Melinda Blanco

Day # 3: July 11, 2017

Today I was assigned four patients but it was pretty slow. Most of my patients did not require much just
their routine medications. There was one patient that actually made an impact on me. He was a 57-year-
old patient who was admitted with a J tube malfunction. He had a history of altered mental status and
hypertension. Patient had a NG Tube in his left nostril and had been lethargic most of the day. He
appeared to be extremely drowsy and essentially non-responsive. At 1400 he appeared to be more
awake and was delirious. He was having conversations with people who were not present. At one point,
he became agitated and pulled out his NG tube. This was my chance to insert my first NG tube. My
preceptor asked me if I wanted to go ahead and insert it myself. Of course, I jumped up at this
opportunity. I began by gathering all the supplies that I would need for this procedure. I began by
measuring the nasogastric tube from the tip of the patient earlobe to the tip of the nose, then the
xiphoid process. I marked the tube with a piece of tape and was ready to begin. I applied lubricant to the
tip of the NG tube. I had the patient tilt his head forward so that the tube could gently pass the nostril
and posterior pharynx. I advised the patient to swallow and was able to pass the tube with no
resistance. Once the tube was advance to the premeasured length I secured it. Immediately following
insertion, I verified placement via auscultation. This insertion had been another first for me. I am glad to
say that it was done successfully. I am learning new things every day in this rotation and am able to
practice the skills that I have learned in nursing school.