Documente Academic
Documente Profesional
Documente Cultură
03/30/2015
Weekly Self- Evaluation Week 1
Practice as a member of a multi-disciplinary health care team.
My first clinical day was at Tripler AMC. I was assigned to the PICU and I worked with the RN
Paige, who was assigned to care for a 6-month old baby boy who was recovering from TEF repair
surgery. It was his 7th day post-op and he had an esophogram scheduled in the morning to verify
that the surgery (repair) was successful. During my time spent, I was able to observe the
interactions between the RN and the night shift RN during the morning report. I also observed the
RN work with the MD that performed the esophogram and all the different techs she had helping
her. She gowned up in lead and stayed with the patient during the x-rays to make sure that his
PICC lines were stable and that his vitals remained within normal limits. I was also able to
observe her conversations with the attending physician and his conversations with other doctors
regarding the 6-month olds care. There were a lot of people involved in his case and they came in
and out of the PICU periodically. I was also able to watch the speech therapist come up to his
room and work with his mother when she was given the go-ahead to start oral feedings again.
Overall, my experience was positive and the RN worked well with the different members of the
health care team in regards to care of her patient.
Demonstrate therapeutic communication skills in interactions and relationships with families,
individuals, and other members of the health care team with attention to the identification and
correction of non-therapeutic communication techniques.
When I first sat with the RN in the morning as she was getting report from the night shift RN, I
was told that the patients mom was very passive/aggressive, somewhat demanding, almost like a
know-it-all. After further research regarding the 6-month old and his care at Tripler, I learned that he
and his family moved from Guam, where they were stationed, to Hawaii because Guam didnt have
the medical means necessary to care for his condition. I had also learned that this was his 5 th attempt at
fixing the tracheoesophageal fistula (all done at Tripler) and I mentioned to the nurse that this may be
why this mother was so frustrated and hard to deal with. I considered all of this information when I
first went into the room to meet the patient and his mother. I connected with the mother right away
when she learned I was a student and started asking me about the program, when I graduated, what
kind of nurse I wanted to be, etc. We also learned about each other that we each had two daughters too.
The mother was very knowledgeable about the care of her baby. I was able to observe the RN validate
the mothers experience and thank her for sharing all that she knows about her baby and his baselines,
etc. I used therapeutic communication when I was helping the mother attempt to breastfeed her baby
after she had got the OK to start oral feeding again; previous to this attempt, the baby had been NPO
for nearly 3 months and was exclusively breastfed. The mother had some frustrations during feeding
him because he wasnt showing any interest. The healthcare team had been working with this mom for
a long time and knew how to deal with her and what to say when introducing new information. She
was much more receptive when things were explained to her- why its being done, the benefit, what to
expect, etc. I felt that I communicated with her well and was able to learn a lot about her, her baby and
their family during the hospitalization.