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Posted: June 14th, 2023

Learning and Experiences

Hence, reflection can be a valuable tool. It serves as a tool for not only recalling experiences but also for applying lessons learned from those experiences. Keeping a nursing journal provides these benefits and more.

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To prepare:
• Refer to the current Clinical Guidelines found in this week’s Learning Resources and consider how these guidelines inform your clinical experience.
• Refer to your FNP or AGPCNP Clinical Skills and Procedures Self-Assessment Form you submitted in Week 1, and consider how your self-assessment might inform your Assignment.
• Refer to your Patient Log in Meditrek and reflect on Weeks 6–10 of your clinical experience, and reflect on your observations and experiences with patients during this time.
Journal Entry #2 (450–500 words):
In your journal entry, answer the following questions:
Learning and Experiences
Reflect on the 3 most challenging patient encounters and discuss what was most challenging for each.

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Patient one, is a new patient reason not wanting to pay to have labs completed then not wanting to return or a MD visit to followup labs. She was new and no previous lab to review. A very strong will lady.
Patient two is a organice patient asking about organic meds and tools that are natural material much as possible . She really need to explore a doctor that is into this as she look for change.

Patient three is Denied having blood pressure issues yet her blood pressure was elevated each time and later said she is like this for the annual visit only. She never showed owner ship. ( well women visit)
• 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? Pap smear, focused on vitals and how to track the whole patient and health needs.
• What would you do differently?
• How are you managing patient flow and volume? Volume and flow managed by scheduling but I will need to work on this area.
Communicating and Feedback
Ask yourself the following self-reflective questions:
• How might I improve on my skills and knowledge, and how do I communicate that back to my Preceptor?
• How am I doing? What is missing? Missing more on the areas unrelated to GYN. Kinda like Diabetes and Renal areas. I do need to work on a foreign language .
• What type of feedback am I receiving from my Preceptor? I am getting good feedback just need more hands on.

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Learning and Experiences

I have had the opportunity to work with a variety of patients during my clinical rotations. Some of the most challenging patient encounters I have had have been with patients who are:

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Non-compliant with their treatment plan. This can be frustrating for nurses, as we want to help our patients get better. However, it is important to remember that patients have the right to make their own decisions about their care. In these cases, I have tried to educate the patient about the importance of following their treatment plan and to offer them support and encouragement.
Difficult to communicate with. Some patients may have difficulty communicating due to language barriers, cognitive impairment, or other factors. In these cases, it is important to be patient and to use a variety of communication strategies. I have found that using simple language, providing visual aids, and being patient can help to improve communication with these patients.
Emotionally distressed. Some patients may be experiencing emotional distress due to a variety of factors, such as a recent diagnosis, a death in the family, or financial difficulties. In these cases, it is important to provide emotional support and to connect the patient with resources that can help them cope with their distress.
What did I learn from this experience?

I have learned a lot from working with challenging patients. I have learned to be patient, to be flexible, and to be creative in my approach to care. I have also learned the importance of communication and of providing emotional support.

What resources did I have available?

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I had a variety of resources available to me when working with challenging patients. I had the support of my preceptor, who was always available to answer my questions and provide guidance. I also had access to a variety of resources, such as textbooks, journals, and online databases.

What evidence-based practice did I use for this patient?

I used a variety of evidence-based practice resources when working with challenging patients. I reviewed the literature on non-compliance, communication with difficult patients, and emotional distress. I also used evidence-based practice guidelines to develop a plan of care for each patient.

What new skills am I learning?

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I am learning a variety of new skills as a nurse. I am learning how to provide patient care, how to communicate effectively, and how to work as part of a team. I am also learning how to manage my time effectively and how to deal with stress.

What would I do differently?

I would do a few things differently if I had the chance to work with challenging patients again. First, I would try to be more proactive in addressing the patient's concerns. Second, I would be more assertive in advocating for the patient's needs. Third, I would be more mindful of the patient's emotional state and would provide them with more support.

How are you managing patient flow and volume?

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I am managing patient flow and volume by scheduling patients in a way that minimizes wait times and by prioritizing patients based on their needs. I am also working on developing efficient and effective ways to document patient care.

Communicating and Feedback

How might I improve on my skills and knowledge, and how do I communicate that back to my Preceptor?

I can improve my skills and knowledge by continuing to read and learn about nursing. I can also communicate my needs to my preceptor by asking questions and seeking feedback.

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How am I doing? What is missing?

I am doing well in my clinical rotations. I am learning a lot and I am feeling confident in my skills. However, I would like to learn more about diabetes and renal care. I would also like to improve my fluency in Spanish.

What type of feedback am I receiving from my Preceptor?

I am receiving positive feedback from my preceptor. She is pleased with my progress and she feels confident in my ability to provide safe and effective patient care.

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I am grateful for the opportunity to learn and grow as a nurse. I am confident that I will be able to provide compassionate and effective care to my patients in the future.

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