Running head: REFLECTIVE JOURNAL ONE 1

Reflective Journal One:

A Nursing Student’s Perspective in a Long-Term Care Facility

Leah Will

Trent University
REFLECTIVE JOURNAL ONE 2

Date of Experience: January 29th, 2017 Journal # 1

My first placement in a long-term care facility was eye-opening, challenging, rewarding

and fun. As I currently work at a hospital, interacting with patients is something I do all day.

However, it was interesting to switch into the primary caregiver role and assist the nurse I got

paired up with for her morning duties. The role of the RN in the mornings is to go around the

floor and get the residents up, washed and dressed for the day. This experience was significant

due to the personal responsibility I felt while working on my own, in particular with an older

resident who was cognitively impaired with extreme confusion. I love to learn by just getting

thrown into a situation, and this is exactly what happened.

After assisting the nurse with several lifts, transfers, bed pans, brief changes and bathing,

she allowed me to get two residents up and bathed and dressed for the day. This surprised me, as

I didn’t expect to be working on my own on the first day. However, I felt no hesitation and was

excited to learn. She had asked if I felt comfortable working with a resident who had extreme

confusion and trouble with her ADL’s. I told the nurse I was confident interacting with residents

who have cognitive impairments due to my previous patient experience at a hospital. The

resident was highly confused, as I needed to remind her what we were doing while bathing

numerous times, and calm her down when she would get agitated if she did not understand. This

required me to have great patience, and also allowed me to learn to give instructions in several

different ways if the resident did not understand me the first time. It often took a long time for

her to understand a basic instruction of taking her shirt off, or she would resist forcefully

sometimes if I tried to help her move her arm out of the sleeve. This made me feel frustrated and

sometimes made me lack confidence in myself because I thought I was doing it wrong. I had to
REFLECTIVE JOURNAL ONE 3

remind myself that it may take a long time for her to understand, and that she is probably more

frustrated than I am.

A factor that contributed to this situation initially was the trust the nurse felt in myself. I

would imagine that if the nurse did not feel confident in my abilities at this point, she would not

have allowed me to do anything without her being there. I learned that my strength in this

particular situation was my patience and ability to effectively communicate with the resident. I

was able to shift the way I was explaining the bathing process to her when I saw she did not

understand or would begin to get agitated.

I would envision that this experience for the resident is very frightening, with her being

severely confused and not sure of what is happening when her clothes are being taken off and

she is being bathed. I would hope that this experience for the RN supervising me was confident

in my abilities to be able to effectively and safely handle this situation on my own.

During this event, I learned how to be professional in this situation very quickly. Being

respectful for the residents while bathing is important, as they are exposed and vulnerable. I also

learned that every single resident is very different, and as a nurse we have to be able to adapt to

different situations from room to room in a long-term care facility. The learning objective that I

relate this experience closely with would be the development and application of therapeutic

communication skills to establish the nurse-client relationship. I truly felt as if this experience

with a highly confused resident allowed me to critically think on the spot, and figure out ways to

effectively communicate to get the task done. I also feel as if I demonstrated knowledge in

providing client-centered support for activities of daily living. I appreciate the fact that the nurse

allowed me to go on my own to do this, as this is an effective way for me to learn as a nursing

student.