Nursing Assignment: Reflecting on Nursing Placements - Student Name

This nursing assignment is a reflective report on a student's clinical placements, providing a detailed account of experiences in various settings, including a Registered Nurse role and the Emergency Department. The report covers the development and implementation of patient care plans, medication administration, and the importance of therapeutic relationships. The student discusses the application of NMBA standards in practice, including comprehensive patient assessments, wound care, and patient education. Key experiences, such as working in the Emergency Department, administering medications, and providing complete patient care, are analyzed. The assignment highlights the development of skills, competencies, and knowledge in areas like cardiac care and pharmacology. The student also reflects on challenges encountered and the growth of confidence and independence in handling patient loads and developing care plans. The report includes references to relevant literature supporting the practices and experiences discussed.

Running head: NURSING ASSIGNMENT
Nursing Assignment
-Reflecting on my nursing placements
Name of the Student
Name of the University
Author Note

1NURSING ASSIGNMENT:
During my placement as a Registered Nurse:
Working as a Registered Nurse, I had to actively work with patients, developing and
implementing care plan for them and administering medicine (Griffiths et al., 2016;
Smolowitz et al., 2015).
During my placement as a professional nurse, I had the opportunity to develop an
understanding about the various roles a Registered Nurse has to and helped me to develop
critical thinking skills. This aspect has been implied in Standard 1 of NMBA that requires
nurses to cortically analyze nursing practice (Nursing and Midwifery Board of Australia,
2016). While working with patients, I was able to learn about the importance of an effective
therapeutic relationship with patients which is based on both a professional and personal
approach, which is a part of the NMBA Standard 2 (Parry et al., 2015; NMBA, 2016). I was
able to develop my skills to perform comprehensive assessment of the patient, involving
strategies of primary and secondary assessments, as per NMBA Standards 3 and 4 (NMBA,
2016). I often had to prepare care plan for patients by implementing my knowledge into
practice which is a part of Standard 6 of NMBA (Bobay et al., 2018; NMBA, 2016; Auerbach
et al., 2014).
I understood that to ensure further improvement in my professional skills and
competencies I need to further develop my understanding of the patient conditions and how it
affects the wellbeing of the patient (Kankaka et al., 2017).
During my placement in Emergency Department:
While working in the Emergency Department, I had the opportune advantage of being
mentored by an efficient educator who guided me through my professional journey as a
Registered Nurse.

2NURSING ASSIGNMENT:
The experience in the emergency department helped me appreciate the importance of
collecting comprehensive information from the patients after their admission such as past
medical history, lifestyle and medications, as is implied under Standard 4 of NMBA (NMBA,
2016). My ability to perform primary and secondary assessment on the patient proved to be
an added advantage in the process and ensure compliance to Standard 4 of NMBA. However
the first week was very challenging for me, as I came across new experiences and challenging
situation and critically analyze and evaluate the practice as per Standard 1 of NMBA
(NMBA, 2016; Carter & Jones, 2017).
I was able to provide a satisfactory performance, developing my skills and
competencies in the emergency department. This helped me utilize Standard 3 and 7 of
NMBA that implies maintenance of professional capacity and evaluating outcomes of
practice (NMBA, 2016; Farrell et al., 2015).
Week 1 in Emergency Department:
In the first week of my placement in the Emergency Department, I was entrusted to
take complete responsibility of care delivery for a patient from the point of admission until
their discharge, which included preparing care plan and discharge plan for the patients. The
initial days were very challenging due to the fast paced environment in the emergency ward
compared to surgical or medical wards and also due to a lack of prior experience in the
emergency department (Hensel et al., 2018).
I developed competencies in reviewing patient information (such as medical history,
medication charts) and clinical documents, which helped me identify the care goals and care
needs and helped to relate the patient condition to the problems presented by the patient, and
implement Standard 4 and 5 of NMBA (Haas & Swan, 2014; NMBA, 2016).

3NURSING ASSIGNMENT:
By the end of the week I was able to implement the best practices guidelines in my
professional work, and significantly improved my competency to work in the emergency
department and as a result, my confidence grew further. This was in accordance to Standard 1
and 7 of NMBA (NMBA, 2016; Tycon et al., 2017).
3rd week of placement in Northeast Health:
In the third week of my placement I had the opportunity to gather experience on
wound dressing and wound care. One of my patients presented with a head wound. The
wound was 3 cm deep, freshly cut with continuous bleeding, as I was assisting a doctor who
cleaned up and dressed the wound before and after suturing it (Griffiths et al., 2016).
The doctor supervised me while I performed the sterile technique for wound
management. I followed the hand hygiene practice before starting to clean and dress the
wound and maintain a sterile environment (Smolowitz et al., 2015).
I was successful in implementing and maintaining a clean and sterile environment,
which prevented the risks of any infections, and thus promoted timely healing of the wound,
as was implied under Standard 6 of NMBA that recommends safe and appropriate response to
the patient (NMBA, 2016; Parry et al., 2015).
Administration of medicine:
Working in the Emergency Department gave me more opportunities to administer
medications to the patients, compared to the other departments where I worked. This also
included setting up intravenous channels and collecting blood (Bobay et al., 2018).
This experience helped me develop my skills further in the safe administration of
medicines and using effective techniques to set up IV channels and collect blood from the
patients. I gathered in depth knowledge about appropriate medications in context to the

4NURSING ASSIGNMENT:
patient’s condition and how the medication works, including the possible side effects or
consequences of using the medication. The Standard 4 of NMBA implies the need for
comprehensive assessment which I was able to follow (NMBA, 2016; Auerbach et al., 2014).
I was able to develop my knowledge about medications and its effects in a more
comprehensive manner, working in the emergency department; this was supported in the
Standard 3 of NMBA. As per my supervisors, I was able to perform effective care
assessment, planning and intervention as well as educate the patient to an adequate level
(Kankaka et al., 2017).
Providing complete care for a patient:
In the second week of my placement, my educator entrusted me to take complete care
for one patient, since I was in my third year of nursing and have developed enough
confidence to handle the responsibility. I developed a complete plan for the patient, from
admission to discharge (Carter & Jones, 2017). The NMBA Standard 5 implies the
development of care plan for patient, which I was able to utilize in my work (NMBA, 2016).
My responsibility was to constantly monitor his vital signs and heart rate as per the
Standard 4 of NMBA that recommends a comprehensive assessment of patient (NMBA,
2016). I also had to document any change in the vital signs and alarm the doctors in case of
any worsening of the condition. When the hart rate increased I had to send the patient for
DCR. This gave me an exposure on how DCR worked as well as understand the importance
of monitoring the vital signs (Farrell et al., 2015).
The understanding helped me develop my skills and competencies in cardiac care, and
develop my knowledge and skills to handle similar scenarios in the future. The supervisor’s
feedback supported that I had developed my knowledge and competency in administration of

5NURSING ASSIGNMENT:
medicine, and of pharmacology, which was in accordance to Standard 6 and 7 of NMBA,
what recommends the need for developing care plan and provide appropriate and responsive
treatment for patient (NMBA, 2016). However, I still need to be more conservative to the
needs of the patient and administrating medication based on the assessment of patient needs
more appropriately.
4th week of placement:
By the fourth week, I developed significant confidence in taking over the patient load
and develop care plan for the patient. I was more independent and confident than before in
my work and was able to take handovers from previous nurses during shift change. I also
followed up with the doctors proactively and checked for any additional duties that I might
have to follow for the patient. The doctors always provided supervision during collection of
blood samples, placing of catheters, administration of medications, and setting up infusions
for blood transfusions (Hensel et al., 2018).
I was confident in the independent gathering of all relevant information by the 4th
week of my placement, conduct all the appropriate assessments, and implement time
management strategies to maximize my output. This experience proved to be a great learning
lesson for me as I worked with multiple patients during this time in the ED. According to my
supervisor, I was able to take care of the patient load, including assessment, admission and
discharge. This was in accordance to Standard 5 of NMBA which implies developing a care
plan for nursing (NMBA, 2016; Haas & Swan, 2014).
Educating patient:
During the second week of my placement, I had the opportunity to educate a patient
with asthma, who has been using inhalers for the last 1 year. The patients used to self

6NURSING ASSIGNMENT:
administer the inhaler, and complained that he wasn’t able to completely inhale the dose
(Tycon et al., 2017).
I educated the patient on the most effective way to administer the dosage using a
spacer with the puffer and how it can improve the affectivity of the inhaler. I was able to
develop a rapport with the patient and develop a therapeutic relation, which helped the patient
to a great extent, and thus helped to utilize the Standard 2 of NMBA in my practice (Griffiths
et al., 2016; NMBA, 2016).
The patient was quite happy with the information as it helped him to use the inhaler in
a more appropriate way and he was able to take the full dose of the medication thereby
maximizing the outcome of the dosage. My assessor agrees that I am very eager to learn, and
have developed knowledge about pharmacology as well as pathophysiology and able to
understand the patient’s needs and condition in a comprehensive manner, which is important
according to Standards 4, 5, 6 and 7 on NMBA (NMBA, 2016; Smolowitz et al., 2015).

7NURSING ASSIGNMENT:
References:
Auerbach, D. I., Buerhaus, P. I., & Staiger, D. O. (2014). Registered nurses are delaying
retirement, a shift that has contributed to recent growth in the nurse workforce. Health
Affairs, 33(8), 1474-1480. DOI: https://doi.org/10.1377/hlthaff.2014.0128
Bobay, K. L., Weiss, M. E., Oswald, D., & Yakusheva, O. (2018). Validation of the
Registered Nurse Assessment of Readiness for Hospital Discharge Scale. Nursing
research, 67(4), 305-313. DOI: 10.1097/NNR.0000000000000293
Carter, M. A., & Jones, M. (2017). Nationwide Doctor of Nursing Practice/Advanced
Practice Registered Nurse Survey on Roles, Functions, and Competencies. Journal of
Doctoral Nursing Practice, 10(2), 108-112. DOI: 10.1891/2380-9418.10.2.108
Farrell, K., Payne, C., & Heye, M. (2015). Integrating interprofessional collaboration skills
into the advanced practice registered nurse socialization process. Journal of
Professional Nursing, 31(1), 5-10. DOI:
https://doi.org/10.1016/j.profnurs.2014.05.006
Griffiths, P., Ball, J., Murrells, T., Jones, S., & Rafferty, A. M. (2016). Registered nurse,
healthcare support worker, medical staffing levels and mortality in English hospital
trusts: a cross-sectional study. BMJ open, 6(2), e008751. DOI: 10.1136/bmjopen-
2015-008751
Haas, S. A., & Swan, B. A. (2014). Developing the value proposition for registered nurse
care coordination and transition management role in ambulatory care settings.
Nursing economic$, 32(2). Link: https://ecommons.luc.edu/nursing_facpubs/11/

8NURSING ASSIGNMENT:
Hensel, D., Cooper, R., & Craney, N. (2018). Operating Room Personnel Viewpoints About
Certified Registered Nurse Anesthetists. Western journal of nursing research, 40(2),
242-256. DOI: https://doi.org/10.1177/0193945916682730
Kankaka, E. N., Murungi, T., Kigozi, G., Makumbi, F., Nabukalu, D., Watya, S., ... &
Serwadda, D. (2017). Randomised trial of early infant circumcision performed by
clinical officers and registered nurse midwives using the Mogen clamp in Rakai,
Uganda. BJU international, 119(1), 164-170. DOI: https://doi.org/10.1111/bju.13589
Nursing and Midwifery Board of Australia. (2016). Registered nurse standards. Retrieved
from http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/
Professional-standards/registered-nurse-standards-for-practice.aspx
Parry, A. M., Barriball, K. L., & While, A. E. (2015). Factors contributing to Registered
Nurse medication administration error: A narrative review. International journal of
nursing studies, 52(1), 403-420. DOI: https://doi.org/10.1016/j.ijnurstu.2014.07.003
Smolowitz, J., Speakman, E., Wojnar, D., Whelan, E. M., Ulrich, S., Hayes, C., & Wood, L.
(2015). Role of the registered nurse in primary health care: meeting health care needs
in the 21st century. Nursing Outlook, 63(2), 130-136. DOI:
https://doi.org/10.1016/j.outlook.2014.08.004
Tycon, L. E., Root, M. C., & Ersek, M. (2017). How to Survive as a New Palliative Care
Advanced Practice Registered Nurse (FR475). Journal of Pain and Symptom
Management, 53(2), 382. DOI: https://doi.org/10.1016/j.jpainsymman.2016.12.158

9NURSING ASSIGNMENT: