It's about clinical psychology which helps in Clinical practice and the psychology of ywou, Study notes of English

Download It's about clinical psychology which helps in Clinical practice and the psychology of ywou and more Study notes English in PDF only on Docsity! Reflective Journal Assignment Introduction/Background: On the second clinical day, I was assigned to a 79-year-old male patient with a Debility. He was also diagnosed with low oxygen saturation, pneumonia, and urinary tract infection. He had reduced mobility because of a history of falls. I first met this patient, taking the report with the night shift nurse. I entered the patient's room, introduced myself to him, explained that I was a nursing student today to assist him, and mentioned that I was interested in learning more about his condition and what had brought him to the hospital. I asked about his situation in the hospital and offered to assist him with his request. I saw the patient lying in bed in a disoriented stage, and he could not hear because the hearing aid was not correctly attached to his left ear. Because of my prior experience, I could relate to the situation. I worked at Virginia Hospital Center, Arlington, as a clinical tech on the cardiac and multispecialty floor. I frequently encounter similar circumstances with elderly, disoriented patients. My experience and learning skills from nursing college have improved my ability to comprehend cases and provide patients with the best care possible. Moreover, his disorientation makes him weak and more likely to fall. Therefore, he needs to be assessed frequently. Noticing: As soon as I walked into the patient's room, I noticed the patient lying on the bed, depressed, unable to speak, and not in the proper bed position. His leg was touching the foot rail, and he hesitated and felt uncomfortable as he fell asleep. He had the Foley catheter and had a bowel movement the previous night. The nurse said he could move with two assistants, but getting out of bed was not advisable because of his debility. The nurse also informed me that the patient will work with a physical therapist, a speech therapist, and an occupational therapist today. We can assist him with ADLs with the help of an Occupational therapist. I took his vital morning signs to monitor his oxygen and blood pressure. He had much pain in his left upper hand because of his previous fall. The Foley catheter care needed to be done in the early morning, so I cleaned with the Foley care wipes, emptied the urine from the bag, and told the nurse that 250ml was dark yellow color urine. Afterward, I helped him get into bed and repositioned him with the nurse's help. I retook the vital signs and completed pulmonary and cardiac assessments. I was auscultating the posterior side of his body and noted a mild crackle sound when the patient breathed deeply. Interpreting: In my working experience in health care, I frequently encounter similar circumstances with elderly and disoriented patients diagnosed with urinary tract infection, pneumonia, shortness of breath, and confusion. In my experience, when the patient has pneumonia, it affects the lungs and breathing. The breathing system is also impacted by immobility; when a patient cannot move, their capacity to breathe deeply and at a normal rate diminishes. Therefore, I first elevate the head of the bed and monitor the oxygen level. Another way is to ask the patient to take a deep breath to promote the oxygen level. I questioned the nurse about the patient's degree of assistance because the patient's shortness of breath leads to dizziness, and the patient has a high risk of falls. I suggested to the patient that using the bedside commode, which is safe, would be preferable since the patient was not moving out of bed. As the patient becomes more independent, his condition will improve. Responding: My goals for the patient are to feel safe due to his immobility and to engage in PT, OT, and speech therapies to receive better care and progress with their treatment. First, the occupational therapist assessed the patient's strength and asked me to assist him with ADLs like brushing his teeth, washing his face, and changing his gown. In another session, the speech therapist asked me to help with the question and asked whether he was answering it clearly or needed an assistant for his daily routine of medication intake. The speech therapist showed the patient how to take the medication on schedule without skipping a dosage and highlighted the importance of not forgetting to take a dose or overdosing. The patient practiced with divided medicine boxes to prepare for a week's easy use. The patient could determine which medications he needed to take and how to organize his prescription for a week. Finally, in the morning session, the PT worked with the patient on mobility and strength exercises and monitored his vital oxygen level during the workout. I proceeded to the physical section area with the patient in the wheelchair following physical therapist. Although his blood pressure was average, his oxygen saturation level was at saturation to 95 percent. I retook the vitals during the physical strength assessment to check his BP and oxygen. Maintaining monitoring for any modifications in his heart and lung sounds and any respiratory issues is essential. His mobility is directly impacted by impaired gas exchange because he cannot move around in adequate amounts of oxygen. My clinical experience was unique and taught me the confidence that I could help the patient with the help of the staff. My intervention helped the patient recover faster and improve his situation. The patient was pleased to have me as the student nurse so he could express his feelings and have someone watch over his activities. He got the confidence that he would go home soon. The therapy went very well, which helped the patient to strengthen his body movement and physical activities. I would follow the fall prevention measures in place, like locking the bed at the lowest level, making sure the patient is wearing non-slip socks, keeping the call light and any personal items within reach to allow for easy access, and emphasizing the significance of calling for help rather than getting out of bed on his own when he is weak. Reflection-in-Action and Clinical Learning: I observed that the patient was quiet. I talked to the patient quietly and greeted him with respect. Also, I told him that taking vital signs in the morning and whenever needed is essential. I spend time with him, talking and listening to his words, which encourages him to work with me freely and build trust that I will provide his best care and help him with needed assistance. Another change is patient care. Repositioning is significant for this patient because a patient experiencing decreased mobility will lead to functional disability and pressure ulcer development. A patient safety sign or board should be placed at the patient's bedside and outside the door, and equipment that reduces the risk of falls should be available to keep the patient safe. As a result, there was a great danger of falling, and there was no padded cushion under the bed. The call button was within the patient's reach. In the future, the three things that I would improve are: 1. I must exercise critical judgment by listening to and understanding the patient's history, giving close attention to every detail about