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Reflection #1

Megan Scott

Trent University
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Clinical Reflection

Look Back and Elaborate

For my 3020 clinical placement, I got placed in Orthopedics at PRHC. When I found out

that this was my placement, I was very excited. Going into my first shift, I was more comfortable

then I was last year in maternal child because I already knew what colour and where the MARS

were kept, I knew where the vital carts were, and where the patients’ chart is kept, etc. I thought

to myself, “we are the new student here”, and therefore we cannot get in anyone’s way. Luckily,

we got paired up with another nursing student on the first day and were off to go introduce

ourselves to the patients and applied our nursing knowledge – performing vitals/assessments and

developing therapeutic relationships with the patients. In doing this, it gave me a good

understanding on what to expect for the upcoming clinical days I have in Orthopedics.

On our first week on A5, we were introduced to the floor and were given the opportunity

to explore on our own to find items – e.g., supply closet, dirty utility room, etc. By the second

week I already had noticed that I was getting comfortable with the unit and talking to the nurses

if I had any concerns. The next week, we were able to experience our first Post-op simulation at

school, and on Friday we had the evening shift. It didn’t take long to realize that there were more

tasks to do on the AM shift. I was also the team leader that night, which I really enjoyed. I was

still able to be a part of the assessments with my peers, but also had the expectation and role of

being charge of their break times and reporting off to their nurses. Overall, the nurses and our

clinical instructor were able to help us while doing a dressing or removing an IV with feedback

on how to improve for next time. From the first, second and now third week of clinical, I believe

I performed the assessments well for my first time and found that the more I repeated them

throughout the shifts, the more comfortable I became with my hands-on skills.
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Analysis of Experience

When I arrived on the floor, I was nervous about performing assessments on actual

patients because in lab, we practice on the mannequins. My nervousness was primarily

influenced by the fact that these patients just had surgery, and it was still a learning experience

for me on how to help them. I know one thing I struggled with was finding the pedal pulses,

indicating circulation of blood to the lower extremities. My nurse actually took me into another

patients’ room and allowed me to practice with her, because she knew that the patient had a

strong pulse. I feel as though I was professional about how I acted towards the patient, and she

also knew that it was a learning experience and opportunity. In the article by Lippe and Hudson,

(2018), they were able to identify a strategy to help the students before going into their clinical

setting. The expected outcome was for the students to feel comfortable and to be able to

effectively communicate with the patient (Lippe et al., 2018). The faculty members observed the

student’s anxiety on their first day of placement and while they were performing their first full

health history. Over time, practical simulations have been proven to show positive outcomes

when the student is faced with that same interaction. The faculty members created a simulation

for their students with real actors, and through doing this, the students were able to receive

feedback as well as suggestions for improvement (Lippe et al., 2018). I know that I can relate to

this because it is completely different when practicing on a mannequin in labs, who cannot

respond or show any signs of pain, compared to an actual patient whom we are helping. Our first

simulation took place during our second week, and I feel that it gave me a better idea of what to

expect when I arrived at clinical the following week. Although it was one of our students

pretending to be the patient, the patient was still able to actually verbally communicate back to

us and explained what they were feeling. I strongly feel that practicing in lab and/or simulation
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aids overcoming those fears that myself and my peers feel. When I needed assistance, my peer,

instructor or nurse in charge were able to explain and demonstrate how to properly perform an

assessment.

Evidence of New Learning

It was quick to notice that in order to get better at an assessment, practicing was the

number one thing that helped. I also learned that the best way to overcome nervousness was to

make sure that I was obtaining knowledge in order to complete the task. Personally, I am the

type of learning that prefers to watch first, and “do” second. I believe by doing this, I can adapt

techniques of others and bring them into my practice. An example of this was when I was

changing my first hip dressing. My clinical instructor came into the room with me and

demonstrated what to do. He also told me that because they are unable to roll by themselves on

the hip, to have a second person there to have roll the patient and have the incision facing

upwards rather than to the side – which makes it easier to perform the dressing change. I will

become more confident in my practice after every shift, because I know that I have learned

something knew to take home with me and reflect on.

Revision and New Trial

When overcoming negative feelings regarding something I did in clinical, I know that I

can ask my clinical instructor, nurse in charge or peer to review what they are performing prior

to completing my own assessment. I have the opportunity in labs to improve on my skills

independently or with my peers for assistance. In another article by Cowen, Hubbard, and

Hancock (2018), they examined the emotions that students had when going into their clinical

setting, how long they spent preparing for clinical as well as what they thought were the best way

to learn skills. The study demonstrated that the majority of students had experienced feelings of
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excitement entering into clinical, additionally towards learning new skills and procedures. The

average length of time that students spent preparing for clinical was 3.2 hours (Bowen et al.,

2018). I feel that this is an accurate number for many reasons, plus the fact that I can also relate

to this. To me, prepping for clinical is not just receiving your patients’ summary and history. It is

doing work prior to lab and lecture, because what we learn in those settings can also be applied

to our clinical practice, and it most definitely makes me more comfortable performing skills in

the hospital.

Identification of Further Learning

The learning styles that I have gained this far from this experience, can benefit me in my

future career as a nurse. I think the biggest issue that I want to work on is feeling more confident

when charting and knowing what everything means. To do this, I want to be able to apply my

knowledge and strategies that I have been learning to help me through future situations. I want to

be able to take a deep breath and trust the knowledge that I know and go with it. I can take this

experience and use it to relate to other patients and peers to help them overcome any concerns or

nervousness that they may be feeling. In the future, I know that I will face situations that will

make me feel nervous, but I will have to come up with a strategy to overcome my emotions and

reflect on how I did it. It is important to always have an open mind going into any situation, and

to welcome new experiences. Through all of my clinical days, I have reflected at the end of the

day what I have done well, and what I could improve on, and I know that I will continue this in

the future.
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References

Cowen, K., Hubbard, L., Hancock, D. (2018) Expectations and experiences of nursing students I

n clinical course. Nurse Education Today, 67, 15-20. doi:

https://doi.org/10.1016/j.nedt.2018.04.024

Lippe, M., Hudson, S. (2018) Communication Simulation Using Laypersons as Standardized

Patients Preparing Students for Their First Day. Nurse Educator, 43(2), 5-6. doi:

10.1097/NNE.0000000000000459