Reflective Journal: Nursing Care Plans and Practice Reflections

This reflective journal explores various challenges and scenarios encountered in nursing practice. It discusses situations involving patients with complex health issues, including drug interactions, chronic conditions, and age-related diseases. The journal reflects on limitations in the scope of practice and the importance of interprofessional collaboration and continuous learning. It also includes nursing care plans for patients with unstable blood glucose levels and increased sputum production, detailing nursing diagnoses, desired outcomes, and interventions. The journal emphasizes the significance of comprehensive patient care, effective communication, and the need for ongoing professional development in nursing.

Reflective Journal

Table of Contents
INTRODUCTION...........................................................................................................................3
TASK 1............................................................................................................................................3
Reflective journal entries........................................................................................................3
TASK 2............................................................................................................................................4
Nursing care plan....................................................................................................................4
CONCLUSION................................................................................................................................6
REFERENCES................................................................................................................................7

INTRODUCTION
Nursing refers to the autonomous along with collaborative care to individual with all ages,
communities, groups, families within all settings. It includes health promotion, illness prevention
along with care of ill. In this, there is need to provide better care to address complex issues where
they are having some limitation to delivery care through limiting scope of practice. There is need
to make nursing care plan to client with different multiple diagnosis (Davidson and et. al.,
(2018)).
TASK 1
Reflective journal entries
Situation 1
As a nursing staff, there is need to deal with different patient in which one condition where
one patient came with complex issue where patient was dealing with the combination of drug
interaction and multiple chronic condition which includes the stroke and depression and type 2
diabetes. Patient was around 65 years old and needed higher level of nursing care which was not
possible to deliver at that time. In this, there was very less staff member were present within
healthcare settings (Devik and et. al., (2018)). There were also less resources to carry patient
healthcare service in effective way. This created the situation of complex issues to patient where
to deliver better healthcare services it was need for referral to another healthcare practitioner. In
that situation, it was the effective decision to deliver quality services to patient to improve health
to avoid to the risk of worsening of health condition.
It was needed for the referral to another healthcare practitioner which allow to get better
understanding about handling the situation through providing temporary healthcare services. In
this, it was needed to take are about the patient complex issue and need to get communicated to
the registered nurse. Through sharing the information about the complex issues, there registered
nurse was consulted who help to provide the authority and help in completing official paper
work to refer patient for better delivery of healthcare services and treatment (Déry and et. al.,
(2018)).
Situation 2
There was a situation in which one patient came with complex issues. in this, it was
needed to take care about the situation and provide better service delivery along with effective

treatment (Neiman, (2019)). But due to having limited scope of practice, it was difficult to deal
with the situation where learned nursing practices was not sufficient to effectively deal with
situation and needed for consultation with other healthcare professional. In this, there is need to
learn about attending patient with complex issues and should take care about the using those
learning in practice. In this, there is need to improve the technology skill, improving efficiency
and getting an advance degree can be effective to deal with such type of situation in future. This
can also help to improve nursing practice during professional work (Cerri and et. al., (2019)).
Situation 3
There was a situation when a patient came with multiple health issues and was about 63
years old. due to age patient was suffering from the high blood pressure and Parkinson’s disease
which was highly effective and needed healthcare and support to live effectively. In this, it has
been observed that Parkinson’s disease is due to higher age of patient in which there is need to
deliver proper care and support to patient to attain good health. In this, there is need to provide
proper care to client to improve health that can allow to achieve health improvement. In this,
there is need to provide care support by patient family member to address patient care through
developing emotional maturity (Brunetti and et. al., (2020)). This can allow to get better
interaction with family to instruct them to perform activity in such manner that can help in
achieving better health to patient.
TASK 2
Nursing care plan
Nursing care plan is the formal process to identify patient need and potential risk. It provides
communication among patient and healthcare professional. This can be effective to allow nursing
staff to take care about the patient health which can be effective in improving patient health.
Patient Nursing diagnosis Outcomes and
evaluation
Interventions
Patient A Unstable blood
glucose level,
decreased utilisation
or production of
insulin as evidenced
Decrease in blood
glucose level to the
normal level.
It is evidenced by
normal capillary
 Daily weight
recording.
 Administer
Insulin therapy
as per

by hyperglycaemia,
related with Insulin
resistance. High blood
pressure, anxiety and
mental illness like
eating disorder.
blood glucose levels.
To get better
medication for health
improvement and
reduce the risk of
anxiety on declining
health (Ben-Zacharia
and et. al., (2018)).
prescription.
 Advice client
to reduce the
uptake of
carbohydrate
or direct sugar
diet.
 Regularly
monitoring
capillary blood
glucose levels
as per
prescription.
 Monitoring
patient health
to reduce
anxiety by
helping and
supporting.
 Advice to
intake of
proper diet.
Patient B Increased sputum
produce AEB
coughing, purulent
sputum, dyspnea,
ineffective airway
clearance RT tracheal
bronchial
inflammation.
After nursing
intervention, patient
maintain patent
airway with breath
sound. Absence of
cyariosis, dyspnea. It
provides evidence to
keep patient airway
along with clearing
 Need to
change
position
frequently.
 Assessing
rhythm along
with depth of
respiration,
use of

secretion (Flaherty
and et. al., (2019)).
accessory
muscles and
movement of
chest.
 Suction,
frequent
coughing,
desaturation to
airway
secretions,
adventitious
breath.
CONCLUSION
From the above discussion, it can have concluded that nursing care is effective to take care
about the patient health. Nursing staff should take care about the patient health to reduce the
impact of getting declining health condition. They need to take care about the situation that
includes the referral, limitation in practices and impact of age to create disease. There is also
discussion about the nursing care plan to provide better care services to patient with different
multiple diagnosis.

REFERENCES
Books and Journals
Ben-Zacharia and et. al., (2018). Impact of shared decision making on disease-modifying drug
adherence in multiple sclerosis. International journal of MS care, 20(6), 287-297.
Brunetti and et. al., (2020). Healthspan enhancement by olive polyphenols in C. elegans wild
type and Parkinson’s models. International journal of molecular sciences, 21(11), 3893.
Cerri and et. al., (2019). Parkinson’s disease in women and men: What’s the difference?. Journal
of Parkinson's disease, 9(3), 501-515.
Davidson and et. al., (2018). Suicide prevention: a healer education and referral program for
nurses. JONA: The Journal of Nursing Administration, 48(2), 85-92.
Déry and et. al., (2018). Scope of nursing practice in a tertiary pediatric setting: Associations
with nurse and job characteristics and job satisfaction. Journal of Nursing
Scholarship, 50(1), 56-64.
Devik and et. al., (2018). Variations in drug-related problems detected by multidisciplinary
teams in Norwegian nursing homes and home nursing care. Scandinavian journal of
primary health care, 36(3), 291-299.
Flaherty and et. al., (2019). Addressing the community‐based geriatric healthcare workforce
shortage by leveraging the potential of interprofessional teams. Journal of the American
Geriatrics Society, 67(S2), S400-S408.
Neiman, (2019). Nurses’ perceptions of basic palliative care in the Hmong population. Journal of
Transcultural Nursing, 30(6), 576-586.