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Clinical Day 1: November 9th, 2017

First day at clinicals for Jackson South Hospital and I was placed in the ICU floor. My
preceptor was very encouraging in letting me practice my skills and she taught me a lot as well.
She quizzed me on some medications, which reinforced my knowledge. I was assigned 2
patients, one diagnosed with seizures and the other with sepsis. The one diagnosed with
seizures was intubated and sedated. The nurse allowed me to give the patient Lovenox
injection in the abdomen. I also learned how to crush the medications and mix it in water, then
insert it in a syringe into the NG tube. The nurse also taught me strategies used to prevent
ventilator related infections, such as having the bed elevated to 45 degrees, suctioning the
patients mouth and providing oral care, as well as providing PPI medications to prevent any
reflux from the stomach. For the other patient with sepsis, he was continuously on antibiotics
Vancomycin. He would get blood drawn continuously to monitor serum levels of the antibiotics.
It was a pretty productive day and I got to practice new set of skills.

Clinical Day 2: November 16th, 2017

Second day of clinicals for Jackson South and I was placed in the medical- surgical floor
in the 4th tower. I was assigned 6 patients. My preceptor asked me to perform morning
assessments on all patients and I did with her supervision. The nurse encouraged me to ask
questions and will explain to me the patients condition and the what to focus on based on the
condition. One patient was experiencing chest pain; however, the nurse knew the patient
suffered from anxiety and checked that the anxiolytic medication was not yet administered.
The nurse asked the appropriated questions to the patient and ruled out MI, the patient was
instead very anxious and so the nurse gave the patient his medication. That day 2 patients were
discharged and I removed both of the patients IV. I learned to be more alert when a specific
patient is on anticoagulants, thus I must apply more pressure than usual to stop the bleeding
when removing the catheter. I also learned when a patient returns from a cardiac
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catheterization, one must remove the 15 ml of air intermediately and observe for any signs of
bleeding.

Clinical Day 3: November 17th, 2017

Third day at Jackson South and I was placed in the same floor in the 4th tower. My
preceptor encouraged me to be independent. He trusted me to go on my own and administer
the medications to the patients, as well as hanging IV fluids. I also did a lot of blood glucose
checks. I also learned that if a patient was not on any anticoagulants, the patient must be on
SCD devices in order to prevent any blood clots. I had a lot more hands on experience and I got
to enhance my skills. The nurse also taught me how to document and chart assessments using
Jacksons system. I was able to chart some of the patients assessments on my own. We had 3
discharges. I also got to do a lot of insulin injections as well as administering eye drops to one
patient with glaucoma. It felt good being independent and I felt as if I accomplished more
compared to yesterday.

Clinical Day 4: December 7th, 2017

Fourth day at Jackson South and I was placed in the medical- surgical floor in the 3rd
tower. Again, I was assigned 6 patients. My preceptor was very kind and also encouraged
questions. I assisted the doctor with one of the patients who was having his staples removed
after surgery. I also had the opportunity to remove a Foley with nurses supervision. He also
taught me what to do in case the patient was discharged home with a Foley. That day we had 3
discharged patients from post-surgery. I remember the nurse giving discharge instructions and
mentioning to all of them to come to the hospital if patient has a persistent fever for one day,
or persistent pain that not relived with pain medication, and if any signs of infection such as pus
draining from the wound. The nurse also quizzed me on the first thing to asses on a post-op
patient is for any signs of pain. Unlike the other nurses, this nurse specifically was very attentive
to his patients and made sure they were comfortable. He also encouraged most of his post-op
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patients to start ambulating as soon as possible to pass gas and relieve any pain or abdominal
discomfort. He would actually help is patient sit in the chair and pat their back to let out gas
such as burping, which was very effective. Right away the patient will feel relieved. It was an
interesting day and very productive.

Clinical Day 5: December 8th, 2017

Fifth day at Jackson South and I was placed same floor in the 3rd tower. The nurse I was
assigned to was also assigned 6 patients. I helped the nurse scan and administer the
medications. I also helped remove 3 IVs. Two patients were discharged and with the help of my
classmate we transferred each patient down with a wheelchair to the lobby. One patient in
specific felt very weak and when we administered her medications, a few minutes later she
vomited all the medication contents. The nurse had to return to administer the same new
medications again and to make sure the patient absorbed it.