Value: Complete (P)/Incomplete (F)
Due: Day 7
Grading Category: Complete (P)/Incomplete (F)
Reflect on the clinical experiences you’ve had over the past week, and record your thoughts in a document no more than 500 words long. Your peers will be able to read and reply to what you have written.
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Your reflection must satisfy these criteria:
It must be about a client encounter you had this week.
It must include an analysis of the nurse practitioner role or the potential role in the clinical setting.
All clinical discussion or communication must protect the confidentiality of clients; your reflection must not use any patient names, ages, or other personal identifiers.
You will not be graded on the experiences you have had, but instead on your commitment to reflecting on those experiences and using those reflections to improve your professional identity and skill set.
Select one of the following options to help you give your reflection focus:
Option 1
Write about a situation that you felt you handled well. What did you do?
Option 2
Write about a situation in which you felt unsure of yourself. What happened? What made you question your decision making? If faced with the same situation in the future, how would you like to handle it differently?
Option 3
Write about a situation that you felt you handled incorrectly. What happened? How would you change your actions to result in a different outcome?
Option 4
Write about a continuing situation that began earlier in your clinical. How has the situation evolved since you first faced it? What have you done to guide the relationship? What interventions or strategies have you tried? What is the current outcome? What are your goals with this patient?
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This week something that I could have handled better was helping a patient during an emergency. This week we had a patient come into the office for leg swelling. Upon getting her in the room and starting to take her vitals, we found her heart rate to be in the 160’s at rest. We did an EKG and saw she was in new onset a-fib with RVR. My nurse practitioner preceptor went to call an ambulance and discuss the case with the physician in the office and I was left with the patient. I wanted to reassure the patient that she was in good hands but did not want to give her false confidence that nothing was wrong or that she wouldn’t need admission to the hospital. I felt in an uncomfortable spot wanting to make her feel better as she was very emotional and scared. Going forward I think I would just give reassurance that it is the right thing to do to go to the hospital to be evaluated and provider her with factual information to avoid making false presumptions or giving her misinformation. It was a good learning experience to see how my preceptor handled the whole situation and told the patient about her condition as it was all new to her.
I have had four clinical shifts at the time of writing this reflection, and I can see a difference between my first day and my fourth. I see an average of 15 patients per day with varying reasons for entering our office. There are patients who are straightforward OM, rhinosinusitis, and strep throat to more complicated patients who are having suicidal ideations, pelvic pain with vaginal discharge, and children who have a fish hook embedded in their face. One of my favorite aspects of this rotation is that I never know what I am going to get.
Option 2
This week, I have started to take more patient care responsibility. I am conducting the HPI, ROS, assessment, and charting. There is not one specific situation, as every encounter has been a learning experience where I could have done more. My preceptor is there to fill in the gaps so nothing is missed. I am not questioning myself; however, it is frustrating to miss pertinent HPI questions or assessments. I feel I have been a nurse long enough that I should know what to ask and the appropriate assessments. My issue is that I am not confident with the potential pathologies that I see, and that makes me miss certain aspects of the encounter. I am working on trying to take my time and let the patient lead the conversation while I make mental notes about future questions to ask and potential assessments.
Moving forward, I know I will become more confident. As I learn about the various pathologies and their associated assessments and treatments, I will gain confidence. I am impressed with my NP preceptor as she is able to switch her brain from a sore throat, to UTI, to cleaning a laceration and suturing the wound closed. I am impressed with her ability to chart and manage patient care as the waiting room becomes more full. It is inspiring.
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