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 Tanner’s (2006) Clinical Judgment Model
Introduction

What professional nursing meeting(s) did you attend and where was it located?
I attended the Education Council meeting in the auditorium at St. Mary’s on August 16, 2018.
Background

Describe the purpose of this professional nursing meeting? Describe the agendas of the group and subgroup. What
type of issues did they address?

This meeting has a pre-established purpose to define and evaluate nursing education and orientation needs in order
to develop a highly skilled professional nursing staff that delivers quality patient care. The four sub-committees of
this meeting are the competency committee, continuing education committee, new products committee, and patient
and family education committee. After the call to order and chair report and announcements, the four sub-
committees broke off for about 45 minutes of discussion, after which each sub-committee in turn then presented
their reports to the group as a whole. The Competency committee report was on updates to the learning management
system and how new policies will be easier to access. The continuing education committee report was regarding
their formulation of a “survival guide” for new nurses and how they were accepting suggestions for research articles
to enhance their support of new nurses. The new products committee discussed the new wound vac that was now
available, and how it differed from previous models. The patient/family education committee primarily discussed
how they need a delegate representative and more participants to be effective. After this time the group as a whole
discussed new business, including information updates on obtaining consents and mislabeled lab specimens,
information on a new nurse mentorship program that will be available in September, a product demonstration of the
new Vial2Bag IV connectors, and a sepsis update. The meeting then dismissed after briefly discussing five
takeaways for the group.

Noticing

What did you notice about the professional nursing meeting initially? Describe what you saw, heard and did during
the meeting?

It was interesting to me that the environment of the meeting was fairly casual, with many people using this time to
eat lunch. However despite this everyone stayed on track and got a good amount of ground covered, which to me
shows that any casualness over eating during the meeting is simply a practical consideration and not because people
weren’t taking the meeting seriously. The meeting opened with a call to order, a blessing, and the chair making
announcements, after which time the sub-committees split off for discussion. I opted to join the new products
committee in their discussion of the new wound vacs and defibrillators that are now available.

Interpreting

Describe what you thought about the information being discussed. Have you been involved in similar discussion
during your previous student nurse experiences? Describe the similarities and/or differences to those encounters.

For the most part most of the information presented in the meeting was straightforward and needed little in the way
of discussion. The two exceptions were the discussion of the new state mandate for physician consent on blood
transfusions, and issues with mislabeled specimens. The discussion of consent forms overwhelmingly showed the
nurses were frustrated with physicians who seemed to take it for granted that nurses would be doing the brunt of

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obtaining consent even though it is outside of our scope of practice. This ongoing paradigm shift in the nurse-
physician relationship is something that has been touched on frequently in our classes. Most of the nurses in the
meeting were glad that state law is now requiring physicians to step up and take the lead on consents in blood
transfusions, and more than one nurse seemed to wish that the mandate could have been extended to all consents.

The discussion over mislabeled specimens initially began as discussion over a form intended for root-cause analysis,
but many of the nurses there indicated that their perception of the largest factor in mislabeling incidents is a
technical issue with the label printers. Several ideas for potential solutions were then brainstormed, with both a
temporary solution being shared within the meeting as well as a commitment from the chair to investigate the
possibility of a long-term solution with the IT department. For me, this was exciting to watch because I’d rarely seen
a problem be presented and solutions being given within such a short time span in a professional meeting.

Responding

Describe stresses (both positive & negative) you experienced as you responded to the new learning or the challenge.

The largest challenge I had at this meeting was simply being unfamiliar with a lot of the jargon that the nurses were
using. Although I have a decent proficiency in patient care, a lot of the discussion centered around organization-
specific trainings and forms that I have no personal experience with, as I am not currently a Bon Secours employee.

Reflection-in-Action

What role would you take being assigned to represent your unit in this group? What subcommittee would you like to
participate with and why?

I think that being on the MIU this semester, I could make the biggest impact being on the patient and family
education subcommittee. A significant portion of what we do on the MIU is educating new parents, so nurses from
that unit should theoretically be some of the best prepared to assist in developing information that is easily shared
with patients and evaluating its effectiveness.

Reflection-on-Action and Clinical Learning

What written evidence is available to support professional nursing groups and their impact on the development of
evidence based practice and improved patient outcomes. Cite/reference all journal articles that contributed to the
evidence.
What is the value of professional nursing meetings both as a part of a healthcare system and within a professional
organization?
Describe any changes in your values or feelings as a result of this experience.

Structural empowerment is one of the categories used in the American Nurses Credentialing Center model for
Magnet status. Numerous studies done since 1994 have shown that hospitals with Magnet status have improved
patient outcomes in numerous categories including mortality after surgery, falls, outcomes of very low birth weight
infants, and patient satisfaction. It is possible that these improved outcomes may be in part due to enhancements of
the nurses work environment, as nurses’ participation in hospital governance is more prevalent in Magnet hospitals
than in those without Magnet designation (Kutney-Lee et. al., 2015). If further research supports this hypothesis,
then that would indicate that nurses participating in a shared governance role and in other professional meetings can
have a significant impact on the improvement of the nation’s health.

On a personal note, I was quite impressed with the shared governance meeting that I attended. I had participated in
governance meetings as a Girl Scout delegate, and always found myself frustrated in the Scout council meetings by
how everyone seemed to have a problem but no one wanted to offer potential solutions. To see problems identified
and solutions proposed within just minutes of each other was an exciting and refreshing change for me.

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References

Kutney-Lee, A., Stimpfel, A. W., Sloane, D. M., Cimiotti, J. P., Quinn, L. W., & Aiken, L. H. (2015). Changes in

Patient and Nurse Outcomes Associated with Magnet Hospital Recognition. Medical Care 53(6), 550-557.

doi: 10.1097/MLR.0000000000000355

Nielsen, A., Stragnell, S., & Jester P (2007). Guide for reflection using the Clinical Judgment

Model. Journal of Nursing Education, 46(11), p. 513-516.

Professional Nursing Meetings

St. Mary’s Hospital

NOC: first and third Wednesday of each month. Let me know when you would like to attend.

Shared governance council meetings:

Professional Practice Council-Second Wednesday 8a-12n

Strategic Planning Council-Second Thursday 8a-10a

Applied Research Council-Third Thursday 10a-12n

Education Council: third Thursday from 12n-4p (the meeting part lasts for 2-2 ½ hours and then
the members work on unit education)

Memorial Regional Medical Center

Third Tuesday of each month (Room 3008, Net Center)

Nursing Practice council 0800-0930

Nursing Quality Council 0930-1100

Nursing Recruitment & Retention Council 1100-1300

Nursing Education/Research 1300-1430

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