Third semester: Mackenzie Reactivation Care Centre - Professional Practicum I
Throughout the semester, I have been learning different essential skills to the nursing practice, some of those skills include:
When I would start my shift, I would begin with doing morning care which includes giving the patient a bed bath, changing their brief if applicable, and helping them to brush their teeth. If they wanted to sit up or move to the chair I would first check where they are on the fall risk assessment and check how much assistance I would require for the move.
I would first remove the old dressings and then irrigate the wound, after irrigation I would apply a new dressing to the wound.
Feeding is important, especially for bed-bound patients in need of full assistance. I would have to use my clinical judgment to determine who I am going to feed first. This was challenging sometimes because of how many patients would need my help to eat, for those still sleeping I would let them rest until I could wake them for feeding.
I have not done this skill alone personally, however with the nurse educator, as a group, we would watch how to pack the wound and even practice, it was a great experience to practice before having patients of my own that require packing wounds.
There would be workshops in which different skills were presented and explained. In the workshop, a student nurse educator was explaining the new best-practice guidelines for tracheostomy care and suctioning. It was great to be able to be updated on the best practices to optimize patient care.
This skill was another part of morning care. When I would first enter the patient's room, I would take their vital signs to establish their baseline early morning. I had to monitor some patients who were experiencing low oxygen levels or high blood pressure.
This skill is essential to the entire nursing practice. I was able to practice on all of my patients the full head-to-toe to make sure their health isn't undergoing any major changes and to make note of the normal findings vs the abnormal findings.
4th Semester: Humber River Hospital - Wilson site - Professional Practicum II
Throughout the semester most of the patient population in the unit I was working in (8 EAST), were tracheostomy patients. I got to attend a workshop with the RT from the unit who was discussing different oxygen therapies for patients as well as how to properly suction a patient and provide tracheostomy care by changing the inner cannula and dressing when necessary as well as suctioning PRN when the patient needs it.
I also had the opportunity to perform full head-to-toe assessments on each of my patients with a primary focus on integumentary, cardio and respiratory. This really enhanced my skills and understanding of why it is very important to do these assessments.
My clinical supervisor this semester really pushed the students to use our critical thinking when it comes to patient care. I learned how to understand lab values and how they correspond to patient diagnoses as well as look out for signs and symptoms of the effects of their illness or medications.
This semester was the introduction to medication administration, I learned about many different types of medications as well as their routes, the only exception being insulin and measuring blood glucose, as well as anything IM.
In the unit there were a lot of clients with tracheostomies which hinder their speech ability, there were also clients who were comatose according to the Glasgow coma scale. Due to this, I had to learn new ways to communicate and figure out patient needs through non-verbal cues and observation.
Since the unit was full of stable and unstable patients, there were some casualties. Although an unfortunate event, it provided me with a good learning opportunity to provide post-mortem care. The nurses were explaining how different hospitals have different policies regarding post-mortem care but the main goal is to clean up the patient and remove all IVs and tubing unless otherwise stated.
5th Semester: BSN525 Humber River Hospital - Wilson site - Professional Practicum III
The unit had multiple clients with various injuries ranging from pressure ulcers to diabetic foot infection. It was a good learning experience to familiarize myself with the orders for wound care as well as finding through research what each dressing does for the wounds, and, learning from wound care nurses more specifically
6th Semester: BSN625 Brampton Civic Hospital - Professional Practicum IV
7th Semester: BSN725 Vaughn Cortelucci Hospital - Professional Practicum V