Learning at Lyle Torrent

My learning experience at Lyle Torrent

Rita Alcaraz

Jackson College
Learning at Lyle Torrent

As a student nurse, attending a clinical day at the Lyle Torrent center was an invaluable

experience that I will carry with me throughout my future nursing practice. In the following

report, I will discuss the things that I observed and learned at Lyle Torrent, as they relate to

nursing roles of being a provider of care, manager of care, and member of the nursing profession.

As a provider of care in the nursing profession, it is imperative to understand the

diagnoses that I will encounter, as well as the implications as it relates to my nursing care. In the

classroom, the diagnosis of cerebral palsy was predominant. I learned that cerebral palsy is a

chronic and nonprogressive disorder of posture and movement, that often presents with co-

morbidities such as cognitive, hearing, speech and visual impairments, and seizures (McKinney ,

2012). Many of the children in the classroom were reported to have seizure disorders as well as

CP, and I personally observed a seizure, visual impairments, and cognitive and speech

impairments in these children who have cerebral palsy. While it was unfortunate that the child

had a seizure, it was a great clinical learning experience for me to witness. I was feeding a

student lunch, this student had the diagnosis of cerebral palsy with seizures, and I made sure to

pay close attention to his swallowing mechanisms. Throughout his feeding, I did notice that both

of his hands would open and close, and move around. I contributed that to the spasticity that can

accompany CP. A few times his hands seemed to be opening and closing a bit more than usual,

and my initial interpretation was that he was trying to indicate that he was all done, due to the

communication picture for “all done’’ depicting two moving hands. I was way off the mark, he

was actually having a short seizure as I was feeding him, and thank goodness he had no food in

his mouth at the time. The teacher recognized it and came over to asses him, it was very short

and he was fine to continue eating. This was an extremely valuable clinical event for two reasons

: 1. I learned that I can never focus on only one area during patient care, such as monitoring the
Learning at Lyle Torrent

swallowing mechanism, I need to constantly use peripheral assessment and always keep on my

mind ‘’what is the worst that can happen right now’’, in order to recognize that seizure when it

happens. 2. I saw firsthand the difference between the wide, involuntary movement of the arms

and hands as is typical with these children with cerebral palsy, and the fine tremble that occurred

in both hands simultaneously at the time of his seizure. I realize now that it is very unlikely, and

maybe even impossible, for that student to move his hands so minutely without that seizure

activity going on. As a provider of care, the nurse needs to focus on, and implement

interventions in many areas for the child with CP. For example, to address the impaired physical

mobility, I observed the nurse in the classroom utilizing the wheelchairs and other mobile

devices, repositioning to promote skin integrity, working on activities to improve gross motor

movement, as well as assisting with toileting and feeding. To address the children’s delayed

development and impaired verbal communication, I observed the nurse communicating with the

children using pictures and audio prompt buttons, addressing them according to their

developmental level, following protocols to meet goals in their IEP, and giving them constant

positive feedback throughout the day. To address safety risks related to CP, I observed the use of

safe toys and tools for the children to play with, the nurse and staff always applied all safety

restraints on wheelchairs and the various equipment, the children were positioned upright during

meals, food was blended or mashed, and any child who weighed over 50lbs required two people

to lift / transfer between equipment and to position the children in the bathroom to use the toilet.

In relation to being a manager of care, I learned that the nurse needs to collaborate with

various professionals and caregivers to assist the childrearing family with achievement of

universal self-care requirements and help them deal with alterations related to a sense of

normalcy. According to Orem’s theory of self care, the universal self-care requirements consist
Learning at Lyle Torrent

of air, water, food, elimination, activity/rest, social interaction, prevention of hazards and

promotion of normalcy. These requirements are very basic, and seemingly easily attainable, if

you are a typical person living in a first world country. However, for the special needs children

of our community, these basic universal requirements are simply impossible to obtain without a

team of people to help them achieve these basic needs. The children that I observed in the SXI

classroom needed extensive help with all of the aforementioned universal tasks with the

exception of air, none of them experienced respiratory difficulties during my stay. That leaves

food, elimination, activity/rest, social interaction, prevention of hazards, and promotion of

normalcy. Collaboration amongst the professionals at Lyle Torrent was imperative to meet all of

these needs, and to promote an optimal normal childhood experience for these children.

Examples of this collaboration that I observed included : an individualized binder in each child’s

backpack, this binder contained daily logs of activities, observations of staff, and what happened

that day. This binder promotes communication between the parent and the teacher, and facilitates

that collaborative relationship. Each child has an IEP, or individualized education plan. In the

initial development of this plan, there is a tremendous amount of collaboration amongst the

caregivers in that child’s life, who include the physician, a psychologist, teacher, parents, OT,

PT, nurses, and other professionals depending on the child’s physical and cognitive needs.

Technology has aided tremendously in the collaboration process between school and home,

throughout the day the teacher/para-professional/nurse take photos of the children while they

participate in art, gross motor activities, field trips, etc. and are able to immediately send that

photo to the parents of the child. Technology also aided in meeting those universal requirements

of activity/leisure, elimination, social interaction, and prevention of hazards. These tech devices,

such as a smart t.v., auditory prompt buttons, different mechanical pieces for safety in the
Learning at Lyle Torrent

bathroom, wheelchairs, etc. are only available to these children through the collaboration

between the school, medical insurance companies, and state/federal funding.

As members of the profession of nursing, it is our responsibility to be knowledgeable of the

various healthcare needs, disparities, and goals in our communities. One way to do that is to be

aware of the national Healthy People 2020 goals. After my Lyle Torrent clinical, I researched

these Healthy People 2020 goals to find some that relate to children with disabilities. The

following is one 2020 goal that I feel the Lyle Torrent center is actively working towards:

DH-14 Increase the proportion of children and youth with disabilities who spend at least 80

percent of their time in regular education programs .

Based on my observations, the nurse, teacher, and para-professional in the classroom were

working toward this goal by maintaining open communication with the parents of these children.

I witnessed the teacher take time to converse with a parent on the phone regarding certain

paperwork that needed to be completed, or revised, in order for the student to return to school.

The professionals at Lyle Torrent work very hard to develop and maintain a healthy bond with

these children, keep them safe, attend to their complicated health care needs, and achieve the

goals as outlined in their IEPs. By doing these things, they are promoting trust between the

parents and the school, which results in increased attendance of the children at the school. The

center also provides transportation to the school for all of Jackson County, this transportation

also promotes achievement of the DH-14 goal.

I am extremely grateful for the experience I had at Lyle Torrent, the staff were very welcoming

and informational, and the children were absolutely precious, I will never forget it.
Learning at Lyle Torrent

References

DH-14 Data Details. (n.d.). Retrieved October 20, 2017, from

https://www.healthypeople.gov/node/4136/data_details

Mckinnley, James, Murray, Nelson, & Ashwill. (2012). Maternal-Child Nursin (4th ed.).
Saunders.

Outstanding reflective paper about your Lyle Torrant clinical experience Rita. I

applaud your hard work on this submission and have no problem with its length considering the

rubric for the assignment. I am never disappointed with students who care enough to go above

and beyond the call to do their very best.

I was so moved by your writings about the incident of seizure while you were

feeding your child. The learning that you’ve been able to gain from having this lived experience

is priceless. It gave you the chance to understand how when things happen to our patients,

multiple things may occur at the same time. We have to be aware of everything all at once

sometimes, this is why we trust our instincts. I’m so happy that you took the staff’s direction as a

learning experience and have expressed what you’ve learned. By having processed this event in

the way you have, you’ll be much more aware and in-tune to this type of seizure behavior in

your nursing future. This is how we grow as professionals.

Learning at Lyle Torrent

The amount of research and critical thinking you’ve shown throughout the work is

impressive and shows the interpersonal growth I’m looking to see develop within you at this

level in your learning. Making the connections from research to clinical behavior and further

relating your experience to the Doretha Orem’s theory is outstanding and advanced for this stage

of your learning. Phenomenal Job throughout the entire paper in describing these comparisons,

especially the Healthy People 20/20 goals, and so eloquently capturing them in your writing.

Thank you for taking such amazing care of the children at the school Rita. I am so

proud to have students like you demonstrate such professionalism and the very best of our

nursing program in the community clinical setting. OUTSTANDING JOB!!