NUR 206 – CLINICAL SKILLS APPLICATION

REFLECTIVE JOURNAL ASSIGNMENT NUMBER 1

Summer 2009

The goal of the reflective journal writing assignment is to provide an opportunity for student nurses to
practice the skill of reflection in their nursing practice, in order to become more proficient in thinking like
a nurse. Reflection is a skill that involves taking the time to pay attention to the moment “on purpose” in
order to notice all the significant data in a patient care situation, thinking about the situation after it occurs
in order to increase understanding of the total situation, as well as increasing self-awareness of the nurse’s
response to the situation. Reflection can be a building block that leads to evidence based patient centered
nursing care and maturing clinical judgment.

Directions:

For each course objective, answer allof the questions related to the objective. Journal entries must
address all course objectives.

Course Objective 1: Minimize risk of harm to patients and providers by implementing individual safety
measures and participating in safety promotion at the facility level consistent with
the PN and ADN dimensions of practice.

A. What skills did you perform during the last two (2) clinical days? Review each skill using the
agency’s policy manual and related texts/ resources to make sure you are performing the skills
correctly and competently. What variations did you find in the policy manual and what you were
doing? Were the differences you found acceptable variations or are there changes you need to
correct in your practice? Explain your answer.

B. Give an example of something you did for a patient to promote safety. How did your action
promote safety?

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C. Describe a policy that is practiced on the nursing unit where you are assigned which promotes
safety for all patients and staff on the unit. What is the rationale for the policy?

Course Objective 2: Demonstrate a working knowledge of the nursing process when providing caring,
compassionate, coordinated patient-centered nursing care and promoting health
in a diverse population consistent with the PN and ADN dimensions of practice.

A. How many patients did you care for each time you worked during the last two (2) clinical days?
Describe their level of care.

B. Select a brief patient care interaction (approximately 5 minutes) with a patient you have not seen
before. Immediately after leaving the patient’s room, make a list of everything you remember about
the patient and the room environment. Include observations of the patient, equipment (IV tubing,
IV pumps, catheter bags, etc), family members present and the condition of the room. After you
have made the list, go back into the patient’s room with paper and pencil and make another list of
the same type of observations. When you have time to compare the lists and reflect on your
observations, answer the following questions:

1. What was the greatest difference in your 2 lists?

2. What was the most significant observation that you made on your second list that you omitted
from the first list? Why do you think this was a significant omission?
3. What will you do to increase your observational skills during your next patient interaction?

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C. Describe what you did during the last two (2) clinical days to improve your organizational skills.
What is one (1) change you will make in your organization to achieve increased efficiency in your
work while maintaining excellence in patient care?

D. Give an example of a nursing intervention you implemented in which you considered the
preference of the patient. How did you know the patient’s preference? How would the outcome of
the intervention been different had you not considered the patient’s preference?

E. Give an example of patient care where you included the patient’s family in your care. What were
the family members’ needs in this situation? How did you perceive the patient’s feelings about your
inclusion of the family in your care? How did the family respond to your efforts to include them?

Course Objective 3: Use evidence based practiceto deliver optimal nursing care that reflects sound
decision making and quality improvement consistent with the PN and ADN
dimensions of practice:

A. What nursing knowledge did you already know that was helpful in a patient care situation? What
new nursing knowledge did you acquire (not clinical opinion, but scientific evidence) that
contributed to your understanding of the total patient situation? How did you acquire this
information?

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B. In what way did the theories you learned in psychology, anatomy and physiology and English
composition influence the nursing care you provided during the last two (2) clinical days? Give
one example for each subject area.

C. Choose one complex patient who interests you and review the patient’s chart carefully. Explain
how your knowledge about this patient’s pathophysiology, medications and treatment of a medical
condition influence your decisions about nursing care during the last two (2) clinical days. Include
diagnostic studies as well as lab values.

Course Objective 4: Use effective verbal, non-verbal and written communication with patients,
patients’ families and members of the health care team consistent with the PN and
ADN dimensions of practice.

A. Describe an example of therapeutic communication you had with a patient or family member. What
made the communication therapeutic vs. a social conversation? What did you accomplish? What
might have made the communication even more effective?

B. Describe a patient care situation in which you observed significant non-verbal communication.
What was the patient communicating non-verbally? How did you respond?

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C. Write a short paragraph to describe your observations of a patient’s medical status. Your
description should be clear, concise and specific (Example: your assessment of a patient’s
respiratory status, level of consciousness or your observation of a change in a patient’s condition).

Course Objective 5: Demonstrate a working knowledge of the concepts related to collaboration,

communication, decision-making and delegation in the role of member of the
interdisciplinary health care team consistent with the PN and ADN dimensions of
practice.

A. Describe your contribution to an effort in teamwork in patient care on your assigned nursing unit.
What did you achieve? What would you have done differently if you had been working alone?
What do you think you would have achieved working alone?

B. Discuss an example of working cooperatively with a patient’s family member (s) to achieve a
patient care outcome. What were you trying to achieve? Were you successful? What would you
have done differently if you had the opportunity to care for the patient again?

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Course Objective 6: Uphold the legal standards and ethical frameworks of the nursing profession by
demonstrating accountability and competence consistent with the PN and ADN
dimensions of practice when providing care for a group of patients and their
families.

A. Describe one situation with legal implications that you experienced during the last two (2) clinical
days. Include specific reference to the Nurse Practice Act.

B. Give one example of professionalism that you observed in another health care worker during the
last two (2) clinical days. Explain what it was about this example of professionalism that made an
impression on you.

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