During my clinical experience in the intensive care unit, I was able to achieve several course objectives and incorporate clinical practice guidelines. In this reflection, I will discuss the objectives I met during my clinical experience, my incorporation of course objectives and clinical practice guidelines, and provide specific examples to illustrate my experiences.
Objectives Met During Clinical Experience The main objective of my clinical experience was to refine my clinical decision-making skills in advanced health assessment, clinical diagnosis, procedural skill acquisition, and care management of acute and chronically ill adult-gerontological patients. Throughout my clinical experience, I was able to meet this objective through various activities. For example, I participated in daily rounds with the multidisciplinary team, where I reviewed patient cases, discussed the management plan, and made recommendations based on my assessment findings. Additionally, I was able to develop and implement care plans for critically ill patients, which included pharmacological management, ventilation strategies, and fluid and electrolyte management. Through these activities, I was able to enhance my knowledge of the pathophysiology of acute illnesses, refine my clinical reasoning and decision-making skills, and improve my ability to manage critically ill patients.
Incorporation of Course Objectives and Clinical Practice Guidelines To incorporate the course objectives and clinical practice guidelines into my clinical experience, I utilized a systems framework to assess and manage patients. This approach involved a comprehensive assessment of patients’ physical, emotional, and psychological needs and the development of an evidence-based plan of care. For example, when managing a patient with sepsis, I utilized the Surviving Sepsis Campaign Guidelines, which provided evidence-based recommendations for the management of sepsis, such as fluid resuscitation and antimicrobial therapy. I also utilized clinical practice guidelines to manage patients with chronic obstructive pulmonary disease, heart failure, and pneumonia. In all cases, my care plans were evidence-based and tailored to meet the unique needs of each patient.
Clinical Objectives The three to five clinical objectives that I focused on during my clinical experience were to enhance my knowledge and skills in:
- Advanced health assessment: I was able to refine my assessment skills through daily rounds, where I performed physical assessments, reviewed laboratory and diagnostic test results, and made recommendations based on my findings.
- Pharmacological management: I was able to enhance my knowledge of pharmacology by reviewing medication orders, identifying potential drug interactions and adverse effects, and recommending appropriate medication adjustments.
- Care management of acute and chronically ill adult-gerontological patients: Through daily rounds and care plan development, I was able to enhance my skills in the management of acute and chronic illnesses, including ventilation strategies, fluid and electrolyte management, and pain management.
Examples to Illustrate My Experiences One example that illustrates my experiences in advanced health assessment is a patient with acute respiratory distress syndrome (ARDS). During daily rounds, I performed a comprehensive respiratory assessment and reviewed the patient’s laboratory and diagnostic test results. Based on my assessment findings, I recommended a change in the patient’s ventilation strategy, which resulted in improved oxygenation and decreased work of breathing.
Another example that illustrates my experiences in pharmacological management is a patient with sepsis. After reviewing the patient’s medication orders, I identified a potential drug interaction between a medication the patient was taking and the antibiotic therapy prescribed for sepsis. I recommended an adjustment in the antibiotic therapy, which resulted in the resolution of the drug interaction and improved patient outcomes.