Exam (elaborations) NR 511 Reflection

Exam (elaborations) NR 511 Reflection The student identifies at least one gap in specific patient experiences (i.e. ages, acuities, complexities, procedures, assessments, etc.) AND The student outlines their practicum plan for the next 4 courses AND The student presents a brief plan to narrow the gaps within the context of the planned practicum rotations. (Requires 3 critical elements) During the last 8 weeks of clinical rotation, I worked at a family medicine clinic. My preceptor saw 60 % of pediatric patients and 40 % of adults’ patients. I was able to take care of children, teens, and young adults (age 3 to 18), but was not able to meet with patients less than one years old . Most of the patients’ conditions were mild to moderate, and it was uncommon to see patients with severe conditions. When it came to procedures, I was able to perform venipuncture, vision/ hearing assessment, EKG along with physical assessment. However, many of the diagnostic tests or procedures were not offered at the office due to its limited resources. I plan to find another practicum site and get exposed to more variety of patients and different procedures so that I can expand my clinical experiences. Moreover, I would like to get involved with variety of diagnostic tests according to patient’s condition with my next rotation. The student discusses their overall progression in this clinical rotation by identifying the following: 1) One professional goal that was achieved 2) One goal that was not achieved 3) A plan in future practicums to achieve the goal that was not met. (3 critical elements required) Through the clinical rotation, I was able to learn how to perform a thorough physical assessment according to patients’ various symptoms. Also, I learned that a systematic and detailed assessment including interview and physical assessment is necessary to find out what really is going on with the patients. Furthermore, I was able to provide preventative care through patient education. However, I still need to get more practice making differential diagnosis according to patients’ condition sometimes. I feel that making the lists of differential diagnosis and narrowing down to one final diagnosis is the most important process in patient care to guide treatment. I would like to actively get involved with patient diagnosis process, so that I will be proficient at making differential diagnosis based on my assessment. The student identifies a minimum of three specific areas of professional weakness in the clinical setting AND The student communicates a clear plan address these deficiencies. (2 critical elements required) First of all, the dominant patient population at the clinical site was Hispanics and I was not able to perform a thorough assessment due to language barrier for some patients. I feel that I need to work on learning Spanish to serve the patient population better. Second of all, I feel that I need to work more on physical assessment skills in patients less than 1 year old. I was not exposed to many patients less than 1 year old and even though I could met some baby patients, it was difficult to perform a through physical examination sometimes due to their irritation (for example, cry and move a lot). I will actively engaged with patient care in next rotation especially babies so that I could learn physical exam skills regardless there’s some limitations. Third, I would work on ordering diagnostic tests according to patients’ condition. For this, I would be more proactive on searching rationales on each diagnostic tests that were ordered so that I could order proper tests based on patients’ symptoms to narrow down the diagnosis lists. This study source was downloaded by from CourseH on :35:22 GMT -05:00 This study resource was shared via CourseH NR 511 Reflection Student choses two CORE NONPF competencies AND The student describes how the CORE competency was met or how the student plans to meet the CORE competency AND Two specific examples from the clinical rotation are provided for each CORE competency. (3 critical elements required) Core NONPF competency 1: Quality competencies- Uses best available evidence to continuously improve quality of clinical practice. With the help of the preceptor, I was able to offer patients with treatment options based on best available evidence. However, sometimes the care provided was not based on clinical practice guidelines (CPG) and I feel that there are some gap in between actual practice and evidence. For example, I had a patient with symptoms of allergy rhinitis and antibiotics was given along with other medications even though the patient did not have any systemic infection symptoms. The utilization of antibiotics was not mentioned in CPG and over usage of antibiotics can provoke asthma symptoms in younger children according to my research. I would keep searching for the best evidence based care so that I can improve the quality of patient care. Core NONPF competency 2: Independent Practice Competencies- Provides patient-centered care recognizing cultural diversity and the patient or designee as a full partner in decision-making. Through patient interview and assessment, I was able to establish a relationship with the patient based on mutual respect and collaboration. Having enough time to interview patients was very helpful in making a good relationship with patients and get to know them and their symptoms. Through the help of my preceptor, I provided patient centered care that considers their cultural and spiritual preferences, values, and belief. For example, I had a teenage patient who seemed very depressed. I let her parents to leave us alone and sit down with her then start approaching patient gently by talking common issues. After couple of minutes, she told me that she did not want her parents to know about her sexual activities and warries about the possibility of acquiring STDs. I explained to the patient that if she is experiencing any symptoms related to STDs, it needs to be treated as soon as possible to prevent possible complications. I also asked the patient if it’s ok for me to discuss this condition with her parents. She was hesitant at first time, but agree with getting her parents get involved. I did a separate interview with her parents and found out that they were very supportive of their daughter. Her parents seemed little surprised when I told them what was going on with their daughter, but they accept the fact that checking for possible STDs is a priority at that time. I also explained them how the patient feels about this situation and it is important to consider her feelings because this is a sensitive issue. Her parents understood and I was finally had all family in one room and started talking about diagnostic tests to further investigate her symptoms. They all aware of the situation and agreed with the treatment regimen. I felt that it was important to give the patient a chance to decide on her care and that made her comfortable with treatment decision. And having famil