The direction for the journal and questions to answer is listed below. APA format 2 pages. Keep it simple. Reflective writing on clinical experience.
Follow my thoughts and my day for clinical below to answer what is needed for the journal. Come up with what’s related with nursing to answer too
-Time management is a factor caring for 4 patients that I struggle with during clinical.
-Also ethical issue, I cared for a patient with sepsis from surgery for lumbar stenosis. He also had c. difficle, leukocytosis, and acute renal failure. Patient had mental altered consciousness throughout the shift. There were CNA, nurses, and charge nurse going in and out of the patients room. He seem to be declining but still trying to recover. I found out at the end of the shift that his family wanted to provide palliative care/comfort care. All his treatment were removed. I felt like I spent a lot of time with that patient and every patient has the right to make the decision if they want to live or die, but it’s hard to see someone you care for and could recover to decide otherwise, or his family decided? Patient passed away the next day with the comfort care.
¬ Performed head to toe assessment: neuro check, blood pressure, HR, RR, temp, and SPO2.
¬ Performed a condom catheter for patient who fractured 4 ribs and is anuria, but afraid that he is incontinence.
¬ Removed Purewick and replaced it due to incontinence.
¬ Administered OxyContin for pain management for patient that underwent back surgery.
¬ Remove IV from patient’s right foot.
¬ Check blood sugar level for Diabetes Type 1 patient on NJ feeding tube. Administer insulin injection.
¬ Changed tube feeding and Peptamen AF formula.
¬ Priming IV tube, administering 0.9% sodium chloride, piggy-back azithromycin; and administer Tylenol (narcotic makes patient paranoid) and synthroid for patient with history of hypothyroidism, hypertension, lumbar stenosis.
¬ Assist with removal of rectal tube for patient with C. Diff. Patient was distended and unable to pass flatus. After the rectal tube removal, patient had one bowel movement, mucus and serous.
Journal Entries
The objective of keeping a journal is to analyze and reflect on the student’s learning experiences through writing. Journaling provides an opportunity to reflect and synthesize clinical and theoretical knowledge obtained during the clinical experience. The journal entries should be a minimum of two pages each. The student should choose a challenging or problematic situation to get the most out of the journaling activity. Research on stress management has shown that for many people, journaling helps them reflect more objectively about a stressful or personally difficult situation thus reducing the stress and tension associated with the experience.
Expectations:
1. Students will be required to submit 2 journal entries for this course. Journals are to be completed as soon as possible following the clinical experience and turned in within 1 week of the experience. Each journal assignment will be graded as satisfactory or unsatisfactory.
2. The format of the journal entry is structured to develop the student’s critical thinking and own voice through reflection on the student’s professional growth as a novice clinician in the following areas:
a. Discuss a learning experience in a clinical situation, the student’s interventions and the client or family response to the student’s interventions and therapeutic efforts. This area may also include a staff situation or others members of the interdisciplinary team involved in the care of the patient/family. (MD, LVN, PT, RT, RN, Lab etc.)
b. Describe thoughts, feelings and reactions to the clinical situation
c. Identify what resources the student accessed in resolving the clinical dilemma or problem, steps the student took to resolve the clinical or professional problem and what the student learn about themselves, the situation and the student development as a professional nurse that the student would apply if the student encountered the situation again and any remaining questions needing answers.
3. The student will need to include a minimum of one situation involving a staff situation which may include physician, nurse, or other member of the interdisciplinary team.
4. A clinical problem can include a deficit or difficulty in applying one or more steps in the nursing process, written or verbal communication breakdown, barriers or obstacles in development of a therapeutic relationship with the client or family, ethical dilemma, challenges in assertive communication, etc. Journal assignments will be evaluated based upon how well the student identifies, describes and synthesizes all three areas delineated below.
(A)
Problematic patient/family or staff situation
(B) (C)
Personal Thoughts/Feelings Resolution and Learning
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