Reflection On My Clinical Experience

Clinical day started slow, I was a bit anxious about waking my patient up that morning but I knew I had to go in. I woke him slowly and took his vitals and proceeded with my assessment. As I assessed my patient, his wife came in to his room and I introduced myself. During the morning I found out that my patient was being discharged. Before discharge, my patient was going to be fitted for a LifeVest.

There was no need for this procedure at this time since Sue did not need suctioning. She was still mobile and was not showing the signs of needed to be suctioning. I came to this conclusion that she did not need to be suctioning based on his careless response. “I just want you to know what we’ll be doing when your condition gets worse” (16). Suctioning can be painful for the patient especially if the pressure setting are too high. During my time in the hospital rotations, respiratory therapists and other staff always communicated what they were going to

Looking back on this clinical day, I would state that I effectively met my overall goals for the day - Safely and efficiently administer medication, enhance my nursing/CNA skills, and determine how to implement infection control into a health care setting. During medication administration, I did come across some difficulties – dropping a few pills and being unsure of the medication in the med cart – but that did not prevent me from safely administering my medication. I completed the three medication checks, while ensuring that I recognized the six medication rights. This experience sanctioned me to acquire comfort in passing meds, and permitted me to see how to prioritize time when a patient takes numerous medications. Alongside medication

Overall, I do not feel like a great deal of improvements needed to be made in my delivery of care. I felt comfortable communicating with my nurse and the health care team, assessing the patient, and educating family members. My nurse did not feel well, so she started off the day a little on edge and irritated, but through showing that I was willing to assist her in any way possible, she was more than willing to assist in my learning. I could improve my delivery of care by asking my nurse more questions and looking up more information in the patient’s chart. I noticed that the layout of the NICU was quite different than last week, so I did not have a computer to look up patient information, but rather, I looked alongside my nurse.

For this reflection instead of focusing on a specific situation I am going to be reflecting on my feeling throughout the shift. Going into the clinical rotation I was really looking forward to a experiencing the new pace of the surgical floor. Last semester I was on Medicine A. While I doubt I want to work full time on medicine I did fine it as a very easy way to transfer from Long Term Care to the Hospital. I found that it really taught me to prioritize and spend my time wisely while on the floor, because even through it was a slower pace, there was a lot to complete each shift. It also helped me to work on creating therapeutic nurse-client relationships not only with my assign patient but also for the patients I was helping by answering call bells. I found all of this gave me a good background to go into the surgical floor. Even from the moment of report I could tell the more serious feel from how the nurses went through report, it was quick, informative and effective. I was nervous about meeting my co-assign because I did not ever really have a good experience with them on Medicine. However I found my co-assign this week was approachable and answered all of my questions and even helped explain the differences between how she does

On my second day of clinical experience this week I focused a lot on time management and documentation for a full patient load, and also on the admission and discharge process. After taking report on all three of our patients, I began my initial morning assessments. It was clear that our 8-year-old post-operative appendectomy was ready to be discharged. My priorities were assessing her incision sites and ensuring the presence of bowel sounds, as well as making sure she did not have a fever and was tolerating a general diet. After completing my assessment and documenting in the computer, we

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.

How effective was the hand off for preparing to assess the patient? Are there additional questions that you would have liked to ask your nurse practitioner?

I felt that I asked the appropriate questions to get information about the patient’s current illness. Also, I felt that I carried out the doctor’s orders in a timely manner.

Week three in clinical was difficult for me, I had a great experience overall but I hated seeing and holding a baby that had passed away at 21 weeks. To know what the family could possibly be going through was heartbreaking. I wouldn’t exactly know what to do if I was with the patient and her family exactly. I do know that I did place her in the room when she was admitted to triage. I do feel good about seeing the scenario play out, while being a student rather than being in the field alone. Other than that I was able to see the beginning stage of labor as well as a C-section. Everyone was so bent out of shape on making sure I eat and that I don’t faint, but it seriously wasn’t bad. As a matter of fact I was too intrigued with the mother rather

I arrived at clinical 0630 and picked up patient information the morning of. I reviewed all assigned diagnoses, medications, labs, and orders with my assigned students, and we discussed our plan for the day. We both took report from the patient's nurse and then Elizabeth presented at preconference. Kala shadowed the Nurse Lead and I helped Elizabeth with brief changes, pericare, and vital signs. I continued to check on both Elizabeth and Kala throughout the day. Last, lunch and then post-conferance.

Throughout most of the shift, my nurse preceptor and I were in the patient’s room either evaluating her and the fetus, performing exams, taking vital signs, administering medications and fluids, charting, or reading the fetal monitoring strips. We also kept in regular contact with the physician to keep him up to date on the patient’s status and to receive new orders. We also spent a lot of time talking to the patient, her mother, and her boyfriend. They were concerned for the status of the mother and the baby. We explained to them that both the mother and the baby’s heart rate was high and their goal was to decrease them both. In addition, my nurse preceptor explained how we were administering Tylenol and amoxicillin to reduce the fever and

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 was my last day in the hospital I dedicated to observe the skills and procedures performed in the emergency room after the doctor evaluates and places medical orders. I could evaluate the electronic medical orders, preparation of medicines, the use of pixie for dispensing the necessary drugs necessary for dispensing pixie and control them. I was in the guidance given by the nurse to the patient prior treatment, patient identification, how the EHR is used, also observe the canalization, blood test, the placement of cardiac monitor and oxygen mask. How patients are placed according to their condition whether in the general observation area, in cardiac, CPR or OB /

I was working night shift in a level 3 Neonatal Intensive Care Unit facility and my 10 days orientation was over. It was my first day working without my preceptor. Since I was a new staff, the charge nurse allocated two stable babies for me. One was Baby Zahra, a 33 weeks preemie, on room air, with nasogastric tube, with peripheral intravenous line to keep the vein open and feeding with expressed breast milk every 3 hours. I started my shift with a bit of nervousness knowing that I am on my own and wondering if I can remember everything that my preceptor had taught me during our orientation. I started my assessment and observed Baby Zahra to be pale, her skin was slightly mottled. I checked her vital signs. The cardiac monitor showed that she