QUESTION 1: Using the uploaded ‘Guild for Reflection” Clinical Judgement Model, Write about your “Clinical Reflection”. This is the summary of my actual clinical Background below.

My Clinical Background

One of the numerous encounters I had was with a female primigravida patient (27 years) who had just had a premature baby (24 weeks) through a C-section, in the emergency unit. According to the handoff report my preceptor and I received from the morning shift nurse, this patient was very sick and had contractions. She was then delivered at 24 weeks, a premature baby. After her delivery, she was transferred to our unit(mother-baby) unit. Due to her premature delivery and health conditions, the baby was taken to the NICU (Neonatal Intensive care) unit for proper care.

     After the patient was admitted into our unit, she was placed under our care for proper monitoring. The doctor in charge examined her current state and placed her on various medications. These medications were necessary immediately because of her infections that were discovered before she gave birth. My preceptor and I watched her closely by checking her current vital signs. Her temperature was still elevated (103 degrees). Her current pain level was 8. This is due to her c-section for her delivery. Some of her ordered medication includes but is not limited to cefepine, oxycodone 5mg (Prn), Motrin 600mg (Prn), Norco 5mg (Prn), etc. Cefepime is an antibiotic to help with infection. She was also, placed on IV fluids. We ensure that all due medications are administered accordingly. We monitor and reassess her vital signs. We also educate her on the need for the light exercise of walking to the bathroom herself and in the hallway when she can to relieve her pain. We further assess her heart rate, lungs, abdomen, and most especially the spot of the cesarean section.

    My preceptor did place a consult for social worker intervention since the patient had no close family relation or member to assist or accommodate her during and after she left the hospital. Before coming to the emergency hospital, she stayed with a friend, and she didn’t believe that the friend would be ready to accommodate her and her newborn baby. She claims she lost her job some time ago. She wouldn’t want to say anything about her ordeal of the pregnancy. My first encounter with this patient was as a student nurse shadowing my preceptor (RN).

     Our goal for this patient is to ensure she gets well as soon as possible, to be able to take care of herself and her baby. This we do, by ensuring that medication regime orders are followed. Assessment and education are done when necessary.

QUESTION 2: Write a Journal Reflection by answering the following questions.

1. Describe three ways your nursing care skills expanded during the clinical rotation.
2. Name three things you might do differently if you encounter a similar situation again.
3. What additional knowledge, information, and skills do you need when encountering this kind of situation or a similar situation in the future?
4. Describe any changes in your values or feelings as a result of this experience.
5. Identify and explain one key behavior that, through your experience within the clinical intensive, expanded or enhanced your nursing practice.   
6. Identify and explain one key behavior that you have identified on which you need to improve during your next clinical intensive.