1. Focused Reflection (30 points)   

Objective: To reflect on the interprofessional roles (MD, SW, OT, PT, RT, RD, PharmD) you saw on the unit and describe communication between them and the nurse. 

· List all of the different providers that were involved in your patient’s care. What was the focus of each of these providers in the patient’s care? What was your nursing focus in the patient’s care? Be specific and give examples. 

· How did you or the nurse communicate with each different provider? How did each provider communicate with the nurse? Be specific and give examples. 

· What did you see done well and what would you improve? What would you specifically do to improve it?

The reflection should be 2-3 pages, but not longer than 3 pages. Use Times New Roman 12 point font, 1 inch margins, and double spacing to format your paper. The reflection does not need a title page or references. See syllabus for late assignment point deductions.

Focused Reflection rubric

  

0

3

 

Length and Mechanics

Does not meet page   requirement.

One formatting   error. Multiple spelling/grammar   errors. Point is not   understandable.  

3 pages typed.

Double spaced.

TNR 12 pt font.

1 inch margins.

Minor spelling/ grammar   errors, but point is understandable

 

0

3

5

7

9

 

Listed providers and   their focus vs. nursing focus. Was   specific and gave examples.

Does not address.

Needs improvement.

Mostly complete.

Above   average.

Completely   addresses.

 

0

3

5

7

9

 

Described nurse to   provider and provider to nurse communication. Was specific and gave examples. 

Does not address.

Needs improvement.

Mostly complete.

Above   average.

Completely   addresses.

 

Described what was done   well and what to improve. Gave   specific suggestions on their improvements.

Does not address.

Needs improvement.

Mostly complete.

Above average.

Completely addresses.

Clinical Check-Offs 

1. Medication Administration Check-off

STUDENTS CAN ONLY ADMINISTER MEDICATIONS WITH THE CLINICAL INSTRUCTOR. This includes the administration of any kind of medication by any route. Medications cannot be administered with a staff nurse. Failure to follow this rule will result in failure of the check-off, immediate dismissal from the clinical site and inability to pass NM 322. 

The clinical instructor will give medications with two students per day. Students must pass the medication check-off by the end of the semester.

2. Clinical Performance Evaluation

The Clinical Performance Evaluation will be reviewed with the student as needed, at mid-semester and at the end of the semester.  Failure to satisfactorily meet core competencies on the Clinical Performance Evaluation can result in being sent home from the clinical site, an academic alert, a corrective action plan and/or dismissal from the nursing program.

Please review the Student Laboratory and Clinical Handbook, especially the sections entitled “Standards for Student Behavior in the Laboratory and Clinical Setting” and “Clinical Attendance Policy.” 

Other Clinical Expectations

1. Timeliness

Students are expected to be in the assigned room ready to go for pre-clinical at 2:00 pm. Time will be determined via the instructor’s cell phone. 

Students arriving after 2:00 pm will be given the opportunity to prepare for patient care. Failure to complete the Pre-Clinical Patient Care Form completely by the end of pre-clinical will result in the student being sent home from the clinical shift and losing all points associated with the clinical day. 

Students who are able to complete the Pre-Clinical Patient Care Form will be allowed to stay for clinical, but will lose all points associated with the clinical day. All assignments must still be completed for the clinical day. 

Failure to arrive on time will be reflected on your Clinical Performance Evaluation. Failure to meet core competencies on the Clinical Performance Evaluation can result in being sent home from the clinical site, an academic alert, a corrective action plan and/or dismissal from the nursing program.

Any student who is not at pre-clinical at 2:00 pm needs to have notified their clinical instructor. See the first page for how to notify instructor.

2. What You Can Do as a Student Nurse

Provide the best possible care for your patient that day. This includes assessing the patient, documenting your assessment and providing personal cares. Learn as much as you possibly can from this experience. Attend therapy or tests/procedures with your patient. Please notify the patient’s nurse, so they know where you and the patient are at all times. 

Students should answer call lights when they are not providing care for their patient. The student should then check with the patient’s nurse regarding the patient’s request before carrying it out. For example, a patient may ask for water and be NPO. The student would not know this without checking with the nurse. A patient may say they can walk to the bathroom, but really need assistance with transferring. 

3.  What You Can’t Do as a Student Nurse (Per BSN Clinical Instructor handbook)

1. Administer Blood

2. Program a PCA pump

3. Manage Epidural Infusion, Tubing or Pump Settings

4. Do EKG or Fetal Monitoring Interpretation (it is crucial that students not document in a fashion that would suggest they have done any monitoring interpretation)

5. Take Verbal or Telephone Orders

6. Verify Informed Consent

7. Advance the plan of care (must be licensed professional)

8. Blood Glucose Monitoring 

9. Blood draws from any line

10. Discontinue a central line

11. Administer IV push medications, including IV flushes

12. Start IVs

13. Administer chemotherapy

14. Insert a urinary catheter (Regions new policy)

4. What You Can Do as a Student Nurse, But Only with the Instructor Present

a. Administer medications by any route

b. Anything IV or tube feeding related (hanging a new bag, programming the pump, etc.)

c. For anything other than a patient assessment or personal cares, the student must connect with the clinical instructor. The clinical instructor will then determine if the student can perform the skill with the patient’s nurse or the instructor. Students can always observe a nurse doing anything for a patient, if it is okay with the patient.

Failure to follow the rules regarding what a student can/can’t do will be reflected on your Clinical Performance Evaluation. Failure to meet core competencies on the Clinical Performance Evaluation can result in being sent home from the clinical site, an academic alert, a corrective action plan and/or dismissal from the nursing program.

Last Day of Clinical

We will show our appreciation for all of the unit staff for their help on every clinical day. All interactions with staff should be respectful and include a thank you for their help. In addition to our daily thanks, we will sign a card and bring treats for the staff on our last  v vvvvvv

 

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Use the image in “Discussion Question Resource: Chest X-Ray” to answer the following Critical Thinking Questions.

Examine the x-ray of a patient diagnosed with pneumonia due to infection with Mucor. Refer to the “Module 4 DQ Chest Xray” resource in order to complete the following questions.

Critical Thinking Questions

1. Explain what Mucor is and how a patient is likely to become infected with Mucor. Describe the pathophysiologic progression of the infection into pneumonia and at least two medical/nursing interventions that would be helpful in treating the patient.
2. Examine the laboratory blood test results and arterial blood gases provided in “Discussion Question Resource: Laboratory Blood Test Results.” What laboratory values are considered abnormal? Explain each abnormality and discuss the probable causes from a pathophysiologic perspective.
3. What medications and medical treatments are likely to be prescribed by the attending physician on this case? List at least three medications and three treatments. Provide rationale for each of the medications and treatments you suggest.

 

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In a short essay (500-750 words), answer the Question at the end of Case Study 1. Cite references to support your positions.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to Turnitin.

Case Study 1

Ms. A. is an apparently healthy 26-year-old white woman. Since the beginning of the current golf season, Ms. A has noted increased shortness of breath and low levels of energy and enthusiasm. These symptoms seem worse during her menses. Today, while playing in a golf tournament at a high, mountainous course, she became light-headed and was taken by her golfing partner to the emergency clinic. The attending physician’s notes indicated a temperature of 98 degrees F, an elevated heart rate and respiratory rate, and low blood pressure. Ms. A states, “Menorrhagia and dysmenorrheal have been a problem for 10-12 years, and I take 1,000 mg of aspirin every 3 to 4 hours for 6 days during menstruation.” During the summer months, while playing golf, she also takes aspirin to avoid “stiffness in my joints.”

Laboratory values are as follows:

Hemoglobin = 8 g/dl

Hematocrit = 32%

Erythrocyte count = 3.1 x 10/mm

RBC smear showed microcytic and hypochromic cells

Reticulocyte count = 1.5%

Other laboratory values were within normal limits.

Question

Considering the circumstances and the preliminary workup, what type of anemia does Ms. A most likely have? In an essay of 500-750 words, explain your answer and include rationale.

RUBRIC:

Accurate identification of anemia classification and rationale.

Identification of anemia classification and rationale is offered in detail, while demonstrating evidence of deeper insight and/or reflection.

Explanation of patient diagnosis with rationale from case findings. Outside sources and/or medical and nursing references used to support conclusions.

Explanation of patient diagnosis uses outside sources and/or medical and nursing references to support conclusions and is offered in detail, while demonstrating evidence of deeper insight and/or reflection.

Thesis Development and Purpose:

Thesis and/or main claim are comprehensive; contained within the thesis is the essence of the paper. Thesis statement makes the purpose of the paper clear.

Paragraph Development and Transitions

There is a sophisticated construction of paragraphs and transitions. Ideas progress and relate to each other. Paragraph and transition construction guide the reader. Paragraph structure is seamless.

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

Writer is clearly in command of standard, written, academic English.

Paper Format(1- inch margins;12-point-font;double-spaced;Times New Roman, Arial, or Courier)

All format elements are correct.

Research Citations(In-text citations for paraphrasing and direct quotes, and reference page listing and formatting, as appropriate to assignment)

In-text citations and a reference page are complete. The documentation of cited sources is free of error.

 

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The Patient Protection and Affordable Care Act (PPACA) was passed into legislation in March of 2010. Identify the impact of this legislation on your nursing practice by choosing two key nursing provisions outlined in the topic material “Nursing and Health Reform.” Discuss how these two provisions have impacted, or will impact, your current practice of nursing.

 

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