Natalie Wong

N320
Clinical Reflections
Week 2: 4/41/14
Having a child go home with abnormal lung sounds in clinical this week, I was
able to apply the SLO 6, recognize benefits and limitations of community and
governmental support for family units and individual members with illness. With the
way hospitals run, it is based off meeting guidelines to receive funding from the
government. Hospitals are also known for trying to make a patients stay as short as
possible. One of the limitations with the need to get patients out of the hospitals and back
home, is having patients prematurely discharged before having the condition or problem
completely resolved. This child in clinical today was sent home with coarse crackles and
a tachypnic respiratory rate. It was being discussed with a fellow student and instructor
how it seemed to be a questionably early discharge. It places a higher importance for the
family to complete the antibiotics sent home with, attend the follow-up appointments, and
carefully observe for any signs and symptoms of returning to a respiratory distressed
state. Mentioned in the discussion with my classmate and instructor, there are now
beneficial guidelines that if a patient returns to the hospital in an allotted time frame after
discharge, the hospital will lose funding. Thus this ensures hospitals are making sure
patients really are stable before going home
The second SLO that was addressed in clinical this week was SLO 8,
demonstrate therapeutic communication skills in interactions and relationships with
families, individual, and other members of the health care team with attention to the
identification and correction of non-therapeutic communication techniques. With
therapeutic communication with a patient, it is the patient that is the focus. So when
doing patient care, it required communicating with the mom and addressing all that she
shares or explains. I also was in the room weighing the soiled diaper when the mom and
dad apparently were having an argument and exchange of harsh words. It would not have
been therapeutic to butt into their argument and add my opinions. As I have been
reminded with our guest speakers, nurses can see families unfiltered and at their worse.
Understanding this, after I was done with my task and before leaving the room, I just
asked if they needed anything else and did my charting in the hall to allow them privacy.