HD Workbook
Nursing 6 High Dependency Elective Clinical Workbook
This workbook is designed to assist your learning during your clinical experience at St.Vincent’s Hospital, North Shore Public and North Shore Private Hospital and in the high dependency component of Nursing 6. You must take this workbook with you to the hospital on your visit. You should read the questions in the workbook and do your pre- reading prior to your clinical experience. You will be able to acquire some of the answers to the questions in the workbook by directly observing patient care in the high dependency environment and by asking questions of the relevant staff working there. You are required to complete your workbook as part of the requirements of the high dependency component.
Workbook
Due Date: Friday 28th September
Allocation of marks: 10%
Clinical Experience
You are going to observe and experience high dependency nursing at St.Vincent’s Hospital, Mater Hospital, Royal North Shore or North Shore Private Hospital on Monday or Tuesday mornings as part of your workshop requirements for the high dependency elective. You will each spend one session of three - four hours duration (in groups of up to five) in the high dependency environment. This clinical experience is compulsory and details are set out below.
Meeting Place
St. Vincent’s Hospital Foyer Tues am 9-12md
Facilitator
- Debra Moss St. Vincent’s ICU 83822609
- Marea Reading St Vincent’s Cardiac 83822608
- Astrid Frotjold 0414971991 9739 2040
Meeting Place
North Shore Private. Go to ICU unit Level 1 and ask for Dena Hogben 8am-12md
Facilitator
- Dena Hogben
Meeting Place
North Shore Public. Go to main foyer and Felicity Elias will meet you there 8am-12md, 1pm-5pm
Facilitator
- Felicity Elias
Rules for Clinical Experience
Students must arrive 15 minutes prior to starting time. You must be neatly attired with hair tied back (if applicable) wearing ACU nursing uniform and identification. Remember that we are visitors in the institution and behaviour should be exemplary.
Jewellery
Jewellery is not to be worn with the exception of a wedding ring, one neck chain and sleepers or stud earrings which are secure.
NB. Bangles and bracelets should not be worn and watches should not be worn when undertaking direct patient care.
Any students not adhering to these guidelines will not be admitted.
What to Bring
- This workbook
- Paper and pens
Observations Required By Each Student
Tick off each observation when complete
o The layout of the high dependency unit
o Safety procedures
o Documentation
o Monitoring equipment
o Care of relatives
o Staffing ratios
o Models of care
Pre Reading
Brown, D. & Edwards, H. (2005) Lewis’s medical-surgical nursing Elsevier, Marrickville, Australia pp.1756-1793.
Section 1: Critical Care Nursing
The Australian College of Critical Care Nurses (ACCCN) is a useful professional body for nurses working in the area of critical care. Using the following link, answer the following questions.
1. Describe the aims of the ACCCN
2. Describe the educational opportunities of membership to this college.
3. What post-graduate courses are available for registered nurses in the area of critical care in Sydney? (use the internet for this)
Section 2
1. Select one of the following topics. Provide one evidence-based article discussing your chosen topic and submit it along with this workbook. Summarise the main points of the article. (please use APA referencing)
· Oral hygiene in the ventilated patient.
· Sleep deprivation in ICU.
· Nutrition in the critically ill patient.
· Candidiasis in the immunocompromised person.
· Induced coma.
· Clostridium difficile.
· Stress ulcer prevention for the ventilated patient.
2. a) What are three common problems a critically ill patient may experience in a high dependency unit (not their diagnosis)?
b) Describe one of the above (1 paragraph)
3. Define the following abbreviations:
a) ET tube
b) CVP
c) CI
d) IABP
e) MAP
f) VAD
g) SV
h) SaO2
i) SvO2
j) PaO2
k) BUN
Section 3
1) Describe a procedure or haemodynamic monitoring that you observed in the clinical area.
2) What was the patient’s diagnosis and what were the clinical indications for this test/ monitoring device?
3) What is the nurse’s role in preparation for this specific test/ monitoring device?
4) What are the side effects/complications that can occur?
5) What is the nurse’s role in post procedural care or ongoing management of the monitoring device?
6) Describe the most important nursing assessments done when the patient is received in the high dependency unit post procedure or in ongoing management of the monitoring device. Provide a rationale for each assessment.
7) Ventilated patients must never be left unattended. Provide the rationale.
8) Take the time to look at the equipment on a “crash trolley”. What equipment is required for an emergency intubation?
9) During an intubation, the nurse may be asked to apply “cricoid pressure”. What is this?
10) What action is indicated if a ventilated patient experiences sudden and severe respiratory distress? Discuss with the ICU nurse.
(You must reference throughout the workbook even if it is information from your facilitator)
Overall Experience
Reflect on your experience in the high dependency environment. What were the positive aspects of nursing care in the area that you observed and were there any negatives? What did you learn from this experience? Describe what was good about the experience, how you felt and how this experience has impacted on you. (Minimum 200 words)
