RJ3 - This is for clinical evaluation PDF

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This is for clinical evaluation...

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George Brown College, School of Nursing Practical Nursing Program Reflective Journal Recordings

Student _Melanie Lingat_

ID# _100969141_

Clinical Instructor _Maria Isorena_ Date _______________

Professional Standard Select 1 professional standard from CNO professional standards with 1 indicator that relates to the described event (E.g. Accountability, 5a: found in clinical performance evaluation tool) Ethics -` creating environments that promote and support safe, effective and ethical practice LEARN framework: Look back, elaborate and describe: Look back at a recent meaningful and relevant practice event that you personally experienced within

the last 2 weeks. Briefly describe what happened: experience, event or change in your practice that was significant to you. Analyze the outcomes: Identify key issues then compare and contrast the situation with what you have learned in nursing. Use supporting scholarly nursing literature. Revise the approach: Based on the analysis, decide what will you continue to do and what you will change in the future. New perspective: What is your learning plan with defined actions or strategies for the practice improvement? Look back: Failure to identify options to resolve ethical issues Elaborate: In my first day of simulation, I reviewed each scenario so I could have an idea of what to expect when going into the simulation room. I leveled each situation from most difficult to least difficult so if I had the chance to pick which situation to do, I’d know which one I’m most competent in. However, when we were picking which scenario we wanted to do, the scenario I wanted to do was already taken and I got the most difficult situation. It didn’t really matter what scenario I had, because I knew what all the situations were and what to expect. Prior to my simulation, I knew my patient was short of hearing, and suffered from Alzheimer’s Disease. I expected my patient to be in bed sleeping, since the scenario starts from a 7am shift. Before I entered the room, I heard noises from the room, so me and my classmate Palden, who was my partner in the simulation, went in the room to see what was happening with the patient. We found the patient to be out of bed, throwing everything everywhere, and not listening to me or Palden. This made me realize that I shouldn’t expect anything when I’m in practice, and that anything can happen. Analyze: My issue in this case was failure to identify options to resolve ethical issues (CNO Practice Standards, 2002, p.6) which is important to know when taking care of different patients. What my clinical instructor told me was to consider all the factors of my patient, and to be very observant of everything in the patient’s room in order to make an ethical action of how to deal with a patient. What I had done was tell the patient to calm down and say “everything will be okay”. I also focused on taking the patient’s vitals first instead of acknowledging that my patient did not know who I was and what my patient was doing at the hospital. I knew that my patient wasn’t in the right state of mind, but I didn’t realize that my patient would not listen since I am a stranger to her. My clinical instructor also told me I should look around the room for clues on how to treat my patient. In my patient’s room, I saw that she had old pictures laid out on her bed and she only listened to old music which came from an old radio. This patient also had a toy baby that she liked to play with, which is what she was looking for when Palden and I came into the room. My patient also left the room looking for this baby, in which I replied, “there’s no baby”. This was an action that was not suitable in this scenario, and I realized this when my patient started to act more aggressive towards me. The vitals machine also scared this patient away, and I kept bringing this machine towards her which is the opposite of what I should be doing when trying to calm my patient down. Revise: When dealing with a complicated patient for the first time, I will consider everything about the patient and look for any clues that could help me clam down the patient. In this case, I would play along with my patient and help her look for the baby. I would ask her about the baby and even the pictures that she had on her table. This will get my patient to be calm and will help her to be more comfortable with my presence there. Looking around the room and finding out what objects make the patient more aggressive is something I’d look for as well. New Perspective: From this point onwards, I know that expecting the unexpected is what I should get used to, especially going into different units and fields of nursing. Patients aren’t all the same, and as a nurse, you have to be mindful of clues and options around you to help you take care of certain patients. I need to know why patients are acting the way they are, and that there’s a reason why they’ve been admitted to the hospital.

Self- Evaluation: Outstanding, Competent, Acceptable, Unacceptable, Unsafe: Unacceptable S121Reflect i v eJ our nalRec or di ngf orALLSemes t er s

Rev i sed20182019

George Brown College, School of Nursing Practical Nursing Program Reflective Journal Recordings Clinical Instructor’s feedback and recommendations related to your self-reflection and your performance in clinical:

I have reviewed the Clinical Instructor’s comments _____ (initial) Over the term, the student should address all competencies from the semester clinical evaluation tool.

S121Reflect i v eJ our nal Recor di ngf orALLSemest er s

Revi sed20182019...