PEDS clinical reflection PDF

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After clinical reflection journal...

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As I reflect on my experiences in the NUR4358L_L01 pediatric course at Tallahassee Memorial Hospital on the 2nd floor labeled as the pediatric floor. I start to remember how every morning when my peers, instructor and myself would all meet to discuss the plan for the clinical day that was ahead of us. Other meetings/groups I participated in during clinicals were change-of-shift reports. Hand off reporting during shift change is a critical process that is crucial in protecting a patient’s safety, it also supports the transition of significant information and continuity of care and treatment. A misconception of mine about pediatric patients is that they don’t have chronic illnesses. There are many children with chronic illnesses that are detrimental to their health. Most often when I see children they are well, playful, and full of joy. So, to see children the same age as many of my cousins undergoing the effects that these illnesses have on these individuals was really a culture shock and devastating. This made me even more grateful and thankful for the conditions my loved ones are in. It seems as if most pediatric patients present with conditions that were present are hereditary and present since birth. It hurts to not be able to fully understand or to only be able relate to their hurt to a certain extent. As a pediatric student nurse it’s not uncommon to often visualize the fear, sadness, and emotional pain of children along with their parents and/or guardians. I can grasp that this may be emotionally draining for pediatric nurses to watch their young patients endure multiple surgeries, frightening treatments or painful symptoms. Too add, it can also sometimes be frustration attempting to relay messages or explain things to the child’s guardian. Being that the parents often feel angry and helpless when their child is ill, and they might take out their frustrations on you as the nurse, but it’s important not to take these situations personally. Encountering situations like these can cause the student nurse to become frustrated or more nervous while performing care for this patient although I may be

competent in specific information or skill. Also, The role of the nurse working with children is to be an advocate and source of support for the child and their family. The pediatric nurse goal is to provide comfort and security to children. The pediatric nurse must work on building rapport, offering emotional support, handling difficult family members or situations, making enough time for self-care, and managing time effectively. Initially, in comparison to the medical surgical clinical: the pediatric floor was quiet, the nurses were more social, the floor was a lot more decorative and animated. At first, I was nervous about the pediatric floor because with the pediatric patient you are required to have a different approach, know different information regarding children specifically such as developmental level, vital signs, and genetic disorders, and how to engage with parents. The nurses on the pediatric floor are much more willing to help and engage with the nursing students; most of the nurses are open to providing new opportunities, answering questions, and guiding us. This became more evident the more we spent time on the floor. The longer we were present in the facility I became less anxious as I became more oriented to the floor. I have not encountered any similar situations in the past. Most of the patients I’ve cared for were geriatric patients. There’s many things that we could have been exposed to such as communicating with parents regarding care of their offspring in OB but we weren’t granted the opportunity to go to OB clinicals because of the pandemic, Covid 19. Most times with the patient's I cared for in the Medical Surgical Clinical they didn’t have visitors. But, when caring for children often the parents are more engaged with the situation than the child. The parents may have a lot of questions and concerns that they may express. As a student nurse it's critical that I provide holistic care which includes caring for the parent’s family as well as the child. Holistic care is complete or total patient care that considers the physical, emotional, social,

economic, and spiritual needs of the person, his or her response to illness and the effect of the illness on the ability to meet self-care needs. Having the opportunity to work as a pediatric nurse and observing the registered nurses interact and care for the children and their family was very beneficial to my learning and future as a RN. Clinical experiences are a reliable way to monitor and test a nursing student's knowledge and competence.Clinicals reveal that studying, reading, and watching videos can only help you so much as you work to become a nurse, for example; a student may have read that a patient with sickle cell anemia requires oxygen but without clinicals or skills practice you may not properly know how to start oxygen and/or monitor it with real observation and implementation. I realized this recently when we were required to perform in a simulation this previous week. The only advantage separate from the simulation, during clinicals you are able to ask questions and seek help. It’s very different from me as a member of the general public because when you speculate the patient, it's like you are doing so through a microscope. From this experience, I learned that everything does not always go as planned. Nurses should always have a plan b for when these complications occur. There were many times when the unexpected had occurred and I had to adjust to the situation such as; having two different patients on consecutive clinical days resulting in double clinical work on top of the work I had planned for the upcoming weekend as well as studying and having a patient on droplet precautions. This made it clear that as a nurse I will have to be content with change. As a nurse anything can happen and it’s the role of the nurse to be prepared and act fast to provide care to elevate the patient to their own individualized optimal health status. I became actively involved with client’s at the facility during vital signs, physical assessment, and rounds. Aside from this, something different and interesting I got to experience

with one individual patient is I got to go with the patient to get an magnetic resonance imaging. I was very nervous. I didn’t know what to expect, not to mention that this particular patient was prone to seizures. For a moment the patient and I were alone without any other healthcare personnel. Although, I’ve read how to implement seizure precautions. It was frightening thinking that a seizure could occur with no other nurses or my instructor present if guidance was needed. Once the patient was getting the magnetic resonance image procedure done I sat in a room and organized myself to perform care for the patient, make a schedule, and review care for a patient who has seizures. I didn’t voice my concerns to anyone so there wasn’t anyone to intervene or respond to this experience. A nursing skill that was very fascinating was during the last day of clinical at Tallahassee Memorial Hospital was caring for an infant and I’ve never cared for an infant prior to this opportunity. Taking vital signs for this patient was very different for this pediatric patient compared to the other pediatric patient I had been assigned to. A skill I need to work on in the future is obtaining an infant’s vitals signs fast and efficiently. What I'll do differently next time I obtain vital signs for an infant is make sure I hold the leg the blood pressure cuff is on while getting the blood pressure so that the machine will read faster and will obtain the most accurate blood pressure. I also think I need additional practice caring for an infant. For the majority of the clinical day I had children that were in grade school. I need more experience providing assessment and getting vital signs of patients within this age group. This was another moment where I read how to perform a specific task, it was more complex trying to actually do it during clinicals. During the entire clinical experience I did well communicating with the different patients according to their age and development level.

By the end of clinical I was no longer nervous when arriving and became more confident while providing care. This floor was an easy floor to transition to because most nurses were nice and helpful. I would like to have more experience working on the pediatric floors because as a nurse I was to be competent in all forms of care including: different disorders, age groups, and ethnic backgrounds....