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Senior Seminar Practicum at SHW

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Xerxeser Kayode

on 29 April 2013

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Transcript of Senior Seminar Practicum at SHW

My Preceptor: Mary Miller, RN, MSN, CCRN Trinity Washington University
Senior Seminar Clinical Presentation
Xerxeser Kayode My S.M.A.R.T. Goals #6. Medication Administration: Safely administer IV, IM, PO, PEG, topical medication to patients during each clinical shift

#7. Physical Assessment: Continue to increase proficiency in full and/or targeted head to toe assessments.

#8. Patient Teaching: Provide effective patient teaching on smoking cessation, cough and deep breathing exercises, incentive spirometry, range of motion exercises

#9. Understand Mechanical Ventilator Settings: Analyze Positive End Exipratory Pressure (PEEP), FiO2, PaCO2

#10. Enteral tube feedings: Administering enteral feeding via syringe with standard precautions (clean gloves, stethoscope, enteral formula, water for flushing, 60-ml syringe, empty cup for aspirate, pH reagent strip) My S.M.A.R.T. Goals Developing my S.M.A.R.T. Goals In order to develop my objectives, I had to assess my current skills and acknowledge what I was best at accomplishing and what skills needed more improvement.

I also needed to make sure that my objectives were: Specific, Measureable, Action Oriented, Realistic and Timely. Welcome to Level 3: ICU A majority of the patients seen on this floor were on mechanical ventilators and had acute to chronic complex medical conditions (i.e. heart failure, respiratory distress, renal failure, hematological disorders, spinal injuries) The Bridge to Getting Better #1. Time Management: To become efficient in organizing patient diagnoses, nursing interventions (i.e. am care, medication administration), and time for documentation at the beginning of each shift, during shift and at the time of reporting with the outgoing unit nurse.

#2. Communication: Effective communication skills to subacute care unit RNs, physicians, technicians and patients during each clinical rotation utilizing the SBAR communication tool.

#3. Nursing Documentation: To become efficient in correct procedural terminology and in composing nursing progress notes.

#4. Suctioning: Efficiently perform intermittent endotracheal suctioning and tracheostomy care using sterile technique when necessary to patients during each clinical shift.

#5. IV Infusion Pump Settings: Properly prepare, set, initiate an IV infusion or PEG infusion pump during each clinical shift or convert IV infusion to a saline lock and vice versa; assess patency of peripheral IV tubing; properly change primary and secondary tubing as per hospital protocol The Specialty Hospital of Washington (SHW) and Nursing Center (Capitol Hill Campus) is a long term extensive medical care facility in Washington, DC that provides care to patients with chronic medical conditions requiring individiualized treatment with interdisciplinary healthcare teams. SHW is accredited by The Joint Commission on Accreditation of Healthcare Organizations Ms. Miller provided her students with the most optimal learning experience during each clinical day. With her expertise in long term and intensive care facilities, Ms. Miller enabled us to apply textbook knowledge to clinical practice. Her constant bedside quizzes kept us on our toes and prepared to care for our patients. We were assigned one patient a day. Responsibilities included obtaining report from outgoing shift nurse, head to toe assessments, AM care, vital signs, obtaining lab reports from the computer, oral care, medication administration, endotracheal suctioning and wound care when appropriate How I achieved my Goals I achieved most of my goals by:

Taking initiative
Each clinical experience provided a learning experience either through Ms. Miller 's teaching moments or during Rounds Session with the medical students.

During Rounds Session, the medical students, Nurses, physical therapists and speech therapists discuss their respective patients course of treatment as a team. I often observed and "sat in" on those rounds to learn as much as a I can regarding patient care, various disease processes, and interdisciplinary communication. I even answered some of the questions the Med students were quizzed on by their preceptor!

Asking for assistance when needed

Maintaining self-confidence Biggest Challenge(s) My biggest challenges during this clinical experience were:

At times, hospital personnel did not wear proper PPE when door signs indicated that it should be worn.
There was uncertainty and miscommunication as to whether PPE should be worn potentially placing anyone at a health risk. There would be a discrepancy in what was stated in shift change report versus the information in the patient chart versus what the Nurses actually do when it comes time to enter the room. When this occurred, I wore PPE to be on the safe side

Communicating with patients who had an endotracheal collar and could not verbally express their needs was often emotionally frustrating for me and the patient however I am a patient individual and learned to work it through with the patient or another Nurse to tend to their needs.

Understanding mechanical ventilator settings and EKG readings Greatest Achievements My Future goals as a BSN-prepared Registered Nurse Pass my NCLEX the very 1st time!

Work in Maternity (Labor and Delivery or Postpartum Units)

Become an excellent Neonatal Intensive Care Unit (NICU) Nurse and Lactation Consultant

Obtain my Masters and Doctorate Degrees in Public Health

Become an expert in the field of Maternal and Child Health Ensuring that proper PPE precaution signs were outside my assigned patient's room was a priority for me through this entire clinical for the safety of my patient as well as my own safety. Conclusion "A combination between SHW's atmosphere,
my preceptor's guidance and my commitment
to becoming the best RN possible, my Senior
Seminar experience was fulfilling!" Understanding mechanical ventilator settings!

Enhancing my organization and time management clinical skills which will be an important skill in any area of Nursing!

Interacting with an interdisciplinary healthcare team during teaching Rounds session!

Administering Wound care! (a task I have not been able to do in my previous clinical experiences)

Realizing that I still have more to learn and I still have room to GROW!
Full transcript