实习心得

时光飞速，11个月的实习生涯已经结束了，在这将近一年的实习中我严格遵守医院及各科室的规章制度，学习态度端正，学习动机明确，工作主观能动性强，在老师和学姐的带领下，严格“三查七对”你及无菌操作。现在我为我的辛勤付出写下在医院实习的心得。因为实习的医院实行的是全责制的护理模式，与以往的功能制护理不同，在这里我们学到了以“我的病人，我的护士”为原则，尽心尽力的为病人提供优质护理服务理念。

记得去年的5月份，刚走出校园的我带着紧张、兴奋、渴望的心情到医院实习，第一个科室就是急诊，从没见过那么紧急的场面，我一下子慌了，虽然才刚实习，但我已经懂得：我如今所面对的将不再是学校的理论知识和初步的实验课，我要面对的是真正脆弱的病人，是不可以出一丁点差错的。急诊是一个综合科室，对护理人员的能力要求也是比较严格，因此我学到的知识也是很多，了解到了急诊预检分诊和院前急救的流程，掌握了心电监护仪、心电图机等的操作方法，掌握并加强心肺复苏等专业技术和急诊仪器（洗胃机、除颤仪）的操作和维护，熟悉了急诊常见疾病的护理。

在各科室的实习工作中，根据学校和医院的要求我积极主动地完成了病历的书写、读书会、病例讨论，而且能规范书写各类护理文书，做好病人出入院评估护理，能做好各科室常见病的处理和护理工作，认真执行无菌操作规程，能熟练进行内、外、妇、儿及重症监护等各项操作能力，严格执行三查七对等等，这些都培养了我书写、组织、表达等各方面的能力。

根据医院制定出来的教学活动计划，让我从简单到复杂，从看到做，从依赖变独立，从临床具体实例循序渐进的学习。通过下临床，我也意识到理论知识的重要性，因为在各个科室中，最重要的就是给患者和家属卫教，在卫教当中，会由于理论知识不够扎实，而卫教得不全面，

因而在各科室的学习中和老师学姐的指导下，我学会了如何根据患者住院期间的护理评估和照护重点来扩展对疾病的认识，从而学习更多的理论知识，为病人更好的卫教。当自己的卫教得到患者及家属的认可和表扬时，心底不由而衷的涌上自豪感。

通过将近一年的实习，我的理论水平和实践水平都有所提高，在今后的工作中，我将继续努力，牢记护士职责，不断加强学习与操作技能学习，全面提高自身综合水平，为患者提供优质服务，并在工作过程中克服急躁情绪，积极、热情、细致地对待每一项工作，做一名合格的护理人员。

 

第二篇：毕业实习总结

UNIT THREE

Operations Research

运筹学

Brief history

Operations research is relatively young discipline, being organized as a separate professional field of study only since the end of World War II. The Operational Research Society of the Untied Kingdom (ORS), Operations Research Society of America (ORSA), and the Institute of Management Sciences (TIMS) were found in 1948, 1952 and 1953, respectively. However, the methods and practices of operations research were being applied just prior to the war by British scientists working for the Air Ministry. In fact, two of these scientists are credited with first coining the phrase “operational research”.

简单的历史回顾

运筹学是一门相对比较新的学科。它是从二战以后才开始作为专业学科而被研究的。 英国运筹学会，美国运筹学会和管理学会分别成立于1948,1952 和1953。然而，早在二战之前，英国的科学家就将运筹学的理论和实践应用于空军。事实上,正是这些科学家中的两位首次提出了“运筹学”这一名词。

The earliest application of operations research involved improving the early warning system of the RAF’s Fighter Command. This system was quickly put to the test during the Battle of Britain. Throughout the remainder of the war, the methods of operations research were used by all branches of the British military to improve the results of their operations. As might be expected, the armed forces of the United States began to apply similar techniques soon after Pearl Harbor.

运筹学最早应用是在提高英国皇家空军司令部的预警系统上。这个系统在英国的战争中很快被测试。在整个余下的战争中，运筹学的方法被英国的分支部队用于提高他们的控制结果。正如期望的那样，在珍珠港事件后，美国军方也开始应用类似的技术。

After WWII, the use of operations research continued in the military and was greatly expanded. In addition, businesses on both sides of the Atlantic began to apply operations research to a broad range of management problems, such as accident prevention, production planning, inventory control, and personnel planning.

二战后，运筹学继续运用在军事方面，并且有极大的拓展，另外，大西洋两岸的商业活动开始将运筹学应用到管理问题的广阔的领域，例如，事故预防，生产计划编制，存货控制和人事计划编制。

The first formal university courses and curricula also began to be developed during the immediate postwar period. MIT, Case Institute of Technology (now Case Western Reserve University), and the University of Pennsylvania were among the first universities to offer formal degree programs in the United States in the early fifties. It is interesting to note that similar academic programs did not develop in the United Kingdom until latter, although lectures and courses were offered at a few universities. University programs in operations research in the United States and Canada are located in a wide variety of colleges, schools, and departments, reflecting the field’s highly interdisciplinary nature. Programs are found in departments of mathematical science, decision sciences, statistics, industrial engineering, computer science, management science, engineering management, mechanical engineering, and operations research. These departments are located in school or colleges of engineering, business, management, industrial engineering, and applied science.

战后，第一批正规大学课程也开始涌现，并迅速得到发展。xx年代早期，麻省理工学院，卡斯技术学院（现在的卡斯西方储备学院）和宾夕法尼亚大学是他们之中第一批提供正规的学位课程的大学。尽管这些课在少数的大学被设立，有趣的是，在英国尽管有零星的大学也进行了一些有关运筹学的演讲和课程，但是直到后来类似的学术课程才在英国得到发展。在美国和加拿大，运筹学方面的课程在各种学校、学院和院系中被广泛设置，反映出这个领域高度融合的性质。这些课程被设立在材料科学，决策科学，统计学，工业工程，计算机科学，管理科学，工程管理，机械工程和运筹学等院系中。这些院系隶属工程、商业、管理、工业工程和应用科学等学校或学院。

Operations research as defined by the Operations Research Society of America, “is concerned with scientifically deciding how to best design and operate man-machine systems, usually under conditions requiring the allocation of scarce resources.” Important to the field is the development, testing, and use of models to predict various outcomes under differing conditions or to optimize the outcome for a given condition. This gives decision makers the ability either to choose the “best” outcome or to enhance the likelihood of a given set of desired outcomes. The application of quantitative methods is also very important.

美国运筹学学会将运筹学定义为：在需要对紧缺资源进行分配的前提下决定如何最好的设计和运作人-机系统的决策科学。这个领域的重点是发展，检测和应用模型去预测在不同条件下的各种结果，或者优化给定条件下的结果。决策者应有的能力是：要么选择最优结果，要么增大一系列给定结果中的好的结果的可能性。定量方法的应用也是非常重要的。

Some OR accomplishments

Some important breakthroughs of the 1970s and 1980s are highlighted below, with description of how they have employed and the resulting economic impact.

运筹学的一些成果

在20世纪xx年代到xx年代之间取得了一些十分突出的重大突破，下面讲述他们如何被应用以及其对经济的影响。

Integrative OR accomplishments

In 1983 and 1984 , Citgo petroleum corporation , the nation ’s largest independent refining and marking company ,with 1985 sales in excess of $4 billion, invested in a unique set of comprehensive and integrative systems that combine such OR disciplines as mathematical programming, forecasting, and expert systems, with statistics and organizational theory. Ctigo applied the OR systems to such operations as crude and product acquisition, refining ,supply and distribution ,strategic and operations market planning ,accounts receivable and payable, inventory control ,and setting individual performance objectives ,and now credits these OR systems with turning a 1984 operating loss that exceeded $5 million into a 1985 operating profit in excess of $7 million .

综合的运筹学成果

在1983和19xx年，全美最大的石油独立冶炼和销售公司--citgo石油公司，将19xx年超过4亿的销售额投资在一个独一无二的全面集成系统中，这个系统将运筹学的数学规划、预测及专家系统结合到了统计和组织理论中。Citgo将运筹学系统应用到诸如：天然物资的产品开采，冶炼，供应和配送，运作市场规划，应收应付款，存货控制和制定个人执行目标， Citgo公司由19xx年5000万的营业损失变为到19xx年高达7000万的营业利润要归功于这个运筹学系统。

Optimization

Optimization—determining how to get an objective function or performance index to its maximum within the limits of available resources and technology—is a fundamental goal of decision making and, moreover, an important tool in engineering design. For more than three decades, research in optimization—a considerable fraction of which has been funded by the STOR program of NSF—has been active and fruitful, with payoffs accumulating through a multitude of application.

最优化

最优化—决定如何得到一个目标函数或性能指标以使得在有限的资源和技术有限的条件下达到它的最大值—是决策的基本目标，并且除此之外，它还是在工程设计方面重要的工具。三十多年来，最优化方面的研究—它的很多方面的研究已经被NSF的STOR计划资助—已经通过大量的实践积累产生了作用并取得累累硕果。

Linear programming is widely used throughout the world. Optimization also involves techniques for solving large-scale, discrete, nonlinear, multiobjective, and global problems. Some recent advances in the filed have such great potential that they have been cited prominently in popular publications, including the NEWYORK Times and the Wall Street Journal. Moreover, optimization is in a new stage of proliferation because its techniques are now accessible to microcomputers. Since optimization has achieved a degree of maturity, it is natural to take a hard look at what can be expected from further research.

线性规划在全世界范围内被广泛应用。最优化也包括解决大规模，离散，非线性，多目标和全球化问题的技术。在这个领域最近的一些探索有如此大的潜力以至于它们已经被一些受欢迎的出版物大力宣传，其中包括《纽约时报》和《华尔街日报》。此外，因为现在最优化的技术可通过微机来实现，所以它正处在一个快速发展的新时期。既然最优化已经达到了一个成熟的程度，那么关注在更进一步的研究中被期望的结果是自然而然的了。

In the more mature areas such as linear programming and unconstrained optimization, and in those of intermediate maturity such as integer and constrained convex optimization, emphasis will be placed on rapid, large-scale computation. This will be driven both by the need to solve large problems in manufacturing and logistics, and by the opportunities created in new computer technologies such as parallel processing. Research in such newer and lesser understood areas as global, multicriteria, and qualitative optimization, will necessarily deal with basic issues.

在那些更为成熟的如线性规划和无约束优化等领域和一些不太成熟的如整数和约束优化等领域，研究的重点将被放到快速的，大规模的计算上。制造业和物流上的一些重大问题需要和如并行进程等新的计算机技术所创造出的机会将会推动这些研究的进行。一些在全新领域和我们知之甚少的领域如全球性和多标准定性优化等研究，将会必然的应用于处理一些比较基本的日常事情上。

Stochastic processes

We live in a world in which we have limited knowledge and an inability to predict the future with certainty. A telecommunications network may suddenly be flooded by calls; a vital machine in a manufacturing plant may fail unexpectedly; a firefighting service may be called into action without warning. The study of stochastic processes provides us with a systematic way to model, design and control service systems characterized by such uncertainly. Operations research will continue to provide an observational framework for such studies through fundamental research into foundations of probabilistic phenomena.

随机系统

我们生活在一个知识短缺和无力对未来事实进行预测的世界中。一个通信网络可能会突然被阻塞；车间的一个至关重要的机器可能意外发生故障；一个消防系统可能在没有任何征兆的情况下被要求执行任务。对统计过程的学习将会为我们提供一种系统的方法去建立、设计和控制系统中的不稳定因素。运筹学为我们提供了一个通过基础研究而了解基本的概率现象的框架。

Flexible manufacturing systems (FMS) and computer/communication networks exemplify complex systems that fall into a class called discrete event stochastic systems (DESS). The efficient design and operation of these systems is extremely important to economic competitiveness, yet system behavior is not completely understood. Present methods of analysis and design of DESS focus on their behavior in the steady state, a conceptualization that requires performance measures to be made “in the long run” or “averaged over time.” Yet, most systems exhibit dynamic behavior on their way to (or sometimes even during) the steady state that may produce a deviation in performance from that computed by steady state analysis. Design and control of such systems (for example, multiechelon spare parts inventories, integrated manufacturing cells or computer/communication nets) involving explicit consideration of the cost or impact of transient behavior, is now a real possibility.

柔性制造系统和计算机通信网络是一个复杂的系统，也就是所谓的离散事件随机系统的很好的例证。这些系统有效的设计和运转对经济学上的竞争是极其重要的，但是系统行为却是很难被完全掌握。现代离散事件随机系统的分析和设计方法集中在它们在稳定状态下的行为上，在长期的运转或超过平均时间的运作中一个需要绩效测量的概念形成了。然而，在他们向稳定状态过渡的过程中大多数系统展示动态行为，而稳定状态也可能会产生一些被稳定状态分析计算出来的执行偏差。这类涉及成本的清楚估价或短期行为影响系统的设计和控制，现已成为一种可能。（例如，多样级别剩余零件的清单，集成制造组织，或计算机通信网络）。