Examples Of Clinical Judgment

Reflecting on the past seven weeks I have acquired countless knowledge, which I will use to further strengthen my profession as an Advanced Practice Nurse. The course allowed me to think beyond my current practice knowledge and acquired innovative ways to evaluate the situation at hand. The learning objective in program outcome four helps set standards that I will use to guide my clinical practice to meet various healthcare needs. Using the case studies has helped to further enhance my knowledge on disease physiological state, using differential diagnosis, disease manifestations, and clinical presentation. It has also taught me the skills on how to differentiate between similar diagnoses to properly identify the problem and treat the patients.

This allowed staff to become an emotional and in some ways spiritual support for patient. Patient did not desire religious spiritual leader, because he is agnostic. Also, by providing staff that knew that patient’s non-verbal cues this helped increase communication between staff and patient.

What a blessing it is to have the United States Department of Veterans Affairs (VA), Veterans Health Administration (VHA) providing multiple healthcare services to our heroes, our veterans! To be afforded the opportunity for our heroes to attend and be treated, at little to no cost, for a wide range of ailments from the common cold, to a mental health disability, or for the possibility of a healing surgery is a well-deserved and a wonderful privilege. One of the major demographics of care providers within the VHA is the registered nurse. There are over 51,000 registered nurses nationwide, with 60.7% of the total population of providers of healthcare, within the VA hospitals, VA outpatient clinics and VA Patient Care Medical Homes (VHA, Office of Nursing Services, 2012).

When being examined by a doctor first the signs and symptoms will be evaluated, then the medical history will be under review, and finally

Burnout is classified viewed in three phases. The first phase of burnout is the arousal phase. The nurse shows anxiety, insomnia, forgetfulness, inability to concentrate, feelings of beings overwhelmed, frustration, sadness, and new physical symptoms, such as headaches and stomach problems. If the nurse does not recognize that these symptoms require intervention, the second phase is energy conservation. In this phase, the nurse starts to call in sick to work; o she may be chronically late getting to duty. Deadlines are not met, a cynical or resentful attitude develops, a persistent sense of fatigue pervades both are the nurse’s personal and professional’s life.

During the FNP III rotation, the student has seen many patients who have complex chronic illnesses than other two rotations that she completed for the FNP I and FNP II courses. The student had many opportunities to independently interview and exam the patients, then come up with differential diagnoses and treatment plan based on the pertinent and impertinent information and evidence-based practice. The preceptor, Dr. Jeanne-Elyse Cedeno, a medical physician/owner of the clinical site, always encouraged the student to think as a primary care provider in many ways. In this paper, the student is going to discuss the progress of the eight objectives (see Appendix A for details), discuss her personal growth and development in the nurse practitioner role, provide the information on what she learned in the clinical that will be valuable to her future practice, and describe any missed opportunities that she did not get out of this experiences as expected, discuss for areas of improvement in the future clinical rotation, and the summarize the final evaluation with her preceptor.

The Calgary-Cambridge model of assessment (Kurtz and Silverman 1996) was used to guide the practitioner through the health assessment process. The guide provides an easy-to-use structure that complements nursing 's traditional holistic assessment approach.

The following nursing diagnosis’ is based off of our families weaknesses and strengths. It is important for the family to know their strengths and problems to limit potential problems in the future like: conflicts between family members and family stability. The most important problem that K. S. faces is caregiver role strain. While S. S. is at work and going to school full-time, K. S. is busy taking care of the day care and their two daughters, M. S and A. S.. K. S. also are busy doing things around the house like cooking, cleaning and taking care of their dog. This is related to 24 hour caregiving causing feelings of exhaustion from being the main caregiver, which plays a big role in this nursing diagnosis.

Nursing sensitive outcome measure demonstrates the sensitive need of the patient. Poor nursing care will have a negative impact on the quality of care the patient receives. According to Saul’s, nursing sensitive indicators are outcomes related to the quantity and the quality of care a patient receives (Sauls, 2013). Here in this situation, nurses must be aware of sensitive indicators, such as: pressure ulcers, a patient’s dignity, and quality of life. These indicators represent unfortunate nursing care, and reflect a negative outcome. Mr. J’s. daughter assists her father to the restroom and notices a red area to the lower back, the redness was overlooked by the nurse. Mr. J received a non-kosher diet, which is against his religion. The

Once a patient and nurse agree on the diagnosis, a plan of action can be developed. If multiple diagnoses need to be addressed, the Head nurse will prioritize each assessment and devote attention to severe symptoms and high factors. Each problem is assigned a clear measurable goal for the expected beneficial outcome. For this phase, nurses generally refer to the evidence based nursing outcome classification, which is asset of standardized terms and measurements for tracking patients’ wellness. The nursing intervention classification may also be used as a resource for planning.

Deciding to pursue a career in nursing, is often done form a place of giving. Giving of oneself to better the wellbeing of another. The process of providing care starts with an assessment of the situation and developing goals. Goal development happens with the patient present and takes efforts on the part of the nurse and patient. Imogene King created a systems approach to help the nurse-patient relationship and further created the goal attainment theory.

Nurses are critical for promoting health in the society. The profession is highly flexible, since they specialize in diverse operations in the medical field. Registered nurses, for instance, are responsible for the administration of medicine and inoculations to patients (American Nurses ' Association, 2000). Additionally, these professionals observe, record, and enlighten doctors of any changes in a patient’s health. Nurses interpret and evaluate diagnostic examinations to determine an individual’s condition, as well as making the necessary adjustments in patient treatment plans on their health progress. In collaboration with other medical personnel, nurses engage in the development and enactment of patient care plans. Furthermore, they provide education to families and groups on various health issues such as disease prevention, among others.

Nocturnal enuresis "Bed wetting" is the involuntary loss of urine that occurs only at night. It is normal voiding that

Nursing assessment has a significant role in providing effective, accurate and safe nursing care in clinical practice. Nursing assessment is the first stage of the Nursing Process. It is used to explore the physical, psychological, spiritual and social aspect of the patient’s life. It is therefore a holistic and systematic guide for nurses to obtain a greater understanding of their patient’s wants and needs. It is the underlying foundation of the process, on which other phases of the process are based upon (Foster & Hawkins, 2005).

Dorothea Orem was an extravagant nursing theorist whose theories were first published in 1971 (Dorothea Orem 's Self-Care Theory, 2014). Orem established several fascinating theories of nursing which are still are current in today’s nursing. Orem proposed three nursing theories that are identified as: self-care theory, theory of Self-care deficit and theory of nursing system (Dorothea Orem 's Self-Care Theory, 2014). Orem’s nursing theories are defined as a grand theory (Nursing Theories: An Overview, 2014). Grand theory is defined as an abstract outline under which the key conceptions and values of the discipline can be acknowledged (Nursing Theories: An Overview, 2014). Orem’s theories mainly proposed that