NR 511 Week 1 Clinical Preparedness

Sample Answer for NR 511 Week 1 Clinical Preparedness

I too share the feelings of being nervous for the first clinical rotation despite being a nurse for so long. The feeling of not being prepared or not having the correct answers is very disturbing. I am starting my third day of clinical tomorrow and I still have some nervousness surrounding the flow and being able to connect all the history, labs, and current chief complaints to have a holistic picture of the patient. My first two days I struggled because I was not familiar with charting in the clinic setting and I felt that it slowed me down. I also wanted to instill trust in my preceptor and fumbling with the EHR did not make me feel good.  

I was reviewing an article by Brent, et al.,(2021) discussing the confidence level of FNP students during clinical. The article was reassuring because the pre and post surveys were favorable in that the students confidence level increased as they matriculated through clinical rotations. There was also some benefit in not knowing everything going in and having those experiences that required processing and thought generation. 

I look forward to hearing about your journey this session. Best of luck to you. 

Ro

References:

MacDonald, B., Floyd, O., Dowd-Green, C., Bertram, A., Fingerhood, M., Sharps, P. & Stewart, R. (2021). Measuring the contribution of clinical rotations to skills confidence in primary care nurse practitioner students. Journal of the American association of nurse practitioners, 33(12). DOI: 10.1097/JXX.0000000000000562

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Sample Answer 2 for NR 511 Week 1 Clinical Preparedness

I have the same feelings about Chamberlain University as you do.  I don’t think the staff has been helpful with much of anything. I understand this is a graduate degree and we are adults but not having an assigned person for questions throughout the program can be very stressful. The main problem I have found with this university is the lack of communication by phone or email. The professors are great at responding, but the staff does not return calls or emails on time. Also the a lack of communication on their part regarding the approval of preceptorships. They have not communicated if my preceptors have been approved and this is the reason why I started a week late in this class. They wait until the last minute to approve anything. This last phone communication with them it took me a few days to get through to them and I just wanted them to simply register me for this class. If I didn’t push as much as I did, I believe I would have waited another 8 weeks to start up again. This three-year program is turning into 4 years. I have put my education schedule on hold three times due to their lack of communication.  At times I just want to quit this program and find a different one but I am already too vested here, so for now, I will make the best of it.

Olivia, thank you for your post. I realize we are all going through the same stressors and the pressure to get things done. Also, I like the reminder that all NP started where we are today. 

Sample Answer 3 for NR 511 Week 1 Clinical Preparedness

I will be starting clinicals this week at Alameda Health System in Oakland California working in the internal medicine department. The ages of the patients we will be caring for are in the primary care department is over the age of 18. Children under 18 are seen in the pediatric department unless they have a special condition that will continue to managed by the pediatrician. My anticipated schedule will be 2 8-hour shifts per week initially, then I will pick up additional half days over the eight-week schedule. I am currently working with three preceptors, 1 FNP and 2 MDs, the FNP is my primary preceptor and I will be with the physicians when she is out of the office. I am grateful to have found an NP to precept me considering the lack of available preceptors in my area. According to Todd, et al., (2019), preceptors lay the foundation for how APRN’s participate on interdisciplinary teams as well as shaping the student NP’s clinical acumen and examination skills.  It is important to me to learn the role of an APRN from an APRN, in my situation I will have the opportunity to compare and contrast the two this clinical rotation.

My goals for this practicum will be to focus on completing my assessments and building time management skills. The pace will be fast, this is a very busy clinic with a patient backlog of over 2000 new patients waiting to be seen. I will also learn about how to manage my in-basket and respond to patients remotely. My first day in clinicals I will focus on learning the environment and meeting my colleagues. I would like to understand where emergency equipment is and gain an understanding of the flow of the clinic. I am also looking forward to taking a patient and completing a full assessment including the documentation. By the end of the session, I would like to be able to handle a full schedule of patients and provide care to them with minimal supervision. I am looking forward to building my confidence and understanding my limitations and areas I need to focus more. Utilizing the list of practicum procedures I will use this document to help me select patients to see based on their history or chief complaint. It is my goal to have some experience with as many of these procedures as possible to help build my skill set and level of comfort.

This experience will be different from my undergraduate experience, I feel the expectation level will be higher since I am already a nurse. Also, this role has different characteristics from being an RN nursing student; establishing a relationship with the client within the allowed time of the appointment versus over the course of a shift will be different.  I do think that I will quickly overcome this situation because working in an emergency room also requires you to move quick and learn a lot about a patient in a short amount of time.  I will meet the challenges of completing my practicum by being observant, prepared and open to learning. 

Factors that may prevent me from being successful in this practicum may be a limited patient diagnosis or if I am unsuccessful in connecting with the patients. My clinical site is a part of a safety net organization and it may initially be a challenge for me to understand the different social determinants of health that will present. My ability to connect with them and understand their life situations can be a challenge. If the patient’s diagnosis is all very similar that may also be an issue with me obtaining a wide range of experience.  To overcome these perceived challenges, I will try to be as prepared as possible with reading the patients charts and understanding any obstacles they may be facing. I will connect with my preceptor to discuss my plan of care and learn about the resources available to our patients. Additionally, I will be sure to pick my patients that will meet my learning objectives and provide me as much experience possible. Resources that will be helpful for me during my clinical preceptorship to ensure I am using the most recent clinical practice guidelines are online tools such as Epocrates, the standards for practice from the American Association of Nurse Practitioners or Elsevier Health is available for providers in the clinic.

Reference

Todd, B., Brom, H., Blunt, E., Dillion, P., Doherty, C., Drayton-Brooks, S., Hung, I, Montgomery, K.,

Peoples, L., Powell, M., Vanacore, D., Whalen, D., Aiken, L. (2019). Precepting nurse

practitioner students in the graduate nurse education demonstration: A cross-sectional

analysis of the preceptor experience. Journal of American Nurse Practitioner, 31(11).

Doi:10.1097/JXX.0000000000000301.

Sample Answer 4 for NR 511 Week 1 Clinical Preparedness

I too share the feelings of being nervous for the first clinical rotation despite being a nurse for so long. The feeling of not being prepared or not having the correct answers is very disturbing. I am starting my third day of clinical tomorrow and I still have some nervousness surrounding the flow and being able to connect all the history, labs, and current chief complaints to have a holistic picture of the patient. My first two days I struggled because I was not familiar with charting in the clinic setting and I felt that it slowed me down. I also wanted to instill trust in my preceptor and fumbling with the EHR did not make me feel good.  

I was reviewing an article by Brent, et al.,(2021) discussing the confidence level of FNP students during clinical. The article was reassuring because the pre and post surveys were favorable in that the students confidence level increased as they matriculated through clinical rotations. There was also some benefit in not knowing everything going in and having those experiences that required processing and thought generation. 

I look forward to hearing about your journey this session. Best of luck to you. 

Ro

References:

MacDonald, B., Floyd, O., Dowd-Green, C., Bertram, A., Fingerhood, M., Sharps, P. & Stewart, R. (2021). Measuring the contribution of clinical rotations to skills confidence in primary care nurse practitioner students. Journal of the American association of nurse practitioners, 33(12). DOI: 10.1097/JXX.0000000000000562