REGARDING PRIMARY CARE CLINICALS:
- Refer to the “Advanced Nursing Practice Competencies and Guidelines” found in Week 1’s Learning Resources and consider the quality measures or indicators advanced nursing practice nurses must possess in your specialty of interest.
- Refer to your “Clinical Skills and Procedures Self-Assessment Form” you submitted in Week 1 and consider your strengths and opportunities for improvement.
- Refer to your Patient Log in Meditrek and consider the patient activities you have experienced in your practicum experience and reflect on your observations and experiences.
Journal Entry (450–500 words): REGARDING CLINICALS IN A PRIMARY CARE/INTERNAL MEDICINE OFFICE
Learning from Experiences
- Reflect on the three most challenging patients. What was most challenging for each?
- What did you learn from this experience?
- What resources did you have available?
- What evidence-based practice did you use for this patient?
- What new skills are you learning?
- What would you do differently?
- How are you managing patient flow and volume?
Communicating and Feedback
- Reflect on how to improve on your skills and knowledge and how to communicate that back to your Preceptor.
- How are you doing? What is missing?
- What type of feedback are you receiving from your Preceptor?
Expert Solution Preview
Introduction: Primary care clinicals provide an excellent opportunity for nursing students to learn and develop advanced nursing practice competencies. This journal entry focuses on reflecting on the clinical experiences in a primary care/internal medicine office and addressing the challenges faced during patient care, evidence-based practice, resources utilized, skills learned, patient flow management, and feedback from preceptors.
1. Reflect on the three most challenging patients. What was most challenging for each?
During my clinical experience in a primary care/internal medicine office, I encountered several challenging patients. The first patient was a diabetic patient who had missed his medication for several days and was experiencing uncontrolled hyperglycemia, requiring immediate intervention. The second patient was a hypertensive patient, whose blood pressure was difficult to control despite adequate medication. The third patient was a post-operative patient who developed wound infection and required close monitoring.
The most challenging aspect of caring for each patient was the complexity of their medical conditions and the need for immediate and accurate interventions. These patients required close monitoring and frequent adjustments to their medication regimen, which made their care challenging.
2. What did you learn from this experience?
Caring for patients with complex medical conditions taught me the importance of thorough assessment, accurate diagnosis, and timely interventions. It also taught me the importance of effective communication with patients and their families to ensure they understood their medical conditions and the importance of medication compliance.
3. What resources did you have available?
During my clinical experience, I had several resources available to me, including textbooks, online resources, preceptor advice, and hospital protocols. I also had access to a variety of medical equipment and supplies, which helped me provide evidence-based care to my patients.
4. What evidence-based practice did you use for this patient?
For my diabetic patient who had missed several days of medication and was experiencing hyperglycemia, I used evidence-based practice protocols for insulin administration and monitoring of blood glucose levels. For my hypertensive patient, I used a combination of medication therapy and lifestyle modifications, as recommended by current guidelines. For my post-operative patient with wound infection, I used evidence-based protocols for wound care and infection management.
5. What new skills are you learning?
During my clinical experience, I learned several new skills, including medication administration, patient assessment, communication, wound care, infection control, and medication management. I also learned how to effectively manage patient flow in a busy clinic by prioritizing patient care and utilizing available resources.
6. What would you do differently?
If given the opportunity, I would like to improve my skills in patient communication and education to ensure that patients and their families have a clear understanding of their medical conditions and treatment plans. I would also like to improve my time management skills to ensure that I can effectively manage multiple patients with complex needs.
7. How are you managing patient flow and volume?
Managing patient flow and volume in a primary care/internal medicine office requires effective time management, prioritization, and triaging of patients based on their medical needs. During my clinical experience, I utilized several strategies to manage patient flow, including pre-planning and prioritizing patient care based on their immediate needs, utilizing available resources and equipment, and effectively communicating with patients and their families.
8. How are you doing? What is missing?
Overall, I feel that I am doing well in my clinical experience, and I am learning a lot. However, I recognize that I still have much to learn, and I am still working on improving my skills in patient communication, time management, and effective utilization of available resources. To improve further, I would appreciate more specific feedback from my preceptor to help me identify areas for improvement and develop a plan to address them.
