Throughout my time as a student at Bon Secours Memorial College of Nursing, I was

fortunate enough to accumulate many practicum and class experiences that facilitated my
personal growth and development in knowledge, skills and attitudes. Though I cannot possibly
explain every experience I had as a nursing student, I have selected three notable experiences to
share that enriched my education and prepared me for my entrance into the nursing profession.
During week seven at Memorial Regional Medical Center (MRMC) on the Renal Unit for
our Adult Nursing Science I practicum, I built a positive relationship with my patient by
applying principles of therapeutic communication with him. Despite some of the staff members
warning me of my patient’s snarky and stiff attitude, I found that my time spent with the elderly
man was quite enjoyable and humorous. When we first started talking I shared with him that my
dad was a fighter pilot in the United States Air Force (USAF) for 20 years, and he smiled and
told me he was contractor in the United States Air Force for 20 years! I believe it was this simple
connection in the beginning of our relationship that allowed us to bond and share playful banter
back and forth all day. Beyond our connection with the USAF, he also went on to tell me about
his faith and how as a young man it was something he took for granted, but that after a big life
event, he turned his life around and values his faith in God more than anything now. As a young
woman who highly values her Christian faith as well, my heart was warmed to be able to discuss
the topic of faith in God. Again, this connection furthered our therapeutic communication for the
day as I was able to provide more holistic care through spiritual hope and guidance as well as
providing the medical interventions within my role as a student nurse. My nursing skills
expanded during this experience by providing me with an example of how applying general
principles of therapeutic communication and collaboration benefits patients and their quality of
care. Further, it expanded my communication skills by challenging me to dismiss preconceived
notions regarding my patient and preventing such notions from hindering the quality of care I
provided him
During my Mental Health practicum, I connected most with the clinical experiences at
Poplar Springs and Cumberland Hospital, when I interacted with adolescent patients. In the
initial stages of my mental illnesses, I was admitted to the Children’s Hospital of Richmond at
VCU’s Virginia Treatment Center for Children; therefore, observing the behaviors of, talking
with and reading the charts for all the children with a variety of mental illnesses brought me full
circle. I remember reading through a little girl’s chart with two of my other classmates and
finding a list of reasons that are stopping her from killing herself. Shamefully, I did not find
myself shocked as my fellow classmates did; in all honesty, I saw my younger self in this girl’s
chart. I had written a list quite similar to the one we were reading when I was deep in my
depression and struggling with suicidal thoughts and three suicide attempts. Though I was not
shocked initially, I did find myself on edge during debriefing, shaking my legs and wanting to
get out of the building. I think I began having negative flashbacks of how scared I was as a
teenager at VTCC, walking through locked door after locked door, unable to color on my own,
sleeping in a small concrete room with caged windows, sirens and sounds of the city late at
night; I felt so claustrophobic with the weight of my memories falling on me. Nevertheless, I was
able to use positive coping mechanisms to effectively work through my flashback. The two other
times I interacted with adolescent behavioral health patients I used my experience for the better
by approaching them with a shared perspective and small understanding of what they were going
through.
Finally, one of the most educational experiences took place during my senior clinical
immersion on St. Mary’s 2 North Medical-Surgical Unit. My preceptor and I received a direct
admission from Tuckahoe Orthopedics two hours before shift change, so I took on the task of
contacting Tuckahoe Orthopedics to reach the on-call physician. I provided a brief SBAR and
included the facts that the patient required a STAT MRI but was claustrophobic. The physician
immediately responded, stating a one-time order for 10 mg of Ativan. I paused, and kindly read
back to her: “a one-time order for 1 mg of Ativan IV?” The physician then told me I was wrong
and corrected me by saying: “No. TEN milligrams; one-zero. And wait, yes, IV!” I looked at my
preceptor with confusion and disbelief plastered on my face, and tried to clarify that the patient
only needed Ativan for minor anxiety. Despite my best efforts the physician became infuriated
and yelled at me for even considering questioning a physician’s order, saying “I know, so I am
ordering a 10 mg dose IV for the patient! You know what, fine! Put in two separate orders for 5
mg IV Ativan, but I am telling you that you will use both orders because the patient will need the
full 10 mg of Ativan, okay?!” In fear of upsetting her further, I concluded our conversation by
asking her to verify her name for the order. I used my reasoning abilities and applied critical
thinking skills in order to efficiently reach a resolution. My clinical judgement told me that
despite the order coming from a licensed physician who was adamant that she provided an
appropriate order, the main problem was not only my current patient’s safety, but the safety of
other patients under that physician’s care. The ultimate goal was to properly address the
physician about her order and politely inform her that the dose she instructed me to give is
considered the maximum daily dose cap in general, but was more importantly lethal to my
patient who only required it for minor anxiety. I wanted to ensure that she recognized her
mistake so that it was not repeated in further patient care situations