Summary NR 511 Week 8 Reflection|Week 8 Reflection NR511 Differential Diagnosis and Primary Care.

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NR511 Differential Diagnosis and Primary Care July session, 2019 Dr. P Clinical Experience and Gap Review This study source was downloaded by 100000861165608 from CourseHero.com on 01-29-2023 07:3... 0:31 GMT -06:00 https://www.coursehero.com/file/55073349/NR-511-Week-8-Reflectiondocx/ 2 Reflection After careful review of the clinical encounter summary, I was able to identify gaps in types of patients I have seen during my clinical rotation. In my clinical rotation for NR 511, I followed one preceptor in the family practice setting where I saw a total of 172 patients and completed 129 clinical hours. During this rotation, I had the opportunity to see a wide range of the adult population from age 18-95. The majority of the adult population fell in the age range of 66-75. Upon reviewing the clinical report from the MyEvaluations logging tool, about 86.63% of the patient population seen in this clinical rotation were African American, which is representative of the ethnic population in the Orange county of Orlando Florida. I also saw 8 Caucasian patients (4.65%), 12 Hispanic or Latino patients (6.98%), also 3 American Indian/ Alaskan Native descendant patients (1.74%). Lastly, only a few procedures were carried out during my rotation. I was able to perform one PAP smears, a breast exam, and mostly venipuncture. I was lucky enough to have a clinic that performed x-rays inhouse and I was also able to see and learn from a diagnostic testing stand point. In terms of client complexity, the majority of the visits (75.58%) were chronic condition associated with hypertension, hyperlipidemia, diabetes, and hypothyroidism. As I progressed towards the end of the clinical rotation, I was able to see more health maintenance visits and acute conditions. Nonetheless, I felt that this was a significant gap in the category of client complexity. Since the majority of the patients were chronic visitations, I was unable to perform many of the procedures listed in the competency list. I hope to close this gap with the next clinical rotation in general internal medicine. If I continue to see this particular gap in client complexity and procedures, I will obtain preceptorship in an urgent care facility that may provide plenty of opportunities to gain exposure to higher acuity patients and perform more procedures. This study source was downloaded by 100000861165608 from CourseHero.com on 01-29-2023 07:30:31 GMT -06:00 https://www.coursehero.com/file/55073349/NR-511-Week-8-Reflectiondocx/ 3 Reflection Urgent care facilities can certainly help fulfill procedures such as laceration repairs, foreign body removal, wound debridement, and nail avulsions. The other significant gap in this clinical rotation is the lack of pediatric exposure. Even though the practice is listed as family medicine, the youngest patient I was able to see was 17 years of age. Generally, the pediatric population is typically seen mostly by a pediatrician. In order to meet the pediatric requirements for this program, I will need to obtain a preceptorship at a specialized urgent care center or a pediatrician office. Luckily, I found a pediatric office for the November clinical rotation. Since the school required a 15% of total hours for woman women’s health, and I feel that in this session I was not expose enough to women's health category, hopefully by next session, I will have more opportunity to see more women issue, in order to meet the goal, or I will be looking for a preceptorship in a women's health clinic or health department to be able to have my skills. Clinical progression I felt that my progression through this clinical rotation was appropriate as a novice nurse practitioner student. When I first started this clinical rotation, my personal goal was to gain confidence in completing a full head-to-toe assessment in a primary care setting. While my assessment skills are proficient as a med-surgical nurse, my goal was easily achieved in this clinical rotation, and I gained more confidence in my assessment skills. I was also able to successfully fulfill my personal goal of presenting patients in SNAPPS format. For future practicum experiences, I hope to broaden my patient presentation skills to encompass more complex patients with multiple uncontrolled diseases. Areas of Weakness This study source was downloaded by 100000861165608 from CourseHero.com on 01-29-2023 07:30:31 GMT -06:00 https://www.coursehero.com/file/55073349/NR-511-Week-8-Reflectiondocx/ 4 Reflection Even though I am improving on my assessment skills in this clinical rotation, I feel that my area of weakness is developing differentials for acute concerns. Developing differentials for “common cold” symptoms have become easier as I gain more exposure to cases of upper respiratory infections and bronchitis. However, I still have trouble with other acute concerns such as orthopedic injuries and abdominal pain. My other area of weakness involves choosing the appropriate antibiotic regimen. With a wide range of antibiotic choices, I am not as confident in choosing a specific medication. To address these deficiencies, I plan to create a document during spring break with the most common complaints seen in the primary care setting, along with symptoms, differentials, and possible treatment plans. I will also study the different classes of antibiotics for specific illnesses ranging from respiratory to dermatology disorders. FNP NONPF CORE Competencies I plan to work towards meeting two of the practice inquiry competencies in the family/across the lifespan section of the core competencies. As a novice FNP student I believe that I am constantly working to generate knowledge from clinical practice to improve practice and patient outcomes (Thomas et al., 2013). In order to generate knowledge, I need to apply evidence-based research that is patient centered and use an evidence-based approach to manage, evaluate and apply research finding to improve the patient’s outcome. I have identified this as an area of weakness found during my clinical rotation. I need to become more proficient in determine appropriate, and cost-effective testing, and drug management, in order to do so I will be using the evidence-based research and clinical practice guidelines This study source was downloaded by 100000861165608 from CourseHero.com on 01-29-2023 07:30:31 GMT -06:00 https://www.coursehero.com/file/55073349/NR-511-Week-8-Reflectiondocx/ 5 Reflection . In addition, providing patient centered care that focuses on the patient’s values, preferences and needs to help aid in decision making for the plan of care of an individual patient is also an area that needs to be enhanced with practice and obtaining clinical experience. The second NONPF competency within the technology and information literacy area was met during clinical rotation where I was able to integrate appropriate technologies for knowledge management and health care improvement. The primary care office’s electronic medical record (EMR) was Cerner, and the system was user-friendly to personalize every individual’s health care plan. I was able to demonstrate information literacy skills to capture data, including vital signs, lab results, history and physical and patient education, on every visitation. Learning the electronic prescription component of Cerner was also useful in promoting a safe and costeffective method of improving health care needs. As master’s prepared nurses working in today’s technologically advanced system, proficiency in informatics skills is more imperative than ever (Hsien-Cheng, Meng-Hsian, & Chen-Wei, 2014). Therefore, the use of available technology will certainly help enhance and monitor health status and outcomes within the primary care setting. This study source was downloaded by 100000861165608 from CourseHero.com on 01-29-2023 07:30:31 GMT -06:00 https://www.coursehero.com/file/55073349/NR-511-Week-8-Reflectiondocx/ 6 Reflection References Hsien-Cheng, L., Meng-Hsiang, H., & Chen-Wei, Y. (2014). The influences of computer system success and informatics competencies on organizational impact in nursing environments. CIN: Computers, Informatics, Nursing, 32(2), 90-99. Thomas, A., Bissinger, R., Brackley, M., Buron, B., Davis, R., Delaney, K. R., Weber, M. (2013). Population-focused nurse practitioner competencies. Population-Focused Competencies Task Force. Retrieved from http://c.ymcdn.com/sites/www.nonpf.org/resource/resmgr/Competencies/CompilationPop FocusComps2013.pdf This study source was downloaded by 100000861165608 from CourseHero.com on 01-29-2023 07:30:31 GMT -06:00 https://www.coursehero.com/file/55073349/NR-511-Week-8-Reflectiondocx/ [Show More]

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