Whittier hospital overview

Journal Entry# 1

As a disorder, metabolic syndrome is characterized by the grouping of cardiovascular disease risk factors. The disorder is connected to increased susceptibility to some familiar cancers, and its pathophysiology is associated with insulin resistance (Wang et al., 2016). However, there is no concrete evidence that all patients suffering from the syndrome are resistant to insulin. For this reason, the aetiology of the disorder takes into consideration various concepts including adipose tissue disorder and obesity among others. The disorder is prevalent among adults, but also affects children who are obese. Nonetheless, the disorder can also affect lean individuals indicating that obesity is an indicator of the syndrome rather than a cause. For this reason, the paper provides a reflection of my experience while handling a patient who presented with the metabolic disorder during my pediatric experience.

My Experience in Assessing and Managing the Patient and His Family

My experience was not that hectic because the patient and the family members were very cooperative and adhered to every instruction and recommendation I provided. For instance, the patient I was in charge of was a smoker and very inactive when it came to physical exercises. For this reason, it was my duty to help the patient modify his lifestyle so as to manage the disorder. In collaboration with the family members, I educated the patient on the importance of dietary modifications, smoking cessation, and exercise in managing the disease. Besides, I designed a menu plan for the patient. I informed him that he must limit the intake of white rice, white flour, refined sugars, and dietary facts. I encouraged him to eat fish, especially salmon, sardines, and herring because of the omega-3fatty acids. I also advised the patient to take more vegetable and fruits, stop smoking, substitute saturated fats with mono-saturated fats, and reduce alcohol consumption. The family was very helpful in managing the patient care because they ensured that they prepared meals that adhered to the patients’ meal plan. The most difficult part in my pediatric experience was to stop the patient from smoking. The patient was an addict and could not go on for a single day without a cigarette. However, with the help of the family members, I ensured that the patient stopped smoking and adhered to the care plan. In the assessment of the patient’s condition, I had to identify the risk factors of the disorder by obtaining an in-depth history of the patient, checking laboratory findings, and performing a physical examination.

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Explaining How the Experience is Connected to My Classroom Studies and the Real-World Clinical Setting

The primary goal of managing metabolic syndrome is to reduce blood pressure and LDL cholesterol as well as managing diabetes. Another goal is to prohibit the development of type 2 diabetes. According to Wu et al. (2016), the onset of diabetes coupled with its long-term complications results in a leg amputation, vision loss, kidney, and heart diseases. For this reason, my experience is connected to my classroom studies and real-world clinical setting because they both emphasize on lifestyle changes including quitting smoking, managing stress, being physically active, eating healthy and maintaining healthy body weight (Colado-Simão & Dichi, 2016).

Conclusion

In conclusion, my practicum experience provided me with significant insights on how to manage and assess a patient with a metabolic disorder. It is imperative to take details of the patient’s medical history and involve the family in the design of individual care plan. Lifestyle modification is crucial in managing the disease.

Practicum – Journal Entry# 2

The gastrointestinal system is used to process energy and nutrients from the ingested fluids and food. However, this function is impaired in people with gastrointestinal problems such as vomiting, nausea, diarrhea, and constipation (Aderinto-Adike & Quigley, 2014). These problems might be self-limiting, mild, and temporal or persist for some time resulting in the impairment of one’s health. For example, prolonged constipation results in impaction and diverticular whereas sustained diarrhea leads to low blood pressure which in turn results in heart rhythm abnormalities or fainting. Fluid and nutrient loss due to vomiting or diarrhea results in malnutrition, weight loss, vitamin deficiency, electrolyte imbalances, and dehydration (Reinhard, 2011). Likewise, constipation and indigestion reduce food intake and appetite. Gastrointestinal problems are linked to sedentary lifestyle, stress, diet, allergy, medications, food intolerance, or change in routine. Excessive consumption of dairy products, less fiber intake, and not drinking enough fluids subjects an individual to constipation whereas diarrhea is as a result of an individual intolerance to some types of food.

Describing My Experience in Assessing and Managing the Patient with Gastrointestinal Problems and Her Family

The patient that I was assessing was a pregnant woman and was suffering from constipation. According to Cunningham and Banez (2012), a majority of pregnant women often suffer from a wide range of gastrointestinal symptoms including constipation, heartburn, vomiting, or nausea. Most of these problems are caused as a result of motility disturbance triggered by changes in hormones. The management of these symptoms requires simple therapeutic measures including dietary changes and lifestyle modification. The patient’s condition was not severe to warrant medical therapy. In pregnancy, constipation is a common occurrence, and it is caused by the impacts of progesterone on the bowel muscles. Therefore, to manage the condition, I made use of non-pharmaceutical methods including surfactants and bulk laxatives to manage the conditions. To calm the patient and her family members, I informed them that some level of constipation in pregnant women is normal and a reduced frequency in the movement of bowels does not need treatment rather the intake of required amount of roughages.

 Explaining How the Experience is Connected to My Classroom Studies and the Real-World Clinical Setting

Gastrointestinal problems are a common disorder and are a frequent problem among pregnant women. The most common gastrointestinal problems include vomiting, nausea, diarrhea, and constipation. Many of these disorders can be managed by lifestyle modification, undergoing screening, and the practice of good bowel habits. For individuals suffering from constipation, laxatives are recommended. However, overuse of these medications might result in rhythmic contraction of the intestines causing an individual to rely on them. Overdependence of these drugs makes them ineff

NURSING OBJECTIVES

 

 Objective  1: Whittier hospital overview

The Whittier hospital medical center is a general medical and surgical hospital in CA with around 800 employees. The hospital has provided residents of the southeast San Gabriel Valley with sufficient medical care for the past fifty years. The hospital’s mission statement is a commitment to the provision of quality health care and community services.  Moreover, the hospital focuses on versatile medical care, and therefore the center's quality measures hierarchal on top of each state and national averages.  The hospital objectives have been highlighted on their homepage website alongside the various health care services they have to offer (AHMC Healthcare, 2016). The hospital is committed to its mission to providing equal health care to all individuals regardless of cultural affiliations. Providing similar services ensures that all members of the community receive quality health care as per their mission statement.  Moreover, the hospital takes part in community-based health events, such as blood drives, diabetes programs and health fairs, which are aimed to either create awareness or raise funds which are used to get better types of equipment for treatment. Over time the commitment to such values tend to wear out; however, Whittier’s focus on the communities’ health has been unwavering over the years because of the administration.  As per the administrative theory, Whittier values the well-being of the community and has throughout the years, through effective leadership and proper strategy, provided it to keep the society going.

 Objective 2: Whittier’s nursing unit

The essential obligation of an executive nurse is to guarantee that patients and their families are getting the best level of care from the nursing staff. However, there is little contact between the head nurse and the patients compared to the other nurses. Therefore, to ensure patients are getting proper care the head nurse is in charge of creating and actualizing approaches, guaranteeing that her staff individuals comprehend and take after the rules and arrangements of the association. An example of such a policy would determine the ideal portion of the staff, per shift on every unit (White, 2016). Additionally, the head nurse is in charge of communication between the nursing staff and different ranges of the association, for example, the medical and managerial staff. With proper interpersonal and communication skills, a head nurse could employ Taylor’s scientific management approach which depends on the idea of arranging of work to accomplish productivity, institutionalization, specialization, and rearrangements, to improve the situation of their staff.  Other roles carried out by the executive nurse include enlisting new attendants, employee preparation, preparing faculty, performing worker assessments, directing employees by advising and settling on contracting and terminating decisions with regards to the nursing staff, all of which for the most part include working an extraordinary manage the HR office.

Objective 3:Whittier’s organizational structure                                                                                                              
 

The size of a nursing unit depends entirely on the kind of services the hospital can offer its patients.  The Whittier medical center has a nursing unit comprised of nurses from the following fields of practice; behavioral health services, children's and women's services, clinical research unit, a continuum of Care Management, intensive, dialysis services and specialty Services, Medical Surgical Services, ambulatory care services, Perioperative Services. The nursing administrator position performs proficient supervisory nursing practice under the watchful eye of the physically and mentally ill. The responsibilities regarding administering the procurement of value nursing care given at the office. The position is in charge of keeping up the quality and sufficiency of nursing practice; for organizing nursing and preparing programs; for recognizing and helping with comprehending proficient, regulatory and supervisory issues in a doled out region (Society of Human Resource Management, 2016). Position practices, an extensive judgment in applying skilled information in taking care of nursing issues inside set up strategies and rehearses and is surveyed by the chief through meetings, reports, and perception of results acquired.  The nursing unit at the Whittier medical center gives multidisciplinary consideration to surgical oncology, medicine overflow patients, hematology patients requiring active cancer treatment, post-surgery care, chemotherapy and biotherapy administration, radiation medications/inserts, autologous, allogeneic and cord blood undifferentiated cell transplants and supportive measures. The advantage of having such a resourceful nursing unit is the exceptional quality of health care the hospital will be able to deliver to the community. The Whittier medical center has been ranked among the state’s top health care providers. On the other hand, such a proficient workforce requires a proper payment plan which requires a significant amount of funding.