Author: Bianca

Being a great nurse requires a multitude of skill sets. Along with practical and hands on skills, a nurse must have both empathy and compassion. Although compassion and empathy are closely related, they differ in meaning. Empathy is the ability to see one’s pain and suffering and understand what they are going through (“Compassion Definition” 2020). By viewing the situation from the patient’s perspective, a nurse should be able to take on and feel the same emotions. When a nurse experiences empathy, generally what comes next is compassion. Compassion is the desire to help relieve the patient’s suffering after empathizing with what they have been going through (“Compassion Definition” 2020). These two concepts played a large role in Jean Watson’s development of the 10 carative factors that are critical to providing patients with caring interactions, which I can apply to my future clinical practice.

When it comes to Jean Watson’s theory, caring and compassion are essential to nursing practice. She believed that compassion can change simple medical care into health promotion, which is a focus of nursing. By taking a holistic approach to practice, it promotes healing and a feeling of being accepted, instead of a patient feeling judged. This shows that a patient is truly valued and cared for, which can create a more open environment to healing. These concepts are what influenced Watson’s development of the 10 carative factors for nursing practice.  The purpose of her developing these factors was to create ideals to be addressed by nurses when caring for patients. By integrating these 10 factors, a nurse can change their job of just practicing their profession into a caring role. Through caring practice, a patient feels valued, is more likely to heal quicker, has less pain, and expresses less anxiety. Patients are also more likely to follow care plans if they feel supported and are able to contact providers easily if they need help (Steele, 2017). Not only does the patient feel better, practicing compassion can make the nurse 

feel better, slow their heart rate, and decrease their risk of getting heart disease (“Compassion Definition” 2020). When the nurse is feeling good, they are able to provide the best care. 

            During my first 4 weeks of my clinical rotation, I had struggled making a connection with my patients. It was not until my last week that I truly got to know my patient and their family enough to provide compassionate care. I was lucky enough to have both the patient and spouse in the room with me to talk about how the patient had ended up in the hospital. By being able to hear the story from two points of view, I was able to really understand what the couple had gone through. They had spoken about how immersed in their community they were, and how they would always do their best to help their neighbors. Feeling isolated from their community from a long stay and a long commute to the hospital was difficult for them. Being able to be there for them, just as someone to talk to and share interests with, felt important. Not only was I important to the couple through providing therapeutic conversation, they also felt important to me by giving me purpose and meaning as a student who can only perform minimal tasks in the hospital. Through being able to empathize with this couple’s story, I felt compassion. I wanted to do anything I could to try and ease this family’s suffering. I was able to establish a supportive environment and promote an expression of feelings with this couple, demonstrating the use of some of Watson’s 10 carative factors. 

            Later in the evening, the patient began to have intense spasms with pain. The nurse had administered medication, but it had not kicked in yet. In this situation, there was not much I could do for the couple. The role I played in this situation was as a messenger between the family and the nurse. The nurse had told me that the medication was supposed to work within the next 20 minutes. I was able to convey this to the patient and their spouse to assure them that the pain would not last much longer. This was around the time when the spouse was scheduled to leave. They expressed concern about leaving the patient alone, especially in his condition. I was able to put her mind at ease by letting her know that the staff at the hospital will do their best to make sure the patient is okay. By speaking to the spouse, not only was I able make her feel hope that her spouse would be in good hands, I was able to establish trust between her and the healthcare team. This is another example of using some of Watson’s 10 carative factors. 

            In the future, I think it is important to establish a trusting relationship with your patient from the beginning. By establishing trust and compassion at admission, it allows the patient to be more comfortable and more open to receiving care. I wish I was able to spend more time with the patient and develop that trust sooner. This is something that I want to work towards and apply to the rest of my clinical rotations and my future nursing career. I believe trust is one of the best ways to incorporate caring behavior in clinical practice. By establishing a caring nurse-patient relationship through trust, the goals become more easily achievable. Not only is it important to have the patient trust you, you must also have faith in your patients. 

            I know that I wanted to become a nurse because I have always liked helping people and would like to incorporate that into my future career. Some of the best ways to care for people are through empathy and compassion. Without these two concepts, nursing would just be another profession, instead of caring for the ill, restoring, and promoting health. Through empathy, compassion, and Watson’s 10 carative factors, I will be able to improve patient outcomes and satisfaction. The best ways to incorporate these concepts are through establishing trust, providing therapeutic conversation, and incorporating emotions and feelings with problem solving. Caring behaviors are essential to nursing practice and the well-being of our patients, and I plan to incorporate them into the rest of my years as a student, and in my future nursing career. 

Client Name JK                                                        Date of Review 11/1/2020

Allergies: none

Storage of Medication: drawer

Keeps medications in original container?  Yes, unless traveling: will take what is needed for trip and put into one bottle

Access issues? none

How many providers does this client use? 1

Drug (generic)	Trade Name	Dose	Where client obtains meds from?	Frequency	Intended Use	Patient Use (if different)	Demonstrates UnderstandingYes or No
Rosuvastatin Calcium	Crestor	20mg	CVS	1x before bed with full glass of water	hyperlipidemia	High cholesterol	Yes
lisinopril	Zestril, Prinivil	30mg	CVS	1x in morning	hypertension	High blood pressure	yes
Albuterol sulfate	Airomir	90mcg per actuation	CVS	About 5x a year	Bronchodilator	Allergy season rescue inhaler	yes
indomethacin	Indocin	75 mg	CVS	During gout attack (about 1-2x a year)Takes 1-2 a day PRN (ranging from 2 days-2 weeks)	Anti-inflammatory	Gout	yes

Based on your review of the above individual’s medications, what do you feel are actual or potential safety concerns surrounding medication administration and why?

Rosuvastatin Calcium is a medication given to reduce total and LDL cholesterol. The patient expressed known possible drug-drug interactions between this medication and lisinopril. To reduce risk of interactions, rosuvastatin is taken at night and lisinopril is taken in the morning. Another possible interaction with rosuvastatin is with antacids. It is important to remember to take an antacid at least 2 hours after taking rosuvastatin so it does not decrease the effects of the medication. Indomethacin can interact with lisinopril, reducing the hypotensive effects of the medication. Since indomethacin is not taken on a regular basis, it is important to closely monitor blood pressure when taking this medication. If the effects of lisinopril are reduced, the patient should call the provider and see if an adjustment of the dosage is necessary. When taking indomethacin, it is important to take with food to avoid GI upset. Indomethacin can also increase the risk of heart related issues, especially in patients with preexisting conditions. The patient expresses understanding to take this medication for the shortest duration necessary. It is most important with these three medications that aspirin and alcohol uses should be avoided. Safety regarding albuterol sulfate involves proper administration of the medication through the inhaler. The patient demonstrated correct understanding on how to properly use the inhaler and when the inhaler is necessary. 

Considering concepts of safe medication administration and delivery, how would you approach a teaching plan with this individual to improve the safety of their medication delivery?

When it comes to a patient who has high cholesterol and high blood pressure, education is extremely important. Even though this patient was genetically predisposed to these conditions and is not overweight, diet and exercise can still contribute to decreasing these levels. Cardiovascular exercise is a way to strengthen the heart muscle and decrease the mass of the left ventricle (Bacon et al., 2004). By having a stronger heart, blood can be pumped more effectively. When blood is pumped more effectively and efficiently, blood pressure will decrease. Exercise is also a great way to reduce stress, which can lead to a decrease in blood pressure. For patients with high cholesterol, it is important to avoid a diet high in fats. The best way to do this is by avoiding fried foods and saturated fats. Another great way to affect lipid levels is by adding more fruits and vegetables. For the best results, medication therapy for these conditions should be given in conjunction with diet and exercise 

When doing the medication reconciliation assignment, I had noticed some safety concerns. The first safety concern I noticed was that indomethacin can interact with lisinopril. Indomethacin reduces the hypotensive effects of lisinopril, so it is important that blood pressure is closely monitored when taking these two medications together. It is also important to avoid alcohol and aspirin due to its interactions with rosuvastatin, indomethacin and lisinopril, and wait 2 hours before taking an antacid after taking rosuvastatin. The patient showed significant knowledge of each medication and why they were taking it. They also showed appropriate understanding of how and when to use their albuterol inhaler. The only interaction that was unknown to the patient was between indomethacin and lisinopril. By doing this assignment, I was able to learn more about these drugs which allows me to apply this knowledge during my clinical rotations.

3. This module provided me with information on learning styles. This was especially important for me as a student when understanding new content. I have come to understand that I am not most efficient with a single learning style. I work best with a combination of visual, auditory, and tactile methods. I learn best by doing, talking aloud, and looking at images. Now that I know what works best for me, I can apply them to my study habits for exams and eventually the NCLEX.

4. Priority setting questions are ones that I tend to struggle with most. I find it difficult to determine which patient requires the most immediate attention. I have learned previously about the nursing process, ABC’s, and Maslow. This module helped me to understand different frameworks for answering these kinds of questions. Things like least restrictive, survival potential, and acute vs chronic are additional ways to help with priority setting on exam and NCLEX questions.

bkrapian@une.edu

1- This module is going to be most useful to me while I’m a student. I learned many different test taking strategies that I was able to use for my last exam. The tip I used most was the plus, minus, question mark strategy for multiple choice questions. Priority setting is another concept that will need to be used as both a student and a nurse. The strategies they suggested for figuring out what is most important can be helpful in both test taking and practical settings. I will be using these tips for the rest of my student career, for the NCLEX, and in my future as a nurse.

2- I believe that this module will be very helpful to integrate into my future nursing practice. Through this lesson, I was able to explore different concepts on how to make important clinical judgments. Patient catered care is something I believe is most important. I learned that it is impossible to have patient centered care without the concepts from the helix of success. I hope the integration of these concepts will lead to success in my current career as a student, and when I become an RN.

Learning outcome 1 

As a student, when it came to revision, it was definitely not my favorite thing to do. Previously, I was more of a “one and done” type of person. I was not alone in this aspect, although. Many students, when hearing the word revision, would sink down in their chairs and groan and then wonder why all of this was necessary. In Nacy Sommers’ selection about revision strategies, she talks about the differences between student writers and experienced adult writers. She states “Such blindness, as I discovered with student writers, is the inability to “see” revisions a process: the inability to “re-view” their work again, as it were, with different eyes, and to start over… The students have strategies for handling words and phrases, what they lack however, is a set of strategies that help them identify the “something larger” that they sensed was wrong and work form there”(1). Being a student, I have definitely struggled with this. I was always so focused on what I now know as local revision that I did not realize how important global revision was. This class has taught me to pay more attention to the global revision of my paper instead of the local. By the time I was editing my last draft of my final paper, I had begun to realize that if I did not used the strategy of global revision, my paper would have been a jumbled mess. I had noticed myself completely rearranging my paragraphs and changing the theme of my paper completely. I was able to do exactly what Sommers said and look at my paper through different eyes and realize what my biggest mistakes were.

Learning outcome 2

In my significant writing project, my sources were extremely important for my thesis and claims to be supported. The source that I chose I found through the library services. The library is extremely helpful when trying to find sources that are credible considering it it hard to find sources that we think are credible through the internet. The article that I chose was about internet addiction. The author talked about what an addiction consists of. This can connect back to Bill Wasik’s article when he talks about boredom. Here is an example directly form my paper of how I connected these two articles together: “when all of our interactive technologies – video games and mobile devices as well as the web – have kept those of us most boredom-prone from generally thinking, as we might while watching TV, that we are ‘doing nothing’, even if in every practical sense we are doing precisely that” (475). This idea of feeling a sense of accomplishment by doing nothing of meaning or purpose is the perfect example of how the use of technology can lead to addiction. This helps me to support my claim that the dependence on the internet can lead to addiction.

Learning outcome 4

My peer review strategies included global and local revision. When I first started peer reviewing, I used to only focus on the local revision. In the beginning, it was hard for me to try and focus on the global part of the revision. There were points where my professor had asked us to focus only on the global revision but I kept finding myself trying to fix the local parts. As we kept peer reviewing throughout this class, I learned to find a balance between the two. Not only has this allowed me to help with my peers papers, it now helps me when I am going over my own paper. Overall, learning about how to globally revise has positively benefited me and will be beneficial to me in all of my future writing.

Learning outcomes 5 and 6

MLA formatting has always played a large role in my significant writing projects since high school. Because of this, it makes it much easier for me to cite my sources having done it for so many years. It is important to get the MLA formatting correct because if there is a mistake in a citation, it can possibly lead to plagiarizing. Local revision has always played a role in my papers as a student. As a person who enjoys grammar, I always try to make it a point to make mine correct. Although we all make mistakes for the most part, I try avoid the small mistakes like grammar.

this i believe

The paper above was written for my first year experience class. This class is meant to help us transition into college and learn more about ourselves. This paper is called “This I Believe” and is a popular prompt among students. The title is fairly self explanatory, you are to write about something that you believe in. When trying to write this paper, I had a really difficult time figuring out what I wanted to write about. To begin, I started to make an outline. Being in english class this year has taught me the importance to outline what I want to talk about and to make sure I get all of my ideas down. As I was finishing up writing my paper, I began to realize I was going in a completely different direction that I had originally thought. Without learning how to globally revise, my paper most likely would have been a mess. Before this class, I had never really paid much attention to global revision, instead I focused on local revision. Now I see how important this revision strategy really is and I plan to apply this to all of my writing in the future. Going along with global revision, I released how important it is to make drafts. In high school, I used to make one draft and pretty much be done. Now I realize how important it is to do more than one draft. To be honest, I feel like my papers could have improved even more if I had done more than two drafts. I found that eve just reading over my paper quickly allows me to find my weak points that I need to fix and also find the strong points that are focal points of my paper. Steven Pinker’s essay “Why Academics Stink at Writing” talks about wording in essays. “metadiscourse—verbiage about verbiage. Thoughtless writers think they’re doing the reader a favor by guiding her through the text with previews, summaries, and signposts. In reality, meta​discourse is there to help the writer, not the reader, since she has to put more work into understanding the signposts than she saves in seeing what they point to, like directions for a shortcut that take longer to figure out than the time the shortcut would save(5). I agree with Pinker that this can be a problem. I tend to find myself doing this a lot. Sometimes I feel like I am adding words just to add words. I think it is more important to focus on what you are writing about instead of going off to explain things that aren’t necessary.