I target to identify new areas of medical practice related to nursing that I have not learning. In comparison to my list of weaknesses and strengths, I will focus on these areas so that I can get a stable grasp of the practical knowledge.
The first objective that I have in this field is to act professionally with regards to my decorum. This will involve my punctuality to the hospital facility, a positive attitude towards patients and a positive image of the medical institution that I am engaging for this elective program. With this basis, I look forward to adhering to the uniform policy that is laid out at the hospital.
I would like to maintain remarkably efficient and effective communication with the patients at this medical facility. I would also like to achieve effective communication with my mentor, other clients especially this in charge of the patients. I would like to maintain effective communication with the personnel at the University placement office and the hospital.
I target to cultivate a vital component of medical practice related to confidentiality. This objective seems to be a hard task on my side because of the magnitude of personal information and medical conditions that this elective practice will expose to me.
I seek to practically learn how to use the heart monitor machine and the ECG. This will involve the use of learning tools; follow up on assessment, keeping a current log of learning activity and sets of action of learning.
I look forward to being proactive in looking for chances that will enable me to practice the knowledge I have acquired in school. I will target to grasp this under the dedicated guidance of my mentor.
I target to cultivate a questioning and reflective approach that will enable me to express my needs and fit well with the team of fellow nurses and other practitioners.
I aim to seek help from managers who have the clinical experience. In case the mentors are not present, I will seek the indulgence of the lecturers so as to facilitate maximum learning.
I will identify the role played by other members of the professional staff existing at the medical facility. I have an interest in the people running x-ray, the pharmacy and the unit dealing with outpatients.
I look forward to keeping updated records of the drugs that I will give to patients. With this basis, I will seek to enhance the quality of feedback that I will give and also expect from other people in the medical facility.
In the course of my elective practice, I have been able to administer medical assistance to a number of patients. I would like to note that these patients had different conditions that challenged my pharmacology knowledge memory of dosages.
Brand name/Generic name: Quinapril
How and for what it was used: I administered quinapril to Mr. Smith who suffers from congestive heart failure (Ackley & Ladwig, 2010).
Quinapril is used as an angiotensin converting enzyme inhibitor (Gulanick & Myers, 2010).
There are numerous side effects that quinapril has on most congestive heart failure patients. These include chest pain, fatigue, extremely low blood pressures, wheezing in extreme circumstance, skin rashes and blisters, decrease in the amount of urine and stomach pain (Aschenbenner & Venable, 2008).
I did not alter the recommended dose because the patient has not indicated any drug resistance.
Brand name: Amiloride
I administered this as a diuretic to Mrs. Khan who has hypertension. This drug enables patients to lose as much water as they can from their body. Common side effects include feeling of nervousness, confusion, fast irregular heartbeat, weakness in the feet, yellowing of the skin and eyes, numbness and tingling of the hands and feet and also breathing problems.
I did not prescribe an abnormal dosage because of the poisonous effect of the overdose of Amiloride.
Brand name: Isoniazid INZ
I administered this to Mr. Brown in treatment of Tuberculosis (Aschenbenner & Venable, 2008).
This drug’s side effects include changes in vision and eye pain, dark urine, hallucination, loss of appetite, tiredness and unusually weak together with breathing problems (Aschenbenner & Venable, 2008).
I did not prescribe any dosage against the recommended dosage. Mr. Brown had hallucinations and felt tired in the mornings.
Brand name: Glipizide: Metformin
I administered this medicine to Mr. Abdul to treat type 2 diabetes (Gulanick & Myers, 2010).This medicine acts to enable the body use insulin well.
This medicine has a number of side effects that should be well assessed and handled. The side effects include, allergic reactions like skin rash, swelling of the face and tongue, itching and hives. The drug can also cause breathing problems, feeling faint and light headed, low blood glucose and irregular heartbeats (Gulanick & Myers, 2010).
I did not prescribe a different dose than the normal.
Reflective journal and evaluation of clinical experience
The medical facility seemed busy because of the number of patients that other hospitals had referred to this facility. This gave me a chance to learn more about medical conditions like Hypertension and Diabetes 2. On the third day of the first week, I came across Mr. Green who has been suffering from Hypertension for about 20 years. The unique bit about his case is that he has interacted with many drugs. I was confused at the beginning what drug I would prescribe for him. On consulting my mentor, I was guided to prescribe Amiloride. I have not prescribed Amiloride to another patient elsewhere. This gave me a starting point in my study of this drug. The challenge in this case has given me a starting point in my study of how hypertensive patients become resistant to common drugs that have worked well for others.
In this first week, I was also able to meet rare medical conditions from the histories I collected from most patients. For instance, I met Mr. Steve who has a rare fungal skin infection that seems to have arisen from his exposure of his skin when he went for holiday along the coastal islands. It looked tricky to me because the infection subsides and erupts periodically. I learnt how to look up for alternative medicines in the updated drug index at the facility.
This week started on a busy note because I was required to submit many reports of the patients I had met in week one. I experienced confusing cases of how I would deal with confidentiality. The reason behind this is that I could not differentiate between the correct information to give out to different medical personnel. The question that kept coming to my mind was related to the issue of the patient history and the complications that have come up. For instance, I did not know if I were right to indicate to the placement personnel at the university the different ailments of my patients.
At the end of this week, I got the challenge of using some of the learning tools that I met at the facility. I particularly had a problem with the manual systems that seemed a slower option being that I was used to the computerized check up software available in the school environment.
I was able to attend a session at an external medical practitioner’s office. This office serves outpatients only. At this facility, I met patients with numerous medical conditions who had little time to stay at the facility. This challenged me further because of the speed of action that is expected at the facility. This place gave me the urgency that I needed in checking up prescription and also helped me to devise a quicker way of locating entries in the drug index.
In this week, I met a patient who seemed to be in a rush to attend to other business issues elsewhere. The challenging bit of this case is that the patient’s rush spurn me into rushing to prescribe for him drugs so that he could attend to his duties. In my rush, I made a wrong prescription with an overdose. I realized this just before I cleared the patient to go. This was an eye opening experience. I learnt that safety is essential for the patient before anything else (Ackley & Ladwig, 2010).
Betty J. Ackley, Gail B. Ladwig (2010), Nursing Diagnosis Handbook: Evidence
Based Guide to Planning Care. Elsevier Health Sciences
Diane S. Aschenbrenner, Samantha J. Venable (2008), Drug Therapy in Nursing.
Wolters Kluwer Health.
Meg Gulanick, Judith L. Myers (2010), Nursing Care Plans: Nursing Diagnosis and
Intervention. Elsevier Health Sciences.