NURN 218 Weekly Reflection Assignments 6_2019 (1)

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NURN 218 – Maternal-Newborn Nursing Concepts Reflection Assignment for the Concept of Childbearing – Laboring Family Purpose: Reflection is an active process whereby the professional can gain an understanding of how historical, social, cultural and personal experiences have contributed to professional knowledge and practice (Wilkinson, 1996). Learning is derived from experience but it doesn’t just happen. For it to take place you not only need to engage in reflection you must also record it. By thinking about what you are doing and why you are doing it is what turns your experiences into meaningful learning. If you are to become a reflective practitioner you have to use that learning to increase your professional knowledge and skills to the benefit of not only yourself but also to your patients. Reflection then, is really a process that begins with looking back on a situation, pondering over it, learning from it and then using the new knowledge to help you in future similar situations. Directions: The CCBC Nursing Program is designed to prepare a nurse generalist who, upon graduation, is strong in each of the four areas below. Reflect and respond thoughtfully but concisely to each of the questions listed to demonstrate how you are progressing in developing these skills. Your responses should be typed (1-2 pages) and written in paragraphs, using complete sentences, proper grammar and spelling. Refer to the Grading Rubric for Reflection Assignments to understand how your reflection will be evaluated. Due Date: Reflection is most helpful when it is done as soon as possible after your clinical day (as the details of your day are fresh in your mind). Please submit to your clinical instructor as an email attachment in Blackboard as soon as you like but no later than 72 hours after the end of your clinical day . I. Promoting Optimal Health (in a single paragraph, address the following points:) What nursing interventions were used in the care of the laboring family? If you could take care of this laboring family again, write about at least two to three additional nursing interventions you could employ to optimize a safe and positive labor experience? Share important insights you have gained about nursing care of the laboring family. The family I cared for came in becaue the mother’s water broke. Because of the fetus’s breech presentation, a cesarian section was indicated. The nursing interventions in caring for the mother involved mainly assessment, monitoring, and education. Preoperative interventions included physical assessment, fetal heartrate monitoring, setting up an IV, foley catheter insertion, education regarding what to expect during and after the procedure, and obtaining consent. Throughout this, the nurse asked the patient about her pain status and both parents how they were holding up emotionally. The postoperative care interventions included administration of oxytocin to prevent bleeding, giving warm blankets to keep the mother warm because she was shivering, physical assessment including vital signs, breastfeeding assistance, and assessing how the parents were handling the birth emotionally. If I could take care of this same family again, I would have helped the mother with deep breathing exercises following the procedure to help the mother get the shivering under control. I also would have done more to assess how the husband was doing emotionally after the procedure. Nothing specific went wrong, but I feel I could have done more. The main insight I gained while caring for the laboring family was the major difference between caring for one patient at a time like I am used to and caring for the whole laboring family during and after the labor process. One patient occupies far less headspace than a couple and a newborn, and in caring for a laboring family, I found that the care requires a great deal of prioritization and awareness of how each member in the family is handling the situation. II. Developing Nursing Judgment (in a single paragraph, address the following points:) What actual/potential complications/risk factors were/could be seen for this laboring family? Give examples of your own and the nurse’s use of clinical decision making in response to those actual or potential complications/risk factors. The main complication for the laboring family was a breach presentation of the fetus. Before the family came in to the hospital, they had an appointment for a procedure to correct the fetal position to occipital presentation. However, the mother’s water broke

before there was time for the intervention, so a cesarian section was indicated. The change of plans from vaginal delivery to cesarian section carries a number of risk factors, especially bleeding, infection, and DVT. Accordingly, after the procedure, the nurse and I monitored for signs and symptoms of these complications. I monitored for presence of DVT by assessing perfusion in the legs and checking with the mother if she was feeling any pain in her legs or at the incision site. The nurse and I both positioned the patient and assessed the incision site and perineal area for signs of bleeding. III. Developing a Professional Identity (in a single paragraph, address the following points:) What insights have you gained about the role of the professional Maternal-Newborn nurse? What positive and negative examples of professionalism did you observe during your day? Give specific examples of how your own professionalism is developing? A maternal-newborn nurse is tasked with addressing the concerns of the whole laboring family, all of whom are in a heightened state of emotion. Being a professional is important in all care settings, but in this setting, the nurse needs to be aware that the patient is in an especially vulnerable place and that understanding is vital to being a professional. A positive example of professionalism I observed was effective communication within the operating room. There were a lot of people in a tight space with multiple sterile fields. Everyone in the room understood their role, communicated clearly and effectively, and was extremely focused on the job at hand. A negative example of professionalism I observed would include numerous examples of nurses speaking ill of their coworkers in the workspace and in places where patients could hear. I notice my own professionalism developing in ways involving my situational awareness around patients. I find myself continuously feeling out the room and situation so I can talk and act accordingly to best provide a professional and caring presence. I also find myself thinking more and more in terms of an advocate for the patient. In previous clinical scenarios, I remember focusing mainly in term of orders and interventions, whereas in this clinical setting, I noticed myself focusing on the ways the nurses tailored the care to be patient-specific. Specifically, they were continuously asking how they could care for the mother in a way that is most comfortable for the mother and in line with the values of the laboring family. IV. Developing a Spirit of Inquiry (in a single paragraph, address the following points:) Locate a relevant , current nursing evidenced based research journal article that relates to the care of the laboring family you cared for this week. Describe specifically how the article provided information to support best nursing practices for the care of the laboring family .Include an APA style reference listing for your journal article. (Refer to the Purdue University OWL for sample APA formats). Nurn 218 Reflection Assignments 6_2019 The article I located covers the use of the Triton imaging system in assessment of blood loss during surgical procedures. This technology was used in the operating room during a cesarian section delivery performed on the laboring family I cared for this week It involves imaging of surgical sponges which is used to provide a quantitative measurement of obstetric blood loss. This development is especially relevant to the practice of labor and delivery because hemorrhage is the most common cause of maternal mortality. This article explores the use of the Triton imaging system for assessing blood loss during delivery. Up until recently, the predominant method of assessing blood loss was visual estimation. However, recent research has shown that quantitative methods of measurement of blood loss instead of visual estimation yield improved outcomes in childbirth. This article concludes that the Triton imaging method should be used in cesarian section procedures rather than relying on visual estimation, which the article asserts should not be considered a reliable method of measuring obstetric blood loss. Given the results of the study in the article I located, it appears likely that in the coming years, best practices will widely favor the use of quantitative methods of measurement over of visual estimation for measurement of obstetric blood loss. References Gerdessen, L., Meybohm, P., Choorapoikayil, S., Herrmann, E., Taeuber, I., Neef, V., ... & Piekarski, F. (2021). Comparison of common perioperative blood loss estimation techniques: a systematic review and meta-analysis. Journal of clinical monitoring and computing , 35 (2), 245-258.

NURN 218 – Maternal-Newborn Nursing Concepts Reflection Assignment for the Concept of Childbearing – Postpartum Family Purpose: Reflection is an active process whereby the professional can gain an understanding of how historical, social, cultural and personal experiences have contributed to professional knowledge and practice (Wilkinson, 1996). Learning is derived from experience but it doesn’t just happen. For it to take place you not only need to engage in reflection you must also record it. By thinking about what you are doing and why you are doing it is what turns your experiences into meaningful learning. If you are to become a reflective practitioner you have to use that learning to increase your professional knowledge and skills to the benefit of not only yourself but also to your patients. Reflection then, is really a process that begins with looking back on a situation, pondering over it, learning from it and then using the new knowledge to help you in future similar situations. Directions: The CCBC Nursing Program is designed to prepare a nurse generalist who, upon graduation, is strong in each of the four areas below. Reflect and respond thoughtfully but concisely to each of the questions listed to demonstrate how you are progressing in developing these skills. Your responses should be typed (1-2 pages) and written in paragraphs, using complete sentences, proper grammar and spelling. Refer to the Grading Rubric for Reflection Assignments to understand how your reflection will be evaluated. Due Date: Reflection is most helpful when it is done as soon as possible after your clinical day (as the details of your day are fresh in your mind). Please submit to your clinical instructor as an email attachment in Blackboard as soon as you like but no later than 72 hours after the end of your clinical day . I. Promoting Optimal Health (in a single paragraph, address the following points:) What nursing interventions were used in the care of the postpartum family? If you could take care of this postpartum family again, write about at least two to three additional nursing interventions you could employ to optimize a safe and positive postpartum experience? Share important insights you have gained about nursing care of the postpartum family. II. Developing Nursing Judgment (in a single paragraph, address the following points:) What actual/potential complications/risk factors were/could be seen for this postpartum family? Give examples of your own and the nurse’s use of clinical decision making in response to those actual or potential complications/risk factors. III. Developing a Professional Identity (in a single paragraph, address the following points:) What insights have you gained about the role of the professional Maternal-Newborn nurse? What positive and negative examples of professionalism did you observe during your day? Give specific examples of how your own professionalism is developing? IV. Developing a Spirit of Inquiry (in a single paragraph, address the following points:) Locate a relevant, current nursing evidenced based research nursing journal article that relates to the care of the postpartum family you cared for this week. Describe specifically how the article provided information to support best nursing practices for the care of the postpartum family.Include an APA style reference listing for your journal article. (Refer to the Purdue University OWL for sample APA formats). Nurn 218 Reflection Assignments 6_2019

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