Direct Patient Care

QUESTION

Formulate your weekly reflections around the following objectives. Try to comment on each objective each week. The sentences in italics are only suggestions to help guide you as you reflect on these areas. You do not need to address each italicized cue each week.

Direct Patient Care

How did you feel about your performance in the clinical setting this week? What went well? What would you change about what you did or didn’t do?

Describe a patient(s) you cared for this week. What were the patient’s medical diagnoses? What nursing problems or actions did you address when giving care. List any medications you gave this week that you have not given yet this quarter. Mention any particular assessments you did that helped you identify the patient’s problems or nursing diagnoses.

Critical Thinking/Clinical Decision Making

Prioritizes and organizes nursing care based on relevant assessment findings.

Describe specific examples of where you prioritized your actions or assessments based on the needs of a patient or a group of patients that you cared for. Provide details on your highest priority action or assessment. Why did you decide one action or assessment was more important than another? Describe a situation where you had to revise a plan of care for a patient based on changing circumstances. Describe a period of care when you were especially efficient in completing patient care in a short period of time (e.g. you brought supplies into the room to do multiple tasks at once.)

Skill/Intervention Performance

Perform interventions (previously learned or new technical skills/ protocols) relevant to the care of your patient (s).

Describe any experiences you had using unit specific protocols. List any skills or interventions you performed (include both new and previously learned skills). What went well and not so well? Mention if you used sterile or extra clean technique. Did you have to modify the procedure from the usual in order to accommodate patient needs?

Communication

Communicate effectively with clients and their families in a manner sensitive to condition, age, gender, and social and cultural status.

Describe a communication with a patient, family member, preceptor, physician, or other health care professional (reflect on both, the ones that went well as well as the ones that did not go so well). How did you feel after this communication? Was the communication based on getting or giving information, resolving a conflict, showing appreciation etc. What did you learn? What might you do differently?

Collaboration

Collaborate with other health care providers in planning, implementing, and evaluating care.

Describe a specific situation where you collaborated to plan or give care with your preceptor, another RN, physician or other health care provider.

Leadership

Self-directed in the use of appropriate resources, including research findings, to inform plan of care or solve nursing care problems.

Describe use of a resource to plan patient care that you haven’t used before. This might be an article, research findings, or computer resource such as Micromedex. Describe a situation of delegation: how it went/how you felt.  Describe a situation when you accepted responsibility for: a task, an error or complication. Describe a situation of role modeling for healthcare members, family members, team members, other student nurses. Describe a time that you initiated communication with a physician.

ANSWER

Direct Patient Care

This week in the clinical setting, I felt confident in my performance and the care I provided to my patients. I was able to establish a rapport with them and effectively address their needs. One patient I cared for had a medical diagnosis of pneumonia. I assessed the patient’s respiratory status, monitored oxygen saturation levels, and administered prescribed antibiotics and respiratory treatments. Another patient had a diagnosis of congestive heart failure. I closely monitored their vital signs, assessed for signs of fluid overload, and administered diuretic medications as ordered. This week, I administered medications such as furosemide and albuterol, which I had not given before this quarter. Through my assessments, I was able to identify nursing problems such as ineffective airway clearance, impaired gas exchange, and activity intolerance.

Critical Thinking/Clinical Decision Making

In caring for a group of patients, I prioritized my actions based on their needs. For instance, I recognized that a patient experiencing respiratory distress required immediate attention, so I quickly initiated interventions to ensure their airway was clear and provided oxygen therapy. I decided this action was more important than attending to another patient who required assistance with activities of daily living. There was a situation where I had to revise a plan of care for a patient who developed an allergic reaction to a medication. I promptly consulted the healthcare team, revised the medication administration plan, and closely monitored the patient for further complications. I also had a period of care where I efficiently completed patient care by bringing necessary supplies into the room, allowing me to perform multiple tasks at once.

Skill/Intervention Performance

During this week, I utilized unit-specific protocols for wound care and medication administration. I performed skills such as wound dressing changes using sterile technique and administered intravenous medications following the appropriate protocols for clean technique. Overall, the interventions went well, and I was able to effectively carry them out. However, there was one instance where I had to modify a procedure to accommodate a patient’s physical limitations. I adjusted the technique for turning the patient in bed to ensure their comfort and safety during the process.

Communication

I had a positive communication experience with a family member this week. I provided information and emotional support to a concerned family member, addressing their questions and providing updates on the patient’s condition. The conversation helped alleviate their anxiety and fostered a sense of trust. However, there was also a communication instance that did not go as smoothly. During a handoff report, I struggled to effectively communicate the patient’s complex care needs, leading to confusion among the receiving nurse. I realized the importance of concise and organized communication and learned that using a structured handoff tool could have enhanced the transfer of information.

Collaboration

I collaborated with my preceptor and a physician in planning and implementing care for a patient with diabetes. We discussed the patient’s insulin regimen and made adjustments based on their glucose levels and nutritional intake. Together, we created a comprehensive care plan to manage the patient’s diabetes effectively. The collaboration allowed for a holistic approach to care and ensured that the patient’s needs were met.

Leadership

To plan patient care, I utilized research findings from an article I found related to wound care management. The article provided evidence-based recommendations for dressing selection and wound assessment techniques, which I incorporated into my care plan. I also had an experience of delegation where I felt confident in assigning a nursing task to a nursing assistant. I provided clear instructions, ensured they understood the task, and followed up to ensure completion. I accepted responsibility for an error when I mistakenly administered a medication at the wrong time. I immediately reported the error, documented it appropriately, and implemented corrective actions to prevent a recurrence. Lastly, I served as a role model for other student nurses by demonstrating effective time management, professional communication, and compassion towards patients and their families. I initiated communication with a physician to discuss a change in a patient’s condition and to obtain a new medication order, demonstrating proactive leadership in advocating for the patient’s needs.

In conclusion, this week’s clinical experience allowed me to reflect on my direct patient care, critical thinking and clinical decision making, skill and intervention performance, communication, collaboration, and leadership abilities. I recognized areas of strength and areas for improvement, and I am committed to further developing my skills and knowledge to provide optimal care to my patients.