Observation Experiences: NUR 3112P

Adult Nursing Science II Practicum

Reflection: Care-A-Van observation experience

1. Describe a situation when you were unsure of what to do today. How did you feel? What additional knowledge or
skills do you need in order to handle a similar situation in the future and how do you plan to acquire that
knowledge? (Minimum 1 paragraph.)

When I first got there and towards the middle of the day, I felt like I wasn’t sure what to do or
where to stand so I wasn’t in the way. I just felt awkward because the care-a-van has very little room so it
was uncomfortable and awkward to walk off the van and then get back on when they were finished with
the patient. The whole staff was very nice and provided so much information. The staff made me aware
that Tuesdays and Thursdays were the busier days. So I think for the future, students should go on those
days. My day was still interesting and like I said previously, I did learn from the staff what the usual day is
like. My experience on a Wednesday, there might have been 16 patients that came in. They said normally
it’s much more than that and people wait outside starting at 4:30 or 5AM.

2. What have you observed or learned about nursing roles in the given experience? What have you observed or
learned about the intraprofessional team in this setting? What did you observe about the communication and
collaboration amongst the intraprofessional team members? (Minimum 2 paragraphs.)

I learned from this experience that each nurse rotates around doing different positions. They have
someone who is the charge/discharge nurse, someone for labs, and a nurse that checks vitals. So I
thought it was interesting to know that they do rotate throughout the week. At my experience, there was
only a nurse practitioner. The staff told me that Tuesdays and Thursdays they had someone from PT, OT,
a dietician, and a pediatrician.
This group communicated very well. They had walkie-talkies so when the nurse taking vitals was
ready for the next patient, the charge nurse or someone from registration would send them to the van. If
there was an issue or concern the NP came out from the van to go into the church where the discharge
nurse was at. He made her aware of at information she may needed to know. There was a case
manager/social worker, so if any concerns got brought up, the patient would go see her. Almost all of the
staff spoke English and Spanish. There was one translator there today. He was paired with the social
worker.

3. Provide an example of holistic care that you observed. (Minimum 1 paragraph.)

One example of holistic care that I observed was when the discharge nurse was talking to another person
who was just released from prison. He had hypertension and a lot of anxiety. This nurse could have easily
dismissed what she was seeing and moved on. Instead, this nurse handed him tissues and encouraged
him to discuss what was bothering him. He expressed how he had a panic attack in the store because
there were so many options. The nurse shared her story of being overseas for two years and having the
same experience. She encouraged to follow the DASH diet, but she knew he was having some
challenges. She encouraged him to have what looks good but in moderation.

Rev. 3/5/18
 Observation Experiences: NUR 3112P
Adult Nursing Science II Practicum
4. Identify the National Patient Safety Goals that were observed throughout the day. Discuss the effect of the Goals
on the patient’s outcome. (Minimum 1 paragraph.)
I observed the staff identifying patients correctly & reducing risk of health care associated infections. It’s
especially important for the staff to follow the national patient safety because some patients don’t speak English or
they are on medications that require patient teaching. If a nurse were to mess up and give the wrong medication
or provide education that was meant for a different patient there could be some issues.

5. Did you enjoy this experience? Why or why not? (Minimum 1 paragraph)
At first, I was a little disappointed going to the care-a-van. I had hopes to go to VCU for the burn unit or
even to the OR. I went in with an open mind and was really impressed with how well the staff were. Also,
the process of moving patients around was very efficient. There were quite a few moments that the
charge/discharge nurse had with some of the patients. She showed no judgment towards the patients and
she genuinely cared about each patient that went to her for discharge.

6. Compare and contrast a patient issue that you observed today with an evidence-based nursing journal article from
the Nursing Reference Center (NRC). (Minimum 2 paragraphs.)

There was one patient that had been in prison for 56 years and he was just released. He is staying at a half way
house and they told him to go to the care-a-van because they provided free care. He has over a handful of medications
for his hypertension. The only problem was he couldn’t afford all of them. According to Chauncey, Tran, McNally, &
McEwan, individuals without prescription drug coverage were more likely to not fill their prescription or skip doses (2006).
The discharge nurse was really great at finding coupons for cheaper medications. However, this still was an issue for the
gentlemen because there were still a couple medications she couldn’t find that were cheaper.
In the article, the authors mention that there are multiple programs through pharmaceutical companies that can help
patients if they meet the needs (Chauncey, Tran, McNally, & McEwan, 2006). The only issue is that not many people are
aware about this or it’s not available in certain states. I think it is important for the half way houses to be educated and
could possibly help patients find access to where to find medications.

Reference
Chauncey, D., Mullins, C., Tran, B., McNally, D., & McEwan, R. (2006). Medication access through patient assistance

programs. American Journal Of Health-System Pharmacy, 63(13), 1254-1259. doi:10.2146/ajhp050457

Rev. 3/5/18