This made it easier for me to understand and be incorporated into the system faster. As a result I was able to achieve my goals and make a clear report on what transpires in the hospital. Goals Set The goals set for my clinical experience while in the rural setting hospital in Sauk Centre were met. My first goal was to learn what the nurse to patient assignment ratio was, compared to other facilities and where I work. I was told that the nurse to patient ratio was 1:3 or occasionally 1:4 depending on the acuity of the patient needs. The first day of clinical the RN I was working with was assigned two patients. A comfort care patient that had just suffered from a stroke and a patient receiving GI prep for a colonoscopy scheduled for the following day. There was an elderly lady that was brought to the ER by ambulance due to a recent fall with symptoms of headache, increased weakness and left leg pain. Her head CT was positive for a subarachnoid hemorrhage. She was then transferred to St. Cloud Hospital by the very same ambulance and EMT’s that had brought her to the hospital. The second day of clinical experience I worked with an RN that had four surgical patients that had various types of surgeries. They were all scheduled for different times and were discharged at all different times throughout the day. The RN was responsible for preoperative admission or check in, medications and health history, preoperative and postoperative education and vital signs, as well as discharging of education. The patient needed to be able to eat without nausea and vomiting, was able to void, and able to ambulate before discharge. My second goal was to understand what staff positions were held, who, and how many staff made up the medical and nursing team to accommodate a well ran, highly functioning facility that was valued by its community. How did they function as a team with such a diversity of patient treatment? I learned that there are five family practice physicians and two physician assistants that see patients in the clinic, inpatient hospital, and in the ER. There were several RN’s which were mostly ADN’s with only three being BSN’s of the staff’s members. There are two LPN’s that remain on staff because they were grandfathered in at the time the hospital decided to have patient care provided by a RN’s. The hospital didn’t hire new LPN’s at that time of the year. Through my research is noted that LPN’s are assigned their own patients who they are responsible for, same as the RN would be for her patients. The LPN can give most medications except for blood products, IV push medications, and IV narcotics. The RN on the other hand would give the LPN the needed medicine so that it can be administered to the patients. Per shift on the days of my clinicalduties, there was a Patient Care Assistant (PCA) that assisted with bathing and toileting patients, documenting activity such as intake/output, and assisted with meals. Notably the PCAs could take vital signs from the patients and give a minute to minute analysis of the patients progress. But on the contrary the RNs preferred staying on their feet and monitoring every activity concerning their assigned patient. Clearly the RNs were committed, they gave an account of the patients that came in for outpatient treatments and surgeries, inpatient and emergency patients treated in the Emergency Room (ER) who were discharged after being assessed and
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