Narrative Report for Ward

As our staffing start at Lucena United Doctors Hospital Medical Center we are

distributed to different area such as Ward section, ASCU/CCU, Dialysis and Emergency

department. Staffing is much more different from our past duties. We work independent, with

less supervision. We communicate directly to staff about the progress of our client.

In the ward aspect, we practiced total care for the patient from endorsement, nurse

rounds, history taking, vital signs taking, rendering morning care, practicing bed making,

preparing oral medications as well as IV medication with close supervision of the staff, giving of

oral medication after properly checked in the charts’ standing order and doctors order and

rechecked by the staff. Attending to our client needs, being their advocate, health educator.

From suctioning to OF feeding. Preparing a client that will undergo Blood transfusion, operation,

different laboratory test and scheduled for hemodialysis. From Receiving admission and carrying

out doctors’ order to instructing clients’ home medication and follow up checkup.

We are able to practiced time management as we balance our time to care for the most

critical patient until the least critical one. Being able to learn how to encode medication,

laboratory test in their system. Staff nurses in the ward doesn’t deprive us to learn and

experience new things. But as a student it is important for us to initiate things that we want to

know, we must have the guts to ask them question if we are unsure about what we need to do.

They let me experienced how to suction both the ET and OT. What precaution should I

remember before, during and after the suctioning such as hyper ventilating patient before the

procedure, when to start suctioning and the interval of doing it. As they supervise us they let me

do subcutaneous injection, and skin testing.

seek immediate care. From the first call coming from the ER until the second call come, the

room must be clean, and well ventilated. As the patient was received from the endorsement of

the ER nurse, we must introduce our self, make a history taking, assessed patient general

condition and familiarizing them to the hospital setting such where the CR and nurse stations are

located. As for the paper works waiting to be accomplished, referrals to the attending physicians

should be done immediate providing all the information needed. Encoding and requesting all the

laboratory to be done and medication to be given. From accomplishing the chart to doing

medication cards and skin testing if needed.

As for Blood transfusion staff nurses taught me the step by step procedure like from

checking the doctors order, the consent of the patient to said procedure, securing proper blood

typing and cross matching, to checked the initial vital signs before the blood transfusion start,

assessing the patency of the IV, its back flow. After checking for all of that we are now ready to

get our blood, providing we have a container that have ice. A ready blood line should be

available. As we go to get the blood it’s save time if we fold the necessary information needed in

our chart. When the blood is available the serial number must be checked as well as the name of

the patient, the blood type, and the expiration date. Then attached the sticker in the paper then

counter sign if everything is checked. After getting the blood make sure that you will go to your

head nurse or charge nurse to read back the orders and the information of the blood and let them

counter sign, and it does not stop there the supervisor on duty must also rechecked it and counter

sign it, so no reasons for error. As we start the BT, we make sure that proper instructions and

teaching are rendered to the client such as report any untoward reactions like, rashes, chills or

any respiratory distress. And if no reactions occur, it must be run and be done 4-6 hours.
Referrals to OR, I was able to experience and have a client that was scheduled for wound

debridement. Accomplishing the OR checklist to endorsing to OR nurse. Vital signs shoul be

done prior to transfer. Special endorsement must be note if there’s any. The attending physician,

the surgeon, the physician who CP cleared, the anesthetist must be part of the endorsement. And

time.

During discharged, as I learned, I must checked first if it has a discharge order coming

from the doctor or if it’s a HAMA. If it is HAMA make sure that waiver is submitted stating that

the hospital is not liable for whatever will happen after their discharge. Then if it is with

discharge order, make sure that before forwarding to the billing section the PF form must have

all the doctor of the patient and the medication must be returned. Then do home instruction

proving information that is understandable by them with rX attached, make sure also that the

laboratory result is complete. As they complete the payments and I was able to explain the

instructions to the patient.

Ward is a very complex area where everything may happened. There are still a lot of

things I can learned from it. Things that are necessary for me to grow professionally and

personally. As per staff nurses, I am so honored to work with them as they are so approachable

and kind. That they don’t let us not to experience things that we need to know. That guide as and

believed that we can do it. and last for our clinical instructor that never fails to make us feel that

we can do it, that she trusted us and allow us to work with confident and making herself

available for any inquiries we need to know.

One of the area that I wish someday to work in, the Dialysis department. As I

started my first day, I was quite familiarizing first myself in the setting of this area. During my

first day, I was asked to monitor the V/S of the patient every 15 or 30 minutes, depending on the

demand of the condition of the patient. I was able to see how the staff communicate to the patient

and the relative of the patient and it amazed me that they were all like friends and family that

jokes around, laugh together.