Hi, Hello, dear doctors and experts from Guoya Hospital.

I am Gardenia, Gardenia, Gardenia, and Gardenia. I am a newly recruited intern. I have been internship here for two months, and the next is my internship experience.

Internship is an indispensable learning stage for every medical student. As a beginner who lacks clinical experience, in addition to his own teaching teacher, other doctors, nurses and patients in the ward are teachers worthy of consultation. Therefore, I maintain a modest and serious learning attitude, actively participate in all learning, medical, discussion and other activities in the ward, starting from the most basic physical examination and disease course records, and gradually hone myself.

Before entering IU, Teacher Ji led me to explain the internal management system and disinfection system to me, and introduced the IU environment, so that I had some understanding of the surveillance room and was able to work handy. Special arrangements for specialized disease knowledge lectures, that is, introductions to common diseases in thoracic and cardiac surgery, which gave me a certain understanding of thoracic and cardiac surgery diseases, which was conducive to postoperative monitoring. In addition, I also provided basic nursing teaching, such as preoperative education, psychological care and life care for patients.

First, let me understand the significance and importance of central venous pressure measurement. It is an objective standard for directly reflecting left heart function and measuring blood volume, guiding fluid replenishment speed and evaluating blood volume. Factors affecting central venous pressure measurement value:

1. Determination of zero point;

The fourth rib on the mid-axillary line of the 2-lying position, the fourth rib on the anterior line of the semi-lying position;

3 Patients must measure their pressure in a quiet state;

4 The pressure measuring tube must be kept unobstructed to ensure that the catheter is in the vena cava or the right atrium;

5 When applying a ventilator peep, the peep value must be subtracted to be the real central venous pressure. At the same time, the teacher and I measure the pressure separately to compare the accuracy of my measurement. Pay attention to sterility, avoid injecting vasoactive drugs from the manometric tube, and ensure that the pipeline is unobstructed and in place.

After entering clinical internship, I often focus my learning on operations, and relax my training in theoretical learning and clinical thinking, especially in thoracic surgery. There are many types of thoracic surgery and many surgeries, so I can easily focus all my attention on surgical operations. Therefore, I regard more surgery and practice more as the main purpose of the internship. The pathophysiology after the surgery will change greatly. I must comprehensively and accurately consider various aspects such as medical history, signs, condition, and surgical methods to accurately grasp the key points, see the essence, understand the impact of the surgery on patients, and formulate correct treatment measures. Let them know the truth and know the reason, and then gradually improve their ability to analyze and solve problems in clinical work.

Through a one-month internship, we can understand the monitoring, basically master the clinical application and precautions of monitors, ventilators, defibrillators, micropumps, etc., and independently complete the monitoring skills such as central venous pressure detection, sputum suction in tracheal intubation, writing nursing record sheets, and summarizing inlets and out. Finally, we can pass the theoretical and operational skills examinations.

With the development of medical science, the widespread application of advanced electronic instruments in clinical practice has put forward higher requirements for nurses. Not only should we have a high sense of responsibility, but we should also learn the skills of intensive care and intensive care. During the internship in the intensive care unit of the thoracic cardiac surgery department, I have mastered intensive care and intensive care skills, which has improved the overall quality and professional level of clinical care. During the internship, I understood the purpose, significance, operation precautions and the harm of improper operation. Secondly, I knew that some operations must be experienced in person to master the skills, and after proficient in the methods and techniques, I could operate on the patients.

During the internship in surgery, I strictly abide by the department system, participate in nursing rounds on time, and be familiar with the patient's condition. I can correctly answer questions from the teacher, standardize and proficient in various basic nursing operations and specialist nursing operations, correctly execute medical instructions, strictly implement three checks and seven pairs, and complete handover records in a timely manner. I can prepare preoperatively and provide guidance and complete postoperative nursing and observation. During work, I can carefully analyze and solve problems and proficient in various nursing operations. For urgent, dangerous, old, and serious patients in the department, I can quickly become familiar with the condition and respond to it. Through learning, my theoretical and practical level has been improved. In my future work, I will continue to work hard, keep in mind the nurse's responsibilities, constantly strengthen my ideological and professional learning, comprehensively improve my comprehensive level, and be a qualified doctor.

The diseases outside the Sword are complicated, including various cranial brain injuries, brainstem injuries, spinal injuries, etc. Many patients have symptoms of confusion, restlessness, coma, etc. Therefore, unlike other surgical departments, there are special guardianship rooms here to treat critically ill patients. There are many surgeries in Sword outside, and basically all are major surgeries, so postoperative care is particularly important. Close observation of vital signs, keep the drainage tube unobstructed, keep the patient in the correct position, and strictly record the amount of inlet and exit. These are all very important, and you cannot neglect the slightest.

Our profession is the angel in white who is respected. Perhaps only the colleagues know the hardships and fatigue behind this angel. Work is harsh on us. Once we wear a white coat, all emotions and worries must be thrown away. In the smell of disinfectant in the hospital, we walked through the pure girlhood; we walked through the hot youth from the bloody wounds; sent away countless peaceful nights in the white atmosphere; we put ourselves in the expectations of our lovers and the complaints of our children.

We dedicate to the injured patients. As we all know, our work is hard, and there is no holiday in the turtle. There is no rest time in the turtle. The work is trivial and the responsibility is heavy. Some nurses also need to deal with leprosy patients, mental patients, and infectious patients. We have paid a lot in obscurity. However, we often encounter grievances and misunderstandings. But we have no regrets. Because we know that the service recipients are patients who need help and sympathy and struggle in the pain.

I found that my theoretical knowledge still has many shortcomings. Sometimes I cannot answer the various questions raised by the patient's family. I feel very ashamed. I should also strengthen the review of theoretical knowledge. In addition, I should understand more about the commonly used drugs and medication indications, adverse reactions, precautions, etc. in my department, so that I can better help the patients. After a few months, the internship life will also be of great help to my medical and nursing cooperation in my future work. The responsibilities of doctors and nurses are the same, both to solve physiological and psychological pain for patients. Only when medical and nursing work closely can they bring the greatest benefits to the patients. To do this, we must first understand our own work and the other party's work. As a future nurse, we must understand the work of the doctor. Therefore, this internship I feel that it not only plays a bridge for early contact with the clinical practice, but also enhances clinical thinking ability, cultivates hands-on ability, cultivates hands-on ability, and enhances confidence.

In short, there are three points. The first is: to build confidence. For interns, there are only a few opportunities for practical operations. In addition, sometimes we are scared and dare not get started. In this way, it becomes a habit to retreat in the face of rare opportunities, and it is difficult to take the first step. This requires us to build confidence and believe in ourselves.

Second: Fourth, communication skills are very important in clinical practice. Generally, patients will not choose an intern to help her see a doctor, or to help her check drugs or other treatments, and sometimes even refuse to say anything. This requires us to have good communication skills and get along with the patient. I think he should not be embarrassed to reject you anymore.

5. Attitude to patients. If we treat patients as our relatives from the bottom of our hearts and think about them everywhere, then the patient will treat you as a family member. I think if I were a patient, I would rather get an extra shot than leave the opportunity to my relatives. Even if it hurts, I will say that you have a good injection and it doesn’t hurt at all.

6. Preparation work. Before entering each department for internship, it is best to make some preparations. For example, before entering the burn department internship, I reviewed the basic knowledge of burn surgery: calculation of burn area, the principle of replenishing fluids for large-area burns and the formula for replenishing fluids, etc.

The operating room is a term that makes people feel scary and mysterious when they hear it. The doorway in the operating room divides the inside and outside into two worlds. It puts it on a mysterious veil. Among all the departments, the operating room is the department I yearn for the most, because the operating room is very mysterious to me. Every morning, I go to work at 8 o'clock, change my shoes, wear a hat and mask, and change my clothes in the operating room to enter the restricted area, which further enhances my concept of sterility. During my internship in the operating room, I was honored to have two minor surgeries. It was a nasal cavity to take tumors. I just helped pull the hook to better expose the surgical vision, but from the bottom of my heart, I still felt that the opportunity was hard-earned. From every small step, I deeply realized the strict requirements of sterility during the operation.

Level of class. I learned from brushing my hands to wearing surgical gowns and sterile gloves. I strictly demanded myself at every step to meet the requirements of sterility. In the operating room, I also learned to put trocars and carefully implement the tasks arranged by the hospital department. In clinical work, I should put nursing safety first in the work, prevent and eliminate any mistakes, strictly implement various nursing systems, especially checking the system, carefully and strictly checking, and observing the condition. Guidance and require nurses to carefully observe the changes in the patient's condition, and take corresponding intervention measures in a timely manner to effectively prevent unexpected events, ensure patient safety, establish a harmonious and harmonious nursing-patient relationship and medical-care relationship, and create a good medical environment for patients.

The above is my report. Thank you everyone. After my experience is over, I will do my best to maintain the profession I love in the future.
Chapter completed!