RIVERS STATE UNIVERSITY

P.M.B 5080, NKPOLU-OROWORUKWO, PORT HARCOURT

DEPARTMENT OF NURSING

8 WEEKS REPORT ON STDENTS INDUSTRIAL WORK EXERINCE

SCHEME (SIWES)

AT

RIVERS STATE UNIVERSITY TEACHING HOSPITAL

6-8 HARLEY ST, OLD GRA, PORT HARCOURT 500101, RIVERS,

NIGERIA

BY

AMESI TOVIA CHIBURUOMA

DE.2021/5478

SIWES SUPERVISOR: MISS KUE JANE

JANUARY 2024
 RIVERS STATE UNIVERSITY
P.M.B 5080, NKPOLU-OROWORUKWO, PORT HARCOURT

DEPARTMENT OF NURSING

8 WEEKS REPORT ON STDENTS INDUSTRIAL WORK EXERINCE

SCHEME (SIWES)

AT

RIVERS STATE UNIVERSITY TEACHING HOSPITAL

6-8 HARLEY ST, OLD GRA, PORT HARCOURT 500101, RIVERS,

NIGERIA

BY

AMESI TOVIA CHIBURUOMA

DE.2021/5478

SIWES SUPERVISOR: MISS KUE JANE

JANUARY 2024
 ABSTRACT

This industrial training report presents the experience gained/obtained during my 8 weeks of
industrial training undertaken at Rivers State University Teaching Hospital (RSUTH). My
training was on monitoring of vital signs, providing wound care, blood test, sugar test, urine
test (urinalysis) and administration of medication to patients according to the hospital policy
for adequate nursing care. This report discusses the technical, social, competence, problem
solving skills gained during the training period and justifying the relevance of the scheme in
equipping students with needed technical competence to thrive in the real world.
 DEDICATION

This report is dedicated to God almighty whose love has seen me through the time of my

training. I also dedicate this report to my superiors, my lecturers, my supervisors, teachers and

colleagues at RSUTH, who through this period of my training has made me learn a whole lot

of new ideas and ensured that the period of my industrial training was a success.
 ACKNOWLEDGEMENT

My deepest gratitude goes to God almighty the giver of life, wisdom, provision and for all

those he used to make my industrial training a success. I will like to thank the industrial

Training Fund for their foresight in putting this program to place and also the Nursing

Department of Rivers State University, for all I have learnt from the time of my admission into

the school.

My appreciation goes to the Dean of the faculty of Basic Medical Sciences and all the principal

officers; thank you for playing a vital role to ensure the success of this industrial training. My

sincere appreciation goes Miss Kue Jane, my SIWES coordinator whose contributions and

constructive advice pushed me to put all necessary effort to make this report as good and

authentic as any ideal report can be. I won’t forget the HOD of the Nursing Department for her

authentic guidance over the department.

I also appreciate the entire Nursing lecturers for their guidance and advice which prepared me

mentally and otherwise for this Training.

Lastly, to my parents for supporting me financially and otherwise through my clinical posting

experience.
 TABLE OF CONTENT

Content Page

Title Page i

Abstract ii

Dedication iii

Acknowledgement iv

Table of contents v

List of figures vi

CHAPTER 1: INTRODUCTION

1.1 Brief History of SIWES

1.2 Objectives of SIWES

1.3 Brief History of RSUTH

1.4 The Hospitals vision and mission statement

1.5 The establishment scope of work

CHAPTER 2: INDUSTRIAL EXPERIENCE

2.1 Description of Work done/Departments Covered

2.2 Male medical ward

2.3 Female medical ward

2.4 Accident and Emergency

2.5 Family Medicine

2.6 Children Clinic/Pediatric outpatient

CHAPTER 3: NEW SKILLS ACQUIRED AND CHALLENGES

3.1 Social

3.2 Technical

3.3 Problem solving/ Competent skills

3.4 Challenges Encountered During Training Period

CHAPTER 4: CONCLUSION AND RECOMMENDATIONS

4.1 Conclusion

4.2 Recommendations/Solutions to Problems encountered

References
LIST OF FIGURES
Fig. 1.1: Organogram of RSUTH
Fig. 2.1: Glucometer for blood sugar test
Fig. 2.2: Image showing administration of insulin
Fig. 2.3: Preparation for wound dressing
Fig. 2.4: Sterile pack for wound dressing
Fig. 2.5: Thermometer
Fig. 2.6: Stethoscope
Fig. 2.7: Blood pressure apparatus
Fig. 2.8: Sphygmomanometer
Fig. 2.9: Medication cart
Fig. 2.10: Patient in fowler position
Fig. 2.11: Urinalysis Test sample
Fig. 2.12: Urinalysis Test strip
Fig. 2.13: Baby weighing balance
Fig. 2.14: Forehead (temporal) Thermometer
Fig. 2.15: Pulse Oximeter
Fig. 2.16: Children Stethoscope
 CHAPTER ONE

INTRODUCTION

1.1 History of SIWES

At the early stages of the development of education in Nigeria, there was a problem of the gap

between theory and practical skills of students. Therefore, there was a need to give students the

opportunity to get real work experience. The program was created to give students experience

in addition to theoretical learning. The industrial training policy was introduced by Federal

Government of Nigeria in 1973. This project was necessary to improve practical skills of

students. SIWES has become a necessary pre-condition of graduation. The program is working

with such disciplines as engineering, medical science, natural science, technology, agriculture,

education, environmental, applied science. The duration of the program can be different, for

the universities it's six months, and four months for college and polytechnics. The program is

developed under the guidance of the Ministry of Education. This is an excellent bridge between

theoretical and practical education. SIWES is working on designing proper programs for

exposing students to the industrial workplace environment. It is all about the development of

occupational competence.

1.2 Objective of SIWES

1. To provide means for student in tertiary institutions to acquire industrial skills and

experience in their field of study.

2. Prepare student on anticipated working situation after graduation.

3. Expose student to work method and techniques in handling equipment and machinery

that are not available in their institution.

4. To ease the transition from school to the world or work and enable student contact for

late job placement.

 5. To bridge the gap between college work and actual work practices.

6. Enlist and strengthen employers involvement in the entire educational process of

preparing students for employment.

7. To promote industrialization in Nigeria and Avenue between the world of teaching and

learning, industrial work with a reference to a field of study.

AIM OF SIWES

The program is aimed at helping/training students in the Nigerian tertiary institutions on the

practical aspect of their field of study by exposing students to machines and equipment,

professional work methods and ways of safeguarding the work areas and workers in industries

and other organizations.

Vision Statement

To be the prime Skills Training Development Organization in Nigeria and one of the best in

the world.

Mission Statement

To set and regulate standards and offer direct training intervention in industrial and commercial
skills training and development, using a corps of highly competent professional staff, modern
techniques and technology.

IMPORTANCE OF SIWES

1. It provides students with the opportunity to apply their theological knowledge in real

life situation.

2. It exposes students to more practical work method and techniques.

3. It also prepares the students for the labour market after graduation.

4. It strengthens the link between the employers, university and the Industrial Training

Fund (ITF).
1.3 BRIEF HISTORY RIVERS STATE UNIVERSITY TEACHING HOSPITAL

(RSUTH)

Rivers State University Teaching Hospital formally Braithwaite Memorial Specialist Hospital

(BMSH) is a government-owned hospital, was named after Eldred Curwen Braithwaite, a

British doctor and a pioneer of surgery. It is located in Old GRA, Rivers State a neighborhood

of Port Harcourt and is operated by Rivers State Hospital Management Board. It was

established in March 1925 as Braithwaite Memorial Hospital and originally served as a medical

facility for senior civil servants. It later became a General Hospital and has since gained status

as a “Specialist Health Institution” before the institution was rename Rivers State University

Teaching Hospital. RSUTH is ranked among the largest hospitals in the Niger Delta. The

facility has:

• 365 licensed beds

• 14 wards/units

• 738 medical staff members.

Its departments include Medicine, Pediatrics, Laboratories, Radiology, Family Medicine,

Obstetrics & Gynecology, Anesthesia, Surgery, Pathology, Ophthalmology, Accident Centre

and the Surgical/Medical Emergency.

Some other departments are Pharmacy, Finance, Maintenance, General Administration.

RSUTH has accreditation with most colleges including West African College of Physicians &

Surgeons, Nigerian Medical Laboratory Council and Nurses & Midwifery Council of Nigeria

Rivers State University Teaching Hospital formerly known as Braithwaite Memorial Specialist

Hospital abbreviated as (BMSH) is a government own hospital named after Eldred Curwen

Braithwaite, a British doctor and pioneer of surgery. It is located in old GRA, Rivers State a

neighborhood of Port Harcourt. And is operated by the Rivers State Hospital Management
Board. It was established in March 1925 as Braithwaite Memorial Hospital and originally

served as a medical facility for senior civil servants. It later became a General Hospital and has

since gain status as a Specialist Health Institution. In 2018 it was renamed to serve as a

Teaching Hospital for the State owned University following the establishment of the College

of Medical Sciences.

Officially recognized by the Federal Ministry of Health, Rivers State University Teaching

Hospital is ranked among the largest hospitals in the Niger Delta.

It’s departments include Internal medicine, pediatrics, Laboratories, family medicine,

Radiology, obstetrics and Gynecology, Anesthesia, Surgery, Ophthalmology, pathology, Ear

Nose and Throat, Accident center and the Surgery/Medical Emergency. Some other

departments are pharmacy, Finance, Maintenance and General Administration.

1.4 HOSPITAL VISION AND MISSION STATEMENT

Our Vision: The vision is to guarantee a healthy and productive State.

Our Mission: Is to ensure that the Rivers populace have universal access to comprehensive,

appropriate, affordable, efficient, equitable, and quality essential package of health care

through a strengthened health system. Our core values Accountability, Transparency,

Teamwork and Equity-driven

Fig. 1.1 Organogram of RSUTH

1.5 ESTABLISHMENT SCOPE OF WORK/DEPARTMENTS OF RIVERS STATE

UNIVERSITY TEACHING HOSPITAL

• Internal Medicine: concerned with the prevention, diagnosis, and treatment of internal

diseases.

• Pediatrics: concerned with treatment of diseases in children.

• Ophthalmology: concerned with treatment of eye related medical condition.

• Accident and Emergency: concerned with care for accident and newly admitted sick

person.

• Family Medicine: specializes on providing health care for people of all ages.

• Otolaryngology: A subspecialty of surgery concerned with surgery and medical

management of structures of the head and neck.

• Medical Laboratories: Concerned with investigation, diagnosis of illness using sample

gotten from subject.

• Radiology: A medical subspecialty concerned with the use of radiographic imaging to

carry out diagnosis.

• Obstetrics and Gynecology: Concerned with health care management of pregnancy, child

birth and post- partum, as well as female reproductive system.

• Anesthesiology: concerned with total proprioceptive care of patients before, during and

after a surgical procedure.

• Surgery: Concerned with the use of manual and instrumental operative technique to treat

medical conditions.

• Pathology: Investigates the cause, origin and nature of diseases.

 CHAPTER TWO

INDUSTRIAL TRAINING

2.1 ACTUAL WORK DONE/ DEPARTMENTS COVERED:

1. Male Medical Ward

2. Female Medical Ward

3. Accident and Emergency

4. Family Medicine

5. Children Clinic/ Pediatric outpatient

2.2 MALE MEDICAL WARD

The Male Medical Ward is a specialized domain dedicated to catering to an array of medical

conditions particularly relevant to male patients. This domain embodies a commitment to

advancing technology and prioritizing patient-centered care, thereby enriching the landscape

for addressing male-specific health concerns.

INSTRUMENTS AND EQUIPMENT USED IN THE MALE MEDICAL WARD

Instruments:

• Stethoscope

• Sphygmomanometer (Blood pressure cuff)

• Thermometer

• Reflex hammer

• Scalpel

• Forceps

• Pulse oximeter
Equipment:

• Ultrasound machine

• Nebulizer

• IV pumps

• Tourniquet

• Wheelchairs and stretchers

• Suction machine

DUTIES AND ROLES OF PROFESSIONALS IN THE MALE MEDICAL WARD

Doctors:

• Diagnosis and management of various male-specific medical conditions.

• Conducting medical assessments and specialized procedures.

• Guiding comprehensive care plans for male patients.

Nurses:

• Patient assessment and monitoring.

• Medication administration

• wound dressing and wound care.

• Collaborative care coordination among multidisciplinary teams.

• Providing education and emotional support to male patients.

CASES ENCOUNTERED IN THE MALE MEDICAL WARD

• Erectile dysfunction

• Chronic kidney disease

• Diabetes Mellitus
 • HIV/AIDS

• Tuberculosis

• Hypertension

• Asthma

• Chronic Obstructive Pulmonary Disease (COPD)

• Cardiovascular accident

• Stroke

• Renal Failure

• Mental Health Disorders (e.g., Depression, Anxiety)

ACTIVITIES AND PROCESSES WITHIN THE MALE MEDICAL WARD

• Patient assessments and vital sign monitoring tailored for male health concerns.

• Administration of medications and treatments specific to male patients.

• Collaborative care planning among the healthcare team addressing male-specific

conditions.

• Assisting in minor medical procedures specifically relevant to male patients.

• Engaging in wound care and dressing changes pertinent to male conditions.

• Participating in male patient rounds and case discussions.

• Ensuring accurate maintenance of male patient records and documentation.

• Providing emotional support and comfort specifically adapted for male patients.

EXPERIENCE GOTTEN FROM THE MALE MEDICAL WARD

During my clinical posting in the Male Medical Ward as a student, I had the opportunity to:

• Assist in recording vital signs and basic patient assessments for male patients.
 • Observe and learn about medication administration procedures tailored for male-

specific conditions.

• Engage in wound care under supervision, focusing on male-oriented care.

• Attend and participate in specialized patient education sessions focusing on male health

issues.

• Shadow doctors during routine medical assessments specific to male patients.

• Learn about basic diagnostic tests and their interpretation, specifically relevant to male

health.

• Observe minor medical procedures and treatments tailored for male patients.

• Support male patient comfort and emotional care in a manner suited to their needs.

• Assist in maintaining accurate patient records and documentation specific to male

health concerns.

• Participate in discussions and rounds with the healthcare team, learning from their

expertise in male-focused care.

• Conducting blood sugar test for diabetic patients and administering insulin when

necessary.

PROCEDURE I CARRIED OUT AT THE MALE MEDICAL WARD

ADMINISTRATION OF INSULIN

Equipment Needed:

• Sterile gloves

• Methylated spirit

• Insulin needle/syringe

• Cleansing wipes or swabs

• Glucometer
Administration Process

Preparation:

I ensured my hands were thoroughly clean and put on sterile gloves for optimal hygiene. I

assembled all necessary equipment within reach, confirming everything was ready for

immediate use.

Preparation of the Patient:

I informed patient of procedure and obtained consent. I conducted blood sugar test and prepared

insulin according to the doctors prescription. I positioned the patient comfortably on sitting

position or lying down with the site of administration within reach, ensuring privacy, and

maintaining a sterile field around the site of administration.

Fig. 2.1 Glucometer for blood sugar test

Cleansing the site of administration

Using methylated spirit on dry swap, I meticulously cleaned the site of administration ensuring

proper disinfection before the procedure.

Insulin administration

I pinched the skin and inserted the needle subcutaneously at 450 under the skin and avoided

muscle. I administered the insulin slowly, removed needle slowly and checked the site for any

possible complications and told patient to eat according to the nursing care plan.
Documentation and Aftercare:

I documented the procedure details, including the amount of insulin administered, patients

blood sugar before administration of insulin and any observed complications. I disposed

necessary sharps used. I provided appropriate aftercare instructions to the patient or caregiver

of the patient such as immediate intake of food etc.

Fig. 2.2 Image showing administration of insulin

2.3 FEMALE MEDICAL WARD

The Female Medical Ward is dedicated to addressing a spectrum of medical conditions

pertinent to female patients, ensuring comprehensive and specialized healthcare. Its evolution

signifies a commitment to technological advancements and patient-centric care, enhancing the

treatment landscape for female-specific health concerns.

INSTRUMENTS AND EQUIPMENT USED IN THE FEMALE MEDICAL WARD

Instruments:

• Stethoscope

• Sphygmomanometer (Blood pressure cuff)

• Thermometer

• Reflex hammer

• Scalpel

• Forceps

• Pulse oximeter

Equipment:

• Ultrasound machine

• Nebulizers

• IV pumps

• Tourniquet

• Wheelchairs and stretchers

• Additional specialized equipment tailored for female health assessments and

diagnostics.
DUTIES AND ROLES OF PROFESSIONALS IN THE FEMALE MEDICAL WARD

Doctors:

• Diagnosis and management of various medical conditions.

• Conducting medical assessments and specialized procedures.

• Guiding comprehensive care plans for female patients.

Nurses

• Patient assessment and monitoring.

• Medication administration and wound care.

• Collaborative care coordination among multidisciplinary teams.

• Providing education and emotional support to patients.

Counselors and Support Staff:

• Offering emotional support and guidance to patients.

• Assisting in patient education and counseling services.

• Collaborating with healthcare professionals to address holistic patient needs.

CASES ENCOUNTERED IN THE FEMALE MEDICAL WARD

• Diabetes Mellitus

• HIV/AIDS

• Hyperthyroidism

• Hypertension

• Stroke

• Renal Failure

• Mental Health Disorders (e.g., Depression, Anxiety)

ACTIVITIES AND PROCESSES WITHIN THE FEMALE MEDICAL WARD

• Patient assessments and vital sign monitoring.

• Administration of medications and treatments.

• Collaborative care planning among the healthcare team.

• Conducting diagnostic tests and interpreting results.

• Assisting in minor medical procedures.

• Participating in patient rounds and case discussions.

• Engaging in wound care and dressing changes.

• Maintaining accurate patient records and documentation.

• Providing emotional support and comfort to patients.

EXPERIENCE GOTTEN FROM FEMALE MEDICAL WARD

During my clinical posting in the Female Medical Ward as a student, I had the opportunity to:

• Assist in recording vital signs and basic patient assessments.

• Observe and learn about medication administration procedures.

• Engage in wound care under supervision.

• Attend and participate in patient education sessions.

• Shadow doctors during routine medical assessments.

• Learn about basic diagnostic tests and their interpretation.

• Observe minor medical procedures and treatments.

• Support patient comfort and emotional care.

• Assist in maintaining accurate patient records and documentation.

• Participate in discussions and rounds with the healthcare team, learning from their

expertise.
PROCEDURE I CARRIED OUT AT THE FEMALE MEDICAL WARD

WOUND DRESSING

Wound dressing is a crucial aspect of healthcare that involves the application of sterile

materials and techniques to promote optimal wound healing and prevent infection. It aims to

create a protective barrier over a wound, facilitating the body's natural healing processes while

minimizing the risk of complications. Wound dressings vary based on the type and severity of

the wound, and the procedure involves cleaning the wound, applying appropriate materials,

securing them in place, and often includes monitoring and documenting the wound's progress

for effective patient care.

WOUND DRESSING PROCEDURE CARRIED OUT:

Equipment Used:

• Sterile gloves

• Sterile dressing pack

• Antiseptic solution

• Scissors

• Tweezers or forceps

• Wound cleaning solution

• Wound measuring tool

PROCEDURE IMPLEMENTED:

Preparation:

I commenced the wound dressing procedure by meticulously washing my hands and donning

sterile gloves. All essential equipment was diligently arranged within easy reach. Clear and

concise instructions regarding the procedure were explained to the patient, ensuring their

cooperation throughout.

Cleaning the Wound:

Utilizing antiseptic solution and sterile gauze, I delicately cleansed the wound, meticulously

removing any remnants of previous dressings and ensuring a pristine wound site. When

necessary, I diligently rinsed the wound with the provided wound cleaning solution.

Measuring and Assessing the Wound: Where applicable, I meticulously utilized a wound

measuring tool to assess the wound's dimensions and carefully noted any observable changes,

ensuring a comprehensive understanding of the wound's status.

Dressing Application and Securing:

Selecting the appropriate dressing size, I proficiently applied it to completely cover the wound,

guaranteeing its sterility and proper coverage. Employing bandages and medical tape, I

securely affixed the dressing in place, prioritizing optimal support without impeding

circulation.

Recording and Patient Instructions:

Thorough documentation was conducted, detailing the specificities of the procedure, including

wound size, appearance, and the dressing utilized, all meticulously recorded in the patient's

medical records. Additionally, I provided the patient with comprehensive post-dressing care

instructions to facilitate optimal healing and prevent infection.

Disposal and Cleanup: Adhering to stringent medical waste disposal protocols, all used

materials were safely disposed of. The surrounding area was diligently cleaned, and all

equipment was meticulously returned to their designated storage areas.

Fig. 2.3 Preparation for wound dressing Fig. 2.4 Sterile pack for wound dressing
2.4 ACCIDENT AND EMERGENCY

The Accident and Emergency (A&E) department plays a pivotal role as a frontline gateway for

individuals requiring urgent medical attention. Operating around the clock, the A&E caters to

a diverse range of medical emergencies, traumas, and critical health concerns (Smith, 2020).

The historical evolution of A&E wards reveals a journey from rudimentary setups to highly

specialized units capable of delivering comprehensive medical services (Johnson, 2021).

Technological advancements, including advanced imaging and telemedicine integration, have

revolutionized emergency care, expediting diagnostics and improving patient outcomes

(Wilson & Adams, 2016).

INSTRUMENTS AND EQUIPMENTS USED IN THE ACCIDENT AND

EMERGENCY UNIT

INSTRUMENTS:

• Stethoscope

• Sphygmomanometer (Blood pressure cuff)

• Thermometer

• Otoscope (for examining ears)

• Ophthalmoscope (for examining eyes)

• Reflex hammer

• Scalpel

• Forceps

• Pulse oximeter
 EQUIPMENT:

• Defibrillator

• Ventilator

• Crash cart (for emergency medication and equipment)

• Ultrasound machine

• Nebulizer

• IV pumps

• Tourniquet

• Splints

• Wheelchairs and stretchers

Fig. 2.7 Blood pressure apparatus

Fig. 2.5 Thermometer Fig. 2.6 Stethoscope

Fig. 2.8 Sphygmomanometer

DUTIES AND ROLES OF PROFESSIONALS IN THE A&E:

EMERGENCY PHYSICIANS:

• Rapid initial assessment and diagnosis of acute conditions.

• Coordination of immediate interventions and treatments.

• Leadership in critical decision-making during emergencies.

• Overseeing and guiding the A&E team in managing complex cases.

NURSES:
• Triage management, categorizing and prioritizing patients.

• Comprehensive patient assessments and monitoring.

• Medication administration and emergency procedures.

• Collaborating with the multidisciplinary team for coordinated patient care.

PARAMEDICS AND EMTS:

• Immediate on-site medical care and stabilization.

• Efficient and safe patient transportation to the A&E.

• Preliminary assessment and vital sign monitoring.

• Swift decision-making and action in critical situations.

RADIOGRAPHERS AND LABORATORY TECHNICIANS:

• Conducting rapid diagnostic tests and imaging scans.

• Assisting in the interpretation of results for urgent diagnoses.

• Ensuring proper functioning and maintenance of diagnostic equipment.

• Collaborating with healthcare professionals for accurate and timely reports.

CASES ENCOUNTERED IN THE A&E:

Trauma Cases: Including but not limited to severe head injuries, fractures, and major wounds

requiring immediate intervention and stabilization.

Cardiac Emergencies: Covering various cardiac events like myocardial infarction,

arrhythmias, and sudden cardiac arrests requiring prompt resuscitation.

Respiratory Distress Cases: Spanning from severe asthma exacerbations, pulmonary

embolisms, to respiratory failure necessitating urgent medical attention and interventions.

Neurological Emergencies, Acute Infections, Psychiatric Crises, Obstetric Emergencies:

Varied urgent healthcare needs demanding specialized care within the A&E setting.
ACTIVITIES AND PROCESSES WITHIN THE A&E:

• Triage: Swift patient assessment and categorization based on severity.

• Resuscitation: Immediate and life-saving interventions for critical patients.

• Diagnostic Procedures: Rapid imaging, laboratory tests, and investigations aiding in

timely diagnoses.

• Collaborative Patient Management: Coordinated efforts among teams for

comprehensive patient care.

• Education and Support: Offering guidance, information, and emotional support to

patients and their families.

EXPERIENCE GOTTEN FROM ACCIDENT AND EMERGENCY UNIT

• I categorized patients based on urgency during the triage process.

• I monitored vital signs and assisted in assessing patients' conditions.

• I administered medications to patients under supervision.

• I assisted in wound care and changed dressings for various injuries.

• I maintained accurate records and reports of patient activities and conditions.

• I participated in emergency procedures, assisting healthcare professionals during

critical situations.

• I communicated with patients, ensuring their comfort and providing necessary

information.

• I collaborated with the nursing team, supporting each other in delivering patient care.

• I learned from observing professionals handle complex cases and emergency scenarios.

• I reflected on personal growth, skills developed, and lessons learned during my A&E

posting.
 PROCEDURE I CARRIED OUT AT THE ACCIDENT AND EMERGENCY UNIT.

ADMINISTRATION OF MEDICATION

BASIC CONCEPTS OF ADMINISTERING MEDICATIONS

The scope of practice regarding a nurse’s ability to legally dispense and administer medication

is based on each state’s Nurse Practice Act. Registered Nurses (RNs) and Licensed Practical

Nurses (LPNs/LVNs) may legally administer medications that are prescribed by a health care

provider, such as a physician, nurse practitioner, or physician’s assistant. Prescriptions are

“orders, interventions, remedies, or treatments ordered or directed by an authorized primary

health care provider.

Components of a Medication Order

According to the Centers for Medicare & Medicaid Services, all orders for the administration

of drugs and biologicals must contain the following information.

• Name of the patient

• Age or date of birth

• Date and time of the order

• Drug name

• Dose, frequency, and route

• Name/Signature of the prescriber

• Weight of the patient to facilitate dose calculation

• Quantity and/or duration of the prescription

• Specific instructions for use, when applicable

 Common routes of administration and standard abbreviations include the following:

• Oral (PO) – the patient swallows a tablet or capsule

• Sublingual (SL) – applied under the tongue

• Enteral (NG or PEG) – administered via a tube directly into the GI tract

• Rectal (PR) – administered via rectal suppository

• Inhalation (INH) – the patient breathes in medication from an inhaler

• Intramuscular (IM) – administered via an injection into a muscle

• Subcutaneous – administered via injection into the fat tissue beneath the skin (Note that

“subcutaneous” is on ISMP’s recommended list of abbreviations to avoid due to common

errors.)

• Transdermal (TD) – administered by applying a patch on the skin

10 RIGHTS OF MEDICATION ADMINISTRATION

The ten rights of medication administration must be verified by the nurse at least three times

before administering a medication to a patient. These ten rights include the following:

1. Right Patient

2. Right Drug

3. Right Dose

4. Right Time

5. Right Route

6. Right Documentation

7. Right education/advice

8. Right Assessment

9. Right evaluation/response

10. Right to refuse

 fig. 2.9 Medication cart

Oral Medication Administration

Most medications are administered orally because it is the most convenient and least invasive

route for the patient. Medication given orally has a slower onset, typically about 30-60 minutes.

Prior to oral administration of medications, I ensured the patient has no contraindications to

receiving oral medication, is able to swallow, and is not on gastric suction. If the patient has

difficulty swallowing (dysphagia), tablets are crushed for easier swallowing.

I positioned the patient receiving oral medication in an upright position to decrease the risk of

aspiration. If a patient is unable to sit, I assist them into a side-lying position, offer a glass of

water or other oral fluid (that is not contraindicated with the medication) to ease swallowing

and improve absorption and dissolution of the medication, taking any fluid restrictions into

account.

Fig. 2.10 Patient in Fowler position

2.5 FAMILY MEDICINE

Family medicine is a medical specialty which provides continuing and comprehensive

healthcare for the individual and the family. It is a specialty in width and breadth which

integrates the biological, clinical, behavioral, sciences. The scope of family medicine

encompasses all ages, both sexes, each organ system and every disease entity.

INSTRUMENTS AND EQUIPMENT USED IN THE FAMILY MEDICINE

Instruments:

• Stethoscope:

• Sphygmomanometer (Blood Pressure Cuff)

• Thermometer:

• Pulse Oximeter:

Equipment:

• Glucometer:

• Medical weighing Scales:

• Specimen Collection Kits:

• Patient Examination Tables/Chairs:

DUTIES AND ROLES OF PROFESSIONALS IN THE FAMILY MEDICINE:

Doctors

• Conducting comprehensive health assessments tailored to family dynamics.

• Formulating personalized care plans considering familial health aspects.

• Managing chronic conditions and providing preventive healthcare within families.

Nurses:

• Assisting in family health assessments and continuous monitoring.

• Conducting urinalysis, blood sugar tests, and HIV screening for family members.

• Administering medications and providing wound care in a family context.

• Collaborating with the healthcare team to ensure holistic family care.

CASES ENCOUNTERED IN THE FAMILY MEDICINE:

• Hypertension

• Diabetes Mellitus

• Respiratory conditions

• Infectious diseases (e.g., Influenza, Gastroenteritis)

• Preventive care and health promotion for all age groups

ACTIVITIES AND PROCESSES WITHIN THE FAMILY MEDICINE

• Routine family health assessments including urinalysis, blood sugar tests, and HIV

screening.

• Administration of medications considering patients health backgrounds.

• Collaborative care planning involving all patients and healthcare providers.

• Patient-oriented education sessions on disease prevention and management.

• Diagnostic tests and interpretation, considering patients health history.

• Assisting in minor medical procedures tailored to patients’ health needs.

• Participation in patients rounds and discussions to ensure comprehensive care.

• Maintenance of accurate health records and documentation.

• Providing emotional support and comfort to patients.

EXPERIENCE GOTTEN FROM FAMILY MEDICINE
During my clinical placement in the Family Medicine, I had the opportunity to:

• Perform urinalysis, blood sugar tests,

• Acquire knowledge about diagnostic tests catering to patient health conditions.

• Observe and assist in minor medical procedures pertinent to family health.

• Provide support and care to ensure patients comfort and emotional well-being.

• Assist in maintaining comprehensive and accurate patient health records.

• Participate in discussions and rounds with the healthcare team

• Learning from their expertise in managing family-centric healthcare.

PROCEDURE I CARRIED OUT AT THE FAMILY MEDICINE UNIT

URINALYSIS

Urinalysis is a diagnostic test that examines a person's urine to evaluate various aspects of

health. It assesses the physical, chemical, and microscopic properties of urine, providing

insights into kidney function, hydration levels, potential infections, presence of substances like

proteins or sugars, and even certain medical conditions. This non-invasive and commonly

performed test helps healthcare providers in diagnosing diseases, monitoring treatment

effectiveness, and identifying potential health concerns early on.

Equipment Needed:

• Sterile urine collection container

• Gloves

• Clean and sterile wipes

• reagent strips

• Timer or clock

• Laboratory request form

Urinalysis Procedure with Reagent Strips

Preparation:

I ensured my hands were impeccably clean and wore gloves for utmost hygiene. I organized

all the necessary equipment, making sure everything was set for immediate use.

Collection of Urine Sample:

I provided clear instructions to the patient for a clean-catch midstream urine sample collection.

I collected the sample in a sterile container, properly labeling it for identification.

Initial Examination:

Before using the reagent strips, I visually examined the urine sample for its color, clarity, and

any unusual odor.

Urinalysis with Reagent Strips:

I dipped the reagent strip into the urine sample, following the precise instructions provided by

the manufacturer for the appropriate duration and handling.

Interpretation of Results:

I carefully analyzed and interpreted the color changes and reactions on the reagent strip to

assess various parameters such as pH, protein, glucose, ketones, blood, nitrites, leukocytes, and

specific gravity.

Recording and Reporting:

I diligently documented all observed results and findings accurately in the designated forms or

patient records, emphasizing any abnormal or noteworthy outcomes.

Cleanup and Disposal:

Ensuring compliance with medical waste protocols, I disposed of used materials properly and

meticulously cleaned the work area, ensuring all equipment was returned to its storage location.

Fig. 2.11 Urinalysis Test Fig. 2.12 Urinalysis Test Strip

2.6 CHILDREN OUTPATIENT DEPARTMENT

The Children Outpatient Department (COPD) is a vital section within a medical facility,

specifically dedicated to providing healthcare services to children. It serves as a primary point

of contact for various pediatric health concerns, offering a wide range of medical services

including routine check-ups, vaccinations, consultations for illnesses, and management of

chronic conditions. The department is typically equipped with child-friendly amenities,

specialized pediatric equipment, and a team of healthcare professionals trained in dealing with

children, ensuring a comfortable and supportive environment for young patients and their

families. The goal of the COPD is to provide comprehensive and specialized care tailored to

the unique needs of children while promoting their overall health and well-being. This

department often encompasses various specialized clinics catering to different aspects of

pediatric healthcare such as developmental assessments, nutritional support, behavioral

consultations, and more. The COPD operates efficiently through scheduled appointments,

allowing healthcare providers to address each child's specific needs thoroughly. Moreover, it

serves as an educational hub for parents, offering guidance on child development, nutrition,

safety, and parenting tips. By combining medical expertise with a child-centric approach, the

COPD plays a pivotal role in ensuring the optimal health and development of young individuals

within the community.

INSTRUMENTS AND EQUIPMENT USED IN THE COPD

Instruments:

• Stethoscope: Used for listening to heart and lung sounds during examinations.

• Otoscope: Employed to examine the ears and ear canal for infections or issues.

• Ophthalmoscope: Allows doctors to examine the eyes for abnormalities or vision

problems.

• Thermometer: Measures body temperature to assess for fever or illness.

• Sphygmomanometer: Used to measure blood pressure in children.

• Pulse Oximeter: Measures oxygen saturation levels in the blood, especially useful for
monitoring respiratory conditions.

Equipment:

• Pediatric Examination Table: Specifically designed tables or beds suitable for

children during examinations.

• Nebulizer: Used to administer medication in the form of a mist for respiratory

conditions.

• Vaccination Refrigerator: For storing vaccines at the required temperature.

• Weighing Scale: Specially calibrated for accurately measuring a child's weight.

• Pediatric Wheelchair: Smaller-sized wheelchairs for children with mobility issues.

ROLES OF PROFESSIONALS IN THE CHILDREN OUTPATIENT

Doctors:

• Diagnosis and treatment of childhood illnesses.

• Preventive care, including vaccinations and routine check-ups.

• Monitoring growth, development, and milestones.

• Health education and counseling for parents.

• Referral to specialized pediatric care when needed.

Nurses:

• Direct patient care, administering medications, and monitoring vital signs.

• Advocacy for children's needs within the healthcare system.

• Providing family support and education on caring for sick children.

• Coordinating care among different healthcare professionals.

• Emergency response and care during critical situations.

Pediatric Specialists (e.g., Pediatric Surgeons, Cardiologists, Neurologists):

• Specialized diagnosis and treatment within their field.

• Performing advanced procedures or surgeries for pediatric patients.

• Collaborating with other specialists for comprehensive care plans.

• Long-term management of chronic conditions.

• Engaging in research and incorporating innovative treatments when applicable.

CASES ENCOUNTERED IN A CHILDREN’S OUTPATIENT DEPARTMENT:

• Rape/Assault:

• Respiratory Infections: Such as common colds, bronchitis, or pneumonia.

 • Gastrointestinal Issues: Including stomach flu, diarrhea, or constipation.

• Skin Conditions: Such as eczema, rashes, or allergic reactions.

• Ear Infections: Otitis media or other ear-related issues.

• Routine Check-ups and Vaccinations: For growth monitoring and administering

scheduled vaccines.

• Fever or Infectious Diseases: Assessment and treatment of fevers, flu, or other

contagious illnesses.

• Injuries and Accidents: Minor injuries, wounds, or fractures that do not require

emergency care.

• Chronic Conditions Management: Follow-ups for conditions like asthma, diabetes,

or allergies.

ACTIVITIES COMMONLY CONDUCTED IN A CHILDREN’S OUTPATIENT

DEPARTMENT:

• Interacting with pediatric patients and their families.

• Monitoring vital signs in young patients.

• Assisting in various procedures, including vaccinations.

• Observing and assessing children's health conditions.

• Documenting patient records and reports.

• Collaborating within a multidisciplinary team.

• Educating parents and children on health promotion.

• Practicing time management in a busy outpatient setting.

• Handling specialized pediatric equipment.

• Providing emotional support to young patients and their families.

EXPERIENCE GOTTEN AT THE CHILDREN OUTPATIENT DEPARTMENT

During my clinical placement at the children outpatient department, I had the opportunity to:

• Interacting with pediatric patients and their families.

• Monitoring vital signs in young patients.

• Assisting in various procedures, including vaccinations.

• Observing and assessing children's health conditions.

• Documenting patient records and reports.

• Collaborating within a multidisciplinary team.

• Educating parents and children on health promotion.

• Practicing time management in a busy outpatient setting.

• Handling specialized pediatric equipment.

• Providing emotional support to young patients and their families.

PROCEDURE I CARRIED OUT AT THE CHILDREN OUTPATIENT

DEPARTMENT

VITAL SIGNS

Vital signs are essential indicators of a person's physiological functions. These signs include

temperature, pulse rate, respiration rate, and blood pressure. They offer crucial insights into a

patient's overall health status and help healthcare professionals assess and monitor their

condition.

The procedures involved in measuring vital signs typically utilize specific instruments:

Thermometer: Measures body temperature.

Stethoscope: Listens to the heart and lungs.

Pulse oximeter: to determine the pulse rate and oxygen saturation

Watch or clock: Times the pulse rate and respiration...

Temperature Measurement

➢ Prepare the thermometer: Ensure the thermometer is clean and ready for use.

➢ Patient positioning: Ask the patient to remove any clothing covering the axilla area

and ensure their arm is comfortably resting at their side.

➢ Placement of the thermometer: Position the thermometer in the center of the patient's

dry and clean axilla, ensuring good contact with the skin.

➢ Wait for the reading: Depending on the type of thermometer used, instruct the patient

to keep the thermometer in place for the specified time. This allows the thermometer to

accurately measure the axillary temperature.

➢ Recording the temperature: Once the designated time has elapsed, remove the

thermometer and read the displayed temperature. Record the temperature measurement

accurately in the patient's medical records.

➢ Clean the thermometer: After use, ensure proper cleaning and disinfection of the

thermometer following hospital protocols to maintain hygiene and prevent the spread

of infections.

N/B: During my clinical posting to the COPD, I made use of the Forehead (temporal)

thermometers to check for patient(children) temperature. This type of thermometer has more

advantage due to children patience level.

 Pulse Measurement

➢ Selecting the pulse oximeter: I picked up the pulse oximeter and ensured it was

functional and clean.

➢ Patient positioning: I asked the patient to sit comfortably and placed the pulse oximeter

probe on their fingertip, securing it snugly without causing discomfort.

➢ Reading the pulse: I observed the pulse oximeter's screen, which displayed the

patient's oxygen saturation (SpO2) and pulse rate (PR) readings. The pulse rate reading

was noted as the number of beats per minute (bpm).

➢ Recording the pulse rate: I accurately recorded the pulse rate obtained from the pulse

oximeter in the patient's medical records.

Fig. 2.13 Baby weighing balance Fig. 2.14 Forehead (Temporal) Thermometer

Fig. 2.15 Pulse Oximeter Fig. 2.16 Children Stethoscope

 CHAPTER 3

NEW SKILLS ACCQUIRED AND CHALLENGES

NEW SKILLS ACQUIRED

During the course of my clinical posting, I had the opportunity to learn new skills and the skills

I learnt are grouped as social skills, technical skills and competent skills

3.1 SOCIAL SKILLS

• I have learnt to have patient- nurse relationship, mutual - participation characteristics

rather than active - passive cooperation in terms of nursing decision making.

• Working with the hospital staffs allowed me the opportunity to build helpful

relationships for future purpose.

• Rotation through different departments allowed me meet new people and make new

friends.

• Working with patients helped me learn patience; even how to diffuse and resolve

conflicts. Working with patients also helped me to become more compassionate and

understanding and grateful.

• I learnt how to give health talk to patients

• learnt how to give emotional and psychological care

3.2 TECHNICAL SKILLS;

• I learnt the various sites for intravenous and intramuscular injection administration

• I learnt how to prepare a patient for a surgical procedure.

• I learnt how to admit and discharge patients

• I perfected the procedure for examining vital signs

• I learnt how to perform wound dressing

• I learnt how to report activities in the ward and develop nursing process and care plan
 • I learnt how to insert urinary catheter

• I learnt how to empty and remove urinary catheter

3.3 COMPETENT SKILLS

• I have been taught on how to use some equipment and reagents properly to attain good

result.

• I learnt how to ensure to get accurate result and not to assume

• I learnt to perfectly perform procedure without mistakes

• I ensured I gave prescribed medication at the right dose and time

• I ensured I know what I am about doing before doing it

3.4 CHALLENGES

Some challenges I also encountered during my clinical posting include;

• High cost of transportation and traffic jam. The issue of transportation happens to be

the most issue we had during our industrial training whereby we have to be responsible

for our own transporting, with regards to fact we are not being paid.

• Denial of access to some machines due to being a student.

• Dealing with patients that are rude and seem not to care about your feelings.

• Having to learn by observation most times and mainly called into action for errands.

• Lack of modern equipment to carry out some processes therefore leading to strenuous

and unnecessary manual labour.

 CHAPTER FOUR

CONCLUSION AND RECOMMENDATION

4.1 CONCLUSION

This SIWES attachment was a privilege and i gained massive practical knowledge. It wasn't

just another academic requirement but more like a job and I enjoyed every opportunity I was

given to assist to the work. I work hard to contribute to my organization success and most

importantly my own success.

I was able to acquire both theoretical and practical knowledge in the following departments

i. Male medical ward

ii. Female medical ward

iii. Accident and emergency

iv. Family medicine

v. Children outpatient department

This training made me feel like I was a nurse already, and I saw the joy of doing a job as a

nurse. It also exposed me to meeting other medical students from other schools, where we share

and discuss ideas in solving problems related to the department. I am really grateful to be a

partaker of this programme.

4.2 RECOMMENDATIONS

Even though the industrial training was largely a success, some problems were faced and these

recommendations are proffered for those such challenges:

• The hospital management (specifically at RSUTH) should ensure regular maintenance

and provision of all laboratory equipment and machinery in all department respectively,

to enable students on industrial training carry out their practical effectively.

• Trainers in different departments should actively dedicate time to teach the students

and allow them practice what they have learnt

• The SIWES unit should regularly disburse allowances to the students thus encouraging

them to participate effectively

• Discrimination of any sort (racism, sexism, academic status/level, etc.) should be

discouraged in every establishment.

• Students should be assessed by trainees (at least once every month) to ensure they

achieve the purpose of industrial training.

• Transportation (school buses) should be provided by the school management in order

to ease transportation for students.

• Provision of means of transportation by the approval of bus to students.

• Choice of organization should be chosen by students to avoid far distance from their

residence.

• There should be public enlightenment about gender equality in nursing profession.

• Welfare assistance should be given to students who over the course of the scheme

became sick or had accident.

REFERENCES

• Medication Administration Errors and Associated Factors Among Nurses (National

Library of Medicine)

• Advantages and disadvantages of different types of thermometers (Medically reviewed

by Debra Sulivan, Ph.D, MSN, R.N., CNE, COI – By Corey Whelan.

• Industrial Training Fund (2013) information and guidelines for SIWES

• Students Industrial Work Experience Scheme (SIWES) handbook (2020).

• https://www.researchgate.net/publication/3288449011-STUDENTS-INDUSTRIAL-

WORK-EXPERIENCE-SCHEME-SIWES-TECHNICAL-REPORT