Having clinical rotations at Maine Medical Center has played a big part in enhancing my nursing knowledge by allowing me to get hands on experience. With this, I have been able to communicate with patients, practice critical nursing skills, and collaborate with other health care members. These experiences are invaluable and have given me great experience. With every patient encounter, something always sticks with me. Whether it was a friendly patient or a patient who is truly relying on our help to improve their quality of life, I take away something special from each patient.
Specifically, I remember an encounter with a patient that has stuck with me since. This patient was critically ill and needed a heart catheterization with a possible coronary artery bypass graft to help diagnose and resolve what was going on. Chronic heart failure was the primary diagnosis along with an acute exacerbation of a kidney injury. The patient was retaining fluid and had difficulty with mobility. They required a lot of assistance with things such as eating, going to the bathroom, and changing position in their bed. This patient, even with all their difficulties, was one of the most optimistic patients I have ever cared for. They were extremely polite and grateful that we were able to help him. I was amazed at how appreciative and happy this patient was even though they were in a critical condition. It made me think about all the little things that may have annoyed me and made me realize that they were not that big of a deal compared to this patient.
During the encounter, a lot of things went well. I was there to assist this patient to the restroom. Even though challenges in mobility existed, we were able to slowly use the walker and get the patient to the restroom. During breakfast time, I was able to assist the patient in eating. I opened their milk and containers which helped this patient greatly as they hand strength was diminished. This allowed the patient to eat their meal which will provide them will the proper nutrition to help their diagnosis. I was able to help this patient get washed up for the day via a bed bath. Getting the patient cleaned up can help reduce the risk of having the patient’s skin break down which could develop into a pressure sore or ulcer. The patient was very responsive and let me do what had to be done. These things went well for me as I communicated with the patient through each step of the procedures. They were understanding and willing to participate in each process. I was grateful for this as the patient knew the tasks that I was doing and that it was going to help them. Not everything went well through this encounter. The patient was hard of hearing and it was challenging at times to verbalize what I was going to do and if I had any questions. I used the white board on in their room to write out things that I was going to do throughout the day. This helped bridge the communication so that the patient was informed and ready to actively participate. I should have used this method of communication early during my time so that things could of went more smoothly. Another thing that I could also improve upon is my confidence. This encounter happened earlier in the semester and I was not as confident in my skills as I am now. Clinical has provided me with learning opportunities which has built my confidence as a nurse.
Analyzing this patient in a different perspective, I am able learn more about their demographics and social determinants. Each patient has different health equity and different levels of access to care. The patient that I was taking care of had limited access to care. They lived in an area where health care was not something that was easily accessible. The last time this patient went to the doctor was five years ago. With this, this patient has a lot of new diagnosis such as type 2 diabetes as they have not been able to regularly trend their health. This lack of accessibility could have played a role in their current health by not allowing them to treat issues when early warning signs present. This patient was also at a disadvantage economically and could not afford most of their medications and procedures. This also played a role in the patient’s health. As far as the patient social determinants of health, this patient was educated and is currently retired. They are living off retirement and has a fixed income. This patient’s diet was not well balanced as they only have access to cheap food that lasted a long time. These factors play a big role in the patient’s health. Learning this information on this patient allows me to inquire about what the health care system is doing for the patient. This patient needs more access to health care and could benefit from referrals to primary care offices, physical therapists, and other health care teams that are closer to this patient’s residence. This could ultimately improve the patient’s health as they have the resources to improve their quality of life. The health care team has done a good job at educating and informing the patient on what needs to be done upon discharge. Education on medications, diagnosis, and nutrition is key to maintaining good health. Learning from this patient has allowed me the opportunity to grow as a nurse.
I am a very different nurse now in comparison to the beginning of the semester. I was not as confident in my capabilities and knowledge as I am now. These skills have been strengthened through each clinical rotation. I got to practice important nursing skills which has built my confidence. Patient and team communication was not as good as it is now. This came from talking to numerous patients and collaborating with different health care members. These experiences are invaluable to my knowledge and have helped me grow as a nurse. Growth is an important part in nursing, and it comes each time you encounter a patient. You learn new things and learn new strategies to help provide the best care possible.
