NURS 490: Reflective Journal on Clinical Placement Experiences

This assignment is a reflective journal entry from a nursing student's clinical placement experience, focusing on the challenges and growth encountered. The student reflects on a specific situation where they chose not to speak up for a patient due to the principle of autonomy and the patient's mental state. The reflection covers two areas of difficulty: a lack of confidence stemming from inexperience and the challenge of translating theoretical knowledge into practical application, particularly when faced with differing standard operating procedures. The student highlights the importance of gaining confidence through experience, communication, and learning, and emphasizes the demanding nature of nursing, including the need to navigate ethical considerations and adapt to real-world practice. The student also provides references to support their reflections.

NURS 490 1
NURS 490
Name:
Institution:
Tutor:
Date:

NURS 490 2
Introduction
Working in a new environment or workplace is always challenging. In most cases,
nurses feel afraid and panic thus making it even difficult to initiate obvious nursing
interventions (Hofler & Thomas, 2016). The purpose of this assignment is to reflect on what
I went through during my clinical placement.
Reflection.
The nursing profession entails looking after the patient. However, nurses work in
collaboration with other health professionals such as medical doctors, physiotherapists,
pharmacists and nutritionists. The core objective is normally to improve the quality and
safety of healthcare provided to the patient (Moore et al., 2019). As a nurse, I have on
several occasions had to liaise with different professionals especially during the decision-
making process.
At one given moment, I was looking after a certain patient. He was a 76-year-old
man suffering from lung cancer. During this period, I did not speak on behalf of the patient.
First of all, it was due to the principle of autonomy. It states that a patient should decide
whatever he/she feels comfortable with. Secondly, the patient was in good state of mind.
This therefore means that he was in a position to speak or advocate for himself and
speaking on his behalf would be infringement of the patient’s rights.
Two areas of difficulty encountered
During my clinical placement, I encountered different obstacles or rather barriers.
Lack of confidence is an example. During my nursing placement, I did not have enough
confidence to handle different health issues or complications. This was partly due to

NURS 490 3
inexperience. Every time I was called upon to implement any nursing intervention, I was
totally panicking and this would eventually lead to pain among some patients. However,
with time, I started gaining confidence after asking several questions to experienced nurses
and my mentors. The other strategy that I used to gain confidence was building my
communication skills. This involved active listening and being patient most of the time (Lee
et al., 2019). I also learnt not to compare myself with others as this would bring about
unnecessary pressure.
The other difficulty I experienced was translating theory into practice. This is
common among new nurses (White et al., 2016). Most of the time, we are used to only
classwork theory and rarely do we put it into practice until I went out for clinical
placements. I found out that most of the Standard Operating Procedures available at the
wards were somewhat different from those learnt in class. In most cases, I was forced to
inquire or ask about a contrary or new intervention
In conclusion, the nursing profession is quite demanding. There are times where the
nurse has to advocate for patient rights but might be limited due to the principle of
autonomy. Nurses also go through difficulties especially at new work places. Issues such as
confidence, integrating theory into practice and communication are common. Nurses should
therefore understand what is expected of them always and learn how to circumnavigate
through.

NURS 490 4
References
Hofler, L., & Thomas, K. (2016). Transition of New Graduate Nurses to the Workforce: Challenges
and Solutions in the Changing Health Care Environment. North Carolina Medical Journal,
77(2), 133-136. https://doi.org/10.18043/ncm.77.2.133
Lee, C., Tseng, H., Wu, L., & Chuang, Y. (2019). Multiple brief training sessions to improve nurses’
knowledge, attitudes, and confidence regarding nursing care of older adults with
depression in long term care facilities.‐ Research in Nursing & Health, 43(1), 114-121.
https://doi.org/10.1002/nur.21997
Moore, J., Prentice, D., Crawford, J., Lankshear, S., Limoges, J., & Rhodes, K. (2019).
Collaboration among registered nurses and practical nurses in acute care hospitals: A
scoping review. Nursing Forum, 54(3), 376-385. https://doi.org/10.1111/nuf.12339
White, K. M., Dudley-Brown, S., & Terhaar, M. F. (2016). Translation of Evidence Into Nursing
and Health Care. https://doi.org/10.1891/9780826117830