Diana Holowaychuk

Dr. Gerald Zetter Care Centre

Marion Francis

REFLECTION FOR MAY 13, 2015

Reflecting on my student nurse training in the nursing home has been valuable, since it allows
me to develop an awareness of my awkwardness or competency while looking after a patient.
This awareness can be used to modify my approach with the patient, and to continue with what is
working well to achieve my tasks. This process is ongoing through the duration of my nursing
career and will continue to be used regularly.
The one task that I have been able to do well is the ability to connect with residents of the
nursing home. I am able to create an openness to allow the client to express their thoughts and
feelings. This process establishes trust as well as a working relationship, helping to achieve
goals and also serves as a way of providing a safe place for the patient to confide. A nonjudgmental, empathetic approach and a witnessing of their experience can change a great deal.
Asking questions to gain more information, helps to keep their thoughts on track. When my
client was talking about her family, I was able to understand her as a person who played many
roles in her life. I also began to understand her personal history and family background and the
era that she was born in (1918). With a few photographs displayed in her room, it is easy to get
my client to talk about those people. There is always a story that goes along with each person in
the photo, and using that as a cue helps to draw out memories of different times and places. This
is called reminiscing and can be very therapeutic when a person is near the end of their life. This
process can be a way of understanding they have lived a full life with many loving relationships
and good times spent together. They have also endured difficult or challenging times and it
helped to make them stronger. In other words, a life well lived.
The skill I am having a challenge achieving is performing a quick physical assessment. The
step-by-step approach of moving through each system of the body while assessing the patient

Diana Holowaychuk

Dr. Gerald Zetter Care Centre

Marion Francis

works well for me. Even though I am assessing each system, I still miss a few pieces of data to
be collected. For example, while moving through the integumentary system I think of CTEMPS.
I later notice I have forgot to check capillary refill, skin turgor and the mucous membranes.
When going back a second time to collect more data from the patient, I found she was sleeping
in her wheelchair and I had to wake the client to obtain my findings. It also is time consuming to
assess twice.
In the future I will develop a routine for the physical assessment of clients that flows well,
moving from one body system to another. This will ensure that all parts of each body system are
included, making notes on a checklist or notebook to refer to later while charting or documenting
the results. Knowing the baseline of the clients responses and vital signs helps me as a nurse to
be aware of any sudden changes when needed to be checked again later. With the repetition of
the physical assessment daily for my two patients, I will gain speed and competence. This will
allow the patients I work with to witness me developing as a nurse before them. And for this I
am very grateful.