Nursing Reflection Report: Cardiovascular Assessment and Review

This report presents a comprehensive reflection on a cardiovascular assessment conducted in a simulated clinical setting. The student nurse utilized Gibbs' reflective cycle to analyze the experience, encompassing description, feelings, evaluation, analysis, conclusion, and an action plan. The assessment involved evaluating a patient with cardiovascular complications, including vital signs, inspection, palpation, and auscultation. The student identified strengths in preparation and patient interaction, but also recognized weaknesses in hand hygiene, psychomotor skills, and auscultation techniques. The analysis highlighted the importance of hand hygiene, proper communication, and accurate auscultation for patient safety and effective care. The conclusion emphasized the need for further skill development and the action plan outlined strategies for improvement, such as reviewing evidence-based practices and engaging in additional training to enhance nursing competencies and provide better patient care. The student aims to improve auscultation, hand hygiene and other key nursing skills.

Running head: REFLECTION ON CLINICAL ASSESSMENT
REFLECTION ON CLINICAL ASSESSMENT
Name of Student:
Name of University:
Author’s Note:

1REFLECTION ON CLINICAL ASSESSMENT
Introduction
The clinical assessment is an important part of work for the nurses, which is used to
diagnose and plan treatment for the patient. Health assessment is essential to identify the
problem of the patient and the medical needs required for the procedure. It can be done by
conducting the physical examination of the patient that help in better diagnosis of the disease
(Schmitz et al., 2016). It requires to critically reflect on the past nursing experience to evaluate
the strength and weakness in the practice area (Smith, Brown & Crookes, 2015). The main aim
of the essay is to reflect on the simulation experience related to cardiovascular assessment to
examine my weak areas that need improvement. The reflective cycle has made use of Gibbs
cycles that are linked with the learning experience. It encompasses six stages of reflection, which
includes description, feeling, evaluation, analysis, and conclusion and action plan (Husebø,
O'Regan & Nestel, 2015).
Description
The incident describes the cardiovascular assessments done in the simulated patient. The
patient had an irregular heartbeat and cardiovascular complications; hence, there was a need to
perform a cardiovascular evaluation. In the simulation process, we tried to maintain the ethnicity
and nursing principle. I perform hand hygiene before assessing the patient and recorded his vital
signs, which includes respiration rate, body colour, temperature, blood pressure. I inspected
precordium and venous distribution and other physical changes along with performing
auscultation. All the assessment were recorded, and lastly, the case was handover to other
clinical staffs using the ISBAR tool.

2REFLECTION ON CLINICAL ASSESSMENT
Feeling
Before the simulation, I was mindful that I would deliver quality work in assessing the
patient; however, at the time of assessment, I was quite nervous and low in confident which
ended up with many shortcomings. I felt happy that I have completed the simulation; at the same
time, I felt that I should have worked as per my competency and nursing principle. My mentor
reviewed my work and gave mixed comments related to my steps and role in cardiovascular
assessment. I was feeling guilty about the delivery of work and thought I need practical nursing
skills to become a competent nurse.
Evaluation
In the simulation process, I have done well in the area of preparation and safety where I
have identified the principal rationale for the assessment, gather required equipment, preparing
the patient with maintaining the privacy and dignity of the patient. However, I failed to perform
each of the five steps of hand hygiene. The assessment of psychomotor skill did not go well as I
did not communicate the purpose and procedure before taking postural blood pressure. The
process of inspection also went satisfactorily. However, I forget to inspect the conjunctiva of the
patient. I provided only a brief description of the palpation, which was limited with significant
rationale. The step of auscultation did not go well as I lacked in identifying the major landmark
which could have given a significant idea about cardiovascular complication. My interaction
with the patient was good as I have built a therapeutic relationship by using both verbal and non-
verbal communication skill efficiently. I have successfully used the ISBAR tool for handover,
and overall, the simulation was well with minimal encouragement.

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Analysis
From my experience from simulation, I have analysed that I lacked in many necessary
nursing skill, which requires improvement measure to ensure the safety of the patient. I was
missing in crucial steps of hand hygiene, which can impart health issue to the patient. It is
reported in the study of Gould et al. (2017) that hand hygiene is the first step to avoid healthcare-
associated infection. It is the responsibility of the nurse to do hand hygiene before and after
assessing the patient to control cross-contamination. I am deficient in assessing psychomotor
skill where I did not communicate with the patient about the process and additionally overlook to
inspect conjunctiva. According to Wagner et al. (2018) for the nurse, it is essential to be skilled
and mindful in assessing the patient. Any ignorance by the nurse can lead to an adverse effect on
the health of the patient. It is essential to explain the procedure for taking postural blood pressure
so that the patient would be corporate in the assessment (Sharpe & Hemsley, 2016). From the
study of Tatham and Patel (2018), it was noted in cardiovascular assessment conjunctiva
inspection is vital as it reveals the function of neurological sense and rate of infection. Hence, I
lacked in these major area which needs to be built efficiently. Auscultation provides vital signs
for the cardiovascular assessment, which help in implementing relevant intervention (Ross,
2017). In the process of simulation, I failed to identify the significant landmark which could
have led to the slow recovery of the patient. Therefore, there is a need to develop the required
skills in me, which will help in becoming a successful nurse.
Conclusion
From the above discussion, it can be concluded that I could have prepared more before
involving in the process of simulation. After getting a review from my mentor, I can say that I
need to work with full efficiency and competency to give competent care to the patient. I should

4REFLECTION ON CLINICAL ASSESSMENT
have been more confident and assertiveness in the work so that I could have assessed the patient
with a sense of awareness.
Action plan
After reviewing my experience from the simulation, there is a need to take effective
action to improve my skill of nursing. I will study the steps and importance of hand hygiene by
reviewing the evidence-based practice and academics book, described in the study of Lo et al.
(2016). To improve the auscultation technique, I will get involved in a handful of training which
will aim to teach the critical steps and process the auscultation. It will help in improving my
skills and competency in assessing the patient. I will get also engage in an online course which
will assist in developing a sense of responsibilities, confidence and awareness about assessing
and inspecting the patient so that I could miss any important steps. I will review my books and
research articles focusing on palpation and key nursing skill. Such an action plan adopted will
help in the development of essential nursing skills with the objective to improve the health of the
patient.

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Reference
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