch because I hadn’t ever seen bleeding stop so fast from an external point of view. After my fascination of band aids, I was shown an IV medicine that had powdered medication on the top, and liquid on the bottom. The two were separated by a seal and you needed to push one end and give enough pressure to break it so the two would mix. I had the honor to break the seal and shake the medicine up. It was so much fun, I’d never had that much fun with medication ever in my life. I think Jayesh was even surprised how excited I had gotten. The time was about 11 pm, and the second rounds were starting. We administered medicine (I was happy when Jayesh hung up the IV I had shaken up), and we headed back to the nurses station to chart. It was around midnight when Jayesh had called down to family birth center to see if they had any live births that I could watch on my last night there. Fortunately there was one, we raced down the stairs but when we got there, we had just missed it. I was so excited but sometimes things don’t work out the way you’d like them to. The time was now 12:45 am and it was almost my time to go. I had thanked all of the night nurses, and the security guards for being so welcoming to me. Before I had left to go home, Jayesh showed me the Tuality library that had a plethora of medical textbooks that I was always welcome to come read and study with. It was such a great parting gift. The time was for me to go, I thanked Jayesh one last time and shook his hand. I was escorted back to my car by security.