GC 2/9 and 2/12

This week I went to Garden Bridge.

Dementia is always chronic and we never classify acute dementia and chronic dementia. "Acute dementia" is actually delirium. Delerium is also called the acute confused state, and it is a medical condition that results in confusion and other disruptions in thinking and behavior, including changes in perception, attention, mood, and activity level. Delerium can be caused by an acute medical illness, a "brain event," such as stroke or bleeding from an unrecognized head injury, an adverse reaction to a medication, mix of medications or to alcohol, and withdrawal from abruptly stopping a medication, alcohol or nicotine. Chronic dementia may be caused by Alzheimer's disease, brain damage due to reduced or blocked blood flow in blood vessels leading to the brain, abnormal clumps of protein found in the brain, and the degeneration of nerve cells in the frontal and temporal lobes of the brain. 

Respiratory

Respiratory 

• "My"Responsibilities: Travel around the hospital and help patients with respiratory problems on all floors 
• New Knowledge: I learned about some of the different methods of administering oxygen, why patients need a higher percentage of oxygen, and what happens if they don't get it.
• Best Thing: The best thing was talking to the guy that I was following because he was a great teacher/mentor
• Worst Thing: Seeing someone's dead body be taken out of the hospital room
• Overall: Great because the respiratory therapist was very nice and I find respiratory diseases very interesting.

• Finding the respiratory area was difficult at first, and initially, I went to the cardiopulmonary area for this rotation. Surprisingly, I was luck that this happened, because in order to get into the respiratory room I needed to go up an employee elevator (that needed an employee's ID to work) and a code to enter the room. I was surprised by how much security they had for the room because the only other place with serious security was the NICU/Nursery and Labor and Delivery area. I guess it makes sense though because there are no patients in the respiratory room since all of the respiratory therapists go to different areas of the hospital to see their patients instead of the patients coming to them. I liked that aspect of respiratory because having a change of scenery every day would keep me from getting too bored. 
• The diagnostic procedures consisted of the respiratory therapist checking the patient's oxygen levels and looking for abnormal behavior (like slurring or looking faint). One of the patients was an overweight middle-aged woman, and she was in the hospital because she had sleep apnea. She was also not getting enough oxygen, which was causing her to pass out and act very loopy. 
• No diseases or disorders observed.
• Alveoli- a small air sac in the lungs, where oxygen and carbon dioxide are exchanged with the blood
• Pleura- a thin lining that surrounds the lung and lines the inside of the chest wall
• Obesity hypoventilation syndrome- Extra weight on the chest and abdomen makes it difficult for the chest to expand. 

1. The respiratory rotation was awesome because the respiratory therapists travel throughout the entire hospital and they can see a huge variety of patients every day. While I was there, there was a lot going on and I learned that the respiratory therapists were in charge of different floors every time they came to work. One day they might be assigned to the ICU and the next they might be in charge of all of the cases in the NICU. The doctors and nurses have to be ready for any sudden complication at any time, so they are all very well prepared and fast-paced. However, even though it was a fast paced area, the respiratory therapists seemed calm no matter what was thrown at them. The atmosphere in the room was also much more relaxed than any other unit that I have visited.
2. The therapists were all very comfortable with each other, and they would crack jokes with each other and with me. The man I followed also seemed to know nearly everyone that we saw in the hospital, which is something that I would like in the future when I'm working. They communicated with each other very well and they were comfortable admitting when they were uneasy about a case. The environment was very casual, and the nurses always seemed to be joking with one another. They seemed like a very fun, experienced, and welcoming community of healthcare professionals. 
3. I learned a lot about how respiratory problems can affect the entire body (because having an excess of carbon dioxide in your body throws of the internal pH, and you fall out of homeostasis) and how pulmonary edema actually kills. I now know that pulmonary edema is often caused by congestive heart failure. The heart has to strain to work properly, then a muscle in the heart dies (which is congestive heart failure) and then the blood in the heart is flushed backward and into the lungs. 
4. Respiratory was by far my favorite unit that I've been to in the hospital. I thought that I would find it interesting because the lungs are fascinating to me, but I didn't expect to like it nearly as much as I did. I think that it was a mixture of being able to travel around the hospital, the great respiratory therapists, and the fact that I could actually see myself going into the respiratory field. I would absolutely love to go back to the respiratory unit. 

GC 2/2 and 2/5

This week I went to physical therapy. Hip replacements are used as a last ditch effort to relieve pain in the hip that is caused by severe arthrtis. The surgeon removes the arthrtic bone and replaces it with a metal joint. After hip replacement surgery, the patient will stay in the hospital for about a week, then they will begin going to physical therapy to regain strength and become more comfortable walking the day after surgery.

Administration

Administration

• "My" Responsibilities: Greeting patients, guiding them to where they need to go, and informing the patients of cost
• New Knowledge: I gained some really awesome and unexpected knowledge about creating my own happiness by following my passion
• Best Thing: The best thing was talking with the woman I followed (Darlene). She was literally one of the most interesting and inspiring people I've ever met.
• Worst Thing: Having to leave Darlene before I could ask her more about self fullfillment
• Overall: Unexpectedly Great because of the wonderful woman that I was able to follow

• Administration was a nice and open place with glass walls. The majority of the work is done in that office, in front of a computer. The computer program was somewhat outdated and frustrating to use because it is not user friendly. However, they have a hand scanner that verifies your identity by taking a picture of the veins in your hand.
• Unfortunately, I wasn't able to see any diagnostic procedures because there are no diagnostic procedures in administration since medicine is not actually being practiced.
• I was not able to see any therapeutic procedures while I was in administration because there are no therapeutic procedures in administration.
• No diseases or disorders observed.
• No new medical terms

1. Obviously administration is a very open place where everyone can come and go, which is in complete contrast to the entire nursing/maternity floor. It's set up likethis so that the patients can see where to go, and the administrators can see how many patients are outside waiting to meet with them. The walls are made up of glass so that everyone can see inside them and the entire area is set up like a business office. When I went into the "back room" area, I saw a lot of cublibles and office supplies, and I couldn't help but think of my dad's job as a computer programmer. 
2. It seemed like eveyone got along well, especially with the woman that I followed. They communicated with each other very well and they seemed very comfortable with each other. The environment was very professional, and it reminded me of what a typical office would look like. It was interesting to see how independent and autonomous each administrator is because they act less like a team than the nurses, but more like a team than the typical administrators that do not work in hospitals. 
3. I learned a lot about following my passion, and pursuing a career that gets me excited. This might seem like an odd thing to learn about in administration, but Darlene was so inspiring. She told me about how her daughter wanted to become a cosmotologist, but she didn't because there wasn't enough money in it. She went to technical school instead and hated it. Now after four years her duaghter is finally going to cosmotology school. Darlene also told me about her own experiences; she has a had a wide variety of jobs in the medical field, but she only recently found her passion, juvenile consulting. After she told me about herself and her life, she gave me several very imprtant pieces of advice: find what define me, follow my passion, and make a connection. 
4. I really thought that I would hate administration, that it would bore me to tears and I wouldn't learn anything from it. However, I was so lucky to talk to this wonderful and inspiring woman. After talking to her, I've made it more of a priority to travel in my life (because that is my passion), to make connections with everyone that I meet, and to try and better understand myself so that I can pursue that will make me happy and help me make a positive contribution to world. I would never work in administration, but I would absolutely love to speak with Darlene again.

GC 1/26 and 1/29

This week in GC I went to LTAC. 

Sundown syndrome is the onset of confusion and agitation that is fairly common amongst the elderly population and generally affects people with dementia or cognitive impairment. It is called sundown syndrome be as is usually occurs around sunset.

Researchers typically equate sundown syndrome with dementia, but people without dementia sometimes develop delirious and agitated behavior in the hospital as a reaction to pain, medical procedures, or infection.

There is an association between sundown syndrome and changes in the internal biological clock among people with dementia. Studies suggest that the biological clock shifts in people with dementia, and that shift may make some people with dementia more prone to sundown syndrome. The change in circadian rhythm will cause the person's body the crave food at odd times, and blood sugar will drop. The sudden drops in blood sugar are the probae cause of the mood swings and agitation.

Labor and Delivery

Labor and Delivery

• My Responsibilities: none
• New Knowledge: I learned about some of the medications that the labor and delivery nurses use to induce contractions and stop bleeding in women after they've finished giving birth.
• Best Thing: The best thing was talking with all of the nurses on the floor and actually seeing a patient who was about to give birth.
• Worst Thing: Having to leave before the woman went into labor
• Overall: Good because I liked all of the nurses and I was actually able to observe a lot

• When I came to Post Partum, I was immediately greeted all of the nurses at the nursing station. They welcomed me and immediately started explaining how their charting works and what certain symbols mean on the computer. They also tried to find the most interesting case for me to observe and because of this, I was able to see a woman get an epidural, have her water burst by the doctor and prepare for the delivery of her baby.  The nurses went out of their way to try and find things that were interesting for me to see, and I was tossed amongst several nurses throughout the rotation so that I could always see the labor and delivery nurses doing something. 
• The diagnostic procedures were mainly done before I came, but there was fetal monitoring going on (the babies pulse and blood pressure were monitored), and the doctor checked the woman's cervix several times to see how much longer it would be before she was dilated enough to push the baby out. A cool piece of technology that they talked about was a suction cup used on the babies head that is used to pull the baby out of the mother.
• No diseases or disorders observed.
• Amniotomy- artificial breakage of the water
• Oxytocin- Drug used to cause more contractions
• "Bloody Show"- the blood and brown liquid that comes before labor

1. The Labor and Delivery area was much more hectic than the nursery and postpartum area. The doctors and nurses have to be ready for any sudden complication at any time, so they are all very well prepared and fast-paced. It reminded me of the ER because none of the nurses knew exactly what was coming next, and they told me stories about women coming into the labor and delivery area halfway through birth.
2. The nurses and doctors work very closely in this unit (it's the only unit where I've seen the doctor stick around and have a spot in the nurses station). They communicated with each other very well and they seemed very comfortable with each other. The environment was very comfortable, and the nurses always seemed to be joking with one another. They seemed like a very fun, experienced, and welcoming community of healthcare professionals. 
3. I learned a lot about delivering a baby and what medications the doctors and nurses use to make the experience less painful for the mother and more safe for the baby. I now know that oxytocin is used before birth to cause the mother to have more contractions (and, therefore, have the baby earlier), and it is also used after birth to stop the bleeding from the uterus. I also learned about a suction cup that the doctors use on the babies head to pull them out of the mother if they are stuck. The suction cup can measure the amount of pressure on the babies' head and it will pop off the baby before there is too much pressure and damage can be done. 
4. The Labor and Delivery area was more interesting than the other "maternity" areas because actual surgical procedures were happening. I never thought that I would even consider working in labor and delivery, but I liked the nurses and was able to see the most that I've ever seen in any rotation in labor and delivery, and I would love to see more.