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Cardiology Heart Rhythm

Cardiology Heart Rhythm

A Medical Surgical Nursing II Clinical Reflection Paper

Pallavi Mangal

Swedish Institute College of Health Science

Author Note:

This paper was prepared for NUR 241: Medical Surgical Nursing II, Spring 2020

Taught by Roger Escarda.

Reflection is a process that is known to assist nurses in the development of necessary

skills and competencies when undertaking training within clinical settings. It helps nurse

students to develop many skills which will help them to improve their skill in their future career.

It is that form of practice which seeks to problematize many situations of professional

performance so that they can become potential learning situations and so the practitioners can

continue to learn, grow & develop in and through practice” (Jarvis 1992). This semester we had

medical surgical nursing clinical setting where they examined our nursing skills and determine if

they meet seven nursing core competencies: patient-care center, safety, teamwork and

collaboration, evidence-based practice, quality, improvement, informatics and technology, and

professionalism. We were fortunate to do our clinicals in the telemetry unit at the 17th floor of

HHC’s Bellevue hospital where we were able to do nursing care of patient with heart disease and

other serious medical condition.

The first step you will learn in nursing is patient care center. They always teach you that

patient care is one of the important skill in nursing process. This means respecting, coordination,

communication, education, comforting and giving priority to family dynamics and patient beliefs

into care. I had an experience where I learned patient centered care is one of the important skill

in nursing. I had a chance to take care of one of the patients who was 75-year-old and had

difficult completing her regular tasks like eating, walking to the bathroom and many other. I tried

to build my trust with that patient by helping her and providing all the facilities she needs. She

also mentioned that she wants to read bible and get some spiritual support. I mentioned her that

health care field respect each and every patient’s culture. I educated her about chapel in hospital

where her relatives can pray for her and also she can read bible and request administration office
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Cardiology Heart Rhythm

to provide her one. She was comforted and satisfied by both physical and emotional support I

provided to her.

Patient safety is one of the important parts of nursing care. According to World Health

Organization (2010), Patient safety is the prevention and avoidance of adverse circumstances or

injuries coming from health care process. Accidents, falls and errors are common event that

occur in clinical site. Physically challenged, immobile, elderly are the ones who have more risk

of falls. During our clinicals, we always made sure that patient have call bells, educate them

about importance of requesting assistance especially patient who have hand band of risk for fall.

In clinical setting, I was taking care of a patient who was 82 years old women, she had difficulty

walking as she had hip replacement surgery and used walker. She always need assistant when

she has to walk to the bathroom. I made sure she had call bell near her, convince her to always

call for assistance whenever she has to go the bathroom. Also, I made sure she wears skid free

socks and her bed was in the lowest position. Nurses learn provide patient safety by doing this

simple intervention.

Communication and collaboration are another key factor in nursing care practice. The

collaborative “approach involves teams of health professionals working together to provide more

coordinated and comprehensive care to clients,” (Kearney 2008). In clinical setting, once in

every two weeks our clinical instructor pair us up and instruct us to take care of patient together.

We all are nursing student work in group to effectively serve our patient. We used to assist each

other with turning and positioning, bathing and cleaning a patient. Moreover, we used to

collaborate with nurses and assist then in giving medication to patients. We also used to take

patients vital signs, record intake and output and report to PCA. If there are any unusual sign

notice in patient we used to report to nurse. I experienced this when I was assisting one of the
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Cardiology Heart Rhythm

nurses taking care of 65-year-old stroke patient who broke his jaw. He was on liquid diet and you

have to keep an eye on him while he is drinking tea and juices due to risk for aspiration. One of

the nurse requests me and my partner to be there and help her to assist feeding the patient. We

also assist her when she was giving IV antibiotics to the patient. We were able to succeed

working in a team and taking care of patient. There is an ideal way of promoting the patient’s

safety and recovery through the process of collaboration and teamwork.

Evidence based practice in nursing is an integration of research evidence, clinical

expertise and a patient's preferences. This problem-solving approach to clinical practice

encourages nurses to provide individualized patient care. One of the most important examples of

evidence-based practice is infection control. Nurses plays an important role to keeping hospital

environment clean and sanitize by following evidence-based infection control policies. They

make sure healthcare environment is clean, wear PPE while providing service to patients and

also doing hand hygiene after each and every patient they see. In clinicals, we all nursing student

made sure to wash our hands before and after seeing every patient. We also make sure that we

wear gloves while taking patient’s vital sign or giving them medication with nurses. This

practice help nurses to keep themselves and patient safe.

Quality improvement in nursing care is to improve service quality by implementing

various meeting and programs. In clinical setting, we demonstrated quality improvement by have

preconference where we get detailed information about patient history and post conference

where we have to present about the patient we attended and discuss all the things we observed

while we take care of that patient. Our clinical instructor gave us feedback after we present them

and discuss with us qualities, we need to improve to give better service to patient.
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Cardiology Heart Rhythm

Informatics and technology are important in healthcare profession. Nurses are using

various tools and technology at their work to provide enhanced service to the patient. In Bellevue

Hospital, all nurses used EHR EPIC system which is a safe practice to administer medication.

They have to scan patient’s ID and check the drugs they are giving it to patient. Epic provides

the side effects for each drug given it to patient which made easier for nurse to explain patient

what they are getting and what are their side effects, nurses don’t have to memorize each drug

and their side effects. Also, in telemetry unit they have each patient attach to EKG where they

monitor patient’s rhythm 24/7, this helps them to keep observing their patient and intervene

immediately if they need any help.

Professionalism is one of the best future nursing competences which promote

accountability. Nurses are known for professionalism which means dressing appropriately, be on

time, respectful towards their patient, and also respectful towards your colleague and work. In

clinical, setting, our clinical professor train us to be on time, dress in certain uniform and respectful

towards our peer and patients we are taking care of. He also taught us even if your patient is being

disrespectful towards you, you still have to show you professionalism by treating them right and

without any discrimination. This shows that how professionalism is one of the essential roles in

nursing care.

This semester, I was fortunate to learn many nursing skills competences. This knowledge

will help me to get success in my future nursing career. I was also able to apply these nursing skills

in clinical setting under trained nurses. This semester clinicals gave us very knowledgeable and

valuable experience. After this semester, I feel more confidence in performing patient care and

nursing skills.
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Cardiology Heart Rhythm

Reference:

Giddens J. F (2013). Concepts for nursing practice. St Louis, MO: Elsevier

Janice Hoffman and Nancy Sullivan (2017). Medical surgical nursing. Making connections

to practice. Philadelphia, PA: F.A. Davis

Kearney-Nunnery, R. (2008). Advancing your career: Concepts of professional nursing

(6th ed). Philadelphia, PA: F.A. Davis.

World Health Organization. (2010). A report about health.