Reflection: Clinical Assessment

1. What are your goals for the day? (Address health assessment, psychomotor skills, and communication techniques/phases) Coming into the fourth clinical day, I retain three goals: Safely and accurately checking blood glucose with insulin administration, gaining resident trust through demonstrating my desire to assist, and distinguishing how perfusion implements into resident care. Vast arrays of residents on station four require blood glucose checks and insulin administration prior to meals, and I would like to use this week as an opportunity to enhance my confidence in this skill. Through insulin safety and patient encounters, I desire to gain trust with the residents, as many of the residents have refused care from nursing students. I

Because we did not have a clinical last week, I wanted to ensure that I did not disregard little details about my assigned resident that may have been overlooked. I reviewed the information my partner and I completed in the concept map, my resident's assessment/health history information, and how my resident behaved the prior clinical day. It rests imperative to not only retain background knowledge of my resident, but also to distinguish how she has transformed over my time with her - physically, mentally, and emotionally. Going into this week's clinical, I will be able to utilize my knowledge to make an assessment of her current condition. Along with taking a look back on my assigned resident's information, I also reviewed the concept of perfusion. I recently learned about perfusion in class, so I am aware that perfusion relates to the body's ability to distribute blood through a vascular bed. Due to the fact that perfusion entails the whole body, perfusion assessment includes components such as: vital signs, skin color, skin temperature, diaphoresis, level of consciousness, and capillary refill. With each of these components comes adequate, diminished, and absent levels. My attention did not subsist as memorizing theses components, but rather as acquiring a general idea of assessing perfusion in my assigned resident.

I plan to start my clinical day on station four, where I will either assist the CNA with awakening the residents or begin taking morning vital signs and blood glucose readings. If I am with the CNAs, I will wake the residents, perform health hygiene and brief changes, and transfer the residents. If I am taking blood glucose levels, I will check the assigned resident's blood sugar, check his or her chart to see if insulin is required, and administer insulin, if it is applicable. Around 11 o'clock, our group normally gathers together and takes a lunch break for a half hour. After the group lunch break, I would like to get with my partner and begin to fill out our concept worksheet - Perfusion - for this week. My partner and I will implement our knowledge on vital signs, question the nurse on why only distinct residents get vital signs taken, and apply a perfusion assessment on our assigned resident. When communicating with our assigned resident, we will obtain both subjective and objective data on perfusion, utilizing this information not only for our concept worksheet, but also for our resident's concept map. When we complete our concept worksheet, I would like to gather this week's required information from our assigned partner and her medical record - Nutrition, activity/occupational therapy, systems assessment, basic nursing care choices, vital signs,