Clinical Observation

Discuss a clinical experience in which you had to incorporate one or more learning styles such as visual, kinesthetic, and auditory. Explain the outcomes and how you created an effective learning experience.

During my first day of clinical, I encountered an issue that I believe is very significant. As a student nurse, our duty for this day was to follow our health care aide around the ward and assist in completing resident care. The resident required assistance in many of her daily tasks. The health care aide asked if I would perform one of those and do perineal care for her. I turned down her offer because I did not feel comfortable with my skill level. The resident had a bowel movement during the night. There was a significant odour in the room that overwhelmed me. I really wanted to leave the room because it was so unpleasant, but I stayed in the room so that the resident would not be embarrassed. This feeling of embarrassment, I assume,

Throughout my clinical experiences, there have been quite a few circumstances I have been placed in that have remained with me whether good or bad. All of them have been learning experiences for me whether it is how to improve and to do better next time from a mistake, for me to learn that this is or is not how a patient should be treated, how to handle family situations, and many others. One experience that I was able to participate in that will remain with me because I had not experienced this before was during my critical care rotation in the fall of 2015. This patient was dying and we were implementing comfort care for him.

Diabetes is a serious medical condition that can also be a risk factor for the development of many different diseases and conditions including dementia, heart disease, and CVA. Thus, effective management of diabetes is very important. Patient compliance can be difficult to achieve if the person affected with diabetes is not educated about the illness or treatment, has not fully accepted the diagnosis or its severity, will not change habits or believes that the prescribed treatment regime is too difficult or ineffective, has cultural beliefs conflicting with the treatment regime, experiences stressful events, lacks social support, or suffers from psychiatric issues unrelated to diabetes (Gerard, Griffin, & Fitzpatrick, 2010). As one may expect, adequate education programs are essential tools when dealing with diabetics. Solid education will provide the patient with information as well as teaching the necessary skills to manage the disorder. The primary focus of any diabetes education program must be to empower patients as a part of the multidisciplinary team. This team should be focused at integrating diabetes into the lives of the patients and this focus should be based on the decisions made by the patient, otherwise the treatment plan can be looked on as forced (Gerald et al., 2010). Every patient stricken with diabetes has the right to benefit from an education program of this type. First, basic education and facts should be administered directly following the diagnosis of

Dale Gordon has been a patient in the ICU for 6 days after developing complications after open heart surgery. He is an 82-year-old African American who is disoriented to place and time. He lives with his daughter Claudia in her home. Claudia and her two brothers visit Mr. Gordon daily since he has been hospitalized. Mr. Gordon has not been eating well since the surgery and has lost 3 pounds. Mr. Gordon has type 2 diabetes and is on oral antihyperglycemic medication. Before he came to the hospital, Mr. Gordon was able to only ambulate for short distances. He has orders to get up in a chair twice a day. Joan, a student nurse, is caring for Mr. Gordon this morning. She has reviewed his medical record and is now ready to start caring for him.

Over this last week, I have received a patient named Sherman “Red” Yoder. He is an 80-year-old male farmer, who lives alone in the farmhouse that he had grown up in. Red was married for 50 years and has been a widow now for 10 years. Red has one son, Jon, who takes care of the farmhouse and the land. He has one daughter-in-law, Judy, who is in involved with his care. Red was diagnosed with diabetes six months ago. Diabetes mellitus is a chronic condition that affects your body 's ability to use the energy found in food. As of only a few weeks ago, Red has been managing his diabetes with insulin. Insulin is a hormone that controls blood sugar. Before he began using insulin, he managed his diabetes with oral medication. After carefully assessing Red’s chronic illness, diabetes, many red flags were presented that could interfere with his management. In turn, this would cause further complications.

The Hispanic population is constantly growing and we have an estimated 13.7% of Hispanics making up the United States. “The annual percentage of patients with prediabetes in whom overt type 2 diabetes develops is about 5% in the general US population and may reach 15% in the Hispanic American population” (Idrogo & Mazze, 2004, para. 7). This a community health issue because of the percentage of Hispanic individuals that may end up with diabetes. These individuals need to be educated to help the promotion, protection, and maintenance of diabetes in this group. That is why I have created the intervention program for this ethnic group.

This clinical experience took place at Peyton Elementary School and Prairie Heights Elementary School. Kamille, Ben and I were to teach hand hygiene, covering your cough and brushing your teeth to three Pre-K classes. First we developed a lesson plan and teaching aid for our students. Then, we gathered supplies such as spray bottles, dye, subject specific coloring sheet and a dinosaur with large teeth and tooth brush. Kids Rock dentistry in Colorado Springs was nice enough to borrow us the dinosaur and also gave us activity books for the kids. When we arrived at Peyton Elementary School at 0800, we noticed it was a very nice school. We met the school nurse at the office where we signed in. She showed us to classroom where the children

This essay will inform readers about the best practices, published guidelines, and clinical pathways for management of diabetes. Diabetes is a serious issue that affects millions of people. Unrecognized pre diabetes is also a growing concern that is increasing dramatically. Diabetes is not diagnosed for most homeless people, because they do not do have a yearly physical check-up. Published guidelines are useful to patients and practitioners because they focus on the improvement of care. Clinical pathways are also important, because they focus on the outcome and assessment of their achievement.

Mrs. Jameson is an African American 69-year-old retired teacher who was diagnosed with advanced type 2 diabetes one year ago. She has been responding well to the interventions, including medications, dietary measures, and physical exercise, until recently. She was admitted into the emergency room with muscle weakness, vomiting, fatigue, headache, and confusion. Physical examination revealed that her skin was dry and had lost its turgor, while an osmolality blood test revealed an elevated level of sodium in her blood. She confirmed that in the past week, she had breached the diet as was indicated by a dietician, and had been consuming less water. She further confirmed that she felt unfulfilled due to the disease, and the recognition that she was getting older ‘made’ her seek fulfillment by ‘living her life’. Mrs. Jameson saw diabetes as a limitation to the full enjoyment of her last days on earth, and said she has left it all to God.

The entire concept of diabetes is about living on the edge of trouble. While Type 1 Diabetes is a biological condition associated with a fundamental flaw in the way one's body produces or reacts to insulin a substance that controls and monitors sugar in the blood and cells Type 2 Diabetes is a social and cultural condition. Those most likely groups of people to have to live with it are persons of non-white nationalities (increasingly Hispanics and Asians) who live at or below the US poverty level and/or who have not achieved a very high level of educational advancement (California Department of Public Health, 2010). And in places like San Diego County, California, this puts a major number of people, young and old, quite literally on the border of health and wellness disasters.

Patient G.M. is a four-year-old female from a middle class family living in San Diego. She originally presented with her mother and father to her general practitioner with lethargy and several vomiting episodes in the past few days. Her father stated concern after realizing her frequent urination in the past week. Her vital signs upon initial assessment were HR 140 RR 22 Temperature 102.7 degrees Fahrenheit, BP 70/62, O2 saturation 97%, 32 pounds, and 40 inches tall. Her General practitioner was concerned about type I diabetes and performed a blood sugar check. Upon assessment the monitor read HI, indicating that the level was above 500 and too high for the monitor to read. The doctor informed them she needed immediate treated in the closest pediatric ER due to the potential for diabetic ketoacidosis.

Diabetes is associated with wide range of complications such as chronic renal failure, blindness, amputations, heart disease, high blood pressure, stroke, and neuropathy (Alotabi, A., et al., 2016). There is no known cure for diabetes, but the disease can be controlled through health management that includes multiple perspectives of care such as medications, blood glucose monitoring, diet, nutrition, screening for long-term complications and regular physical activity (Alotabi, A., et al., 2016). Managing diabetes may be complicated and requires the knowledge and skills of both healthcare providers and the clients. Studies have shown that to prevent or delay diabetic complications due to diabetes, counseling and other lifestyle interventions are the effective therapy. Even with many policies set up for diabetes, 8.1 million Americans are undiagnosed with diabetes mellitus, and approximately 86 million Americans ages 20 and older have blood glucose levels that considerably increase their risk of developing Diabetes Mellitus in the next several years (CDC, 2015). For diabetes care to be successful there needs to be a good understanding of the disease and management by both patients and healthcare providers,

He stated he did not really know what type one diabetes was and therefore could not react appropriately to his diagnosis. Sine then, he and his mother have research a lot of information regarding his condition and visits his endocrinologist regularly. When asked about how he manages his condition, he said he just listens to what the doctor tells him to do and he does it without fussing. He said he had to learn how to count carbs and how to put on his continuous glucose monitor. He also states refuses to get a pump because it reminds him of intravenous lines. When asked how he felt about having diabetes, he calmly stated that he wished he did not have diabetes. There was sadness in his eyes even though he tried to be emotionless. He disclosed that he did not like needles, does not like to count carbs, and does hates being treated like a sick child by his mother and a few friends at school. When asked about any positives that came from his diagnosis, he stated he now gets the choice to have more sugar and juice

I observed two different math classrooms for my clinical observation. The first classroom was in an urban school setting, grade two. The second classroom was in a more suburban school setting, fifth grade math. The second grade class period was ninety minutes long, the students rotated in groups to the teacher table and did a mini lesson there for about 15 minutes, while the rest of the 90 minutes was spent on a math website. The fifth grade class period was only 45 minutes long and the majority of what I saw was the teacher working with the students on correcting homework.