Clinical Reflective Report

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 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 second week of my preceptorship brought many new experiences for me, and I can honestly say that each day I spend with my preceptor is better than the last. This week I focused on time management of a full patient load with continued documentation practice as well as admission and discharge procedures. I’ve had brief experiences in my past rotations assisting with discharge teaching and admission assessments however I have never been able to fully take charge and complete the process from start to finish, so this was a great learning opportunity for me.

S: How was your clinical experience this week? This week was an okay week. I spent most of my time trying to get back into the swing of things. I was a little rusty at the beginning of the week but it got better as the week went on.

At this point I know that I am confident, I can critically think and independently plan, organize and provide quality care to my patient. I have made a tremendous improvement on medication knowledge, application and administration and these competencies will be demonstrated in my clinical rotation at Holy redeemer. I have also put studying materials and practices that will help me recall and comprehend what I had learn so far to help me finish strong in this course that I have journeyed so

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 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).

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.

Observations and Thoughts. Throughout the third and fourth week of the clinical practicum, I was afforded more responsibility as a clinical leader. With the inclusion of more responsibility, I was required to attend all daily clinical meetings, with the goal of taking clinical notes and reviewing the same with either the nurse manager of Assistant Director of Nursing, the goal of this assignment was to obtain real word feel of clinical obstacles, staff related difficulties, departmental incidences and client focus problem mapping. The overall expectation is that at week 16 in my clinical practicum I would be best prepared to handle expected and unexpected hindrances in the daily responsibilities of a leader/ manager. Also during this time this I was able to utilize previous work exposures as handling department budget and preforming clinical quality assurance reviews.

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

It is obvious that all of our instructors have a common goal, which is for all of us to learn as much as we possibly can. I honestly think that by allowing as many opportunities as possible to see and experience as much as possible will help us all learn from our clinical experiences.

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

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.

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.