N484 integration iv

Here are my post simulation/ self reflections that I had completed while in N484:

Adelphi University College of Nursing & Public Health

Integration IV

Post live simulation experiences

Name: Darah Daskalakis

Instructor: Dr. Annie George

Date: February 10, 2022

Post Simulation Self-Reflection Improvement Plan

1. After participating in today’s simulation, I am less fearful of communicating with the family member of a patient. Being involved in this simulation put pressure on the nurses to have to answer questions of not only the patient, but the family member in the room as well. Being able to practice these skills on the spot makes me feel more confident and less fearful of this situation.

2. My communication skills with family are fairly good. I am learning to become more confident speaking to family members, it can be very intimidating but the more practice I get, the more comfortable I become.

3. My assessment skills are pretty good! I am fairly confident in assessment skills, while in the simulation I had my eyes on the vital sign monitor as well as the patient. Noticing that the oxygen level was decreasing on the monitor, I knew that the necessary assessment involved the lungs and checking anything that could be affecting the client’s oxygen status (chest tube).

4. What I have learned from this experience is to expect the unexpected. Although the client is in the hospital and is on supportive mechanisms (chest tube), you cannot expect things to be smooth sailing 24/7. In this case, the chest tube was functioning properly, however, the patient was laying on the tubing, causing a malfunction in the effectiveness. I learned that a thorough assessment is necessary in every case, especially when certain factors aren’t adding up when they should be.

5. I confident about being vigilant in the clinical setting. If the patient has a concern, I always check all possibilities to have a better outcome. If there is something that I am unsure of, I am confident in my ability to call in a fellow healthcare provider for assistance- there’s no shame in teamwork.

6. I have identified I need to improve my confidence level when first entering the room of the patient. I am very shy, but I am confident in my skills. Once I get comfortable in the room with the patient, start a conversation, and familiarize myself with the situation, I am a bit more at ease. I would like to learn how to be that way from the start.

7. Knowledge I need to further obtain for this specific simulation would be knowledge of the chest tube. When asked questions on the spot, I realized that I forgot a lot of things that I had learned in fundamentals. I need to review these topics to be prepared for not only my NCLEX, but for the clinical setting as well.

8. As I self-reflect on my overall nursing skills and experience, I would like to comment on the knowledge that I am able to portray in a clinical setting. Not everything that I have learned are facts straight out of a textbook, a lot of critical thinking goes into these experiences as well. Being able to think on your feet and apply the textbook-knowledge at the same time plays a huge role in nursing, I am proud to say that I am becoming more and more confident with the real-life scenarios that I take part in because of this.

9. Three areas I would like to improve my knowledge would be

1- Time management/prioritizing

2- Confidence/assertiveness

3- Reviewing interventions for client care

10 List references used to improve your knowledge:

References

Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth’s textbook of medical-surgical nursing (14th ed., Vol. 2). Wolters Kluwer.

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Darah Daskalakis

Dr. Annie George

NUR 484-600

March 30, 2022

Week 5- Post-Simulation Self Improvement Reflective Plan

1. After participating in today’s simulation, I am less fearful of an emergency where CPR will be necessary to improve the outcome for a patient’s health. Before this simulation, I had never been involved in a situation where CPR was needed; the only time I had done CPR was during my training to become certified. It was very helpful to be thrown into this type of situation, as it allowed me to be able to think quick on my feet and apply the knowledge I had acquired in the past if I am ever presented with an emergency like the one presented in the simulation.

2. Since I was the student acting as the family member in this simulation, I cannot speak for my communication skills with family members when presented with this type of situation. However, during the debriefing, I had learned the proper way to handle a family member. During a code/rapid response, I had learned that the family member needs to be taken out of the room, so that “extra panic/stress” is not encountered throughout the emergency. The patient’s family member should not have to watch this type of situation, as it may not always result in a positive outcome for the patient no matter how much effort is put forth by the healthcare team.

3. My assessment skills are in good standing. While participating in this simulation, I was able to point out to the nurses that the patient’s vital signs were declining based on the monitor reading. As the patient made remarks about not being able to breathe well, I noticed that his O2 sat was declining rapidly along with his heart rate and that something needed to be done (call the HCP/rapid response). Since the patient was complaining of chest pain and not being able to breathe well, I suggested that the nurses listen to his lungs and ask if they could call the patient’s provider to order something for the patient’s pain.

4. What I have learned from this experience is to expect the unexpected. Although the patient handoff report included that this patient has been having chest pain and difficulty breathing, I was not expecting the patient to flat-line and need CPR. I learned that it is important to keep your composure in an emergency, communicate effectively with the healthcare team, and to not be afraid to call a rapid response when you notice a patient’s condition is rapidly declining unexpectedly.

5. I confident about my skills and abilities to act quickly and effectively in an emergency where CPR may be necessary to improve the condition of the patient. Before this simulation, I never had the chance to put my education/skills regarding CPR into action. I now feel more confident in my ability to perform an emergency SBAR report, giving CPR, and how to handle a family member who is present during an emergency.

6. I have identified I need to improve the time that it took to realize that CPR needed to begin on the patient during an emergency. During our debriefing, it was identified that it took 45 seconds for the nurses to start CPR on the patient after he fell unconscious and flat-lined. Although it is very nerve racking to be in this situation, it is important to remember that chest compressions need to be started as soon as possible if no pulse is felt on the patient after they go unconscious. I feel like since I had never been in a situation like this, I was in shock and froze before realizing what needed to be done.

7. Knowledge I need to further obtain would be the correct steps for CPR. It has been a while since my CPR training, and since I never was faced with an emergency such as this, I was a little fuzzy on the exact steps to preforming proper CPR. Since this simulation, I had done research and now feel more confident in myself if ever presented with a similar situation.

8. As I self-reflect on my overall nursing skills and experience, I would like to comment on my growth as far as improving my communication and teamwork skills during an emergency. Although I was in a bit of shock when the patient in this simulation lost their pulse and their O2 had been declining rapidly, I feel that I was able to communicate my concerns with my fellow nurses. Together, we were able to call a code and rectify the emergency at hand by designating specific roles, communicating properly, and focusing on the wellbeing of all active members in the emergency (healthcare workers, patient, family members).

9. Three areas I would like to improve my knowledge would be how to handle stress during an emergency, the proper technique to preforming CPR, and how to handle a family member being involved in an emergency if there is a bad outcome. Although the healthcare team does their best to ensure the quality of care for the patient, sometimes CPR does not help the client. I would like to learn how to handle a family member if they witness an emergency that has a poor outcome because I truly do not know the answer to that.

10 References used to improve your knowledge:

GM;, E. E. L. R. L. L. C. L. W. B. (2017, March). Condition help: A patient- and family-initiated rapid response system. Journal of hospital medicine. Retrieved March 31, 2022, from https://pubmed.ncbi.nlm.nih.gov/28272591/

Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth’s textbook of medical-surgical nursing (14th ed., Vol. 2). Wolters Kluwer.