Katherine M Gomez

3/24/18

Leadership day 1 was short but successful! Our group was first taking to what the nurses

call the “huddle” before the shift begins. Charge nurse Becky initiated the huddle giving

assignments to all nurses in the ER. I was assigned on the floor to 4 rooms with Nurse Mel. As

we arrived at the floor Mel was given report on all four rooms with who was being discharged,

who was admitted, or waiting on a doctor consult. We both then approached patients

introducing ourselves and doing our own patient assessment. There were various patients

coming in today from a vomiting to fractured arm therefore assessment was an essential part

of the day. I was able to begin nebulizer and assist in nasal suctions of infants today in which

was definitely a first. One thing I did notice was the fact that a pediatric nurse needs to find

creativity in communicating with children.

3/25/18

Second day in the ER at NCH was a longer day for me today in which consisted on more

communication between the nurse and doctors as well as multiple protocol procedures. Today I

was assigned to the same nurse as yesterday but was then assigned to a new nurse because she

was not assigned to any patients today. My new nurse Lismarie was working with four rooms as

well in which consisted of various case such as respiratory depression, sleep apnea, baker acts,

and stomach viruses. Priority was a big part of the day when it came to the nurse and when we

saw a patient in the unit. One of the most interesting cases I saw today consisted of a Baker Act

child. I observed many protocols with the hospital itself for example, the room required

security observation for safety. The communication with nurse and doctor was continuous due
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to inconsistent information given by the patient that required intervention by the doctors. As a

nurse and speaking to the child’s parents it was important to prepare for the families’ reactions

to interventions being place on the child. Empathy vs sympathy was to be differentiated when

speaking to caregivers.

4/14/18

Today I was placed in the ED for the second week and I absolutely love it! I was placed today with a new

nurse her name is Jessie. Her journey to where she is now being motivating to where I want to be

somewhere. She mentioned to be that she graduated from FIU in which she was completing her clinical

rotations where she was hired by a staff member from NCH. She then pursued her career in Nurse

Practitioner and is now working part-time in the ED and part-time as a professor in West Coast. This

type of example is the one I hope to become with enough passion and enthusiasm. Today we had

various patients one of which came in after various times with positive Strep. After he was given

acetaminophen in triage, the patient was stable but a couple of hours later the patient began to have

chills and muscle pain. We administered antibiotics in which after 30 minutes the patient’s temperature

improved. Today I felt like I learned a lot about the different testing for children with strep and the flu.

4/15/18

Sunday was a short day because we had to prepare for our Exit HESI on Monday. I was paired with the

same nurse in Triage 1. Triage 1 dealt with all patients that walked into the ED in the entrance. Jessie

was in charge of inputting the patients in and asking all symptoms and time frame of when certain

things occurred in order to have as much information as possible once they were attended to inside the

ED. I oversaw getting all vital signs for the children, placing name tag on their arm or leg, and given the

caregiver a number in which they were called in. One emergency that was taking in immediately as an

infant that swallowed batteries and needed an x-ray immediately. I truly enjoyed working with the kids
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getting vital signs in a creative way that would not scare them. For example, the blood pressure cuff was

a little “bear hug”, and the pulse oximetry was “a sticker with cool lights” on the finger which

entertained them and kept them relaxed while vital signs were taken. Today I learned how important it

was for Traige 1 to receive as much information as possible to give the proper care for each patient.

4/21/18

Today was my first day on 3NorthEast, renal floor unit in NCH. I was placed with Chona as my nurse for

the weekend. Chona has been a nurse for 30 years in NCH and graduated from the Philippines in which

she then came to the United States to work. Chona tells me she enjoys working for this hospital and

would not change one year. Her devotion and passion for her job really intrigued my interest in this

hospital as a possible work possibility. We had varied patients in which most of them had renal or

endocrine disorders and complications. Today I was able to observe teaching with a 10 year old girl who

was just diagnosed with Diabetes Mellitus Type 1. The hospital gives girls a doll from “American Girl”

that carries a kit in which the doll matches the child for example matching bracelets with the words

“Type 1 DM”. The girl seems hesitant when administering her acu-check on her finger but by the end of

the shift she was very confident with this skill. One thing she did have difficulty with was administering

insulin herself in which her mother needed to count calories and administer the insulin on her thigh.

Before discharge Chona assured the family and patient understood the importance for medication

regimen. It was very exciting to see this 10-year old girl being discharged and going home feeling safe

and happy. She hugged both of us before leaving, which truly gave me happiness!

4/22/18

The second day in 3NE, I was with Chona once again! Today Chona still had 3 patients in which we were

caring for yesterday. 1 patient we were waiting on doctor’s orders due to the fact that he was not able

to tolerate his diet and bloody stools continued because of his ulcerative colitis. The second patient was

discharged, I was able to remove his IV and observed as Chona finished her teaching and the parent
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signed for consent. Our third patient was my favorite! He was a 3-year old boy that was brought in by his

mother which was diagnosed with nephrotic syndrome with a large amount of generalized edema.

Throughout his stay he was receiving fluids and Lasix to remove the excess fluid but also keeping him

hydrated. He took his medications very well by mouth but what we found the most difficult was taking

his blood pressure because he was terrified of the blood cuff. Although he fought us on the blood

pressure cuff, he was a great patient! He was discharged today with no edema and lost a large amount

of weight from 18kg to 15kg. Before leaving the boy found Chona and I to give us a hug and thanked us

for our help!