Essay on Journal: Nursing and Preceptor

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Journal Reflection 1
September 11, 2013

Journal Reflection 1 On Sunday, September 8, 2013 I had another day of clinical on 2SE a Medical Surgical Unit at Beaumont Grosse Pointe with my preceptor, Sharon. We were assigned to five patients during our twelve hour shift. The patient I had the most beneficial learning experience with was a 53 year old male, who suffered from a stroke a year ago. The stroke had caused aphasia as well as right sided paralysis. We admitted this patient in the middle of our shift and knew very little information about him. He was admitted for possible urinary tract infection and mild fevers. This was my first time caring for a patient with aphasia. I felt very sad for this man and was a little nervous at first. When first introducing ourselves to the patient and taking care of his needs. He kept repeating “strooo” and pointing around the room. This was the extent of his verbal communication abilities. Cameron discussed in her article, “Best Practices for Stroke Patient and Family Education in the Acute Care Setting: A Literature Review,” the importance of patient and family education related to the physical, mental and emotional changes post-stroke patients face. The nurse must consider the patient’s specific needs and tailor their care towards those needs (Cameron, pp.52, 2013). My preceptor and I did this, as we tried very hard to figure out what are patient wanted. We could not figure out what it was and it was very frustrating to him. He pointed and we asked, “What do you need; pain medication, a blanket, the phone?” He shook his head no and begin to get angry from our lack of understanding. It was very disheartening feeling as if we could not take care of this gentleman's basic needs. My preceptor then had the idea to give the patient communication cards and showed each picture to him. Through going through the pictures we came across a TV and the patient nodded and smiled. We turned on the TV and flipped through a few channels until we came across a football game and the patient put his arm up and smiled again, as if to say this is what he wanted to watch. It felt so great to see this man smile and happy with such a basic thing like watching a football game on TV. After getting him situated and content, he began to motion his hand up to his mouth trying to let us know he wanted something to eat. We heated up a packaged dinner for him. My preceptor and I asked him what type of dinner he would like and went through several different options, which he shook his head yes or no to. After he was all set up eating with his left hand and chewing on his left side, while watching the football game, he had a big grin on his face and seemed very grateful. As a nurse, it is very important to not only care for your patient but also teach them to perform as many skills as possible independently and safely (Cameron, pp. 53, 2013). This is what my preceptor and I tried to do as we set him up to eat independently with his left hand. Taking care of this man was a privilege. After receiving report and before seeing this man, I did not know what to expect or how to care for this patient since he could not communicate verbally. Although after seeing the way my preceptor cared for him, I learned a lot. My preceptor took the time to see what this man wanted and really tried to bridge the gap of this communication barrier in order to take better care him. It felt so great to see him happy over such a basic need. After caring for the man throughout the day, my preceptor and I wanted more information. The endocrinologist came in to see him for the first time and asked us why the patient was not speaking. We explained to him about the aphasia and stroke history as well as the right sided paralysis. The doctor was mainly concerned with this patient’s uncontrolled diabetes but he wanted more information. He talked to the patient’s mother, who told us, he had a
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