Running Head: FINAL ANALYSIS RN STUDENT

Final Analysis:
My Growth after Four Years in Nursing School
Nicole Bayer
Bon Secours Memorial College of Nursing

FINAL ANALYSIS RN STUDENT

2
Practicum Experiences

Throughout the past 915 hours, I have noticed significant growth in myself as I
transformed from a nursing student with little hospital experience, I only had prehospital EMS
experience, to a nursing student acting as a nurse with the supervision of my nurse preceptor.
I began my first clinical in Competencies 1 learning how to give bed baths as a team with
another student. For many clinicals, it was the same thing bed baths and vital signs. Then came
along the insulin shots I can remember how nervous I was. ANS 1 began and I cared for many
chronically ill patients on the renal unit at MRMC.
I was given very challenging patients on the Renal Unit, total care patients. I did not like
clinicals there, but I learned a lot. I was challenged in a way like never before. The call bells rang
non-stop, my patients required constant attention, I had to explain the reason I was giving
medication, the class of medication (i.e. beta blocker), and the action of the medication to my
instructor. I had to feed patients, bathe them, medicate them, and it was all so overwhelming. I
did enjoy my Competencies 2 course where I practiced a variety of skills in the simulation lab
and then went to the ED to practice these skills. I was an ED Tech already so I was comfortable
with the skills. ANS 2 clinicals were much better. I had clinicals on various units such as General
Surgery, ICU, Neuroscience Telemetry and Medical Oncology.
Although I no longer had one patient assigned to me, I was better at multitasking and
prioritizing care. I continued to learn about area specific medications, like chemo agents on
oncology, and even learned new skills like wound care and changing central line dressings. I
started to become more comfortable acting in the role of a nurse. I still asked for help and advice
frequently. Mental Health clinicals also took place the same semester. The nurses did not provide
the hands on, supportive care I had envisioned myself giving as a nurse. The only clinical I

FINAL ANALYSIS RN STUDENT

enjoyed in mental health was my clinical at Poplar Springs on the Military Unit. My friend had
deployed to Afghanistan twice and had similar problems that these brave men and women
struggled with. It was an eye opener to hear their stories, to watch them relive the worst moments
of their lives, and for them to welcome me into the group as family. I developed a lot of
listening skills in mental health and realized a lot of people are desperate for help. The next
semester was fun. The experiences were brand new in OB and Pediatrics.
OB its not a specialty for all nurses. It was interesting to see how births occur in the
hospital, as opposed to in the prehospital setting where I have assisted in the delivery of a
newborn. I learned about contraction patterns and strengths, monitoring contractions,
medications used to stop or to start contractions, and the effects contractions have on the
newborn. I learned about fetal monitoring and spent a lot of time reading strips. I asked a lot of
questions, attended a full term vaginal birth, a preterm vaginal birth, and a C-section. I cared for
antepartum mothers, laboring mothers, and postpartum mothers and their newborns. There were
2 clinicals that I spent in the NICU. I learned how to assess the newborn and the mothers in all
stages of pregnancy. Pediatrics was one of my favorites. I was able to play with the kids while
also reassuring their parents. I loved and felt honored to care for children of every age especially
the infants, toddlers, and preschoolers. After getting a lot of experience as a nurse with critically
ill adults, Id like to work in the PICU. I enjoyed the OB and Pediatrics clinicals and learned a
lot. I learned where my strengths are (caring for children and their families) and where my
weaknesses are (watching C-sections and feeling the fundus). I was fortunately in the CCU at
SMH for my final semester of clinicals.
I learned so much in the CCU. I had wonderful preceptors in immersion who supported
and encouraged my growth. I cared for critically ill cardiac and ICU overflow patients. I was

FINAL ANALYSIS RN STUDENT

proficient with my time management and prioritization. I was able to have 2 critically ill patients
and only require supervision by the end of immersion. This is the semester where I experienced
the most growth. I learned how to titrate pressers and the ranges for the pressers (i.e. Neo 30 to
300 mcg/min), how to monitor a patients hemodynamic status, central line care and Swan line
care, and what are considered normal ventilator settings. I measured I&Os every hour,
suctioned out the ETT as needed, titrated pressers, antihypertensive drips and antiarrhythmic
medications, started IVs and drew blood, learned how to care for rectal tubes, give
suppositories, titrated sedation medication, and learned how to zero the arterial lines and other
hemodynamic lines (PAP and CVP). I asked a lot of questions and took initiative to learn all I
could learn. My critical thinking skills developed a lot and I became very comfortable hanging
IV medications, labeling IV tubing, checking the compatibility of medications, performing
mouth care, turning patients, ETT care and foley care, administering IV push medications, IV
drips, medications via PEG tube, and administering either TPA and lipids or tube feedings for
nutritional support. I became familiar with lab values and documenting critical lab values,
administering blood, and performing groin site checks for post-cardiac cath STEMI patients. I
helped all of the RNs and acted as a team player. I felt like a nurse, my name was written in the
nurse spot on the patient board in their room, and I was treated like a nurse.
Class Experiences
I felt like my classes provided me with the information I needed to care for patients in the
hospital. I was able to learn in depth about every body system (neurological, respiratory, cardiac,
GI, GU, musculoskeletal, and integumentary system) from birth to death. I feel confident in the
knowledge I have gained and feel like I am well prepared to succeed in any environment in
nursing. I have a basic knowledge and will only gain more knowledge as I practice as a nurse.

FINAL ANALYSIS RN STUDENT

Areas for Future Growth

My current area for future growth will be in critical care. I will be working in the MedSurg Trauma ICU at Chippenham Medical Center. I was told I will have patients who will have
ICP monitoring (which isnt something I am familiar with), critically ill medical, surgical, neuro
and some cardiac patients and critically injured trauma patients now that Chippenham is a Level
2 trauma center. I will need the support of a nurse preceptor as I enter professional nursing. I will
need, and have been promised, classes specific to my unit (i.e. a critical care nurse class, ECMO,
and TNCC classes). Bon Secours has prepared me well to practice as a New Grad RN throughout
the rigorous, stressful and demanding four years I have attended as a nursing student. I am
excited to learn in a new environment, to grow as a person, and to have an impact in the lives of
my patients and coworkers. Im confident I will be a good nurse and I cant wait to begin! After
passing the NCLEX, I will be Nicole Bayer RN, BSN and working in the MSTICU. Im so
excited! Dreams do come true with a lot hard work, sacrifice, dedication and determination!