ISTAN Reflective Journal 9/26/2016

Taylor Wilson

NUR 201 

ISTAN Reflective Journal 

9/26/2016

Today, 9/26/2016, during simulation lab my classmates (Cody Fowler and Helen Prouty) and myself collaborated together to provide optimal care to a 41 year old client admitted with a low-grade fever and cellulitis of his interior right forearm. Throughout the simulation, as a group, we administered acetaminophen (Tylenol) 650mg PO PRN for client reported pain and mupirocin (Bactroban) 2% topical cream TID for cellulitis. In addition, we did a complete head-to-toe assessment, provided wound care, handled issues with dietary, obtained laboratory blood samples (CBC with differential, BMP, and ESR), provided education regarding wound prevention and cleansing, and assisted the client onto a bedside commode. During wound care, we removed the previous saturated dressing, noted amount, color, and consistency of exudate, rinsed the wound bed with normal saline 0.9%, applied mupirocin (bactroban)2% topical cream to wound bed, and wrapped the wound with a new clean kerlix gauze. Along with our priority nursing interventions, we also provided the patient with a safe environment; cleaned the room, obtained an Ambu bag for the room, oxygen hookups, and connected suctioning inside the client’s room. 

Throughout our simulation, I learned how working as a team increases our ability to provide optimal care to any client. In addition, I learned to stop and take time to encourage and try to provide for the client’s dietary requests if applicable. We reviewed the correct method for labeling venous laboratory blood samples and the importance of obtaining a wound culture before administering antibiotic therapies. Lastly, I learned to just take a deep breath and think critically. My number one focus should always be my client’s care regardless of his location, care status, or whomever is present in the room. 

During my next simulation, I will utilize the white board in the room to facilitate better group communication. In addition, I will think more proactively in regards to laboratory and diagnostic tests. I will call and recommend diagnostics and laboratory tests if I believe the tests will benefit my client’s health. My pervious simulation experience required me to focus on utilizing my fundamental nursing skills. However, this simulation challenged my group and myself to think critically. I enjoyed working with my group and my simulation experience.

While watching my peers’ simulation experience, I learned how important and inconvenient it can be to the client to draw laboratory tests incorrectly. In addition, the group utilized the white board to communicate effectively and demonstrated excellent SBAR during phone communication. Overall, their group did amazing and worked effectively as a team to care for their client. 

My simulation experience allowed my group to practice several classroom skills and patient education we have learned throughout our nursing careers. We practiced the six rights of medication administration and performed three safety checks before administering medications. In addition, we pre-medicated before providing wound care, obtained labs and safely transferred the client from the bed to the bedside commode. We were able to practice our patient education skills by communicating with the client benefits of skin care and possible ways to prevent further cellulitis in the future; specifically tailored to the client. Our group did amazing and I really enjoyed the opportunity to work with each member! 

Taylor Wilson