Clinical Rotation

2/10/2016, 1600, Vital Signs: BP 140/85 P132 RR32 Temp 102.2 SpO2 85% on 2 liter by nasal cannula. Jacquline Catanzaro is 45 years old female on disability admitted to Medical Unit Hospital. Sister with patient. Reason to admit is can’t breathe. Diagnosis is 30 year of asthma exacerbation, psychiatric schizophrenia, obesity, pneumonia and herniated disc. Smokes 40 packs year. Drinks 2 pots of coffee a day. Drinks 3 beers each day. Frequency ED visits and hospitalization dependence on rescue inhaler. Patient refuses wear nasal cannula because of worry that it contains poison. Patient has a long history of stopping taking psychiatric medication and asthma medications. Patient has isolated herself from others. Sister is only caregiver. Neuro

The nursing practise has continually evolved and can be described as autonomous due to the significant involvement of nurses in patient care. This then necessitates critical reflection as a way to continually develop and improve the nursing practise. The Gibbs' model, one of the reflection models, assists nurses in complying to the codes and guidelines of nursing practice. For example, developing action plans, evaluating patient outcomes, and thinking critically. This essay will describe an event involving nurses and explain the feelings it evoked. It will also provide an evaluation of the positives and negatives, analysis and enhancement of learning, and an action plan.

How is critical thinking used today? This is a typical question that a student in a non-nursing major may ask, but here at the Christ College, we would be happy to answer that for you. As a student nurse, I use and witness critical thinking and clinical reasoning in the clinical field every day. To better understand this topic, I found two articles to read and review. The first article I found is based on education and the second shows the view of a well-practiced nurse.

The First Health video demonstrates proper techniques for transferring, positioning, and ambulating a patient to increase movement and decrease their risk for injury. One proper technique demonstrated is how to reposition a client in the bed who is slouching or has slipped down. This is done by lowering the head of the bed as flat as possible, and if able, having the patient cross their arms and bend their legs. When moving the patient, the nurse should ask them to raise their head up to make the move smoother (“Moving Patient”). As the video dictates, the smaller the client relative to bed size, the easier it is to move them. The video also includes how to position someone with an affected or weaker side, on their back, on their unaffected side, and on their affected side. Providing pillows for additional support is also emphasized. To position the client on their back, place a pillow under the affected arm and gently move it out and away

On this day, my clinical rotation in the community setting step up when Joel Polanco, RN was actively participating with the walk in cases at the clinic. One more time I observed the procedure done with those patients during the visit and how the nurse handle and triage the cases, which contribute to lower the workload of the physicians. Some patients came only for prescriptions on their medications. For those cases, the nurse just sends by email the task and then later in the afternoon, the physician sends the electronic prescription(s) to the pharmacy. This exercise at the clinic save time and bring patient satisfaction. There were very interesting cases like a person with several symptoms of hyperthyroidism. He was first time at the clinic

Patient is a 71 years old female who is from assisted living who presents in the Emergency department due to tachycardia and chest pain. Her symptoms started before going to bed and she felt like her heart rate was racing and felt short of breath. EMS was called and patient states her shortness of breath improved after 12 mg adenocard was given by the EMS. Patient has a medical history of senile nuclear sclerosis, anxiety, hypertension, diabetes, heart disease, asthma, heart attack, copd, renal insufficiency, palpitations and cataract removal. Patient is taking 22 medications in the assisted living. She was then admitted in our telemetry unit with a diagnosis of chest pain. Upon arrival in the unit, patient was Alert and Oriented to name,

Equally important to remember is that the patient has neuropathy which will affect his balance and further increase his fall risk so guarding closely is crucial. In addition, completing positional changes slowly will be critical with the majority of his medications have side effects of dizziness/lightheadedness. Increased risk of bleeding and decreased ability to clot is imperative to realize especially if the patient falls or gets cut during an

Communication is a tool that nurse leaders should master in order to send information, perception and understanding to achieve work activities and goals. Effective communication involves frequent, clear, and direct messaging of thoughts and ideas. The three elements leaders should include in creating and enhancing effective communication are trust, respect, and empathy. For this paper I will discuss some of the issues found in chapter seven’s critical thinking exercise. Nurse Olivia Whitt, who is in charge of an interdisciplinary team, faces several issues regarding communicating with the organization’s physicians about a critical pathway development for ventilator-dependent patients, the dietician who wants to integrate dietary protocols for the pathway and a home health care representative who at the moment is too involved with accreditation issues.

The development of the nurse’s ability to clinically reason and take appropriate and timely action can, in time, become an instinctive and automatic process. Reflective practice by the nursing professional will highlight the areas in which further improvement is needed. Essentially, it is the responsibility of the individual nurse to identify the need to develop this ability, and the skill to effectively communicate the patient’s condition to the other members of the healthcare team to produce positive patient outcomes.

A time when I provided excellent patient care would be when I had my clinical rotation in the special care nursery. I was assigned to a baby who was going through withdrawal. On this day particular the baby was agitated more so than in the past. It seemed as if nothing was going to sooth this baby. We had given all the medications we could, fed him, changed him, rocked him, even moved him to a secluded room for minimal simulation, and still nothing would suffice. As it can be difficult trying to comfort and care for a baby going through withdrawal in the back of my mind I knew there had to be something out there that could sooth him even if it was just for a little while. So I started out by instead of rocking him sitting down, I rocked him

LABORATORY: O2 saturation on 3 liters on ___ [DATE] was 92%. On ___ [DATE] on 2 liters 94%, and on 2 liters on the ___ [DATE] (at) 97%. Telemetry on ___ [DATE] shows normal sinus rhythm. Patient off the ward very often (and) smokes. The patient was discontinued from telemetry.

the interviewer should consider that John is new graduate new nurse; the only experiences he had a clinical rotation under instructor supervision. The questions should be direct and precise; moreover, highlights any achievements during clinical rotations experience. John should be asked about his qualification for the job and requirements that matches relevant skills (Burke, 2014). It is essential to focus on John’s interests in the particular job and his abilities to move forward in caring professional attitude to provide the ultimate patient care.

Nursing is a unique profession which is built upon theories that guide everyday nursing practice. According to Taylor, Lillis, & Lynn (2015), “Nursing theory differentiates nursing from other disciplines and activities in that it serves the purposes of describing, explaining, predicting, and controlling desired outcomes of nursing care practices” (p. 27). Many nurses may unknowingly apply a theory or a combination thereof, along with critical thinking to get the best outcome for a patient. Theories are used in practice today because they have been supported by research and help the profession uphold its boundaries. Most nursing theories consist of four concepts which are the patient, the environment, health, and nursing. Each patient is at the center of focus and they have the right to determine what care will be given to them using informed

The nursing process and Watson’s theory both provide a framework to promote critical thinking by the nurse so conclusions can be made and they can have a caring moment. This is completed by “assessment, plan, intervention, evaluation.” (Nursing Theories, 2012, p.4) The theory is well organized, not complex and “can be used to guide and improve practice.”(Nursing Theories, 2012, p.4)

There are many reasons why it is important to keep patients mobile, even when they are in a position where extended activity is not feasible. Mrs. Simmons is at risk for many health ailments because of her immobility, some of which include pressure ulcers, muscle weakness, and Atelectasis. Her attending nurse must keep these in mind when talking to her about repositioning and also use the proper movement techniques and assistive devices. Not only does the nurse have to keep Mrs. Simmons from developing health