Personal Narrative: My Clinical Experience

Day two: on arrival to 3N at 530 am our clinical instructor handed as the RN patient report to see if anything had changed from yesterday. My second day was less stressful than my first because I had an idea of what is required. I was assigned to stay the same patient. I was more comfortable providing patient care and medication administration without feeling much pressure because I got to review my patient’s medication over the night before my second day. On my second I was also a little bit more settled than my first day, I was able to spend more time caring for my patient. I had completed safety check on my patient and witnessed the dose of insulin and heparin with another RN nurse before administering, double checking medication and

charting.
Everything went perfectly with today’s clinical experience.

Something that comes to my mind in today’s clinical experience was the importance of maintaining a sterile technique and patient safety. I had a lot of experience in today’s clinical experience; I had a three-way Foley catheter insertion on a 91 years-old male patient who had colon surgery with a history of Arterial fibrillation. The three-way Foley catheter was designed for the patient who develops blood clots or infection in the bladder, to provide continues bladder irrigation. Of course, the patient was not able to void urine for longer hours that’s why he had this order. Since the patient was combative/agitated and has an enlarged prostate the insertion processes was very difficult, plus it was uncircumcised patient and it was a phimosis (ability to retract the foreskin) urinary meatus. I had to use a blind insertion, while two RN nurses and one nurse tech were holding the patient for me because the patient was very agitated and trying to fight and get out of the bed. But, I had a successful insertion and the patient was able to void significant amount of urine following the insertion and able to calm down and sleep. I thought a Foley catheter insertion in a male patient is easier than female, however, I found out if the patient is old and has an enlarged prostate Foley insertion on a male patient is way more difficult than a female patient. Something I had noticed different than regular Foley catheter

insertion the catheter size was 20G three-way lumen and I had to inflate the balloon with 30 ml of normal saline to remain securely placed in the bladder.
I had also a short line peripheral IV catheter insertion on a patient for an IV infusion therapy. I assess the patient need for vascular access and choose the right device that is the best chance of infusion for the prescribed therapy for the required length of time. Check the patient MAR using two patient identifiers (name and date of birth), check for patient allergies before administering the therapy. I was able to insert the IV catheter successful on a patient in my first trial. Something I found out, it feels way different when I insert on a real patient than the IV insertion we had in simulation lab on the manikins. In today’s clinical experience I had also an opportunity to see a paracentesis procedure with a patient history of liver failure. It was unbelievable procedure they had to hook the patient in the suction and removed about 7500 ml fluid from the abdomen.
In general, I had learned a lot of things in today’s clinical experience. Moreover, I have completed several things in today’s clinical experience, including a three-way Foley catheter insertion on a male patient, short line peripheral IV catheter insertion, and patient discharge summary. I was using the skill and knowledge from my previous coursework and simulation experience I had to accomplish all of the above things that I had performed in today’s clinical experience. It was a great day. My goals for the next clinical rotation are performing wound care and Foley catheter insertion on a female patient (if possible).