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Internship Nar
Internship Nar
Learning objectives;
3 Evaluate clinical data to include, but not limited to ventilator data, hematology and
For one month and the half, from February of 2018 to April of 2018, I did my internship at
Baptist Memorial Hospital with my main focus being on critically ill Adults in the Intensive Care
Unit (ICU), Emergency Department (ED) and Cardiovascular Intensive Unit (CVICU). During
the internship rotation, I had the above objectives which I needed to improve my knowledge and
learn a better way to improve patient care, but more importantly, I also had a great chance to
sharpen my skills in a professional working environment. In order to achieve the set goal, I had
to ask question whenever I am wasn’t sure and I also had to focus on one objective every day.
For example, I perform a number of skills per day but my focus for the day was to improve my
2
knowledge on initiating plan of care and extubation. The physician explain the importance of
patient assessment to determine weaning, the included the importance of gag reflex, stable
hemodynamic, patient physical appearance, and patients ability to follow command. There are
exception to this protocol for extubating some patients, there was a patient who did not follow
command but was extubated without any problem. This reinforces my knowledge on weaning a
Perform numerous blood gas sampling per day, also improve my knowledge on the
proper technique of drawing blood from a critically ill patient especially the use of heparinised
syringe the correct amount of heparin and blood is very important to prevent coagulation of
blood and to obtain accurate test results. Patients managed in the intensive care unit (ICU) are
potentially increased risk of difficult airway management, and this is associated with a higher
Patient Assessment, during my internship I learn that patient assessment was the key to
initiate treatment. The assessment included patient past medical history, primary complaints
especially cardiopulmonary diseases that chronic or acute. Documentation is also one of the most
important parts of patient care. “if you did not document it, it means you did not do it” was a
common phrase used, documentation tells you if treatment is working or not and was another
Another important thing which strike me was the reinforcement of the used of heated
humidifiers (HH) and heart moisture exchanger (HME). My intern clinical used mostly used the
HME and the physicians where very clear about the important of keeping all intubated patients
airway humidifier to prevent dryness since the upper airway is by pass and this upper airway
One of the things that I learn during the internship which I never thought was important is
why clinician use different codes like full, partial codes in different scenarios. We had a patient
was partial code but when this patient was taken for a surgery, the nurse change the partial code
to a full code which got my attention and I wanted to understand why the patient code is change
without their consent. It was explained that, all patients are put in full code when going surgery
so that if anything goes wrong they will get all the care available to keep them alive regardless of
Through the internship, I was able achieve my goals through skilled validation, physician
student interaction, participation in rounds and impromptus quizzes from the preceptors. The
therapists treated me like a newly hired and the will not seat back if they see me do something
wrong, they will ask me questions and criticized me and direct me or some time work me