Hi, hello to the doctors and experts of Guoya Hospital.

I'm Gardenia, Gardenia's Gardenia, Gardenia's Seed, I'm a newly recruited hand intern, I've been here for two months, and the next thing is my internship experience.

Internship is an indispensable learning stage for every medical student, and as a beginner who lacks clinical experience, in addition to his own instructor, the other doctors, nurses, and patients in the ward are all worthy of advice. Therefore, I maintained a humble and serious attitude towards learning, actively participated in all the study, medical treatment, discussion and other activities in the ward, starting from the most basic physical examination and disease course records, and gradually sharpened myself.

Before entering IU, Mr. Ji explained to me the management system and disinfection system in IU, and introduced the IU environment, so that I had an understanding of the nursing unit and was handy in my work. Specially arranged lectures on specialized diseases, that is, the introduction of common diseases in thoracic and cardiac surgery, so that I have a certain understanding of thoracic and cardiac surgery diseases, which is conducive to postoperative monitoring. In addition, basic nursing care is also taught, such as preoperative education for patients, psychological care, and life care.

First of all, I understand the significance and importance of central venous manometry, which is an objective standard that directly reflects left heart function and measures blood volume, guides the rate of fluid rehydration and assesses blood volume. Factors influencing central venous manometry:

(1) Determination of zero point;

(2) the fourth rib of the midaxillary line in the recumbent position, and the fourth rib of the anterior axillary line in the semi-recumbent position;

(3) the patient must be tested under quiet manometry;

(4) The manometry tube must be kept open to ensure that the catheter is in the vena cava or right atrium;

(5) When applying PEEP on ventilators, the PEEP value must be subtracted to be the real central venous pressure. At the same time, the teacher and I were measured separately to compare the accuracy of my measurements. Pay attention to sterility, avoid injecting vasoactive drugs from the manometry tube, and ensure that the tubing is unobstructed in place.

After entering the clinical internship, I tend to focus on the operation of my studies, and relax the training of theoretical learning and clinical thinking, especially in the Department of Thoracic and Cardiac Surgery. There are many types of thoracic and cardiac surgery, and it is easy for me to focus on the operation. Therefore, I take more surgery and more hand practice as the main purpose of my internship, and the pathophysiology after surgery will change greatly, so I must comprehensively and accurately consider the medical history, signs, degree of illness, surgical method and other aspects in order to accurately grasp the key points, see the essence, understand the impact of surgery on patients, and formulate correct treatment measures. Only by making them aware of what they are and why they are so can they gradually improve their ability to analyze and solve problems in their clinical work.

Through a one-month internship, I can understand the monitoring, basically master the clinical application and precautions of monitors, ventilators, defibrillators, micropumps, etc., and be able to independently complete the detection of central venous pressure, endotracheal intubation sputum suction, writing of nursing records, summary of intake and output and other monitoring skills. Finally, they can pass the theoretical and practical skills exams.

With the development of medical science and the widespread application of advanced electronic instruments in clinical practice, nurses have also put forward higher requirements, not only to have a high sense of responsibility, but also to learn the skills of intensive care and intensive care. I mastered intensive care and critical care skills during my internship in the intensive care unit of thoracic and cardiac surgery, which improved the overall quality and professional level of clinical care. During the internship, I understood the purpose and significance of the operation, the precautions for operation and the harmfulness of improper operation, and secondly, I learned that some operations must be experienced first-hand in order to master the skills, and only after mastering the methods and skills can I operate on the patient.

During my internship in surgery, I strictly abided by the department system, participated in nursing rounds on time, and was familiar with the patient's condition. Be able to correctly answer the questions of the teacher, standardize and skillfully carry out various basic nursing operations and specialized nursing operations, correctly implement the doctor's instructions, strictly implement three checks and seven pairs, and complete the handover and shift records in a timely manner. Able to prepare for surgery, provide guidance, and complete postoperative care and observation. In the work, the problems found can be carefully analyzed, solved in a timely manner, can be proficient in various nursing operations, and can quickly familiarize themselves with the conditions and respond to the urgent, critical, old and serious patients in the department. In the future work, I will continue to work hard, keep in mind the responsibilities of nurses, constantly strengthen ideological and professional learning, comprehensively improve my comprehensive level, and be a qualified doctor.

Many patients have delirium, agitation, coma, etc., so unlike other surgical departments, there are special care units to treat those who are critically ill. There are a lot of surgeries outside the gods, and they are basically major surgeries, so postoperative care is particularly important, closely observe vital signs, keep the drainage tube open, maintain the correct position of the patient, and strictly record the amount of entry and exit, these are all very important, and you can't neglect it at all.

Our profession is to be honored as the angel in white, and perhaps only our peers know the pain and tiredness behind this angel. The work is demanding of us. As soon as you wear a white coat, you have to throw away any emotions and troubles. In the smell of disinfectant water in the hospital, we have gone through the pure girlhood; From the bloody wounds, we have walked through the scorching youth; Countless quiet nights were sent away in a white atmosphere; In the expectation of the lover and the complaint of the child, I dedicate myself to the patients with pain, as we all know, we work hard, and there is no fixed holiday; There are no fixed cap breaks. The work is trivial and the responsibility is heavy. Some nurses also need to deal with leprosy patients, mentally ill patients, and infectious disease patients. We have given a lot in obscurity. However, we often encounter grievances and misunderstandings. But we have no regrets. Because we know that the people we serve are patients who need help and compassion and are struggling with their illness.

I found that there are still many deficiencies in my theoretical knowledge, sometimes I can't answer the various questions raised by the patient's family in detail, I feel very ashamed, and I should strengthen the review of theoretical knowledge, and I should learn more about the common drugs and drug indications, adverse reactions, precautions, etc. in the department, so as to better help patients. The duties of doctors and nurses are the same, both are to solve the physical and psychological pain of patients. Only when the medical staff work closely together can the best benefit be brought to the patient. And to do this, you must first understand your own work and the work of the other person. As a nurse in the future, I must understand the work of doctors, so I think this internship not only plays a role as a bridge for early contact with clinical practice, but also enhances clinical thinking ability, cultivates hands-on ability, enhances bed thinking ability, cultivates hands-on ability, and enhances confidence.

In short, there are three points, the first is: to establish confidence, for interns, the opportunity to practice is only a handful, plus sometimes we will be scared in our hearts, dare not get started, so in the face of rare opportunities to retreat into a habit, it is difficult to take the first step, which requires us to establish confidence, believe in ourselves.

Second: Fourth, communication skills are very important in clinical communication with patients, generally patients will not choose interns to help her see a doctor, or help her check drugs or other treatments, and even sometimes verbally refuse, which requires us to have good communication skills, and the relationship with the patient is good, I think he should not be embarrassed to refuse you.

Fifth, the attitude towards the patient If we treat the patient as our own relatives from the bottom of our hearts, and think about them everywhere, then the patient will also regard you as a family member.

For example, before entering the burn department, I reviewed the basic knowledge of burn surgery: the calculation of burn area, the principle of rehydration and the formula of rehydration for large burns, etc.

The operating room is a very scary and mysterious noun that makes people feel very scary and mysterious, a door in the operating room divides the inside and outside into two worlds, so that it is covered with a veil of mystery. I just helped to pull the hook in order to better expose the surgical vision, but from the heart I still feel that the opportunity is not easy to come by, from every small step I deeply understand the strictness of the sterile requirements in the surgical process. In order to meet the requirements of sterility, I also learned to tie the trocar in the operating room, conscientiously carry out the tasks arranged by the hospital department, put nursing safety in the first place in clinical work, prevent and eliminate any mistakes, strictly implement the nursing system, especially the check system, carefully and carefully, strictly control, and do a good job in the observation of the condition. Guide and require nurses to carefully observe the changes in the patient's condition, take corresponding intervention measures in a timely manner, effectively prevent accidents, ensure patient safety, establish a harmonious and harmonious relationship between nurses and patients, and create a good medical environment for patients.

That's all for my report, thank you, I'm done, and I'll do my best to maintain the profession I love in the future.

Gardenia.