Fredesminda Guevara

0513 Kamloops
Learning Objectives

Standard 1:
Therapeutic
Interpersonal
Relationships

6.09 Utilizes as
appropriate problem
solving techniques
during interactions
My goal is to develop
my critical thinking
skills and be able to
transfer learned
theories into practice.

Resources and Strategies

Types of Evidence of
achievement

Criteria to
validate
objectives
achieved

I reviewed my patients MAR,

focusing particularly on his
insulin as I was excited to
administer it. I realized that his
insulin only contained mealtime
correction factor, and only a
long-acting one at bedtime.
Reading through his diabetic
protocol again, I realized that he
did not have breakfast nor lunch
scheduled for insulin (only at
supper). Also his daytime BGM
readings for the past days didnt
show morning corrections (all
less than 9.0) and he hasnt been
getting any. Things clicked into
place for me and I understood
then how to connect theory on
diabetes and insulin into actual
practice. I interpreted that he
didnt need insulin as per his
protocol but I still confirmed with
my instructor.
(Reflective journal, July 21-22,
2014)

I rate myself 4/5

because I would
like more
opportunities to
exercise
translating
theory into
practice. I have
made
improvements
since the start of
the semester
but I would like
to be more
comfortable and
consistent with
problem-solving
techniques.

Consult appropriate texts:

Perry A. & Potter, P. (2010). Clinical Nursing
Skills & Techniques (7th ed.). St. Louis, MO:
Mosby Elsevier
Lewis, S., Heitkemper, M., Dirksen, S. R.,
O'Brien, P. G., Barry, M., Goldsworthy, S., &
Goodridge, D. (2014). Medical-surgical nursing
in Canada. Toronto, ON: Mosby Elsevier
Stuart, G. (2013). Principles and Practice of
Psychiatric Nursing (10th ed.). St. Louis, MO:
Mosby Elsevier
Consult appropriate websites/videos:
http://canadian-nurse.com/en/search-results?
q=problem+solving+techniques
http://www.canadiannurse.com/en/articles/issues/2012/january2012/blogging-the-nursing-life
Strategies:
I will continue reading, observing and
consulting as to ideas on problem-solving
techniques.

Fredesminda Guevara
0513 Kamloops
Standard 2:
Application and
Integration of
Theory-Based
Knowledge
Clinical Competency
4.02 Prepares,
implements and
evaluates teaching
plan.
I hope to have the
chance to share with
patients a teaching
plan specific to their
need, check for
understanding and
evaluate effectiveness

Consult appropriate texts:

Perry A. & Potter, P. (2010). Clinical Nursing
Skills & Techniques (7th ed.). St. Louis, MO:
Mosby Elsevier
Lewis, S., Heitkemper, M., Dirksen, S. R.,
O'Brien, P. G., Barry, M., Goldsworthy, S., &
Goodridge, D. (2014). Medical-surgical nursing
in Canada. Toronto, ON: Mosby Elsevier
Stuart, G. (2013). Principles and Practice of
Psychiatric Nursing (10th ed.). St. Louis, MO:
Mosby Elsevier
Consult appropriate websites/ videos:
http://allnurses.com/general-nursingstudent/first-pt-teaching-380113.html
http://www.patienteducationupdate.com/200609-01/article3.asp

Strategy:
I will watch videos, read textbooks and observe
nurses while on rotation as well as consult my
instructor.

I identified the itchy patient with

a need for teaching about why
he had to start ambulating again.
His PT had put a note on his wall
that he needed to ambulate
twice a day, but when I asked
him if he wanted to move from
his bed and walk a little bit. He
said that he didnt want to and
that he felt better on the bed
than out of it. I explained to him
that he needed to do some
physical activity to exercise his
muscles and strengthen his body,
as staying in bed predisposed
him to bed sores as well as
weakened his body even more
(Reflective Journal, July 7-8,
2014)
Also, we submitted our brochure
on Anemia to our instructor. Each
of us contributed to the content
and one of our classmates laid it
out in Microsoft Publisher. The
end product was professional
and very attractive something
that would invite patients to read
through and collect relevant
information. I know that this
brochure would be used to
practice patient teaching and
also sharing information with
nurses as well.
(Reflective Journal, July 14-15,
2014)

Im rating myself
a 4/5 because
although I have
not had the
opportunity to
implement and
evaluate a
teaching plan, I
had been able to
share with
patients
rationales about
importance of
adherence to
nursing
interventions

Fredesminda Guevara
0513 Kamloops

Fredesminda Guevara
0513 Kamloops
Standard 2:
Application and
Integration of
Theory-Based
Knowledge

Consult appropriate texts:

Clinical Competency
1.01
Takes nursing
history

Lewis, S., Heitkemper, M., Dirksen, S. R.,

O'Brien, P. G., Barry, M., Goldsworthy, S., &
Goodridge, D. (2014). Medical-surgical nursing
in Canada. Toronto, ON: Mosby Elsevier

I would like to have an

opportunity to take a
full nursing history or
at least sit in on one

Perry A. & Potter, P. (2010). Clinical Nursing

Skills & Techniques (7th ed.). St. Louis, MO:
Mosby Elsevier

Stuart, G. (2013). Principles and Practice of

Psychiatric Nursing (10th ed.). St. Louis, MO:
Mosby Elsevier
Consult websites/ videos
http://www.youtube.com/watch?v=NWZRo6GJnA
http://www.questushealth.com/wpincludes/handouts/Pt%20History%202.pdf
Strategies:
I will look for opportunities to participate in
admissions so I can see how the nurses
conduct their history-takiing.

He was very cooperative though

and I felt that I did better with
him because I was learning how
to assess for more specific
details. By now, I have learned to
ask patients for relevant details
while chatting them up first thing
in the morning. I start with
asking how they slept, if they
had any pain during the night or
at waking, and if there were any
unusual things that they thought
their nurse should know about. I
also ask them about urination
and bowel movements and when
was the last time they remember
doing either. (Reflective Journal,
June 30- July 1, 2014)
He appeared pleasant and when
asked, didnt report any pain
presently or the night before,
and claimed that he slept well.
He also asserted that he had no
issues with urinating or BM- in
fact he was adamant about not
being sick and he just wanted to
get discharged.
(Reflective Journal, July 21-22,
2014)

Im rating myself
3/5 because I
havent sat in on
an admission
process where
the nurse takes
a nursing history
(48/6). However,
I have had
opportunities in
taking brief
nursing histories
of my patients
as I met them in
the morning and
when I took
assessments.

Fredesminda Guevara
0513 Kamloops
Standard 3:
Professional
Responsibility
Clinical Competency
5.08 Functions within
the policies and
practices of the
employing agency
I would like to get more
familiar with how the
medical-surgical is
generally run through its
polices and SOPs.

Consult appropriate text:

Barker, P. Psychiatric and Mental Health
Nursing: The Art of Caring. London, UK:
Edward Arnold
Lewis, S., Heitkemper, M., Dirksen, S. R.,
O'Brien, P. G., Barry, M., Goldsworthy, S., &
Goodridge, D. (2014). Medical-surgical
nursing in Canada. Toronto, ON: Mosby
Elsevier
Stuart, G. (2013). Principles and Practice of
Psychiatric Nursing (10th ed.). St. Louis, MO:
Mosby Elsevier

Consult websites and appropriate videos:

http://allnurses.com/nursing-activismhealthcare/21st-century-nurses-19041.html
Strategies:
I will read up when I have extra time
between tasks, and consult my instructor
and nurses on the ward for more
information.

The infection control officer

came and led us around the
ward, pointing out
important information that
we needed to know about
isolation, airborne and
contact precautions, and
routine protocols about
sanitary and aseptic
methods. (Reflective
Journal, June 16-17, 2014)
Back at the med-surg ward,
there were also a couple of
nurses who explained about
how a code blue is
performed the importance
of knowing if a patient is a
DNR or full code. They also
stressed about our role as
student, which is to keep
out of the way but remain
accessible if something
needs fetching, and to
inform staff the quickest
way possible if we ever
found a patient in
respiratory or cardiac
emergency
(Reflective Journal dated
June 30-July 1, 2014)
One thing that I would like
is to read more about the
standard operating
procedures (SOPs) of the

I am rating myself 3/5

because I am still not
quite familiar with a
lot of policies and
practices of the
hospital.

Fredesminda Guevara
0513 Kamloops
unitId like to read about
their operating manuals and
see if the staff are
consistent in implementing
SOPs. (Reflective Journal,
July 21-22, 2014)

Fredesminda Guevara
0513 Kamloops
Standard 4:
Professional Ethics
Clinical Competency
7.03
Gives factual information
to client/family
I hope to communicate
appropriately with clients
and their families about
their disease processes,
treatment, and care after
discharge.

Consult appropriate text:

Barry, Goldsworthy & Goodridge textbook
(3rd Canadian ed): Chapter 4: Caregiver
and patient teaching
Loxton, M. (2003). Patient education: The
nurse as source of actionable information.
Retrieved from
http://www.medscape.com/viewarticle/4533
48
Consult appropriate videos/websites/other
resources
https://www.cancercare.on.ca/common/pag
es/UserFile.aspx?fileId=60065
http://www.youtube.com/watch?
v=3tVeCjXP7mY
http://www.youtube.com/watch?
v=GJVa7Q0QUN4
Strategies:
I would observe how nurses work together
with patients and how they conduct patient
teaching. I will also ask my instructor for
pointers,

He was NPO as he was

waiting for his pacemaker
surgery that day, and he
was anxious about being
hungry and of the
procedure not going
through. I chatted with him
and shared with him the
function of pacemakers and
how one would help his
heart have a more stable
rate and rhythm (he had
sinus bradycardia and
arrhythmia). (Reflective
Journal, June 16-17, 2014)
. In my main patient, I
identified that he needed
more teaching on why he
had to drink more water as
he constantly refused it and
said he was fine, but his
care plan clearly stated that
he needed more fluids as he
was not taking in enough. I
informed him about the
benefits of adequately
drinking fluids, such as
helping the body maintain
its electrolyte
concentrations and easing
muscle cramps
(Reflective Journal, July 7-8,
2014)

Im giving myself a
4/5 because I have
shared factual
information with
patients about their
condition. However, I
would like more
opportunities to do so
particularly when
family members are
present as well.