Journals, Essay Example

Journal 1

As a nurse practitioner student working in an internal medicine office, I have effectively mastered the necessary theoretical framework to guide practice. Firstly, since this is an internal medicine office, my responsibilities include the ability to work with a diverse group of patients, provide useful medical advice and perform examinations, and to treat my patients equally and fairly. I believe I have achieved all of these goals after my time in this office, although it was difficult to adapt to this setting at first. Identifying the unique needs of patients was particularly challenging when I first started working here; since I worked with pediatric, adult, and geriatric patients, it has become important for me to grasp a greater understanding of the unique health needs each group has. For example, geriatric patients are more susceptible to certain infectious diseases compared to the adult population, and different types of examinations and preventative measures are recommended to ensure their health. After I worked in this office for about a month, I felt that I was able to grasp the theoretical frame work necessary for this particular situation. I was proud of myself that I was then able to enter a room with the guidance of this knowledge and be able to perform my interviews and examinations more effectively due to an increased understanding of this concept.

According to the American Nurses Association, it is recommended that nurses and other health professionals “identify sources for statistics and best practices related to care of older adults for each specialty, customize the Guidelines to fit an association’s Scopes and Standards, and review drafts of Scopes and Standards in relationship to care of older adults”. Since I’m working in internal medicine, I felt that these guidelines were of particular relevance to my position. In particular, this situation reminds me of how the flu shot was differentially dispersed for high risk groups and members of different age groups. Firstly, it is recommended that pediatric and elderly people receive the flu shot before healthy adults. In addition, it is recommended that elderly people receive a flu shot with the attenuated virus rather than the live, weakened virus. Furthermore, people with chronic diseases like asthma should be given the flu shot before flu season begins and preferentially over those with less of a risk if a shortage were to occur. Ultimately, we learned and adapted this information as a result of the American Nurses Association Guidelines, particularly the one that indicates that we should “identify sources for statistics and best practices related to care of older adults for each specialty”. The research provided on this topic regarding normal adults has given us insight into how to treat elderly and other at risk patients in preventing and treating this illness.

As my time working in the internal medicine office progressed, I felt that I became more comfortable managing multiple, complex, adult or older adult patients with chronic health problems. Although it was difficult to differentiate symptoms and assign them to one disease or another at first, many of the patients who have multiple symptoms have been regularly visiting the office for years and have not developed these illnesses simultaneously. Fortunately, the medical records at this office were very precise and it was easy to use them as a guide when I was getting started. After working with these patients for a while however, I began to be able to differentiate the illnesses and their symptoms even when patients had overlapping symptoms. Despite this however, I didn’t see many “complex” medical cases; most of the patients I worked with had more common illnesses, such as the common cold, arthritis, etc. typical for the age group they belonged to.

Journal 2

This course greatly aided my writing skills. I feel that I am able to now write more clearly about my nursing experiences, which in turn helps me conceptualize what I’ve learned and apply this information to similar situations. In addition, this has positively influenced my ability to research information pertinent to the field and my own practices; because I have had to write so much about my nursing experiences, I have learned to take advantage of several important journals and other resourced including PubMed and Google Scholar. This practice has emphasized the importance of using primary journal articles as sources of information both for nursing writing and practice. I found it highly interesting that many nurses are helping conduct research studies and I believe that it is important for them to continue this type of work so that it could help improve both the nursing practice and the ways that our patients are being treated.

In addition to my overall writing skills, the research and assignments I have been required to complete have increased my ability to incorporate the APA format into my works and improved my critical thinking skills. For example, I don’t think I’ll ever forget to take information from an article without including a “(Name, Year)” reference at the end of the sentence. In addition, I’ve basically memorized the APA references format, which has proved useful due to the frequency with which I use it now. My critical thinking skills have increased due to the amount of papers I’ve read and the opportunities I have received to type out my thoughts. In a sense, nursing is like solving a puzzle; in order to be a good practitioner, one simply needs to put the pieces together. In practicality, this means the ability to read a large quantity of primary articles, scanning them for relevance, and then being able to piece the information from primary research together in a way that is meaningful for nursing practice.

I also found that as my critical thinking skills improved, my decision making skills have as well. Since the two topics are connected, I argue that these skills have improved for the same reason; solving the “puzzle” using critical thinking leads to an increased understanding of new information and ideas that can be applied to nursing practice. Once this information is connected, it is my responsibility as a nurse practitioner to ensure that this idea makes conceptual sense and has the potential to help a patient. If this information is logical and agrees with what I have learned throughout my education, I will agree with it and let it guide my nursing practice. However, if it contradicts logic or any information I thoroughly believe in, then I will be required to search for other options and decide not to apply this to my nursing practice.

Throughout my experience as both a nurse and a student, I have been certain to apply the theoretical guidelines for practice. In a sense, this ties into my ability to legally and ethically carry out the professional regulatory guidelines which guide practice. Essentially, both involve carrying out best nursing practices. I have been certain to treat patients only on the basis of evidence that exists in the medical field. In situations where I was uncertain of an answer or diagnosis, I have consulted my superiors in order to ensure that my patients received the best care; furthermore, I have regularly consulted my peers in order to ensure that we all agree on the diagnosis and treatment for cases that were atypical. In addition, I have made sure that I treated all of my patients equally; regardless of illness, health insurance, age, gender, or race, my patients have all been allowed the same amount of time with me, been allowed to ask any questions they felt necessary, and been provided with fair and equal treatment.