Clinical Journal 3/11/16
The first day of clinicals began with orientation. We were introduced to the facility and all of the rules. After orientation, we took a quick tour of the facility and went to our assigned unit. Once at my assigned unit, I sat in the nurses’ station and reviewed several different charts. I was surprised to find that many of the patients had a history of injuring their pets as well as family. I was then able to observe the nurse practitioner do a physical with a young boy. When watching him during the physical he seemed so sweet and fragile, but I learned that he was one of the patients that had tried to hurt his family, teacher, and pet. It really surprised me and was hard to picture him doing the things he had. I was able to watch another physical as well as a history on an older girl. I found the history session interesting because she was very angry and upset, and the provider was able to calm her down by having her focus on herself sitting in the chair and being present. I thought that was a good technique to remember. We then attended an awards ceremony and a group session. The group session didn’t start on time, and I was only able to watch a few minutes of it before it was time to leave. During the group session, I noticed that there was a lot of chaos and it was hard to control all of the young boys. The techs tried to calm them down, but they just yelled at them and said things I didn’t find very appropriate.
Throughout the day I was wishing that there were more hands on activities I could participate in. If I could repeat this clinical day I would get more involved when I could. There weren’t many opportunities to interact with patients, and I spent most of my day in the nurses’ station. The only situation that really stuck out to me and I took something away from was listening to the provider talk to the older girl about her history. The technique he used to discuss her history with her was helpful to observe. Although she didn’t want to discuss anything, I still learned what kind of questions to ask and how to handle different responses.
I now recognize different ways of using therapeutic communication. This has taught me how to make the patient feel safe and comfortable, and let them know that they are free to answer or discuss anything they want to. It has also taught me how to calm the patient down when they are getting uncomfortable or mad when talking about different things.
I will use this experience in the future when I am discussing difficult topics with a patient. I will remember the different techniques I witnessed and implement them in my practice as a nurse.