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Samples attached from previous class

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Samples attached from previous class. I did volunteering for community health so there was no Telehealth or hospital clinical experience.

Rubric:

Reflects on current theory and clinical class with concepts and theories using the Program Learning Outcomes and BSN Essentials listed in the syllabus: 1. Reflects on current theory class and clinical and how courses support each other (transfer of knowledge to apply to clinical)- Focused to Current Term. 2. Synthesizes theories and concepts from liberal education to build an understanding of the human experience. 3. Uses skills of inquiry and analysis to address practice issues 4. Applies knowledge of social and cultural factors in the care of populations encountered in this course.

This criterion is linked to a Learning OutcomeDevelops an effective communication style for interacting with current patients, families, and the interdisciplinary health team when providing holistic, patient centered nursing care to populations encountered in this course: 1. Reflects on providing holistic patient care to populations encountered in this course. 2. Describes inter-collaborative involvement (i.e. Interprofessional rounds; consultations and interaction with PT/OT; Respiratory Therapy, Pharmacist consultation---describe their role/ contribution.)

This criterion is linked to a Learning OutcomeModels leadership when providing safe, quality nursing care; coordinating the healthcare team; and when tasked with oversight and accountability for care delivery: 1. Describe an event that demonstrates: • application of leadership concepts, skills and decision making in the provision of high quality nursing care, • healthcare team coordination • the oversight and accountability for care delivery 2. Describe an event that demonstrates leadership, appropriate teambuilding and collaborative strategies to effectively implement patient safety and quality improvement initiatives within the context of the interprofessional team

NURSING EVOLUTION Nursing Evolution Nicollete Juarez NURS 307 – Developing Family and Community West Coast University 1 NURSING EVOLUTION 2 Nursing Evolution The theory class helped me understand the foundation of nursing pediatric care by learning the basic information that served as my basic foundation knowledge I significantly needed to become successful in my clinical experience during this term. Learning how children transition through different stages of development, acquiring knowledge about major health promotion and disease prevention concepts, application of nursing process to pediatric patient population suffering from different types of acute and chronic diseases, nutritional requirements for pediatric requirements and current issues regarding health care in theory class allowed me to apply the concept of nursing process and critical thinking during patient care and support and performed the therapeutic nursing interventions specific for the patients and families assigned to me during clinical rotations. During my clinical rotation this term, I have provided holistic patient centered care by utilizing therapeutic communication not only with my patient but also to their family members. I was able to prioritize their needs and provided it with the highest quality of care that meets the standard protocol of my clinical site. I was able to participate in a collaborative care for the patient assigned to me. I was assigned to an eight-year-old male patient who was admitted to the pediatric intensive care unit of the hospital. The charge nurse asked me to take the patient’s temperature and assisted her in providing personal care to the patient such as removing the soiled diaper and changed it to a new one, provided oral care, and repositioned the patient. During the care, the patient had an episode of seizure which lasted about three minutes. The charge nurse who was with me at that time, instructed me to watch the clock to remember when the seizure started and asked me to time the duration of the seizure. She also yelled out for the rest of the staff to inform them that the patient was having a seizure. She asked me to help her turn the NURSING EVOLUTION 3 patient to the left side while she gave instructions to the LVN and another RN nurse in the room. The charge nurse also gave instructions to the Respiratory therapist as the patient’s oxygen dropped to 72 %. I have never witnessed a child had a seizure prior to that day and it was really intense. After the seizure stopped, the nurses and Respiratory therapist worked on the patient to stabilized him. I assisted by attending to their every request such as getting them new towels, diaper, wipes, etc. I have seen a lot of situations where the application of leadership concepts and skills and decision making were done to ensure that high quality nursing care, healthcare team coordination and collaborative care happens. In addition to the seizure episode event that I already described above, I wanted to share that the same team I mentioned above had shown excellent care to the same patient while I was there throughout the day. They were able to assess the patient and quickly identify that his health status was declining really fast. They were able to render and implemented therapeutic nursing interventions by constantly and effectively communicating with the primary doctor, the pharmacy, the laboratory and diagnostic department, and family. The patient had three more episodes of seizure lasting about three to four minutes and the last episode, the patient became unstable and unresponsive. The team followed protocol on what to do during a seizure on every seizure episode the patient had. After the last seizure, they were quick to determined that the patient’s status became unstable and the doctor decided that he needed to intubate the patient. As soon as the doctor told them the plan, everyone worked into action. The charge nurse called the pharmacy to order the medications needed for intubation, the respiratory therapist gathered her equipment for ventilation support, the LVN and other RN started another IV line on the patient and the primary doctor provided oversight and made sure that everyone is up to the task. I witnessed how quickly everyone moved to gather all the NURSING EVOLUTION 4 necessary tools, equipment and medications needed and completed the intubation procedure. The situation was intense, emotional and chaotic but I would say that it was an organized chaos. I could tell from everyone’s faces who collaborated in that patient’s care that they were under a lot of pressure and stress, but they worked cautiously, effectively and safely trying to save the patient’s life. The doctor took charged of the situation by respectfully telling his team on what they needed to do. The team which included of two RNs, one LVN and one Respiratory therapist, effectively communicated with one another, did the tasks assigned to them by the doctor and most importantly, they showed support to one another during the entire ordeal and setting their differences and emotions on the side. Running head: NURSING EVOLUTION 1 Stephanie Martinez Nursing Evolution NURS 307 West Coast University Professor Dyer July 30, 2018 Nursing Evolution 2 Reflection on Current Theory and Clinical Class: Theory and clinical courses supported each other as I was able to visualize and take part of a health care team collaborating care for my 2-month old patient with epilepsy at Children's Hospital, Los Angeles. Theory instruction taught me how to prepare and implement nursing actions for a lumbar puncture procedure in the hospital; such as maintaining a prone position for my client post procedure to prevent a headache and implementing seizure precautions. In addition to supporting my knowledge base for optimum and safe care the ?Program Learning Outcomes allowed me to provide health care education for the family of my patient, plan preventative interventions that were effective and efficient, as well as develop effective communication to decrease procedure related anxiety, and comply with professional standards of moral, ethical, and legal conduct in practice for my patient. This gave me a new perspective on the human experience and how families deal with a child who is ill and the psychological effect it has on the whole family. As nurses it is important to inquire and analyze many aspects of our care to ensure the patient is comfortable and safe within our scope of practice. Social and cultural aspects of this course enabled me to learn how this affects parents and how their different views influence the way children’s care is delivered. For example, Spanish speaking families may have difficulty understanding the course of disease and the care that is being coordinated. Communication Style: I developed effective communication for interacting with my patients and their families, as well as the health care team of RN’s, doctors, RT’s, and patient care associates by providing holistic, patient centered nursing care to children from ages 2 months to 20 years of age. I communicated with the healthcare team in a professional manner by making direct eye contact Nursing Evolution 3 and correctly documenting findings and observations. I was in constant communication with my charge nurse to ensure I communicated changes in condition and vital signs that were out of the patients baseline. The population I served consisted of caucasian and hispanic origin and I was sensitive to their needs by answering questions, directing them to the proper personnel, and inquiring how they felt about the care being provided. During rounds I communicated the importance of medications, procedures, as well as psychosocial understanding. I made sure to listen to their needs by making eye contact when appropriate, leaning slightly forward, in a relaxed position without making them feel rushed. Leadership: I demonstrated leadership by providing safe, quality nursing care under my instructors directions and enabling coordination within a health care team. I was confident and made sure to complete my tasks of patient rounds, documentation, and effective communication was completed prior to moving on to the next task. I took accountability for every action I took and the effect it had on the care delivered under my responsibility. I was able to make independent decisions such as post care for lumbar procedure using evidence based practices that were taught in class which led to high quality nursing care. I implemented seizure precautions without the need for constant direction and reported vital signs that were out of the norm for a 2-month old client to the RN. Rounds were made taking into consideration the patients views and and cultural practices. I was also able to collaborate with my fellow clinical nursing classmates and assisted them in showing them how to document and find sources on the electronic medical administration record to lead to better care delivery. Nursing Evolution 4