Clinical Reflection

I always feel slightly off when returning to clinical practice after a break, whether that is one week due to SIM or a whole month for Christmas break. I felt like my sense of direction was disheveled this week. My first morning with a client I found myself lost on were to even start with her care. I forgot to introduce myself during my first morning and I found myself relying on the outline sheet for a head to toe. Even finding my way around the unit made things take slightly longer than I would have liked. As the day progressed I began to get back into the groove of things. Going into the second shift my morning was much smoother and I didn’t have to look at my head to toe guide as I preformed my assessments. I felt more comfortable with my charting and was able

Reflection is a process of exploring and examining ourselves, our perspectives, attributes, experiences and actions / interactions. It helps us gain insight and see how to move forward (Nursing Times 2018). I believe reflection is particularly important when it comes to Nursing, as medicine is constantly changing/ improving and us ourselves medical professionals must adapt with the changes in medicine. I find that reflection is extremely useful in doing this as we can look over procedures or experiences that we have had, how that made us feel, whether we would change anything, then in the future we can see the changes that may have been made, whether this has changed our feelings and opinions on medical practice.

Skin integrity is an important concept that’s nurses assess on their patients. A key skill in nursing practice is to frequently assess the skin for possible breakdown or decreased skin integrity. Skin assessments should be conducted thoroughly once a shift and frequently reassessed for any signs of change. Skin discrepancies may be the first sign of an underlying issue. Early detection of any breakdown can help to implement interventions sooner. Unfortunately, unless there is a major skin discrepancy, skin issues can easily get overlooked, specifically in documentation and report. The focus of this paper is to research new skin integrity assessments to improve documentation effect and accuracy, resulting in decreased prevalence of skin breakdown in hospitalized patients. Topics discussed include reviewing current practices and new skin assessment techniques that decrease the prevalence of skin breakdown and pressure ulcers.

My clinical day of week 3 started pretty much with the same routine. I had to shadow a CNA preceptor and helped her throughout her assignment. By late morning, I have encountered a patient that at first refused to have a conversation with me despite my efforts of searching the right therapeutic questions that will make her open up to me. I founded the situation to be a little bit frustrated and made me feel unsuccessful that I was not be able to form a relationship with the patient. I did not know what to do or what to say. She just kept staring outside the window without saying anything. At lunch time, she surprised me when she approached me and expressed her apology for her earlier behavior.

This semester, I hope to gain the confidence in my nursing skills necessary to help me work more independently with my patient care. Expanding on my assessment skills, communication skills, clinical judgment skills, and safety skills are important in gaining more independence in my care for my patients. I hope that this semester I can learn how to work with chest tubes, be more direct with what I need from my patient, be more confident with my knowledge in medications, improve my skills in delivering an SBAR, and learning the terminology used at Mayo Clinic and in nursing.

The topic we focused in the class was about Inpatient Rehabilitation and Post Acute Care in the United States. The presentation was given by Susan Hartman and currently, she is working at HealthSouth Nittany Valley Rehabilitation Hospital, position of Chief Executive Officer . The lecture began with the topic of the continuum of care. I had experienced difficulty with this thought because I trusted that everybody should have to know all about acute care because it’s very vital to know in the HPA field. I didn't know whether I could regard it a privilege. I felt that access to health acute care status was significant, particularly because I also, from a place where health care is hard to find, as well as difficult to pay for services. During the lecture, I came to comprehend that without health acute care, few of us could legitimately appreciate the other fundamental rights. This presentation applies to me, when I was working at health clinic volunteer service in Bhutanese American Organization of Philadelphia.

My experience in mental health clinical was very different from any other clinical I had before. In a mental health clinical setting, I am not only treating client’s mental illnesses, I am also treating their medical problems such as COPD, diabetes, chronic renal failure, etc. Therefore, it is important to prepare for the unexpected events. In this mental health clinical, I learned that the importance of checking on my clients and making sure that they are doing fine by performing a quick head-to toes assessment at the beginning of my shift. I had also learned that client’s mental health illness had a huge impact on their current medical illness.

The objective of this reflection is to explore and reflect upon a situation from a clinical placement on an orthopedic unit. The incident showed that I did not provide safe, timely and competent care for my patient when the oxygen saturation was low. Furthermore, this reflection will include a description of the incident, and I will conclude with explaining what I have learned from the experience and how it will change my future actions.

This Fall quarter’s clinical observation paper is comprised of two separate observations. The first observation was on October 4th, 2017 with my focus on understanding the ins and outs of working in the radiology lab. The second observation was on November 8th, 2017 with a focus on patient interaction during medical/dental history.

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

My reflective clinical practice experience was based on my eight weeks placement in an acute mental health ward in a hospital. I was not sure of what to expect because I have never worked or placed in an acute ward and this was my second placement. Before starting my placement, I visited the ward and was inducted around the ward. This gave me a bit of confidence and reassurance about working in an acute ward.

The therapist met with the client for an individual session. The therapist greeted the client and checked the client’s mood. The client reported that she is sad because she is still feeling homesick and she stated, “I will tell my mother tomorrow how I feel being here at the facility and how much I feel homesick.” The client shared that she feels good towards the weekly tier work for this week and the questions of the tier work for this week made her think understand herself in a better way and she likes the idea of the home schedule time management. The client reported that she feels okay with herself being a life and happy although she has heard that her biological parents did not like her to be born and her biological father was pushing her biological mother to have a portion while she was pregnant.

During our return demonstration, we all felt like we needed to look to our instructor for guidance in what we should do. The reason for this was because we all lacked the confidence to feel like we knew what we were doing. If I could do it again, I would have liked to have been more knowledgeable about the scenario so that I could be more confident.

Clinical practicum has provided a valuable study opportunity to me.When I took care of a living person in wards,I could apply the skills which are learnt from indoor lessons in school and books.Also,I could achieve more knowledge outside textbooks.However,I find that there is a difference between the real situation and theory.In ward,nurses have to be multitasking and need to manage several patients,time is precious to them.Nurses have to make an effort to save time from different ways.To give an example,in the ward I worked in this clinical practicum,nurses connected the syringe to the end of tube and administered drug to a patient with nasogastric tube by giving pressure to pump drug solution down the tube.Thus ,the procedure finished in a few seconds.I learnt this method from them and applied it in my practice.However,I was stopped by the supervisor teacher during one of my practise.She told us that it was wrong to administer drug by using pressure.She then asked me for the right method.I was shocked in that time because I learnt this way from the

Also, the objective is to find patient’s document finding and correlate it with chronic disease process of elderly adults. With this reflection, I will discuss what I’ve learned, and my strengths and weakness in my clinical experience.