First Semester Nursing Reflection: Clinical Assessment of BP

This assignment is a reflective piece by a first-semester nursing student at the University, analyzing a clinical assessment experience involving blood pressure measurement. Using Gibbs' Cycle of Reflection, the student describes the experience, including initial nervousness and forgetting crucial steps like explaining the procedure and handwashing. The evaluation highlights both positive aspects, such as learning the correct technique, and negative aspects, such as communication and aseptic technique failures. The analysis delves into areas for improvement, such as better patient communication and adherence to ANSAT Standard 4, which requires nurses to comprehensively conduct assessments. The conclusion emphasizes the need for a revised approach to future assessments, including clear communication and aseptic practices. An action plan outlines steps to ensure future clinical assessments are carried out with confidence and adherence to guidelines. References to relevant literature are included, supporting the reflection on clinical practice and professional development.

Running head: REFLECTION
REFLECTION
Name of the Student:
Name of the University:
Author note:

1REFLECTION
Description
I am a nursing student studying in first semester of my course where currently I was
learning about clinical assessment and had my clinical practical valuation in the university
laboratory. I along with my fellow classmates were present in my university lab to practice
and learn about various clinical assessment that includes measuring and checking
temperature, respiration rate and pulse rate and measurement of blood pressure (BP) (Turner,
Viera & Shimbo, 2015). The clinical assessment method was described by the tutor
succeeding to aseptic technique that involves washing hand before and after patient
evaluation or touching.
Two different groups were formed to initiate the practice of skills and once a group is
done with practicing they need to interchange with the other group students to enhance our
independent skills. I and my fellow partner got clinical evaluation of measurement of blood
pressure. I took the opportunity to first measure the blood pressure of my fellow partner. As
soon as I started the process I forgot few crucial steps like explaining the process of
assessment to the patient and what will I do and washing hand before and after touching the
patient (Parati et al., 2015).
Feeling
Initially during my assessment I was doubtful and nervous if I could perform the
assessment properly or not. Deep in my heart I was stressed as it was the first time I was
measuring BP and was slightly confused between the normal range and abnormal range of
BP. Once I completed my assessment I was little embarrassed as I forgot the crucial step of
explaining the procedure of assessment to the patient that was very significant because
effective communication assist to maintain patient’s cultures, rights, dignity, beliefs and
values (Perry, potter & Ostendorf, 2015). I felt bad when my friend pointed that I also forgot

2REFLECTION
to wash my hand that is very crucial in health care professional to avoid any sort of infection
from one person to other person. Each time we need to guarantee as a registered nurse to
follow all nursing standards, legislations and guidelines in order to avoid any cross infection
between the health professional and the patient.
Evaluation
In the entire process of clinical assessment I experienced many things that were both
good and bad. The good experience was that I learned the correct method of measuring blood
pressure that will help me to enhance my skill and knowledge. The good part of this clinical
practical assessment was that I got a chance to introduce myself to the patient, preparing
assessment equipment’s like stethoscope and sphygmomanometer that is used in the
procedure of measuring blood pressure and greeting the patient in a respectable and
professional manner for their valuable time (Flynn et al., 2017). The things that did not work
well as I mentioned earlier was that I forgot to conduct the aseptic technique of washing
hand, before and after touching the patient and lack of effective communication to maintain
the dignity, belief and privacy of the patient. Every time when we are involved with the
patient or conducting any assessment we must follow the safe practice guidelines to
accomplish outcomes and goals established on patient’s need.
Analysis
I could have introduced myself to the patient in a better way that would have helped
me to prevent from committing mistakes as in I should develop the habit of conducting brief
introduction about myself like who I am, what will I do and the importance of conducting the
assessment so that the patient develops an idea about the assessment. I should also develop
the habit of communicating with the patient so that the patient is assured about the
assessment and feel comfortable and relaxed (Lamego et al., 2017). There will be no

3REFLECTION
fluctuation of blood pressure of the patient is relaxed and comfortable. Additionally, I would
ask the patient to lie down and rest for some time, and in the meantime I could prepare the
equipment’s to yield appropriate and correct BP results. In order to further improve my skills,
I should have helped the patient to fold his sleeves and choose a suitable sized BP cuff to
enhance the accuracy of the BP result. In this way, I could have been easily able to fulfil
ANSAT standard 4 that requires registered nurses to carefully conduct assessments (Bakris,
2016). In my assessment, I could complete the procedure of measuring blood pressure with
accuracy and could complete it on time thus I was able to fulfil ANSAT standard 4, which
involve nurses to precisely analyse and conduct clinical assessment.
Conclusion
From the mistake that I made during the entire clinical practical assessment of
measuring blood pressure (BP), I realized that my approach for the assessment must be
different to avoid any such mistakes in the future. Before continuing with the definite
procedure I must explain the doings to that patient like what I will do, what is the importance,
what is the complication and the possibility of result with respect to the patient health
condition (Staessen et al., 2017). An effective communication will help the patient to feel
comfortable and relax and devoid of any emotional stress that will help me to carry out the
assessment fluently with any error. I would also follow the aseptic method of washing hand
before and after touching the patient to avoid any kind of cross infection.
Action plan
In future I will make sure that I do not repeat my mistakes and be more confident
while carrying out the assessment. As this was my first experience in clinical assessment of
measuring blood pressure, I will ensure in the future that I communicate with every patient I
deal with and follow all the guidelines and strategies of safe work practice. I will carry out

4REFLECTION
my work with dedication and peace of mind so that I do not get confused or stressed before
conducting the assessment (Stergiou et al., 2018). I will try to be more clam and patient to
learn other clinical assessment of measuring temperature, pulmonary rate and respiratory rate
that will be taught to us in succeeding practical class.

5REFLECTION
References
Bakris, G. L. (2016). The implications of blood pressure measurement methods on treatment
targets for blood pressure. Circulation, 134(13), 904-905.
https://doi.org/10.1161/CIRCULATIONAHA.116.022536
Flynn, J. T., Kaelber, D. C., Baker-Smith, C. M., Blowey, D., Carroll, A. E., Daniels, S. R., ...
& Gidding, S. S. (2017). Clinical practice guideline for screening and management of
high blood pressure in children and adolescents. Pediatrics, 140(3), e20171904. DOI:
10.1542/peds.2017-1904
Lamego, M., Kiani, M. J. E., Lam, K., Dalvi, C., & Vo, H. (2017). U.S. Patent No. 9,649,054.
Washington, DC: U.S. Patent and Trademark Office.
Parati, G., Ochoa, J. E., Lombardi, C., & Bilo, G. (2015). Blood pressure variability:
assessment, predictive value, and potential as a therapeutic target. Current
hypertension reports, 17(4), 23. https://doi.org/10.1007/s11906-015-0537-1
Perry, A. G., Potter, P. A., & Ostendorf, W. (2015). Nursing Interventions & Clinical Skills-
E-Book. Elsevier Health Sciences.
Staessen, J. A., Li, Y., Hara, A., Asayama, K., Dolan, E., & O’Brien, E. (2017). Blood
pressure measurement anno 2016. American journal of hypertension, 30(5), 453-463.
https://doi.org/10.1093/ajh/hpw148
Stergiou, G., Palatini, P., Asmar, R., de la Sierra, A., Myers, M., Shennan, A., ... & Parati, G.
(2018). Blood pressure measurement and hypertension diagnosis in the 2017 US
guidelines: first things first. Hypertension, 71(6), 963-965.
https://doi.org/10.1161/HYPERTENSIONAHA.118.10853

6REFLECTION
Turner, J. R., Viera, A. J., & Shimbo, D. (2015). Ambulatory blood pressure monitoring in
clinical practice: a review. The American journal of medicine, 128(1), 14-20.
https://doi.org/10.1016/j.amjmed.2014.07.021