A Reflection On Clinical Placement

This was my first shift back from having a few days off and I returned to work on a night shift. Patient A was admitted to the hospice that day. She was admitted for general deterioration and she had tried to maintain her independence up until breaking point. It was handed over she has aphasia.

Last week Thursday on the orthopedic clinic was a slow but eye opening experience. When I got to the clinic at 8AM, after I was introduced to some of the nurses there, I was immediately assigned to a Medical Assistant (MA) that I had shadow for half of the day. The MA shows me around the clinical and explained her role and responsibility in the clinic setting. During the first several hours, and MA and I were quite busy rooming the patient. Because the MA want me to see how to do thoroughly assessment on a new patient, the MA did a thoroughly assessment and examinations on the first patient we saw. During the assessment, the MA also explained some of the medical procedures to the patient. She did a set of vitals on the patient, particular on new patient, such as blood pressure, height, and weight. We had a total of 15 patients during the morning.

During this day, I was assigned to care to one of our sick residents and based on my assessment, her condition shows no sign of improvement from her chest infection so I checked her vital signs specifically her respirations. After assessing her, we rang in the GP to inform him about the condition of his patient and asked him to schedule a visit. Also, in the afternoon, we had a new admission from Eversley. Firstly, we greeted the patient, introduced ourselves and oriented the resident to the unit. Secondly, the nurse from Eversley informed us about the relevant information about the patient’s

While at Trinity the supervisor gonna call the Activities that were witness today activities that were witness today consistent off the strategies to take me off then off short fast and I have reload a patient karenconsistent off the strategies to take me off then off short fast and I have reload a patients the morning started off within a report give in for all members of securitythe morning started off within a report give in for all this thing is and nurses. Aaron this meeting the unit supervisor very gave with some encouragement to the staff. During this meeting she also informed the nursing staff the clients that were at risk such as the ones with that are prone to bad all sirs the ones are high risk at Falls the ones on isolation precautions. At this meeting was also a clinical nurse educator. On a normal daily basis she is responsible for doing quality rounds and making

Roper, Logan and Tierney’s model has been criticised in the past; it has been seen as a checklist and a very simple nursing model (Townsend, 2008). I found that a lot of the information had already been gathered throughout the assessment stage. My preceptor told me that the nurse usually fills in as much of the Roper, Logan and Tierney assessment as possible not wanting to agitate the patient any further by asking the same questions over again. John was far too paranoid to start questioning him again, the Roper, Logan and Tierney assessment was completed by information gathered during assessment. John was orientated to the unit and shown to his sleeping area, I then carried out a property checklist. I felt very uncomfortable doing this as I was going through his personal belongings. I explained to him that this was routine with every new patient. John did sign his consent to admission which surprised me. To be honest I felt that so far the nurse had little intervention with the patient, to me it seemed like the doctor was doing the communication. I voiced this to my preceptor; she explained that this is the case within this service. The nurse’s input is predominantly around complying a care plan for the patient. This leads into the planning stage where the care plan is developed to meet the patient’s needs.

This essay sets out to discuss the importance of comprehensive and accurate assessment on a registered nurses’ ability to make excellent clinical decisions. It will examine what factors can change a nurses’ capability to be aware of, and act on abnormal assessment findings. As well as assessment being part of the nursing process that is used in every day nursing, it is also a critical part of patient safety (Higgins, 2008). Assessment findings are used to determine what needs to be done for the patient next. Early warning scoring systems currently exist to aid in the early detection of patient deterioration (Goldhill, 2005). The rationale for the use of these systems is that early recognition of deterioration in the vital signs of a

Discuss how an understanding of nursing-sensitive indicators could assist the nurses in this case in identifying issues that may interfere with patient care.

In this paper I am going to discuss my interview with a client, JP. This will include my overall impression of JP resulting from the social history, nutritional and independence in daily living screen, mini-mental exam, and her fall risk screen. I will list a nursing problem JP has and the contributing factors to this problem. Then I will list her medication list that will include her knowledge and schedule of taking the medications, and any concerns that I have with her medications.

Mr. B.’s procedure after sedation (was accomplished) was successful and his sedation level continues. Nurse J then applies an automatic blood pressure machine to measure every 5 minutes and a pulse oximeter, however the nurse does not apply any respiratory monitor or heart monitor which are protocol after a sedation procedure. The nurse then rushes out of the room leaving Mr. B. with his son with no medical personnel at the bedside to monitor the patient. No sedation score or neurological assessment of Mr. B. is noted, which should be performed after any procedure including sedation. This data is either missing, not documented or not performed by Nurse J. Mr. B.’s alarm for low saturation is alarming and the LPN enters the room briefly,

The purpose of this journal is to reflect on my experience and skills gained during my clinical placement at Ben Taub Hospital. On my first clinical day, I was excited and nervous at the same time. My first placement was in the PREOP/PACU area. I was assigned to help a patient who had been in the PACU area going on 2 days. Normally, once the patient comes from surgery they are only in the PACU area for a short period of time before they are discharged home or given a bed in another area of the hospital. This particular patient still had not received an assignment for a bed. The physicians would make their rounds to come check on him daily. The patient was a 28-year-old Hispanic male, non-English speaking, he had a hemicolectomy. He had a NG tube, urinary Foley catheter, and a wound vac. My preceptor had just clocked in and she needed to check on the patient’s vitals and notes from the previous nurse. Once she introduced me to the patient and explained while I was there, she then asked me to check his vitals. (Vital signs indicate the body’s ability to regulate body temperature, maintain blood flow, and oxygenate body tissues. Vital signs are important indicators of a client’s overall health status (Hogan, 2014). I froze for a quick second. I have practiced taking vitals numerous of times and I knew I could do it correctly. I started with the temperature first, when I was quickly corrected on a major mistake I had made by my preceptor. I HAD FORGOT TO WASH MY HANDS and PUT

This is an analysis of a taped interview between a nurse and a patient who is taking pre-employment medicals. The information given during the interview, including her name, Pink Cloud is fictitious because of the need of confidentiality. During the interview, objective and subjective data will be collected. The areas of communication focused on in the analysis are verbal, questioning and listening skills. Analysis will be made and later suggestions and recommendations will be made on how to make improvements in the future. To achieve this, direct quotations from the will be used to make references to the three theories being analysed and will be supported by the literature.

I have chosen as my adverse event to be about a particular patient which falls at the hospital. I will show how common it is for patients to fall in a hospital and suggest some ways of prevention, which includes properly training the whole staff and constant monitoring of certain patients. We will discuss ongoing quality improvement method to minimize any and all falls.

During my third year of nursing clinical placement on 3B surgical unit, I met a client, Mr. X, who was 75 years old Caucasian male with a diagnosis of small bowel obstruction/ perforated bowel. He had a surgery of laparoscopic right hemicolectomy with ileostomy and the laparoscopic incision closure of JP drainage three days after the first surgery. His past health histories were class one obesity, hypertension, asthma and chronic obstructive pulmonary disease (COPD), over 30 years of smoking, chronic lymphocytic leukemia (not on any chemo agents). Mr. X had previously independent activity daily living and remains slow to respond, they lived in bungalow with three dogs. Their daughter and son live out of

During the home health observation day, there were several opportunities to observe a variety of patients with varying levels of functioning ability, different illnesses, and different needs and levels of interaction with the nurse. The first patient seen was a seventy-three year old Caucasian female with an ulcer on her right heel. Several weeks prior, she had scratched her left leg and she also had several small wounds on her left leg. The orders were to clean and redress the ulcer. She has a history of end stage renal disease, pneumonia, weakness, diabetes, dialysis, and right hip fracture. Upon entering the home, the patient was found to be sitting in a wheel chair in the living room watching television with her husband close by her side. She greeted the nurse with a smile and began to update her on her current condition. Her heel was “hurting” and she rated her pain an 8 on a scale of 1 to 10. She also had some “swelling” that she could not “get to go away; because, she could not get up and walk. They need to fix my foot so that I can get up and get around.” She told the nurse that she had been to see the doctor “yesterday” and the doctor had given her a written order that she wanted her to see. The order was written for an evaluation for a soft pressure shoe fitting. The nurse read the order to

I was trying to ensure the patient remained stable, and ensure patient safety was at the forefront of my care through continuous observation as per protocol. Perkins and Kisiel (2013) state that students who work within their scope of practice following trigger protocols are safely recognising deteriorating patients and responding to the degree of illness. However, one furthermore states that students must not forget the physical examination