Clinical Reflective Report

This is a reflective essay based on a situation encountered during my first six-week placement on an ear, nose and throat ward at a local hospital. In order that I could use this situation for my reflection the patient will be referred to as "Mr H". This is in order that his real name is protected and that confidentially maintained in line with the NMC Code of Professional Conduct to

Mr Johan experiences symptoms of panic attack when he feels self-conscious in front of other people when performing certain tasks. He reported feeling faint and had black out of thoughts during those episodes, whereby he was not able to think of anything. Both his hands would tremble and become numb. He would also be sweating but experienced no symptoms of pounding heart or choking

I am posted in st. John rehabilitation center in a4 ward. Every week we had same patients. I want to write a reflection on my one patient he was very aggressive patient. I felt so scared because of his aggression. He was very agitated and some time he forcing to staff members to stop their work by using physical force. One day, he hits me on my hands to stop doing anything . I was so scared at that situationand I told to registered nurse about this event and she helped me a lot to handle that patient. Registered nurse support me to deal with that patient and provide some tips to maintain patient safety and also mine safety too. This is the whole situation that I want to explain in my reflection.

My first clinical experience for this nursing program was completed at New England Rehab Hospital. I walked in with some clinical experience but no experience in the realm of nursing or certified nursing assistants (CNA). During that first semester we followed CNAs to understand their job and gain basic nursing skills like bathing patients, bed making and other daily tasks. It was useful and I’m still happy we were able to have that experience. A situation that made me uncomfortable during that semester that one particular CNA never sanitized his hands when entering and exiting a patient’s room. In most hospitals and nursing facilities there is a “pump in, pump out” rule to abide by when entering and exiting a patients room rule to ensure health care workers are not spreading bacteria to themselves and other patients. This particular CNA admitted to me that he pretends to push the hand sanitizer and rub his hands together without actually getting any sanitizer in his hands. His reasoning was that he found it overly drying to use the sanitizer so frequently despite the hospital providing lotion as well.

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 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.

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.

As part of my clinical experience at St. Joseph unit, I had an opportunity to work with my classmate, Kingly and Dat. Dat was a very kind and efficient nursing assistant and I felt fortunate to have had the chance to work with and learn from him. Our day together seemed as though it was typical for the residence. The first resident was Ms. Nancy; she is in room no. 220A. My duty gave her breakfast and feed her in morning. Upon waking Ms. Nancy I respected her privacy by always knocking before I entered the room and asking permission to enter. I have introduced myself and followed standard precaution by washing my hands before start any procedures. I tried to talk to her while I was feeding her. I tried to wake her up before the breakfast is over. She only ate 35% of her meal. Then, Dat showed me how to use a full sling mechanical lift to move Ms. Nancy to shower chair and show me how to use shower chair while showering Ms. Nancy. After finishing

For my seventh clinical shift at the Loma Linda Veterans Affairs Medical Center, my assigned preceptor Filipina Gumangan assigned me three patients on the 4NW unit. The unit where I precept is an intensive care step down unit. Filipina’s objective for giving me three patients this shift was to give me an opportunity to continue exercising my time management skills and to practice my reporting and charting skills, and wound care. This shift I was responsible for many clinical duties corresponding to the care of these patients. My patients this shift were Mr. B, a 72 year-old Vietnam War veteran newly diagnosed with colon cancer, Mr. S, a 65 year-old Vietnam War veteran in the hospital for complicated urinary tract infection, Mr. R, a 90 year-old Korean and Vietnam War veteran. Caring for these patients taught me more about the humanbecoming perspective of nursing and showed me about multidisciplinary coordination with peers, colleagues, and more.

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.

Today I had a great day at the clinic. For the morning section, I had Omar Lora as my patient. Last time when he came, I collected all my assessment data. Today I updated his medical history, dental history, vitals, and EIOE, then I completed filling out the gingival assessment, the treatment plan, and the SAOP. Finally, I was ready to have my assessment data checked. It went really well, and I learned ways to helped me be more efficient with my time management, for example, I did not know how to have my radiographs up in the other monitor while I was doing my assessments. It was a little time consuming having to open and minimized the window every time I needed to look at the radiographs. Also, I discovered that having a piece of paper out and taking

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.

Looking back to the first day of clinical to the last day I have changed a lot during this time. During the whole clinical experience I had to use a lot of the growth mindset in-order to get fully through the whole process. My clinical teacher and I didn’t quite have the same opinion on certain things. While we did struggle through are different mindsets, it was a great learning experience. I will have people I work with that I don’t always agree with and I will have to find a way to compromise with them. This was something we talked about with each other and worked through. So, Im grateful in that aspect in learning how to deal with those situations. I also changed in that I’m more confident in giving my lessons to my students, along with I tried to not be as scared in-front of them.

This essay is a discussion about my experience during the first two weeks of my clinical placement in an older adult ward. My experiences will be demonstrated using the various nursing skills acquired thus far. The reflective account used is adopted from the work of Driscoll (2007) which splits the essay into three segments namely a) what happened, b) so what, (what were my feelings, what was good and what was wrong about the experience, c) now what, (if I find myself in that same situation what would I do differently).

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