My management experience was a half-day, during which almost all the student nurses had two patients. In total, I was managing 12 patients.
1. Colby was assigned K.M., a 58-year-old female who was admitted on 11/7/16 for pneumonia. Her code status was not determined and there was no discharge plans. Colby had the opportunity to teach this patient about reducing her current habit of smoking two packs of cigarettes a day to zero packs a day. Additionally, he set up an IV antibiotic for this patient. Colby’s second patient, J.H. was a 61-year-old male admitted on 11/5/16 for sepsis. For this patient, Colby was able to perform an Accu-Check to determine his blood glucose and administer insulin as required. He had no discharge plans at the time
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Maddie’s first patient, W.W., was a 68-year-old male admitted on 11/2/16 for hospital acquire pneumonia. The patient did not have a code status. The patient received a chest x-ray and a sputum culture that resulted as gram positive, confirming his pneumonia. Maddie experienced a rapid response initiated for this patient when he become dsypneic and tachycardic during a transfer. Upon her report of his integumentary system assessment to me, Maddie noted that the patient had a small knick on his chin from when his son had shaved his face the day before that was still bleeding due to the patient receiving aspirin daily. The possibility of discharge was being discussed but was most likely hindered by the need for a rapid response. Her second patient, B.S., was a 41-year-old male that was admitted on 10/30/16 for an upper gastrointestinal bleed. Upon report Maddie found out that the patient had vomited blood the day prior. An esophagogastroduodenoscopy was ordered for the patient, it showed that he had an esophageal ulcer and a CT scan of his abdomen showed chronic liver insufficiency. Maddie noted that the patient’s hemoglobin and hematocrit were low as a result of this …show more content…
Sam was only assigned one patient, D.H., a 41-year-old male admitted on 11/7/16 for end-stage renal failure. The patient’s code status was not determined and there were no discharge plans. D.H. was an admission, therefore Sam was able to experience the admission process and how a patient might adjust to their first few hours in the hospital. She reported that he seemed to be slightly anxious and afraid of the whole process. Sam was administering medications on Tuesday and was able to push an IV med for the first time. Additionally, the patient was a dialysis patient, so she was able to accompany him to his peritoneal dialysis treatment that
Today’s clinical experience truly affected me in multiple ways. I went into this day with an open mind, and was pleased with the patients and the way I was able to conduct myself. This clinical affected me because throughout the day I felt that I experienced many emotions. A few times during my day I did have to fight back tears. I felt I had this emotion because some of the individuals expressed how they wanted to get better in order to get home to their families.
During my morning rounds I began my assessment of Mrs. M., and I noted that she had shortness of breath and she was making gurgling sounds. I immediately auscultated her lungs and noted bilateral wheezing throughout all fields, her heart was irregular and rapid and she had 2plus pitting pedal edema. I noticed she had an IV running at 125ml/hr, which I quickly stopped. The patient did not have orders for IV fluid there was only an order to KVO. I raised the head of the bed and paged respiratory to the floor.
She should have not made the assumption that there were no doctors available until 2100 hours. Instead, she should have sought clarifications on whether the Emergency Department (ED) doctor was prevailed on examining the patient. She should’ve escalated concerns to the Clinical Nurse Manager (CNM). She also should’ve not made the assumption that the administration of antibiotic would improve the patient’s condition and “recover” her from the “red zone”. Finally, she should have documented her observations and implement a care
My colleague and I received an emergency call to reports of a female on the ground. Once on scene an intoxicated male stated that his wife is under investigation for “passing out episodes”. She was lying supine on the kitchen floor and did not respond to A.V.P.U. I measured and inserted a nasopharyngeal airway which was initially accepted by my patient. She then regained consciousness and stated, “Oh it’s happened again has it?” I removed the airway and asked my colleague to complete base line observations and ECG which were all within the normal range. During history taking my patient stated that she did not wish to travel to hospital. However each time my patient stood up she collapsed and we would have to intervene to protect her safety and dignity, whilst also trying to ascertain what was going on. During the unresponsive episodes we returned the patient to the stretcher where she spontaneously recovered and refused hospital treatment. I completed my patient report form to reflect the patient's decision and highlighted my concerns. The patient’s intoxicated husband then carried his wife back into the house.
When I was working as a bedside nurse in the Emergency Department, in one of my duties I was not satisfied with the treatment plan made by a resident doctor for XYZ patient. He entered intravenous KCL (potassium chloride) for the patient. The purpose of that medication and its dose for that patient was not clear to me. I assessed patient history and came to know that a middle aged patient came with the complaint of loose bowel movements, vomiting, and generalized weakness. His GCS (Glasgow comma scale) was 15/15, looked pale but was vitally stable. I exactly do not remember about his previous disease, social or family history but I do remember that he was there with his son. According to the care plan, I inserted intravenous cannula, took blood
During one of my rotations, I was assigned a young adult patient who had run out of insulin and had been admitted to the hospital following a Diabetes Ketoacidosis (DKA) episode. I realized that my patient was probably torn between buying insulin and buying healthy food because her chart showed several admissions in the past following the same problems. This particular patient was in her room, isolated in a corner, and she was irritable. As her student nurse, I was actively involved in her care; I was her advocate for the day. The patient lived with her single mother and worked at a fast food restaurant. Since this was my first time dealing with a patient with DKA, it became a definite challenge for me.
Reflection is turning experience into Learning. Reflection is a conscious, dynamic process of thinking about, analysing, and learning from an experience that gives insight into self and practice.
My clinical week was emotional and physically draining this week. I enjoyed being the lead on Thursday because it gave me the opportunity to stop and observe. The nurses and the CNAs were very stressed out, and I clearly saw the effect on the patients. For instance, one of the CNAs asked me to help her with an occupied bed change. I was excited. However, she kept passing a bunch of comments of how hard nursing is and how she did not want to be old. I did not acknowledge any of her comments. Perhaps she thought she could express herself (as a result of her stress) in front the patient since the patient was non verbal and could not understand. I felt very bad. I was very uncomfortable and sad. For me, it doesn’t matter whether the patient
My reflection report will be on how to teach a clinical skill, which could be done either by the simulation training “workshops” or in hospital settings. Any reflection report is basically an evaluation of a person’s records of certain findings about certain topic or experience
The patient was transferred into my care via the Emergency Assessment Unit for Surgical Patients (EAUS). I was given handover by the charge nurse who has already pre-a...
On my first day of week three clinical at 0830, client W and I were on our way to the dinning room and client B asked me to put his jacket on, so I told client W that I would meet him in the dinning room. After I helped Client B, I was on my way to the dinning room and nurse A told me that client W was experiencing difficulty breathing and we needed to give him his 0900 inhalers earlier. He was having audible wheezing and rapid respiratory rate. Therefore, we had to give client W his inhalers, SalbutaMOL Sulfate, which is a bronchodilator to allow the alveoli in the lung to open so th...
I believe placing student nurses in the clinical setting is vital in becoming competent nurses. Every experience the student experiences during their placement has an educative nature therefore, it is important for the students to take some time to reflect on these experiences. A specific situation that stood out to me from my clinical experience was that; I didn’t realize I had ignored the patient’s pain until I was later asked by the nurse if the patient was in any pain.
Reflection is an essential component in the development of professional competencies and critical thinking skills in nursing practice. Reflection in the context of nursing, has been described as a way of exploring an experience in order to look for the prospect of other explanations and alternative methods to doing things. It is through reflection that one can evaluate and identify their strengths and weaknesses to encourage both personal and professional growth and development. In this paper, I will be discussing how student nurses learn and develop from reflection, the emotional response and self-awareness as a nurse, and the appropriate way to reflect as a nurse.
This week’s clinical experience has been unlike any other. I went onto the unit knowing that I needed to be more independent and found myself to be both scared and intimidated. However, having the patients I did made my first mother baby clinical an exciting experience. I was able to create connections between what I saw on the unit and the theory we learned in lectures. In addition, I was able to see tricks other nurses on the unit have when providing care, and where others went wrong. Being aware of this enabled me to see the areas of mother baby nursing I understood and areas I need to further research to become a better nurse.
This reflective essay will discuss three skills that I have leant and developed during my placement. The three skills that I will be discussing in this essay are bed-bath, observing a corpse being prepared for mortuary and putting canulla and taking it out. These skills will be discussed in this essay using (Gibb’s, 1988) model. I have chosen to use Gibb’s model because I find this model easier to use and understand to guide me through my reflection process. Moreover, this model will be useful in breaking the new skills that I have developed into a way that I can understand. This model will also enable me to turn my experiences into knowledge that I can refer to in the future when facing same or similar situations. Gibbs model seems to be straightforward compared to the other model which is why I have also chosen it. To abide by the code of conduct of Nursing and Midwifery Council (NMC) names of the real patients in this essay have been changed to respect the confidentiality.