Practicum Journal
My first experience as a practitioner was met with challenges at the first shift. According to the guidelines, I was expected to take care of two patients for twelve hours. I did not know the criteria used to identify the nurses who were assigned to two patients and those assigned to one patient. My first patient was a female aged fifty and was recovering from a stroke. The patient was, however, stable and did not need much attention. The other patient was a male aged sixty and required close attention due to his resistance to taking medication. The second patient made the duty overwhelming and forced me into engaging a senior nurse concerning the criteria used in assigning duties to staff.
Staffing had appeared as a trial and error idea until the engagement with the senior nurse in the clinic. The factors affecting the number of nurses in the facility range from the number of patients to the severity of the conditions allowed. For example, a ratio of one nurse to two patients is seen as standard, although more nurses are employed where the facility is dealing with critical health conditions. Patients who critically ill require the attention of one or more nurses and hence the need for more nurses. The senior nurse explained that staffing is done on a census basis and in terms of hours in service. For example, a group of five patients will require three nurses, with one of the nurses operating as the in-charge. The logistics behind the allocation of nurses are made at the office, and the nurses are assigned to duties. Some circumstances, such as critically ill patients will require that one or more nurses will be assigned to a single patient. The ratio may also allow for a nurse to have three patients if the patients are stable and advancing towards their discharge from the clinic. However, the number of patients is restricted to three and below to avoid cases of negligence or overwhelming the nurses with responsibilities.
The significance of staffing is insisted on by the senior nurse. For example, staffing affects the costs incurred by the facility as well as time spend (Kim, Song & Son, 2018). The census logistics are used to ensure that admission and discharging of patients are strategized so that the facility only accommodates the right number of patients. Generally, the facility maintains to have one nurse in charge at any given time. Therefore, the number of patients in the facility at any time is maintained below fourteen. When the number of nurses is kept high, the cost of operation is kept low since the facility saves most of the time. Also, fewer mortality rates and better care plans are associated with sufficient staffing. Generally, staffing in hospitals is aimed at avoiding complications that come with insufficient staff.
Goals
Most of my duties in the clinic involved working under the standard conditions for a nurse. As a student, a nurse in charge was always present to assess my progress as well as giving most of the instruction. Two patients were left under my care throughout the twelve-hour shift, and the nurse in charge was not obliged to assist me in dealing with the two patients (Lin, Kuo, Wang, Syu & Tsai, 2016). I successfully took care of the two patients, and my supervisor was always around to help in scanning medication and to clear computer charting orders. Student nursing is still not given access to computer systems; hence, the requirement for the nurse in charge. Most of the activities involved checking the lab assessments for the patients and assisting in the medication process for the two patients. Also, I would take directions from the residents and entering them into the computer. Then, I would take the printed orders to put them back on paper for signing.
The next goal involved an introduction to the unit manager to secure an employment opportunity. After the practice as a student nurse, I would be looking for a job, and the unit manager is the best person to engage. Meeting the unit manager is always a difficult task owing to the several activities they are already undertaking. In this case, I planned for an appointment with the unit manager. I had planned to take along one of my colleagues to take to the office in a bid to boosts my confidence. However, I realized that I was unable to meet the manager as she was out of the office and seemed busy. The nurse who had come up with the idea came up with yet another idea. The nurse assured me that she had overheard the manager talking positively about me and that I needed to leave my resume at the manager’s inbox
Professional Assessment
My confidence as a practitioner was tested on the second shift into my duties. A patient who had appeared stable from the morning suddenly developed breathing problems. The condition was becoming severe that I had to inform the residents as fast as I could (Li & Kwan, 2019). The patient was, however, saved, and the first lesson learned was that I was allowed to seek help whenever things appeared to be going out of hand.
Another experience happened on my third shift as a nursing practitioner. An eighty-year-old was complaining of respiratory complications. Diagnoses were made, and the patient was admitted with respiratory failure. The initial stages of the client’s behavior were full of resistance, with the client acknowledging that they were not comfortable in the clinic.
In sum, staffing forms a central part in the nursing sector. Sufficient nurses are required so that unnecessary costs are not encountered. The experience at the clinic was crucial in affecting most of the goals that I had set before the ordeal. Generally, the experience during the different shifts was enough in making me confident.
References
Altman, S. H., Butler, A. S., Shern, L. (Eds.). (2015). Assessing Progress on the IOM Report The Future of Nursing. Washington, DC: The National Academies Press. Retrieved from http://www.nationalacademies.org/hmd/Reports/2015/Assessing-Progress-on-the-IOM- Report-The-Future-of-Nursing.aspx doi: 10.17226/21838
Kim, D. H., Song, H. B., & Son, H. K. (2018). A Phenomenological Study on the Experiences of Nursing Students’ Communication in Clinical Nursing Practicum. Health Commun, 13(2), 195.
Li, W. H. C., & Kwan, S. W. G. (2019). The efficacy of using adventure-based training in enhancing resilience and competency among Nursing students for clinical practicum. In NET Conference 2019, Advance HE and the NET Conference Organising Committee.
Lin, E. C. L., Kuo, Y. P., Wang, Y. H., Syu, Y. Y., & Tsai, H. C. (2016). First Encountering With Nursing Practice: Undergraduate Students’ Fundamental Nursing Practicum in ICU.