Reflection On My Clinical Presentation

The event that stood out the most to me during my clinical experience this month was when my assigned patient and her family began asking questions about the care the patient was receiving and other non-medical related questions.

My first encounter with a Certified Registered Nurse Anesthesia (CRNA) was during my undergraduate nursing OB/GYN rotation. I was impressed with the CRNA when she placed the epidural to the patient in labor. I remembered patient had difficulty staying still due to the contraction, but the CRNA took her time to explain the procedure while comforting the distressed patient. Once the epidural was in placed and the medication started working, I could tell the relief the patient experienced. I realized then that a CRNA goes beyond the delivery of anesthesia, pain management and monitoring of patients. Thus, obtaining this degree will prepare me to ease the patient’s mind through education, pain management, monitoring, experience and compassion.

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.

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

Throughout my clinical experiences, there have been quite a few circumstances I have been placed in that have remained with me whether good or bad. All of them have been learning experiences for me whether it is how to improve and to do better next time from a mistake, for me to learn that this is or is not how a patient should be treated, how to handle family situations, and many others. One experience that I was able to participate in that will remain with me because I had not experienced this before was during my critical care rotation in the fall of 2015. This patient was dying and we were implementing comfort care for him.

I will look to the feedback and criticisms given in order to improve on my presentation and communication skills for the future.

This paper explores the scenario of a client and looks at the presenting problem from an ecological and strengths perspective. It will also explore advanced clinical skills, intervention strategies and ethical dilemmas encountered. Methods for evaluating progress will be discussed within the social context of the case. Termination and follow-up approaches, and any ethical dilemmas will be included. Any problems with oppressed populations will also be discussed. Finally, the limits of the chosen model and limits of the practitioner, evolution of client and practitioner identities, any ethical or social justice issues for the agency, and an evaluation of the practitioner’s effectiveness will conclude the paper.

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.

It is important to be objective when receiving feedback to possibly consider room for improvement. Sometimes you don’t see the errors or mistakes you missed; by receiving feedback you might be able to catch the errors or mistakes because the person that gave you the feedback caught. The one thing you need to consider is that all feedback may not positive. You need to keep an open mind and take into consideration that persons thought.

A couple of years ago, my mom got a bellybutton pain in her lower-right side of the abdomen. It was an intense pain which moved all around her belly. She decided to ignore the pain, thinking it could be something temporary. Days went through and nothing could relieve the discomfort she felt. My dad decided to take her to a private doctor right away. The doctor had her do some blood tests accompanied by some others. When the results were ready the doctor asked us to take mom immediately to the hospital. He said something related to surgery and I lose control on myself. We had never been as scared of surgery as this day. We knew this kind of surgery was not as risky as others. The problem was hospitals in Honduras. Doctors back then did not care about the patient. Patients in the hospitals would get their wounds infected and they would die. I lacked trust in the abilities of the doctors. Not because they missed the knowledge required in doing this, but their interest in the patient was none. They knew the government was going to pay them either way. Therefore, they mistreated some patients. My mom received a

The feedback I received was varied. The planning, structure and content of the presentation was good and well structured. Based on this feedback I was happy with the flow and how the presentation came across from this perspective. As a result I don’t think I would change how I went about creating the presentation. I do a lot of planning and project work as part of my day to day job so structuring it I found quite

A twist on the "patient's perspective" approach is to describe a time when medicine failed to save or heal someone close to you. The purpose of this tactic would not of course be to rail against the medical profession, but rather to show how a disappointing loss inspired you to join the struggle against disease and sickness.

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

Happy new semester! Sorry I was unable to go to the clinical symposium, but I was working the night shift the day before and the night of the symposium with no offers for coverage. I am still working as a Resource Team RN/Nursing Supervisor while all of my hospital appointment paperwork goes through for Frisbie. I will be sharing a panel with Tyler Edwards at Family Care of Farmington! He has a full panel and still works as a hospitalist (14 weeks next year!), so this way we will be able to take more acute care visits and also add to the panel with me as the PCP.

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.