Describe a nursing situation you have encountered in your clinical placement. The situation can be a specific physiological patient problem, a situation involving a patient’s family or a staff member. It can also be a description of your role in problem solving or of an ethical issue you encountered in practice. The key is you need to have been directly involved in the event. You must also maintain confidentiality of your subjects at all times, that is – do not identify the patient, staff or hospital site.
Describe your relationship to the patient, staff member, person at the time you noticed the situation. That is: was it your patient, had you seen the person before, the quality and length of your relationship.
Consider experiences you have had that helped you provide care in this situation. Describe your formal knowledge (physiology, communication skills etc); previous nursing experience with a similar problem; as well as any personal experiences that helped guide you as you worked through this situation.
Describe your beliefs about your role as the nurse as you were working through this situation.
Describe any emotions you had about the situation.
To have Clinical practice has been a good experience and has made huge impact towards my approach to the patients and their care management. During my clinical practice, not only I am able to develop a sense of the patients but also learning from the patientâ€™s experiences.
During my first clinical practice, I was assigned to provide nursing care and management to Mr. JH. A wonderful man with lot of knowledge and experience of life. My RN was with me and I had the opportunity to introduce myself to Mr. JH as student nurse. He asked me where I was up to my studies and wants to know about my learning goals and plans.
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After spending few moments with him, I was able to understand that Mr. JH was not happy with certain level of care and treatment. I came to know that Mr. JH had certain operation procedures which have made him very discomfort and pain. As I was helping him with his morning tea and toast, Mr. JH started coughing. Immediately I got in touch with my RN and informed her about the situation. She came and saw Mr. JH and encouraged Mr. JH to cough out the food. He vomited some food and seemed to bit comfortable. The RN told me to stay with Mr. JH and told to observe any change in his condition. Even though I was taking to Mr. JH and trying to make him comfortable, I can see him coughing in-between. After few minutes I noticed an irregular pattern of breathing in him. I immediately got in touch with my RN. By the time she came. Mr. JH was not responding well. We made Mr. JH to lie on his bed on her left side. The RN started giving some backslaps and abdominal thrust. This made Mr. JH coughing again and regained his consciousness. Meanwhile the doctor was there and took Mr. JH under his care management.
Activity 2: Noticing
What did you notice about the situation initially?
Initially when I was having communication with Mr. JH, I was able to see the expression on his face regarding the pain he is feeling. To some of my question, he was not able to provide any information and was trying to ignore me. When I went near to him, I was able to feel and see his heavy respiration. Even though I was trying to make him for comfortable, he was shriving. Mr. JH asked for some water, but he was not able to drink it.
Activity 3: Interpreting
Describe what you thought about the situation (its potential causes, potential resolution etc).
Under this situation I was able to interpret that Mr. JH was not able to chew his food properly. That has created all this problems. While having food he was watching Television and listening to news. Mr. JH was not taking under consideration what amount of food is going into the mouth.
This has happen in my family. My elder son who is autistic, never take his food properly. He is interested watching games and television and always forgets what amount of food is going into his mouth. So we have to be very careful, when he is having food.
In my experience, I have always maintained that whether its patients or children in my family , extra care and precaution should be taken. I have always maintained that not only in their diet but also precaution should be maintained in their day to day activities.
Activity 4: Responding
Describe stressors that you experienced as you responded to the patient/others involved in the situation.
As soon I saw Mr. JH was feeling discomfort, I immediately got in touch with him and provided extra protection by handling him with both of my arms. Once I made him comfortable in the chair, I immediately got in touch with my RN Mentor and informed her about the situation. Once the RN was in the room, I immediately took the vital sings of Mr. JH and gave the reading to my RN. I was asking question to Mr. JH to get some positive feedback and also making sure that he is in comfortable position.
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Activity 5: Reflection
What happened? How did the patient/family member/staff respond? What did you do next?
As my RN had wide experience in handling this type of situation, she immediately acted on this situation. My RN got all the information from me and advises me to handle the situation very clam and professional manner. We both got Mr. JH to get back to his bed. My RN made Mr. JH to lie on the left side so that she can remove any food in the mouth. She also made me to check whether there is anything left in the mouth. Then the RN started giving some backslaps and abdominal thrust. This made Mr. JH coughing again and regained his consciousness.
Reflection-On-Action /Clinical Learning
Describe three ways your nursing care skills expanded during this experience.
Remain calm and professional throughout critical incidents.
Strong analytical skills, capable of assessing conditions and implementing appropriate intervention.
Develop rapport with patients, family, staff and physicians.
Identify three things you might do differently if you encounter this kind of situation again.
Try to be more resourceful problem solver and try to be more capable of implementing solutions to complex problems.
Try to possess special sensitivity to meeting diverse needs in varied situations.
Try to develop excellent rapport with patients, family, staff and physicians
What additional knowledge/ information/ skills do you need when encountering this kind of situation in the future?
Due to this experience I feel I have got the ability to work autonomously, set priorities and make independent decisions of a complex nature. I have got the ability to maintain confidentiality of patientâ€™s medical records. This is also given me the confidence to maintain effective written and verbal communication skills, Strong customer service skills and also excellent interpersonal communication skills.
What are the implications of this for your future nursing practice?
This reflection will help me to maintain effective verbal and written communication skills. Also it will help me to develop exceptional interpersonal communication skills, Strong time management skills, excellent organization, analytical, and planning skills.
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