Clinical Reflection

This morning was my first onsite clinical experience. My goals today included implementing the assessments and skills learned in lab into the onsite setting. I was really looking forward to actually performing some of the features we had practiced in lab on a real patient. I wanted to practice taking vitals, the assessment for HEENT and Hair, Skin & Nails in my clinical care. I also wanted to just familiarize myself with the typical flow of the morning routine in the hospital.

Today, I achieved about half my goals. I definitely became familiar with the typical flow of the morning routine in the rehab unit. With the assistance of either our nurse or the nursing aid for the floor, who made our patient’s bed while we helped in the shower, we

For example, one drug we discussed today was mirtazapine (Remeron). I learned that this drug is both an antidepressant and an appetite stimulant. With my clinical instructor and my clinical group, we discussed why this drug would be given. I learned that the drug’s two functions worked hand-in-hand. Because my patient was charted as having both depression and Alzheimer’s, the drug helped the patient to maintain a normal eating schedule. Another drug I learned about was docusate sodium (Colace): this drug is given for constipation, as a stool softener. Due to the fluxing diet, mobility, stress, and possibility of pain medication given in the hospital setting, this drug is sometimes given as a standing order. I think this was also an example of using critical thinking, as we openly worked through and analyzed the pathophysiology, reasoning, and possible side effects of the drugs. There were quite a few other drugs that we discussed today, and I really appreciated and feel I benefitted from this time spent going over the patient’s charts. Finally, the course objective that we met today was applying fundamental concepts and selected principles to nursing actions used in meeting client needs. I applied this course objective when we practiced using the Hair, Skin & Nails assessment for the patient; I practiced this fundamental nursing assessment while helping the patient shower. I noted and later discussed with the other nursing student any lesions we noted on the patient’s body, whether or not we noticed any discolorations, the health of her nails, and so forth. While we assisted and helped meet the patient’s needs for hygiene, it was during this time that we also assessed her independence in meeting her activities of daily living, range of motion, and we observed the level of assistance she needed. All of this was included in her