Summary of Nurses' Work in Urology Department Fan Wenxuan (I)
I feel very lucky to come to our hospital as a urological nurse. During my work in urology, I learned a lot of new things and challenged many difficulties that I have never encountered before. Now I will summarize my recent work as follows:
I. Ideology and politics
As a China party member, I can always demand myself by the standards of a party member. Under the premise of observing the rules and regulations of the department, we should conscientiously study all kinds of advanced ideas, broaden our horizons, strive to improve our ideological consciousness and professional level under the leadership of the department director and head nurse, earnestly carry out and organize professional study, arm ourselves with knowledge, and March forward like an excellent urological nurse.
At the same time, I also actively responded to the call of various departments of the hospital, actively participated in various activities organized by the hospital, constantly improved myself and exercised myself, enriched my spare time, broadened my horizons, increased my knowledge and promoted my all-round development.
Second, the business technology
There are relatively many patients in urology, and they have also learned relevant knowledge before and after operation. Preoperative preparation includes psychological counseling, intestinal preparation and dietary guidance. Postoperative vital signs monitoring, incision observation, infusion volume and infusion speed observation, nursing of various drainage tubes, nursing of urinary tubes, diet nursing, observation and nursing of postoperative complications, etc. In our daily work, we are required to communicate with patients and their families more patiently. Only in this way can we better improve the quality of nursing and make patients trust our work. Because of the fast pace of surgery, the work is busy and trivial. I remember when I first arrived in surgery, I was not used to it. In order to do a good job and obey the arrangement of the leader, I am not afraid of trouble. I asked the teacher, learned from my colleagues and groped for it myself, and soon I became familiar with the work of surgery. Understand the responsibilities of each class, clarify the working procedures and direction, improve the working ability, form clear working ideas in specific work, and be able to carry out the work smoothly and complete the work skillfully and smoothly.
Third, self-management
I also pay great attention to the professional image of nurses, pay attention to civilized and polite service in my daily work, adhere to civilized language, be dignified in appearance, dress neatly, wear no shoulder, do not wear heavy makeup, do not wear high heels or ring shoes, be polite, have a kind attitude and have a standardized language. Seriously study the Regulations on Handling Medical Accidents and its laws and regulations, and actively participate in the learning activities of the Regulations on Handling Medical Accidents organized by the hospital, which enriched the legal knowledge and enhanced the awareness of safety protection. Under the active and serious guidance of the head nurse, I have made great progress and improvement in many aspects. At ordinary times, I insist on participating in the business study of the department and the three-basic training of nursing staff. Can always adhere to the "patient-centered, quality-centered" service concept, improve their own quality and emergency response capabilities.
Fourth, shortcomings and deficiencies.
Of course, I still have some shortcomings to improve. For example, in learning, sometimes there will still be impetuous emotions, and I feel that there are too many things to learn, and I am impetuous, especially when I encounter setbacks, I can't handle them calmly.
At work, sometimes the standard is low. Although I can basically perform my duties and obligations, my initiative needs to be further improved, which is what I need to improve and improve in the future.
In the coming year, I would like to thank the hospital leaders, head nurses and teachers for their education, guidance, criticism and help, and my colleagues for their concern and support. Looking back on the past, there have been many advances and improvements, but there are also some shortcomings; Looking forward to the future, we should carry forward our own advantages and overcome our own shortcomings. In the coming year of 2020, I will continue to carry forward the spirit of the past year, do my job well, be anxious about the patient's urgency, be responsible for the patient, and never make the patient's condition worse because of my reasons. I will be absolutely responsible for my work. This is the minimum work that a good nurse should do to save lives.
Summary of Nurses' Work in Urology Department Fan Wenxuan (Ⅱ)
This year is my first year at work. Under the care and direct leadership of hospital leaders and head nurses, with the service tenet of "patient-centered, patient-centered", we successfully completed all the nursing work assigned by hospital leaders and mastered various clinical operation skills. The work is summarized as follows:
After less than a year's practical study, I think that if we want to combine the theoretical knowledge we have learned before with clinical practice, on the one hand, we should be strict with ourselves in our daily work and consult more teachers, on the other hand, we should study hard in our spare time and understand the essentials.
There are relatively many surgical patients, and they have also learned relevant knowledge before and after operation. Preoperative preparation includes psychological counseling, intestinal preparation and dietary guidance. Postoperative vital signs monitoring, incision observation, assistance in coughing and expectoration, observation of infusion volume and infusion speed, nursing of various drainage tubes, nursing of catheter, diet nursing, observation and nursing of postoperative complications, etc. In our daily work, we are required to communicate with them more patiently. Only in this way can we better improve the quality of nursing and make patients trust our work. Because the pace of surgery is faster, work is busier than talking on the phone. Trivial. I remember when I first arrived in surgery, I was not used to it. In order to do a good job and obey the arrangement of the leader, I am not afraid of trouble. I asked the teacher, learned from my colleagues and groped for it myself, and soon I became familiar with the work of surgery. Understand the responsibilities of each class, clarify the working procedures and direction, improve the working ability, form clear working ideas in specific work, and be able to carry out the work smoothly and complete the work skillfully and smoothly.
After nearly a year's study, I am familiar with the professional knowledge of the department and pay great attention to the professional image of nurses. I pay attention to civilized and polite service in my daily work, adhere to civilized language, have a dignified appearance, dress neatly, do not wear heavy makeup, do not wear high heels, do not ring shoes, have a polite attitude and have a standardized language. Seriously study the Regulations on Handling Medical Accidents and its laws and regulations, and actively participate in the learning activities of the Regulations on Handling Medical Accidents organized by the hospital, which enriched the legal knowledge and enhanced the awareness of safety protection. Under the active and serious guidance of the head nurse, I have made great progress and improvement in many aspects. Usually, I insist on participating in the business study of the department and the three-basic training of nursing staff every Friday. In the past year's work, I have always adhered to the service concept of "patient-centered, quality-centered" and improved my quality and emergency response ability.
Of course, I still have some shortcomings to improve. For example, in study, sometimes I feel impetuous, I feel that I have too much to learn, and I am impetuous, especially when I encounter setbacks, and I can't handle it calmly. At work, sometimes the standard is low. Although I can basically perform my duties and obligations, my initiative needs to be further improved, which is what I need to improve and improve in the future.
In the coming year, I would like to thank the hospital leaders, head nurses and teachers for their education, guidance, criticism and help, and my colleagues for their concern and support. Looking back on the past, there have been many advances and improvements, but there are also some shortcomings; Looking forward to the future, we should carry forward our own advantages and overcome our own shortcomings. In the coming = = year, I will continue to carry forward the spirit of the past year, do my job well, be anxious about the patient's urgency, be responsible for the patient, and never let the patient's condition deteriorate because of my reasons. I will be absolutely responsible for my work. This is the minimum work that a good nurse should do to save lives.
Summary of Nurses' Work in Urology Department Fan Wenxuan (Ⅲ)
Urology is the first stop of our surgery, and we have a natural curiosity about surgery. Therefore, for surgery, we are indispensable. Secondly, according to our predecessors, in surgical operations, what we interns usually do is dressing change, removing stitches, and the unique "extubation" of urology. I hope to master it as soon as possible. Finally, it is said that the operation process is "water", so I think we should give full play to our efforts in internal medicine.
On the first day of urology, we should get on well with our seniors. Fortunately, the assigned seniors are willing to teach and are very kind. First of all, he talked about the time of suture removal and the main points of dressing change during the operation.
The time of incision suture removal after operation depends on the different surgical sites. Generally, stitches are removed 5 ~ 7 days after facial and neck surgery;
6~7 days after lower abdomen and perineum surgery; Remove stitches 7 ~ 9 days after upper abdomen, chest, back and buttocks surgery; The stitches were removed 10 ~ 12 days after limb surgery; It is more suitable to remove stitches in the joint and its vicinity and after tension reduction suture 14 days. Full-thickness skin transplantation, suture removal 12 ~ 14 days after operation. Old, weak, anemia or complications, should be appropriately extended suture removal time. Change dressing after operation. If there is no special reaction, change dressing for the first time after 3~5 days. If the incision is intact and the tension is not great, you can take part or all of the stitches as appropriate, usually after 7~9 days. There are many secretions from infected wounds, and the dressing should be changed once a day and once every 2 days for fresh granulation wounds/kloc-0. Rubber tube drainage wound, dressing change 2~3 days after operation, drainage 3~7 days to replace or pull out.
In this internship, I also met a patient with fat liquefaction. The main reason of fat liquefaction is that there is more fat at the incision. When the electrosurgical excision procedure is used, the high temperature generated by the electrosurgical excision procedure causes surface burns of subcutaneous adipose tissue, and some adipose cells are denatured due to thermal damage. At the same time, the capillaries in adipose tissue are embolized due to coagulation, which further hinders the blood supply of hypertrophic adipose tissue with poor blood supply. Aseptic necrosis of adipose tissue occurred after operation, resulting in more exudation, which affected wound healing. In urology, it is mainly to open the incision, insert gauze for drainage, strengthen dressing change twice a day, and then perform secondary suture when the exudation disappears.
Every morning after rounds, it's time for dressing change and prescribing, which is usually completed within one hour. The next whole day, if nothing unexpected, was spent in the operating room.
On the operating table, I was fortunate to meet an open operation, radical nephrectomy, which is not common in urology. And because of the shortage of manpower, I got the first chance to go on stage in my life. I even forgot how to wash my hands because I didn't prepare in advance. Fortunately, I am fluent in dressing and wearing gloves. However, just like the interns in Qian Qian before, all we can do is to pull down the fishhook and happily touch the pulsating renal artery and warm kidney. After several operations in urology, it is found that the most important thing in the operation is to avoid bleeding, stop bleeding in time after bleeding, find the main arteries and veins correctly, and separate them to avoid accidental injury and prepare for plugging.
However, in urology, transurethral cystoscopy, transurethral resection of prostate and transurethral resection of bladder tumor are the most common operations. The patient took lithotomy position, sterilized towel, inserted cystoscope through urethra, and performed suprapubic cystostomy in some cases. In addition, the second most common method is lithotripsy, including extracorporeal ultrasonic lithotripsy and percutaneous nephrolithotomy. I haven't seen the operation steps.
In addition to surgery, the most important thing is preoperative conversation. The formal statement is that the conversation should inform the patient of the risks and benefits of the operation, but according to the senior, the patient should be scared, not scared away. The risk of surgery, if done carefully, will really scare patients, but it is also a science after all, but unfortunately we have no chance to practice it now.
Urology can also meet some surprising patients. Some patients have only one kidney, while others have four. Some patients have huge tumors, while others have small tumors. In a word, there are thousands of surgical diseases in Qian Qian, and three weeks seems to be inexhaustible. Finally, I can only say that the operation will continue.
Summary of Nurses' Work in Urology Department Fan Wenxuan (IV)
20 19 under the leadership of hospital leaders, nursing departments and department directors, we implemented the deployment and requirements of "promoting quality nursing service", combined with Guangdong health system innovation activities and "three good and one satisfaction" activities, deepened the service concept of "patient-centered", and closely focused on the working purpose of "reforming nursing mode, fulfilling nursing duties, providing quality services and improving nursing level" .21000.000000000105
First, strengthen the implementation of the core system and nursing quality management to ensure nursing safety.
1, the head nurse is responsible for the work control of each nursing staff, and keeps the doctor's advice, inspection, communication, patient care, special inspection and diagnosis and treatment.
2, strictly implement the rules and regulations of the hospital, strengthen the management of the department nursing team, master the nursing core system, and often check the implementation and implementation of various nursing work. Implementing the core system and paying close attention to the quality management of clinical nursing.
3, improve and implement the core work system of clinical nursing, general nurses abide by the rules and regulations of the hospital, obey the arrangement of the head nurse, stick to their jobs, perform their duties, and ensure correct and timely treatment and nursing work.
4. Cultivate senior responsible nurses (above the title of nurse) with comprehensive evaluation, judgment and handling ability on nursing problems.
5. Be able to master the rescue procedures for critically ill, major surgery and difficult patients, be good at communicating effectively with patients or their families, be able to correctly answer the matters needing attention after transurethral resection of prostate and continue the correct operation of bladder irrigation.
6, can carry out and implement the situation and whether the quality of nursing document writing has actually improved.
Second, implement the "responsibility system" to improve service quality.
The responsibility system has been implemented, and the clinical nursing work mode of group responsibility system and responsibility to people has been implemented. Nurses in our department carry out hierarchical management, divide nurses fairly according to patients' condition, nursing difficulty and technical requirements, take responsibility for nursing patients in groups, and build a working mode of professional team leader-responsible nurse. Implement a graded nursing system, so that patients can be graded and nurses can be graded. It not only emphasizes the management of critically ill patients by senior nurses, but also emphasizes everyone's participation in life nursing. Implement holistic and holistic nursing to ensure that the beds managed by the responsible nurses are in place. The professional team leader is not only responsible for patients, but also responsible for supervising and managing the work of this group of nurses, guiding this group of nurses to complete medical care tasks and care for critically ill patients; The responsible nurse is responsible for observing the patient's condition, implementing therapeutic nursing and health education, psychological nursing and life nursing, and achieving all-round nursing.
Third, pay attention to service details and improve patient satisfaction.
Adhere to the purpose of patient-centered, quality-centered, providing quality services for patients, strengthen the construction of medical ethics for nursing staff, implement the code of conduct for nursing staff, and require nursing staff to smile and serve in their daily work, and be civilized in language. The satisfaction questionnaire is distributed to inpatients every month, and the satisfaction survey results are all above 95%. I have also obtained letters of commendation and banners from patients many times. And put forward rectification measures for the problems existing in the satisfaction survey. The department regularly holds a forum on rest work every month to solicit opinions from patients and their families and give maximum satisfaction to the requirements put forward by patients and their families. Further develop patient-centered health education. Through the formulation and distribution of health education cards, through the example of nurses and the publicity of blackboard newspapers, patients are familiar with disease prevention, rehabilitation knowledge and related medical, nursing and self-care knowledge. Because of its small and excellent service, it has been well received by patients and their families.
Fourth, standardize the writing of nursing documents to reduce the writing pressure of nurses.
Nursing documents, namely legal documents, are the objective basis for judging medical disputes. In the process of writing, we should seriously consider, objectively, truly, correctly, timely and completely show the patient's condition changes, and constantly strengthen the significance of formal writing of nursing documents, so that every nurse can strengthen supervision while correcting the attitude of writing. Each shift checks whether the records of the previous shift are defective, the quality control team checks regularly, the head nurse checks regularly and irregularly, and the final quality inspection of the discharged medical records. Since 20== years, our department has adopted tabular nursing documents and used urology and burn nursing records according to the characteristics of specialties, which greatly reduced the time for nurses to record. Nurses have more time to provide direct care services.
Fifth, strengthen the quality education of nurses and improve the quality of nursing service.
1. Give full play to the role of nursing quality control group. The quality control team of the department tabulates the emergency plan and basic operation assessment of the core system that individuals need to complete every month, so that nurses can keep track of the progress and completion of their assessment at any time. Discover nursing hidden dangers and nursing faults, continuously improve nursing quality in time, hold departmental seminars and life meetings, summarize shortcomings and deficiencies in work, and correct them in time. Carefully analyze the cause of the failure and discuss the corrective measures to avoid the recurrence of similar incidents.
2. In view of the large number of young nurses in wards and the lack of experience in dealing with disputes and other emergencies, more attention is paid to the cultivation of nurses' communication skills. By discussing the time-life meeting of questionable medical records, nurses are encouraged to participate in the discussion and cultivate their communication skills. And according to specific cases, specific analysis, organize discussions, and teach young nurses to learn to deal with problems.
Six, strengthen the training of three basics and three strictness, and improve the quality of nursing staff.
1, formulate and implement professional training and three-base assessment plan for nursing staff at all levels. According to the individual needs of posts and nurses, we will carry out all kinds of nursing skills training, and implement hierarchical training and personalized training, such as pre-job training, quality nursing service, nursing technical operation, nursing first aid skills, safety nursing, nursing document writing, observation skills of critically ill patients, nursing quality control, nursing rounds, etc. , so that our technology is becoming more and more skilled, and the skills and abilities of nurses are constantly improving. This also ensures that we provide quality nursing services for patients.
2. In order to better serve the people, it has basically become a normal work of the department to organize nurses to learn core systems and emergency plans, and to study and teach two nursing operations, two core systems, emergency plans, nursing operations, core systems and emergency plans in a planned way every month. Nurses have developed good work habits through study and consciously applied them to their daily work, thus ensuring the nursing safety of wards.
3. Organize business study regularly every month, and study business for more than 70 times throughout the year. In fact, constantly improve the nursing routine of the department. Revise and improve the nursing routine of urology. Broaden nurses' knowledge and improve their theoretical level. In the health education for patients, it reflects the nurses' high level of knowledge and is well received by patients, family members and doctors.
4. Insist on discussing nursing cases every month, and discuss and express opinions on suspicious cases, critical cases and ordinary nurses, which improves the nursing level of nurses for critical patients with doubts, and at the same time advances possible problems and improves their premonition and coping ability for nursing problems.
5. Every month, the quality control team of the department plans to assess the nursing skills of the nurses in the department. At the end of the year, nursing staff at all levels participated in professional theoretical examinations organized by departments and theoretical examinations organized by nursing departments. Participation rate 100%, passing rate 100%.
Through one year's three basics and three strictness training, the professional level of nurses has been continuously improved, providing better services for patients.
Seven, the first aid items intact rate 100%.
First-aid articles shall be subject to "four-fixed" management, that is, positioning and placing, quota numbering, personal responsibility and regular inspection. The supervisor shall conduct a comprehensive inspection once a week, and the head nurse shall conduct weekly inspections and spot check at any time to ensure that the first-aid articles are always in an emergency state. Do not misappropriate or lend at will. Whoever dismantles and uses it will be liquidated and disinfected in time, and the consumed part will be replenished in time. After the replenishment, who will stamp it? All first-aid articles and facilities are in a state of emergency, and within the validity period, all expired articles and medicines exist.
Eight, strengthen the hospital work consciousness.
1. According to the hospital infection management standards, strengthen the management of medical waste, improve the management system of medical waste, and organize the classified treatment process of medical waste, so as to standardize the classification, collection, packaging and handover of medical waste in our department.
2. Organize and learn the purpose and process of hand washing, and make an evaluation to implement hand hygiene and avoid cross-infection in the hospital.
3. Organize research on isolation measures and procedures for patients with multi-drug resistant bacteria infection, and establish isolation guidelines for multi-drug resistant bacteria infection.
Nine, advocate nursing staff to actively report adverse events.
We have implemented and improved the registration and reporting system of adverse events, encouraged non-punitive reports and online reports, and encouraged nurses to actively report adverse events, so as to be realistic, not to conceal, lie or delay. Summarize and analyze the common unsafe manifestations and common causes of nursing accidents in nurses' work every month, and put forward how to avoid nursing accidents and mistakes. There was no nursing negligence accident this year.
X. Existing problems, working ideas and future efforts
1, there is a problem.
(1), the quality of morning care and basic care is poor.
(2) Ward management needs to be improved. Patients should bring their own things and be accompanied by more staff.
(3) The professional knowledge of new nurses is weak, the disease nursing and health education are not advanced enough, and they lack dynamic continuity.
(4) The learning atmosphere is not strong enough and there are no academic papers.
(5) There are some defects in the writing of nursing documents, such as missing items, missing records and lack of continuity in content.
(6) The working ability and psychological quality of junior nurses need to be further improved.
2. Working hypothesis
(1), make a work plan for 2020, make a specific training plan, and standardize the training of nurses in departments.
(2) According to the characteristics of = = post nurses, pay attention to the cultivation of working ability and psychological endurance of junior nurses, so that they can work as soon as possible.
(3) Improve their professional level, strengthen the study of management knowledge and improve their management level.
(4) Strengthen equipment investment and attach importance to creating excellence.
3. Future efforts
In the year when the new building was put into use, in a brand-new bright and beautiful environment, urology department successfully completed all kinds of nursing work in the implementation of hospital goals. Continuously improve nursing quality and work level, adapt to the needs of hospital reform and development, and strive to build a brand of pregnant doctors' nursing and a brand of regional general hospitals. We believe we can do better.
Summary of Nurses' Work in Urology Department Fan Wenxuan (5)
I. Ideology and politics
As a China party member, I can always demand myself by the standards of a party member. Under the premise of observing the rules and regulations of the department, we should conscientiously study all kinds of advanced ideas, broaden our horizons, strive to improve our ideological consciousness and professional level under the leadership of the department director and head nurse, earnestly carry out and organize professional study, arm ourselves with knowledge, and March forward like an excellent urological nurse.
At the same time, I also actively responded to the call of various departments of the hospital, actively participated in various activities organized by the hospital, constantly improved myself and exercised myself, enriched my spare time, broadened my horizons, increased my knowledge and promoted my all-round development.
Second, the business technology
There are relatively many patients in urology, and they have also learned relevant knowledge before and after operation. Preoperative preparation includes psychological counseling, intestinal preparation and dietary guidance. Postoperative vital signs monitoring, incision observation, infusion volume and infusion speed observation, nursing of various drainage tubes, nursing of catheter, diet nursing, observation and nursing of postoperative complications, etc. In our daily work, we are required to communicate with patients and their families more patiently. Only in this way can we better improve the quality of nursing and make patients trust our work.
Because of the fast pace of surgery, the work is busy and trivial. I remember when I first arrived in surgery, I was not used to it. In order to do a good job and obey the arrangement of the leader, I am not afraid of trouble. I asked the teacher, learned from my colleagues and groped for it myself, and soon I became familiar with the work of surgery. Understand the responsibilities of each class, clarify the working procedures and direction, improve the working ability, form clear working ideas in specific work, and be able to carry out the work smoothly and complete the work skillfully and smoothly.
Third, self-management
I also pay great attention to the professional image of nurses, pay attention to civilized and polite service in my daily work, adhere to civilized language, be dignified in appearance, dress neatly, wear no shoulder, do not wear heavy makeup, do not wear high heels or ring shoes, be polite, have a kind attitude and have a standardized language. Seriously study the Regulations on Handling Medical Accidents and its laws and regulations, and actively participate in the learning activities of the Regulations on Handling Medical Accidents organized by the hospital, which enriched the legal knowledge and enhanced the awareness of safety protection. Under the active and serious guidance of the head nurse, I have made great progress and improvement in many aspects. At ordinary times, I insist on participating in the business study of the department and the three-basic training of nursing staff. Can always adhere to the "patient-centered, quality-centered" service concept, improve their own quality and emergency response capabilities.
Fourth, shortcomings and deficiencies.
Of course, I still have some shortcomings to improve. For example, in study, sometimes I feel impetuous, I feel that I have too much to learn, and I am impetuous, especially when I encounter setbacks, and I can't handle it calmly. At work, sometimes the standards are very low. Although I can basically perform my duties and obligations, my initiative needs to be further improved, which is what I need to improve and improve in the future.
In the coming year, I would like to thank the hospital leaders, head nurses and teachers for their education, guidance, criticism and help, and my colleagues for their concern and support. Looking back on the past, there have been many advances and improvements, but there are also some shortcomings; Looking forward to the future, we should carry forward our own advantages and overcome our own shortcomings. 20 12 in the coming year, I will continue to carry forward the spirit of the past year, do my own job well, be anxious about the patient's urgency, be responsible for the patient, and never let the patient's condition deteriorate because of my reasons. I will be absolutely responsible for my work, which is the minimum work a good nurse should do to save lives.
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