Grace Wanyoike

• Assessment & Monitoring:Admission screenings, initial evaluations, and mental status examinations to gauge a patient's psychological and physical state.
• Medication Management: Administer psychotropic medications as prescribed by a physician or nurse practitioner, and monitor patients for therapeutic effects and adverse side effects.
• Crisis Intervention: Respond to psychiatric emergencies, practice de-escalation techniques to handle aggressive behavior, and stabilize patients during acute episodes.
• Patient Safety: Identify environmental hazards, conduct room searches for contraband, and use therapeutic communication to maintain a safe environment (milieu) for all patients.
• Psychoeducation: Teach patients and their families about diagnoses, treatment options, coping mechanisms, and self-care activities.
• Care Coordination: Work with psychiatrists, social workers, and therapists to implement and update individualized nursing care plans.

Airway Management & Monitoring

• Maintain Airway Patency: Regularly check the endotracheal tube position (noted in centimeters at the lip/teeth) and ensure it remains secure to prevent accidental extubation.
• Appropriate Suctioning: Suction secretions only as needed—rather than on a schedule—to maintain a clear airway. Always hyperoxygenate the patient before and after the procedure.
• Assess Respiratory Status: Monitor respiratory rate, bilateral breath sounds, and oxygen saturation continuously. Use capnography to detect early signs of tube dislodgment or circuit disconnection.
• Prevention of Complications e.g VAP
• Nurses implement "care bundles" to reduce the high risk of pneumonia and other complications:
• Head of Bed Elevation: Keep the head of the bed elevated to 30–45 degrees at all times to minimize the risk of gastric reflux and aspiration.
• Oral Hygiene: Provide meticulous oral care with chlorhexidine at least twice daily and moisturize oral mucosa every 2 to 4 hours to reduce bacterial colonization.
• Sedation Vacations: Perform daily 'sedation holds' to assess the patient's level of consciousness and readiness for extubation.
• Prophylaxis: Administer ordered medications for peptic ulcer prophylaxis (blockers) and Deep Vein Thrombosis (DVT) prophylaxis.
• Pain and Sedation Assessment: Use standardized scales to assess pain and anxiety in non-verbal patients. Titrate sedation to ensure the patient remains comfortable and synchronized with the ventilator.
• Hemodynamic Stability: Monitor blood pressure closely, especially after ventilator setting changes, as positive pressure ventilation can decrease venous return and cardiac output.
• Skin Integrity & Mobility: Reposition the patient every 2 hours and perform passive range-of-motion exercises to prevent pressure ulcers and muscle atrophy.

Equipment Safety & Troubleshooting

• Bedside Safety Check: Ensure a bag-valve mask (Ambu bag), suction equipment, and emergency reintubation supplies are functional and immediately available at the bedside.
• Alarm Response: Promptly investigate all ventilator alarms. If the cause of a "low pressure" alarm (indicating a leak) is unknown, manually ventilate the patient with an Ambu bag until the issue is resolved

Communication & Education

• Therapeutic Communication: Explain all procedures to the patient, even if they appear sedated, and provide tools like communication boards or writing pads for those who are awake.
• Family Support: Educate family members on why the ventilator is necessary and how they can safely interact with the patient (e.g., holding hands or speaking)

• Recorded details regarding therapies to keep patient charts updated.
• Contributed to interdisciplinary team meetings by presenting relevant clinical data about patients" progress toward reaching established goals of care.
• Administered medications via oral, IV, and intramuscular injections and monitored responses.
• Managed quality care for patients with heart failure, end-stage renal disease and coronary artery disease.
• Educated family members and caregivers on patient care instructions.
• Monitored patient reactions after administering medications and IV therapies.

• Guided patients, caregivers, and family members on plans of treatment and helpful resources available locally to support care.
• Oversaw various aspects of telemetry by administering pa catheters and arterials, vasoactive drugs, titration, thrombolytic therapy, dyshythmia interpretation, and chest tubes.
• Provided targeted care and treatment to critical patients.
• Delivered nursing care to critically ill patients in a fast-paced step down ICU setting, prioritizing needs and optimizing recovery potential.
• Advocated for patients" rights and autonomy by upholding ethical nursing principles in all aspects of critical care delivery.
• Assessed and documented changes in patient's condition and prepared patient for transfer to higher level of care.

• Administered medications and treatments to patients according to care plans.
• Assisted in daily living activities to promote patient comfort and hygiene.
• Documented patient information accurately in electronic health records systems.
• Observed changes in patient's condition and reported any significant changes to the registered nurse or physician.
• Administered medications and treatments according to established protocols.
• Monitored vital signs, fluid intake and output levels, glucose levels, and other medical tests results.
• Caring for psychiatric patients, behavior monitoring.