Category: NSG 353

Knowledge and Clinical Judgement

Nursing uses evidence based practices and critical thinking to promote health and prevent disease, which aids in providing the best care possible to patients. The clinical judgement of a nurse is important to help ensure the safe high quality care of an individual and being attentive to the patients concerns. Nurses gain their knowledge by obtaining a well rounded education that is later contributed to their ability to educate others. Being a nurse requires the ability to shift roles from caregiver to friend to advocate and in doing this they are able to provide patient-centered care that helps in the healing of the patient, both physically and mentally. From this module I learned that being a nurse requires many different skills and all of these skills are learned in school but also in practice. A nurse must be flexible and calculated to help care for each individual patient to the best of their ability.

Priority Setting Frameworks

This module specifically discussed the need for prioritization of patients and specific prioritizing methods that are used in order to identify which patient’s require immediate care. From what I gathered, the entire basis for determining the top priority patient is based off of the Nursing Process (AD-PIE). From this process we then use Maslow’s Hierarchy of Needs, ABC (airway, breathing, circulation) and safety to determine the patient who needs to be seen first. During the process of care we need to start by doing the least, i.e. elevate the head of the bed to improve breathing instead of starting oxygen right away. This speaks to maintaining the patients safety while also determining the amount of care that needs to be utilized. From this I learned that sometimes doing the least can help the most. I think sometimes we utilize extreme measures in cases that they aren’t necessarily needed and that likely contributes to high healthcare costs or even harm to the patient. This was not only important for patient prioritization but additionally to how our perception of a patients condition contributes to their expedient care.

This is an image of Prouty Garden that was located on the grounds of Boston Children’s Hospital. I had visited this garden once with my mom and sister. I vividly remember walking through the hospital to get to the garden and seeing a young boy, who had difficulty walking, being supported by his great dane service animal. I had never seen anything like it, I was in awe. Then, the three of us walked outside and I was amazed once more. It’s like we had walked straight into a meadow. No cars could be heard, birds were chirping and the air was crisp. At that time it was fall and a good portion of the leaves had fallen to the ground. I remember my sister and I trying to ‘catch’ one of the many wild rabbits that claimed residence there, but never even getting close enough to touch. It’s my fondest memory I have there and if it weren’t for that garden and those rabbits, I wouldn’t have any. That garden was a symbol of hope for the children at the hospital. A small taste of what life can be like once they get better and for a small moment in time they were able to experience life outside of those walls. This garden was a sacred and serene space where families could congregate together and enjoy time outside of the hospital. It was a place that almost seemed too good to be true, it was a happy place until we had to go back inside. Sometimes I think patients can forget what life is like outside of the hospital and these gardens represent what life should be like. I thought it was a really inspiring and thoughtful gesture to incorporate it into the hospital grounds, especially with Boston being such a ‘concrete jungle’.

In Module 1, Nursing Concepts, I learned that nurse competency is something that is built upon through education and experience. Each stage demonstrates new learning and the ability to improve upon newly learned skills. It’s also critical to acknowledge that nurse competency also factors in the nurses ability to work with others, such as other healthcare providers. Interdisciplinary collaboration is critical to achieving patient-centered care and allowing that patient to have utilization of the best quality of healthcare. In the future, this will allow me to recognize that nurses, although they do a large amount of patient care, are not the only individuals whose goal is to better the quality of life for a patient. Hopefully this will aid me to reach out for help if I’m ever overwhelmed.

In Module 2, Testing and Remediation, I hadn’t realized that there was such a thing as a positively or negatively worded questions. From the Test Taking Strategies portion I can now narrow down the answer in a multiple choice question by picking out key words in a question and eliminating the obvious incorrect responses. This will benefit me throughout nursing school as I can utilize these test taking strategies in other courses. In the nursing career this strategy will also help identify which patient should be seen first and hopefully help increase quality of care and efficiency in the work place.