Bryan Trinh

6/25/16
At this stage of preceptorship continues, I am fully taking on a four patient load with little
assistance from my preceptor. At this point I am feeling like one of the team and am a lot more
comfortable on my unit. My preceptor has said my time management skills and organization
have greatly improved. She also states that I have great critical thinking skills as well. For
example, on this particular day one of the patients I was assigned to was s/p for a Hartmanns
reversal a couple days before. This procedure is basically a reversal of a colostomy and the
restoration of the bowls. The patient was on Percocet prn for pain and dilaudid for break through
pain post procedure. He could ambulate with assistance and knew to call for help when he
needed to go to the bathroom.
Of course while Im making my way around to check on my patients; I find him trying to
speed walk to the bathroom by himself. I had no time to think; I instinctively knew this could
become critical since my patient is on controlled pain medication and had major abdominal
surgery. I immediately ran up to him and assisted him to the toilet. I asked him why he didnt use
his call light and ask for help and he told me that it was too urgent and the laxatives and stool
softeners were working really well. I then assisted the patient back to bed, but at this point he
was breathing heavy and complained of being short of breath.
Again I didnt have time to think, I knew I needed to find out my patients O2 saturation
because a major side effect from opiates is respiratory depression; that combined with pain and
the inability to fully expand his lungs due to abdominal surgery was not good. Luckily he had a

vitals machine and a nasal cannula at the bedside. I immediately placed the O2 monitor on him
while hooking up the NC with 2L of O2 as stated in the patients orders. The patients O2 sat was
an initial 89% but quickly increased to about 96% after being placed on the NC and following
my instructions of taking nice deep breathes.
Having a patients O2 saturation below 92% can lead to multiple issues involving tissue
damage related to hypoxic events. Luckily his O2 saturation was only below 92% for less than a
minute and after relaxing for a few minutes the patient presented as asymptomatic and was
stable. The patient thanked me for my quick actions and told me next time hed call for help. I
told him that it wasnt a problem to help him and also complimented on his ability to walk so fast
in his condition and then continued to educate him on the importance of walking post-surgery,
which he then verbalized understanding.
I felt like I did the best I could do in such a fast and critical situation. I didnt panic and if
things did get worse, I knew I could press the call light and yell out for help. Luckily the
situation didnt come to that and the patient showed no further symptoms of distress so my
outcomes couldnt have been better. Im just really glad I was there when I was, because worst
case scenario the patient could have fainted and fell and that would have led to a very critical
situation for the patient.

References
Alimohammadi, H., Baratloo, A., Abdalvand, A., Rouhipour, A., Safari. S. (2014). Effects
of Pain Relief on Arterial Blood O2 Saturation. NCBI. DOI: 10.5812/traumamon.14034