NURBN3021 Reflective Essay: Clinical Skills and Hospital Experience

This reflective essay, written by a nursing student, details their experience as a circulating nurse in a hospital. The essay utilizes the Gibbs reflective model to analyze the student's responsibilities, which included taking blood pressures, applying TED stockings, administering pain relief, and performing blood cultures. The student reflects on both positive and negative experiences, such as forgetting to refill a PTS capillary, and how these events influenced their learning and confidence. The essay evaluates the importance of each task, provides an analysis of the situations encountered, and concludes with an action plan for future improvement. References to relevant literature are also included.

RUNNING HEAD: NURSING 0
Reflective Essay
August 6
2019

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A circulating nurse is a registered nurse with the hospital who is a member of the
hospital staff and performs the activities of recording and monitoring the operations to ensure
the proper care of the patient. The job of a circulating nurse includes activities such as
preparing for the operations; regular monitoring of the patients; monitoring of the staff at the
time of operations; recording of the operation's progress reports; maintain the accounts for the
instrument used in operation; and manages the specimen or samples of the patients. This
essay is being prepared according to the Gibbs reflective model of nursing to discuss my
experience which I gained in the hospital while working as a circulation nurse for the
hospital. It shows the tasks which were allotted to me and the way I handled the allotted job
work. Also, it defines some of the good and bad experience and task disturbances which were
faced by me during my job.
Descriptive experience
I was the circulation nurse at the hospital and I was given the responsibility to do
blood pressures and manually radial pulse to examine the accurate heartbeat of the patient
(Neyens, Bayramzadeh, Catchpole, Joseph, Taaffe, Jurewicz, & Group, 2019). I was also
assigned the job of putting the TED (Thrombo - Embolus Deterrent) Stockings which are also
called by Compression Stockings or Anti-Embolism Stockings on patients. I had experienced
the working of pain reliefs that is 5 mg/ 2 ml morphine working difference. I also had to
perform the blood cultures as directed by the doctors to examine any presence of bacteria in
the blood of the patient (Shinozaki, Jacobson, Saeki, Kobayashi, Weisner, Falotico, &
Becker, 2019). The responsibility for managing and handling all the blood samples and
storing them into anaerobic and aerobic bottles to send them to the pathology lab for testing
was the part of my responsibility. I have learned and gained different experience from the job
as a nurse. I have developed my confidence in working in a hospital over time I was working
there. In the nervousness of the working day, I had forgotten to refill the PTS capillary for the

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testing of dehydration level and peripheral perfusion of the patients (Sonoda, Onozuka, &
Hagihara, 2018). These were some tasks which were performed by me as a nurse in the
hospital which made learn about my profession and practical working in the hospitals.
Feelings
I had a great experience at the hospital; I examined the blood pressure and pulse rate
of the patients. I also had to put TED stocking which made me learn about the actual working
process of the TED stocking provided to patients after the surgery so that the patient does not
suffer any blood clotting in his lower leg because of the physical inactivity caused by the rest
after operations. I practiced the process of blood culture and stored the blood samples in
anaerobic and aerobic bottles to send them for testing in the pathology lab. However, due to
my nervousness the other day, I completely forgot to refill the PTS capillary and perform
dehydration and peripheral perfusion examinations for the patient (Ünal, Açar, Yayla, Balci,
Ertem, Kara, & Balbay, 2017). It made the information about the patient's report lacking the
data about dehydration level and peripheral perfusion which were further completed by me
after the direction of the doctor. I was disappointed that I had messed the task up because of
nervousness and it initiated confidence in me to work harder. It made me realize my
importance as a nurse in the hospital and the impact of my workings on the lives of the
patients and this made me feel responsible, more hard-working and focused person toward
my work as a hospital nurse (Peel, Dylla, Hughes, Lynch, Greenwood-Quaintance, Cheng, &
Patel, 2016). The working in the actual hospital environment made me feel an important part
of the hospital working and motivated me to improve my skills and learning.
Evaluation
The good experiences gained during the training were the learning experience of
working as a nurse in the hospital and its importance in the successful treatment of the patient

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(Ethans, Deng, Townson, Jacquemin, & Smith, 2016). The assistance was needed by me from
my fellow nurse in the hospital in administering the pain relief dose of 5 mg/ 2 ml morphine
when the PTS pain reading of the patient was 10 /10. This helped me evaluate my capabilities
and learning about the appropriate dosage in a different scenario. The checking for infection
in the blood of the patients with the sample taken and blood culture was performed at the PTS
temperature of 38.5 (Hernández, Ospina-Tascón, Damiani, Estenssoro, Dubin, Hurtado, &
Cecconi, 2019). The PTS consent was obtained from the patient as per the consent required
by the law and then I put the 10 mL of blood in the anaerobic and aerobic bottles to preserve
the sample and sent them to the pathology lab for testing.
Apart from the good and helpful learning experience to be utilized in future, an
experience went bad wherein the nervousness to perform the PTS capillary were left without
refill and because of which the reports for the check of dehydration and peripheral perfusion
in the blood of the patient (McInnes, Mease, Schett, Kirkham, Strand, Williams, & FUTURE
2017). It was a bad experience as samples were taken again and then blood checks were
performed when asked by the doctor. Overall experience evaluation of the working nurse was
quite helpful and motivating.
Analysis
The analysis of the situation in the hospital makes me realize that the job of the nurse
is very tough and require care in performing of its activities (Okaro, Addisu, Casanas, &
Anderson, 2017). Every job of the nurse has top performed in time and with proper accuracy
as it impacts the study of the patient with the doctor. The management of the equipment,
samples, patients as well as assistance to the staff is provided by the nurse. In the situation of
10 /10 PTS, pain reading of the patient the assistance was required from the other nurse who
suggested the dose with the analysis of the situation. It is observed that the operations require

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a close analysis of the situation to provide the complete and appropriate details to the
operator (Jindal, Hudson, Blackhurst, Coltman, & McCoy, 2015).
Conclusion
Looking back at this, it has been concluded that the session of training went quite
positive for the learning and understanding purpose. There were many good experiences and
little bad experience which is a part of learning. The patients who were handled by me
provided good feedback to my workings when I asked them to obtain a self-understanding for
the improvement. The blood testing has been learned in the working, the measurement of
blood pressure and pulse rate examination has been understood in the hospital. Also, the
examination of bacteria present in the blood is examined as a part of the working. Thus, the
experience was good for the training purpose which helped in learning the different part of
the jobs to be performed by the nurses in the hospital.
Action Plan
The learning and understanding of the process have motivated me to perform the
nursing job more sincerely than ever. In this training, I have required the help of other nurses
and staffs to execute my activities as the responsible staff member of the hospital. It is
expected that if the same issues arise in the future then I will be able to tackle those issues by
my own with the analysis of the situation. Also for further learning, it is planned to acquire
experience in the new field and grab more learning in the future hospital learning session. To
precise, it was a great way of understanding and the experience will help us in the future.

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Reference
Ethans, K., Deng, G., Townson, A., Jacquemin, G., & Smith, K. (2016). Canadian Practice
Patterns of Venous Thromboembolism Prophylaxis for Adults with Spinal Cord
Injury. J Pediatr Neurol Disord, 2(106), 2.
Hernández, G., Ospina-Tascón, G. A., Damiani, L. P., Estenssoro, E., Dubin, A., Hurtado,
J., ... & Cecconi, M. (2019). Effect of a resuscitation strategy targeting peripheral
perfusion status vs serum lactate levels on 28-day mortality among patients with
septic shock: the ANDROMEDA-SHOCK randomized clinical trial. Jama, 321(7),
654-664.
Jindal, M., Hudson, M. F., Blackhurst, D. W., Coltman, K., & McCoy, G. D. (2015). The
Impact of Electronic Cues and Provider Education on Colorectal Cancer Screening
Referral and Patients’ Screening Decision Stage. SCIENTIFIC MANUSCRIPTS, 169.
McInnes, I. B., Mease, P. J., Schett, G., Kirkham, B., Strand, V., Williams, N., ... &
FUTURE 2 study group. (2017). FRI0494 Secukinumab provides rapid and sustained
pain relief in psoriatic arthritis: 2-year results from the future 2 study.
Neyens, D. M., Bayramzadeh, S., Catchpole, K., Joseph, A., Taaffe, K., Jurewicz, K., ... &
Group, R. O. S. (2019). Using a systems approach to evaluate a circulating nurse's
work patterns and workflow disruptions. Applied ergonomics, 78, 293-300.
Okaro, U., Addisu, A., Casanas, B., & Anderson, B. (2017). Bartonella species, an emerging
cause of blood-culture-negative endocarditis. Clinical microbiology reviews, 30(3),
709-746.

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Peel, T. N., Dylla, B. L., Hughes, J. G., Lynch, D. T., Greenwood-Quaintance, K. E., Cheng,
A. C., ... & Patel, R. (2016). Improved diagnosis of prosthetic joint infection by
culturing periprosthetic tissue specimens in blood culture bottles. MBio, 7(1), e01776-
15.
Shinozaki, K., Jacobson, L. S., Saeki, K., Kobayashi, N., Weisner, S., Falotico, J. M., ... &
Becker, L. B. (2019). Does training level affect the accuracy of visual assessment of
capillary refill time?. Critical Care, 23(1), 157.
Sonoda, Y., Onozuka, D., & Hagihara, A. (2018). Factors related to teamwork performance
and stress of operating room nurses. Journal of nursing management, 26(1), 66-73.
Ünal, S., Açar, B., Yayla, Ç., Balci, M. M., Ertem, A. G., Kara, M., ... & Balbay, Y. (2017).
Manual heating of the radial artery (Balbay maneuver) to facilitate radial puncture
prior to transradial coronary catheterization. Revista Portuguesa de Cardiologia
(English Edition), 36(6), 409-414.