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Community-Based Practicum Reflective Journal Guidelines

Bon Secours Memorial College of Nursing


NUR 4143 - Clinical Immersion
Community-Based Practicum
Professional nursing meeting experience (4 hours)
Guide for Reflection Using Tanners (2006) Clinical Judgment Model
Introduction

I attended professional meetings at St. Francis Medical Center on February 8th. The meetings I
attended were of the Nursing Quality Outcomes Council and Research & Evidence Based
Council.
Background

This first meeting I attended was of the Nursing Quality Outcomes Council at St. Francis. This
meeting had nurses from different units of the hospital that attended on a monthly basis. The goal
of this meeting was to review policy and come up with goals for the hospital.
The second meeting attended was the Research and Evidence Based Council meeting at St.
Francis. During this meeting the council discussed changes they would like to see made in
medical practice. A member of the group also did his own research but it has been turned down
in one of the final steps at John Hopkins. The group also discussed how the interdisciplinary
rounds are affecting patient care positively at St. Francis at this time.
Noticing

During the first meeting I noticed that the group was composed of a diverse group of nurses. The
group had some newer nurses and some that have been nursing for years. Alison, RN, ran the
meeting. During the meeting we discussed a policy that has been revised PAT-122. The policy
revisions explained expectations for hourly rounding, hand offs, the 5 Ps and the policy has
made things more general for staff. The meeting discussed New Goals for 2017. Goal 1 is to
reduce device days to be in top 10% of NHSM. Devices include foleys and central lines. Goal 2
is to decrease discharge time by 30 minutes per unit. Goals 3 is to assist with existing efforts and
participate on teams to improve hourly rounding to reach a goal of 80% house wide.
During the second meeting we discussed how On Q was not approved for C-section patients
because of the price. We also discussed the interdisciplinary rounds that started with 10 patients
per day and three physicians. So far patients seem to like the interdisciplinary rounds and have
been asking more about medications. Currently the interdisciplinary team is rounding 50% of
patients.
Interpreting

I think that both meetings I attended discussed important information for nurses and patients.
The meeting structure was similar to the professional meeting I went to at the college. These
meetings were faster paced and discussed more about patient safety, evidence based practice, and
goals for the hospital. The meeting I had previously attended was about the school dynamics and
goals for students and diversity. Both the college meeting and the nursing meetings compared
their data to others performing the same processes.

BSMCON NUR4143
Community-Based Practicum Reflective Journal Guidelines

Responding

During the first meeting it was hard to keep up because we did not have the schedule of the
meeting because they did not have extra copies. It was nice because they did have an extra PAT-
122 that we could review with them as they went over the policy. During both meetings they had
us introduce ourselves before we started. This made me feel more welcomed by the group.
Another negative was that since we do not go to the monthly meetings we did not have any
knowledge about the information they were reviewing from previous sessions.
Reflection-in-Action
I would like to be part of the Nursing Qualities Outcomes meetings. I would like to be able to be
a representative for whatever unit I work on. Since this group reviews policies and sets standard
this can critically affect care for patients. I think that being part of the committee would allow me
to communicate with the rest of the staff on the unit to get their opinions.
Reflection-on-Action and Clinical Learning

During the Research and Evidence Based Council meeting the nurses talked about how the
interdisciplinary rounds have been successful at St. Francis and they continue to focus on
growing the program. Currently the interdisciplinary team sees about 50% of the patients in the
hospital. They currently have the A, B and C team. After listening to the nurse discuss how well
the program is working. This made me want to look into research on this topic.
The article I chose to review was An evidence-based program for enhancing interdisciplinary
collaboration to promote spiritual care in an adolescent psychiatric residential facility. This
article was looking at how spirituality is a critical component in the healthcare plan. The
interdisciplinary team consisted of registered nurses, advanced practice nurses; occupational,
speech, recreational, and horticultural therapists; mental health specialists; psychologists;
psychiatrists; medical physicians; social workers; and a residential chaplain (Tyson, 2016). They
used Bronsteins Model for Interdisciplinary Collaboration as a guide for their program. This
model focused on members to use these components in collaboration; interdependence, newly
created professional activities, flexibility, collective ownership of goals, and reflection on
process. The study found that nurses are better equipped to address spirituality in the clinical
setting. This collaboration of interdisciplinary care takes a flexible approach to caring for the
patients (Tyson, 2016). I think that each patient has different needs but have all components of
care should be available. Not all patients will need a spiritual component but having it available
can benefit both staff and patients.

Tyson, R. L., McIntosh, D., & Gregg, J. (2016). An evidence-based program for enhancing
interdisciplinary collaboration to promote spiritual care in an adolescent psychiatric residential
facility. Journal of Nursing Education and Practice, 7(4), p15.

BSMCON NUR4143

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