Nursing Student Diaries – Adult Surgery – Entry 1

Best Nursing Practice (Despite Some Bad Examples)

I have really enjoyed the first few weeks of my surgical clinical placement. I have appreciated the opportunity to hone in on assessment skills through initially focusing on one patient, and have been able to practice other clinical skills such as wound care and in and out catheterization. I feel as though my assessment skills are continually developing and improving, and I am starting to make more connections as far as what some variant assessment findings may indicate.

A challenge that I have faced so far in this rotation, as well as in some of my previous clinical placements, is trying to follow and promote best practice when many of the nurses that I am learning from have adopted so many short cuts and quick fixes. Some examples include having an RN disturb my sterile field while I was doing a dressing change, and one who had me use an older, reddened IV access site, rather than wait for an IV nurse to start a new site. Although it is frustrating for me to have these experiences, I think it is valuable to recognize such situations in order to guide decisions about the standards of nursing care I hope to uphold in practice.

The last two weeks of clinical have provided me with several positive learning opportunities. I was able to perform a dressing change, watch a female in and out catheterization, perform two male in and out catheterization, go through blood product transfusion protocol with two unit RNs, and had valuable conferences regarding caring for stroke patients and peripheral IV insertion/assessment.

I was also fortunate to have had the opportunity to tour the hospital’s emergency department and learn more about the different nursing roles in that setting. It was great to get a better sense of what emergency nurse do even though it’s a bit difficult at this stage to think that my skills could develop to the level that I would be able work with such autonomy and under such pressure as in the ED.

I have tried to put a specific focus on performing and writing out more details of my head to toe assessments this past week and through doing so I am feeling more confident in my abilities to communicate and document assessment information. I am looking forward to the challenge of taking on a three-patient assignment in my last few shifts, as I know that the experience will require me to put an emphasis on organizational and time-management skills.​

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