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Portfolio of Integrating Nursing

Practice
Summer 2014
Submission #1
Fiona Amsterdam 6/6/14 Integration To General Nursing Practice




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Acknowledgement
All praise to the almighty God who made it possible for me to accomplish my dream of completing nursing school and
endurance to not give up in spite of my many challenges faced along the way. I would like to express my special thanks of
gratitude to the head of department Mrs S. Jolie for the compassion she has shown to me, for not giving up on me even when
I gave up on myself and for encouraging me to persevere in patience in spite of the many challenges I faced along the way.
My coordinator Mrs. C James, as well as the department of health sciences who gave me the golden opportunity to complete
the general nursing program and by extension this wonderful project integration of general nursing practice, which has
significantly help me to perfect my many nursing skills I acquired along the way. To put into practice all the theoretical
aspects of nursing that I was taught in the classroom and see the joy of nursing come to light as I get a feel of working the
various shifts.
I could not go on without mentioning my preceptors Ns. Jason Missole & Ns. Albertha Mc. Farlane for accepting the challenge
to be my preceptors. Which had a significant impact on me, the guidance they gave me along the way, was very patient with
me and most importantly taught me new skills and took me one step above a novice.
This project has also given me an opportunity to enquire about the various health conditions that I encountered on the ward
and increased my appreciation for nursing research.
I would also like to thank my family for carrying me whiles I was busy trying to live my dream, my children for the sacrifices
they have made for me and friends who assisted me in finalizing this project within the limited time frame.



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Table of Contents
.................................................................................................................................................................................................................................. 0
Acknowledgement .................................................................................................................................................................................................. 1
Introduction ........................................................................................................................................................................................................... 3
Journals .................................................................................................................................................................................................................. 4
Admissions ............................................................................................................................................................................................................. 5
Discharge ............................................................................................................................................................................................................... 6
Health assessments ............................................................................................................................................................................................. 7
Nursing diagnosis ................................................................................................................................................................................................. 8
Nursing Care plans ............................................................................................................................................................................................... 9
Teaching plan ....................................................................................................................................................................................................... 10
Health counselling ................................................................................................................................................................................................ 11
Drug study ............................................................................................................................................................................................................. 12
Laboratory investigations ................................................................................................................................................................................. 13
Conclusion ............................................................................................................................................................................................................. 14
Bibliography ..........................................................................................................................................................................................................15
Appendix ................................................................................................................................................................................................................ 16




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Introduction

This semester I am assigned to the clinical area for 6 weeks to function as a newly graduate nurse. It
promises to be a new experience. Unlike the other processes went I was assigned to the clinical area it
will be required of me to work all the shifts and operate as a nurse manager.
Not only will I be focusing on performing clinical nursing skills but I must in cooperate the theoretical
aspects and nursing research into providing holistic care for the assigned clients.
I look forward to the night shifts as I dont sleep well at nights and think that I will have no problems adjusting
to the shift. Everyone has told me that it is not a pleasant shift I would like to experience it for myself.


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Journals

A summary of my experiences on the surgical ward of the St Judes makeshift hospital. A personal account
of my inner most thoughts and feelings. It is a mixture of excitement as I see my clients progress to
another level. Sadness and fear when I challenge myself to accomplish the things that I dread and the
feeling of victory when I actually did after doubting myself that I couldnt.. Grief when my patient dies and
never returns to the ward after being transferred to the operating theatre.


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Admissions


A list of the patients that I admitted to the surgical ward and the findings of the complete physical
assessment that I performed. Using the findings of the physical assessment I was able to formulate a list
of potential and actual nursing diagnosis to plan care for my patients. (Javis, 2008)


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Discharge


From the time of admission, discharge planning had begun for my patients. They are now ready to go home
and I have summarized some of the instructions, explanation of their prescriptions, referrals and health
promotions activities which they will use as a guide to help them maintain a good level of health, restore
functioning and to live life to the fullest as the limitations of their illness allows them to.


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Health assessments





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Nursing diagnosis

After a thorough assessment of my clients and their families I identified actual, risk, wellness, responses
to their health state and formulated individualized nursing diagnosis to provide care for my clients and
their significant others focusing on health promotion, disease prevention, comfort, and restoration of
function. (Ackley & Ladwig, 2006)


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Nursing Care plans

Using the nursing process I have prioritize nursing interventions in order of greatest need to provide care
for my client using my formulated nursing diagnosis as a guide. Interventions include pain management,
enhancing self-esteem, nutrition and other important areas. (Ackley & Ladwig, 2006)


10
Teaching plan

Teaching plans created after assessing patients knowledge on subject areas needing to make changes,
learning styles of the client and was executed using mostly student nurse- patient discussion session and
brochures. Evaluation was done using question and answer.


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Health counselling

A nurse has many functions one of these functions are health counselling it involves providing support and
helping your patient and significant others to change behaviours to make rational decisions and cope with
their existing situation as they strive to obtain an optimal quality of life as permitted by the limitations
posed by their health condition.


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Drug study

A compilation of the list of drugs that were prescribed for my clients during the course of their
hospitalization period. However I have selected only the drugs that I had never encountered before / that
I need to review to give detail information about to include availability, dosages and side effects. It is
paramount that before a nurse administers medication she is knowledgeable about drugs to look out for
adverse effects and to evaluate effectiveness of the drug action (Karch, 2009)


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Laboratory investigations


A compilation of the list of laboratory investigation which my clients did during the course of their
hospitalization period which assisted in diagnosing their disease condition, confirming it in some cases and
checking for progress after interventions (Kee, 2001)


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Conclusion
Nursing is not measured by the amount of skills signed on your skills list but being able to touch your patients lives like no
one has done before in a positive way.
My time spend at the St. Judes Hospital was indeed a memorable one. It was a totally different experience form the other
processes that I did at the St. Judes Hospital. I got an opportunity to acquire new skills and enhance the ones that I
already had. I developed more self-confidence as I performed my nursing duties. I worked on my time management and
organization in preparation for my nursing task. In the beginning I wasted so much time going back and forth to get
supplies due to poor preparation I also remembered being becoming frustrated as I was not even half as fast as my
preceptor. I was so elated when I was able to do an entire bed bath and made the bed of a post-op client without any
assistance.
I got an opportunity to work the various shifts and even holidays which I enjoyed very much these experiences made
nursing come alive and allowed me to enjoyed the true beauty of nursing. I actually love the night and evening shift
compared to the day shift. Maybe I am just a night owl.
I got a feel of the harsh reality of nursing when my patient died and I was more broken than the family but had to put on a
face of courage and carry on with my other patients, it was also heart breaking when I saw a middle age lady with breast
cancer and had to do a mastectomy.
The part that I love the most is that I treated all my patients with dignity and respect in spite of how annoying some of them
could be and no matter how tired I was I looked forward to seeing them the next day to take them one step closer to
restoration of health as permitted by their health condition.
I am not a yet a pro but I will so get there with patience, practice and perseverance.


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Bibliography
Ackley, J. B., & Ladwig, G. B. (2006). Nursing Diagnosis Handbook, A guide to planning care . St. Louis : Mosby Elsevier .
Javis, C. (2008). Physical Examination & Health Assessment . St. Louis : Saunders Elservier.
Karch, M. A. (2009). 2009 Lippincott's Nursing Drug Guide . Philadephia: Wolters Kluwer.
Kee, J. L. (2001). handbook of laboratory tests with nursing implications . Upper Saddle River : pearson prentice hall.






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Appendix

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