Reflective Journal Older Adult Cedar Hills Langley Student Name Dermot Connolly Stenberg College

Sunday Aug 26th 2012 Our first day of clinical this week was a lab day designed to help us practice our documentation skills. I am pretty confident about my documentation skills primarily because I come from a background of healthcare manufacturing where I worked with a lot of documentation. I found the review of the Data, Action, Response, Plan (DARP) method of record keeping to be very beneficial especially as I got the opportunity to use it during my clinical the following day. I feel I need to be careful when writing my DARP that I dont make them too wordy. I have noticed from one of the examples I tried, that I can sometimes spend too much time trying to explain either the action or the response but I am confident I can improve on this with practice. During the second portion of the lab day, we practiced taking vitals on each other. During my clinical, I have not had a lot of time to practice my vitals so I was nervous going into this. I did not feel that my attempt went very well. I placed the cuff upside down on Bailey and didnt even realize it until after my attempt was over. I also experienced some trouble opening the valve to get the air in and I felt my technique over all was poor. On the positive side, I do feel I did a good job at making the patient feel at ease. I believe the building of a therapeutic relationship with the patient is one of my stronger qualities; I now need to expand on that skill to perform mental assessments on the patients. I also felt I did a good job in troubleshooting the problem with the valve. I didnt panic when I could not get the cuff to inflate, and after a few seconds I was able to get it to work properly. I am aware that I need to find time during my next clinical to practice taking vitals and in the meantime, I need to re-read chapter 17 from my Perry and Potter book and continue to practice on my wife.

Monday Aug 27th 2012 I find I am gaining in confidence during my clinical. I no longer have that feeling of being lost as I am more comfortable interacting with the residents and giving them personal care and medications. There are two instances that happened on Monday that I would like to journal about today. The first instance was the mood and behavior of my patient Reta. Normally Reta is quiet calm and chatting in the mornings but I noticed that she seemed a little distracted when I went into to see her on Monday. I felt her answers were a little short and she wasnt as interested in engaging in conversation as she normally is. She had complained of being in pain which she ranked as a five on a scale of one to five. Her body language did not indicate to me that she had a pain level that high as she was not grimacing and she did not moan or complain as I turned her during her personal care. I was able to conclude that the data Reta gave me was subjective data whereas the data I collected from analyzing her level of pain was my objective data. It was Mary that helped my gain a deeper understanding as to the potential reasons behind her change in behavior. Reta was due to get up and be taking to get her hair cut which involves two people lifting her out of bed and wheeling her down to the cafeteria. Reta had expressed to me in the past that she does not like to get out of bed as the lack of support hurts her neck. I believe she could have being feeling anxiety about her trip to the hairdresser that may have resulted in a change in her mood. This theory certainly holds true when I compared Retas mood in the later afternoon to that of the morning. Once she was back in bed, she was more like her old self. She had no more reports of pain and was engaging in conversation more. The second instance I would like to journal about is that of Bessy, a resident who lives across the hallway from Reta. I gave Bessy her personal care in the morning and she woke up in

pretty good spirits. As I was taking another patient to the bathroom, Bessy became quite agitated as the bathroom was no longer available for her to use. As I sat with her, she complained that one resident in particular was always in the bathroom and as we sat together on her bed, she began to cry. I felt she was embarrassed by her tears and she attempted to stop them despite my assurances that crying was OK. Bessy is quiet independent and requires minimal personal care when compared to some of the other residents. As I reflect on Bessys response I am questioning why she reacted the way she did. Perhaps Bessy is merely expressing her anger at her loss of independence. Her life has changed from one where she had control over most aspects of it, to one where she has to share a bathroom with three other residents and perhaps she feels this is unfair. I think Bessy displays her desire for independence in other ways too. She appears to be quiet proud that she can still dress herself and take herself to the bathroom. I feel her emotions on Monday were a reflection on her inner feelings of anger and despair. I feel Bessy is looking for companionship and ways in which she can show that she is still in control of her life.