Clinical Supervisor: Hi
Student: Hi Jo
Clinical Supervisor: How are you today?
Student: Good thankyou.
Clinical Supervisor: How are you going with your patients this morning?
Student: I’ve got two patients I think. It’s the first week so I’ve got only two.
Clinical Supervisor: Could you tell me a little bit about your first patient? What was his main …
Student: My first patient is a gentleman 75 years old and has CCF or Congestive Cardiac Failure. That’s what it says here and I read it in the notes.
Clinical Supervisor: uh huh and can you tell me exactly what is that?
Student: It’s a heart condition. It’s not pumping as effectively as it would when it’s normal.
Clinical Supervisor: And what were the main assessments you were doing for him this morning?
Student: Ah well. I put him on fluid balance chart. I continued on the fluid balance chart. Continue to the daily weight. Give him a couple of medications as it was charted. So ..
Clinical Supervisor: can you remember what those medications were?
Student: yes, one of them was a diuretic and another one was I think from beta blocker family for blood pressure.
Clinical Supervisor: So since you’ve given him the diuretic have there been any results? Good results?
Student: Yes, he was retaining some fluid yesterday according to the chart. 2 kg more than today. But yesterday according to the medication chart they gave him some IV fluids. He has lost one kilogram yesterday and another kilogram today. He is improving but his observation is still not in the normal limit so I am continuing to monitor him.
Clinical Supervisor: I see and why do you think you would have been giving him a beta blocker?
Student: Beta blocker works to actually reduce the blood pressure but according to the research it strains the pumpage of the cardiac muscle. So the cardiac muscle maybe doesn’t beat as much as before but stronger beats make it a better outcome let’s say. Caused a better outcome.
Clinical Supervisor: I see. Hhhmmm. Is there anything else you’ve been doing for Mr Black this morning? Does he have comorbidity?
Student: Yes, well I notice he has a history of IDDM which is independence diabetes. Sorry
Clinical Supervisor: what was that again?
Student: IDDM
Clinical Supervisor: Insulin?
Student: Yes. Insulin dependent diabetes myelitis. Which is a type of diabetes. Diabetes Type 1 because you need to have the insulin. I would just have a talk with him regarding to see if he has enough education. Regarding that I put in here four time BSL and once I would do it 6am before he didn’t have his breakfast, then 11 before lunch, before tea time and 10pm before sleeping to make sure I get the accurate BSL, to keep his BSL tracked.
Clinical Supervisor: hhhmmm. I see you have another patient there too. Mrs Phillips.
Student: Yeh, I have another patient and she is here for COPD.
Clinical Supervisor: And what exactly is COPD?
Student: Chronic Obstructive Pulmonary Disease. That’s what it is.
Clinical Supervisor: Which is a chronic disease so why is she in hospital?
Student: She had excessive severe weight loss according to this and when I checked the observation I noticed that myself as well. But regarding that I think it’s because she’s using the accessory muscles too much to get enough oxygen she needs. That causes her to have more energy use so she loses the weight. Then I decided to call the dietitian but I didn’t do that yet I just wrote it on the plan but if you’re happy with that I can do that later. To get her some more nutritious food which can improve her condition of weight loss.
Clinical Supervisor: It sounds like you have a reasonable knowledge of your patients today.
Student: Thank you. That’s kind of you.
Clinical Supervisor: Give me a call if you have any problems. Okay?
Student: Sure.