Critical reflection of your growth and development during your practicum experience in a clinical setting has the benefit of helping you to identify opportunities for improvement in your clinical skills, while also recognizing your strengths and successes. 

Use this Journal to reflect on your clinical strengths and opportunities for improvement, the progress you made, and what insights you will carry forward into your next practicum

To Prepare

• Refer to the “Advanced Nursing Practice Competencies and Guidelines” found in the Week 1 Learning Resources, and consider the quality measures or indicators advanced nursing practice nurses must possess in your specialty of interest.
• Refer to your “Clinical Skills Self-Assessment Form” you submitted in Week 1, and consider your strengths and opportunities for improvement.
• Refer to your Patient Log in Meditrek, and consider the patient activities you have experienced in your practicum experience. Reflect on your observations and experiences.

In 450–500 words, address the following:

Learning From Experiences

•  Revisit the goals and objectives from your Practicum Experience Plan. Explain the degree to which you achieved each during the practicum experience.
• Reflect on the three (3) most challenging patients you encountered during the practicum experience. What was most challenging about each?
• What did you learn from this experience?
• What resources did you have available?
• What evidence-based practice did you use for the patients?
• What new skills are you learning?
• What would you do differently?
• How are you managing patient flow and volume? 

Communicating and Feedback

• Reflect on how you might improve your skills and knowledge and how to communicate those efforts to your Preceptor.
• Answer the questions: How am I doing? What is missing?
• Reflect on the formal and informal feedback you received from your Preceptor. 
• this is the preceptor feedback 

 Works independently, yet humble and asks questions and shares recommendations for treatment options, such as medication management and titration and wrap around community service to minimize risk of re-admission.  

Major strengths of student:
Clinical Skills and Knowledge, Empathy, Dedication. Integral member of our multidisciplinary team. Develops strong therapeutic relationship with her patients.  

Comment1

Evaluating the outcome of an evidence-based practice project is the final step of the process.  I would probably choose one or two different methods of evaluation-starting with a survey for staff and patients.  Surveys are easy and usually have a good number of responses.  I would compare the answers to the survey done prior to the implementation of the EBP project.  Another method would be to collect data involving safety issues prior to and since the project improvements.  

A survey for nurses regarding bullying would include questions to see if they are more comfortable at work with the new policy changes in place and if they would make a report if they had a bullying experience.  The main objective in reducing bullying in the nursing workforce is to attempt to reduce the number of nurses leaving and increase nurse retention.  Therefore, it would be important to make sure the message has been understood and policies enforced.  Posting results to employees communicates transparency in the process.

Comment2

Evaluation for my EBP could be done through data collection. Data collection done through monitoring of rate of adherence to treatment by these patient population. Monitoring means “regularly collecting information on your project that will help you answer basic questions about your work”. (Evaluating your Project, 2015). Data collection on persistence with therapy will be one major way of evaluating my project effectiveness. Varying types of data would need to be collected to prove persistence to treatment such as,  (1) data on refill rate or medication possession rate (MPR), because as patients take their medications, they should be refilling their prescriptions. (2) data collection on increasing or decreasing reports of adverse reactions to medications for treatment. If reports of adverse reactions resulting from improper intake of these medication are on the decrease that means patients are receiving the proper education and counselling and are adhering to them (3) Patient satisfaction with treatment and monitoring trends in treatment outcomes such as decreasing rate of fracture and increase bone mineral density in patients taking these oral medications for treatment of postmenopausal osteoporosis, since these medications are found to be effective in reversing bone loss, maintain bone density and prevent fracture. (Osteoporosis Treatment Medications can Help, 2017).

Post an explanation of how competing needs, such as the needs of the workforce, resources, and patients, may impact the development of policy. Then, describe any specific competing needs that may impact the national healthcare issue/stressor you selected. What are the impacts, and how might policy address these competing needs? Be specific and provide examples.

Reflection Assignment 4: Meeting Essential VIII

This week, reflect on your perception of change theory, management roles and nursing leadership, communication conflict, and the nurse management role in patient care as it has evolved over the course of your RN-BSN program at WCU. Identify specific leadership models you support, and compare and contrast communication techniques for patient-centered care effectiveness. How does your academic work support evidence of meeting the following?

Essential VIII: Professionalism and Professional Values

• Outcome #3: Promote the image of nursing by modeling the values and articulating the knowledge, skills, and attitudes of the nursing profession.

Review your past academic work, evaluate your effectiveness at meeting this program essential, and ponder the impact that this proficiency will have on your future.

Identify how you met the essential by referring to the assignment(s) specifically in your response. Additionally, reflect on and make connections between your academic experience and real-world applications. 

Showcase your academic work related to this essential and these outcomes in your ePortfolio and directly reference it in your reflection response.

Recommended: Refer to the work you completed for NURS 510 Policy, Organization, and Financing of Health Care and LDR 432 Principles of Leadership for Healthcare Organizations, as well as other courses, to gather academic examples and evidence of having met this essential. (DOCUMENTS ATTACHED)

Your reflection should be 1–2 pages APA formatted. Reference and cite any sources you use. 

PLEASE REFER TO THE ATTACHED RUBRIC!!!!!