Nursing

CELESTE DU TOIT 3051103 B.CUR NURSING: STUDENT PORTFOLIO OF EVIDENCE ‘To be a trusted nurse who provides the highest quality patient centered care, To become a competent professional practitioner, To restore and give hope and touching people’s life in a significant way’. Introduction Welcome to my portfolio of evidence! This portfolio of evidence is a guide to proof the level of attained knowledge and gained skills and growth within the different categories and disciplines of the nursing profession. It portrays the underlying values such as the level of passion needed for this profession and the inner drive to serve mankind through the art of nursing. Nursing is a profession to be proud of, but far more important, is the ability to understand that it is also a very fine art. Yes, without a deep understanding of the human nature and a driving passion and interest, one will not be able to become a nurse that impacts the lives of others in a significant way and to make that change that is needed. It asks from each and every nurse to focus with self sacrifice on the needs of patients as well as that of other role players within the profession, and to understand loneliness and pain and illness and the destruction it may cause to the human mind. Nursing is more about the healing of body AND mind and how patients can experience caring and healing with kindness and understanding. The radiance of every nurse is therefore of the utmost importance and although this portfolio of evidence proofs professionalism in every aspect of knowledge and skill in the profession, it must never be forgotten what positive effects behaviour such as kindness and friendliness can do in the lives of patients, fellow nurses, doctors and other staff alike. Amidst the best scientific treatment possible and available, the lamp of Florence Nightingale still needs to shine in the darkness to bring live and hope at all times where there is despair. May this portfolio therefore endeavour to capture the totality of this very noble profession and to serve mankind for the times to come. LEARNING PHILOSOPHY To learn fast is to create a passion for what you do. It is important to know how learning takes place and what the student’s responsibility towards learning is to achieve successful study. Learning makes a student competent by gaining and applying knowledge. When learning is done on a regular basis it gives a student self-confidence to work in the clinical setting, and it holds a great reward, for not only will one succeed in having the desired marks, but when the skills is applied that one has learned it can bring a smile to patient, it can restore and uplift dead hope, it can relief a patient from pain or emotional misery and it can even safe a life. The areas for learning in the B. Cur course will be in class, on e-learning, in skills lab and at the clinical setting (various hospitals). Learning is important because it trains and equipts a student. It is a continuous process which shapes you to be the best in your profession you can be. To enhance our ability and to develop knowledge it is important to attend class clinical hours, so that one can engage in an active social process of testing and clarifying his/her understanding. Revision is of utter importance, because it sets a firm foundation, encourages further learning and gives ones confidence to apply that was learned. Learning for me is to make use of initial knowledge, using resources to make your knowledge grow and to use every moment to gain knowledge in becoming the best. This means that if I want to learn I must set a weekly goal for myself, which contains outcomes or subjects to study. It also includes to value others as useful colleagues, to carefully consider the ideas of others, asking questions, developing the ability to work effectively and intensely. To work independently and very important to evaluate my progress in an objective manner. But the most important for me is to learn at least one thing in a day, to be pro-active in the learning process and to avoid premature judgement of myself, but rather identifying my strengths and weaknesses. To develop a vibrant, growing, dynamic and passionate attitude towards my studies, that will automatically engage me in learning. It is important to gain interest in what you study and to enjoy your learning. ‘‘To learn is to gain knowledge and to have knowledge, is having power!’’. LEARNING OUTCOMES My BCUR 1 learning outcomes in theory and in skills lab are the following: * Assessment and Care * Hygiene needs (Disinfecting bed, Handwash, Fullwash, Babywash,Oral care). * Need for Activity and Stimulation ( Mobilization). * Elimination needs (Urinalysis). * Need for Homeostasis (Body Temperature, pulse, respiration and blood pressure). * Need for safety and Infection Control ( Basic Wound Care). Learning outcomes that I have also benefit from in theory work are: * Safety needs * Values and spirituality * Cultural diversity * Communication and The Nursing Process * Ethical code for nurses, Ethos and Philosophy. * Conflict resolution * Nutrition * Hygiene needs * Safety * Sleep and Rest * Pain management * Death and dying Outcomes that relate to my own development as self-directed learner: * Computer literacy * Stress and Time management * Self assessing my learning * Communication skills * Medical Terms LEARNING CONTRACT It is my passion to be the best and a highly competent professional practitioner in my nursing career. I want to take every learning opportunity, on campus and in the clinical setting, and use it to the best of my ability to gain more knowledge so that i can be competent and proud to treat a patient. I want to pass all my subjects. I want to develop a communication skill that will make the patient feel at rest and appreciated. My goal is to have a good knowledge on all the areas of holistic care and to be abe to apply it anywhere and at any time. I will be assessed by my class mates, my lecturer, my Clinical supervisor and the sister in charge at the hospital. I will make use of all my free periods to practise the skills i have learned, as well as studying in the general study hall. My goal is to learn at least three things a day that makes me a better nurse. Please see table on the next page for my futher detail. | Objective | Learning resources and strategies | Means of evaluation | Deadlines | Evidence | 1. | I want to become more familiar with a computer. | The computer literacy classes held in Thintana Walk-in-lab. | To create one of the powerpoint presentations for our case studies in class. | Before the end of week 6 (1-5 March) and Test 1 ( March) | Please refer to Mrs Bimray on the evaluation of our group presentation | 2. | To become skill full in handeling nursing instruments such as the baby scale, oral care, blood pressure and futher evaluations. | UWC-Skills lab, Tygerberg Hospital Skills lab and in the clinical setting. | Assess by clinical supervisior. | Hygiene, Mobilization& Urinalysis: 19 JuneVital signs:21 SeptemberWound care:12 October | Please see evaluation forms. | 3. | To obtain good interacting and personal skills. | UWC-Skills lab, Clinical setting and class discussions. | Peer Evaluation by class, clinical supervisior, lecturer. | Throughout the year, before end year exams: October 2010 | See signatures at end of module. | 4. | To be familiar with medical terms. | Nursing Dictionaries, Class activities. | To present in presentation of a case study. | Throughout the year, before end year exams: October 2010 | Please refer to Mrs Bimray on the evaluation of our group presentation. | LEARNING ACHIEVEMENT I was evaluated on the following clinical outcomes: * Fullwash * Urinalysis * Vital signs * Mobilization * Basic wound care Achieving these outcomes I had to attend demonstrations in the UWC and Tygerberg Hospital Skills lab. There I would visualize and practise the different procedures. After these practises I would go home and practise again, so that I can identify my weaknesses. Practising in the skills lab makes a big difference and after this took place, I was able to do these outcomes in the clinical setting. Revision was a big part of achieving my outcome goals as I studied what procedure was done, why it is done and what must be done after it. Studying the modules for each outcome help me to obtain skills to successful achieve it. Please see attached Evaluation forms. REFLECTION ON EACH OUTCOME Fullwash: It is vital to maintain personal hygiene, to prevent infection, to refresh a patient and lifting his/her mood as well as observing the patients physical and psychological wellbeing, to improve blood circulation and to change the position the patient is laying in to prevent bed sores. It is also to change the linen and pajamas and to communicate with the patient. Urinalysis: Is usually requested by a doctor to assist with diagnosing certain illnesses, to help the patient’s condition to improve. Urinalysis is done by using urine dipsticks, in which the test results can be read as color changes. Vital signs: Includes taking the measure of temperature, pulse, respiration and blood pressure. It is to establish a baseline on admission, to detect any changes or abnormalities and to see if see medication the patient is taking has a desired outcome. There always ranges where vitals are measured at and if there are Any abnormalities in vital signs it should be reported to the health care professional in charge of care or the sister in charge. Mobilization: is important for the patient’s physical, psychological and social wellbeing. It encourages recovery after injury or illness, improves blood circulation. It prevents bed sores and numbness. Basic wound care: To prevent possible reactions, infections and complication of the wound. To promote wound healing, to assess other areas of the skin and to communicate with patient. REFLECTION IN CLASS In class I learned to value the opinions of colleagues by realising that every individual thinks in a different way and so by adding something to my learning process that I might not have thought of or forgotten about. I learned what was acceptable and not acceptable in the nursing profession and how to have a professional working manor at all times. In class I have learned to respect different coultres which helped me to be more comfortable in the clinical setting. It has definitely change the way I assess, approach and handle a situation and solving a problem. The powerpoint presentations has given me confidence to work communicate with patients in the wards and to be a well spoken nurse. REFLECTION OF GROUPWORK When working in a group there are six things that are important: Respect, patience, timing, attendance, co-operativeness and attitude. All of these qualities plays a role in nursing and must naturally come from a nurse. Learning these qualities while I was working showed me how important it is to work together as a group in a hospital. Teamwork makes the work light and it guarantees that the job gets done in a successful and thorough way. It helped us to get to know each other on a personal level and to view and learn each other’s different personalities. REFLECTION IN THE CLINICAL SETTING It enhanced my clinical skills by dealing with real life patients, it encouraged me to think independently, to be able to deal and solve with unexpected problems and to aid in the decision making process, it gave me a chance to interact with the family of the patient as well as some of the interdisciplinary team and health workers, such as doctors, physiotherapists and dieticians. It also brings you to the understanding of not only to the what and why of patient care but also the how to provide the care. For me it was an interactive merge between theory and practical skills and shown my competency of the knowledge I have learned. RELECTION IN THE COMMUNITY Nursing is the art of caring. This means not only for patients and in hospitals, but also in the community. For me it is important that we get involved in the community to help people that don’t have the knowledge, finances or access to hospitals. In fundamentals of nursing we learned to deal with the basic needs of an individual. This helped me to respond appropriately and effectively in the community whether it was by assisting, educating or showing compassion. It definitely helped educate people better and to set an example of a healthy lifestyle. REFLECTING ON THE MEDICAL TERMS Since I started to revise the medical terms we learned in class and in the clinical setting, it helped me to understand what was written in the doctors notes. I could understand what the patient was suffering from and also it helped me to give good feedback in the patients file on the progress report chart. I could engage into conversation with the sister in charge and my fellow colleagues, who would then teach me further about that certain terms and also the abbreviations they and doctors use in the hospitals. REFLECTION ON TIME AND STRESS MANAGEMENT Working in the hospital definitely did drive me to do my work and proper research in the week, because I knew that I would be expected to apply the knowledge and also will be questioned by the sister in charge. This helped met to keep up to date with my work and leave time for test preparations, etc. It did however increased my stress levels, but only to the good of my work to get everything done on time, but I managed it by getting a hobby and jogging regularly. COMPILING THE PORTFOLIO The process was in itself a learning experience for me. It helped me to analyse and assess my learning goals and growth. It compiles all my work together in order for me to see what are my strengths and weaknesses and what I can do to improve them. I already set new goals for the second year of my BCUR course! Submitting the portfolio pushes me through the year to be up to date with all my goals and to gain learning knowledge and I see it as a big motivation. A portfolio is something to be proud of, especially a Nursing Portfolio, because it is a written evidence how you achieved making a difference in patient’s lives and in the community. I am proud to submit my portfolio, because I am proud to be a BCUR student and because I can see that from the start of the course until the end, how my learning outcomes shaped me to be a competent professional practitioner in process! FURTHER LEARNING THAT NEEDS TO TAKE PLACE My next learning outcome or goal is to focus on medical diagnosis. Since we are starting with pharmacology next year it is for me an absolute must that I get more familiar with medical diagnosis or diseases. For me it will be a great achievement, because I can already add my medical term knowledge to it, and if a patient in the clinical setting presents with a disease I might know, it will help me to fully treat that patient to the best of my ability. For me to achieve this I must right down the common diagnosis and a few rare that present itself in the ward, by asking the sister in charge to help me identify them, and it also includes to spend time in the library on campus. Professional Development is a ongoing goal for me to treat patients with the highest quality care in a professional and passionate way. This will take place in the clinical setting. A third learning goal for me is to become a better counsellor in my nursing. I find it difficult to speak the right words when I see a patient suffering from his/her condition. I always tell the patient a story that resembles not giving up hope, but I would like to develop this skill so that I can make a significant difference in my patient’s lives. SUMMARY OF CLINICAL HOURS * My Clinical hours took place in the following hospitals: Karl Bremer Hospital: Term 1 and Term 2. Tygerberg Hospital: Term 3 and Term 4. * The number of clinical hours I am expected to complete : Term 1 : 56 hours March Vacation: 32 hours Term 2: 56 hours June Vacation 80 hours Term 3: 56 hours September Vacation: 32 hours Term 4: 56 hours December Vacation: 80 hours (not yet obtained before submitting portfolio) * The Total hours that is completed are: 282 hours. * The mention of hours in the portfolio are important as it serves as reminder that for me to be registered by the South African Nursing Council, I need to have completed 4000 clinical hours. Writing it down in the portfolio helps me to keep up to date with my count of hours. SUBMISSION OF EVIDENCE Here follows the submission of my valid evidence. Please refer to Mrs Bimray for evidence of the following evaluations: 1) Full wash 2) Urinalysis 3) Mobilization BIBLIOGRAPHY 2010, Fundamentals of Nursing 111 & 112. R Modeste, J Willemse, P Bimray, H Rashe. 2008, Fundamentals of Nursing; fresh prospective. S Duma, T Khanyile, et al. 1986, Mosby’s Medical and Nursing Dictionary,2nd ed. WD Glanze, KN Anderson, LE Anderson, H Harding Swallow.