Community-Based Practicum Reflective Journal Guidelines

Bon Secours Memorial College of Nursing

NUR 4143 - Clinical Immersion
Community-Based Practicum

Professional nursing meeting experience (4 hours)

Guide for Reflection Using Tanner’s (2006) Clinical Judgment Model
Introduction

What professional nursing meeting(s) did you attend and where was it located?
I went to the Nursing Quality Outcomes Council (NQOC) meeting at St. Mary’s.
Background

Describe the purpose of this professional nursing meeting? Describe the agendas of the group and subgroup. What
type of issues did they address?

The NQOC meets to discuss quality control. They review different processes in nursing and the
corresponding patient outcomes. The agenda of the meeting was laid out beforehand. They reviewed last month’s
meeting because it was the Monday before Christmas and not a lot of nurses were in attendance. They discussed
Foley catheter paperwork that would help prevent catheter associated urinary tract infections (CAUTI). The
paperwork was a checklist and requirements before putting a catheter in and once they were done discussing it, they
voted on whether to implement it or not. Next, they discussed falls and the goals for each unit on number of falls for
the next year. They also told the group about a new rule where bed alarms had to be screwed into the beds and gait
belts had to be hanging in the room to help prevent falls. They went on to talk about the magnet program and the
seven categories of the nurse’s satisfaction survey and how to improve their numbers. Then different committee
members came in to talk about their committees. This included night shift, safe patient handling, mislabeled and
unlabeled data, and staffing. They ended by going over the charters and bylaws of the council.

Noticing

What did you notice about the professional nursing meeting initially? Describe what you saw, heard and did during
the meeting?

I noticed that there was one member from each unit in the hospital at the meeting, or at least there was
supposed to be one person, and then the nurses in charge of the committee. There was also a recorded to write down
everyone’s ideas and what was said for and against the ideas. It was a round table discussion instead of a
presentation. They did have a projector to show everyone statistics and other information, but everyone was facing
each other and there was no one really up front just lecturing. There was a lot of good back and forth discussion on
all of the topics. The CAUTI checklist was a hot topic because they all felt this was a waste of charting because they
already had to do it in the computer. They said the checklist was more for the hospital while the charting in the
computer was for patient records.

Interpreting

Describe what you thought about the information being discussed. Have you been involved in similar discussion
during your previous student nurse experiences? Describe the similarities and/or differences to those encounters.

I thought the information was really interesting. I think everything brought to the discussion would help not
only patient outcomes but nurses as well. I also understood the nurses’ side of things because a lot of the new ideas
would add to the workload of the nurses. I have not been involved in similar discussions as a student nurse, but I
have been in the room during new policy talk between nurses and providers at my job. VCU has a new pediatric
code chart and a few other things providers want implemented and the nurses have expressed different opinions on
what they think are the good ideas and the bad ideas. This was more of an informal discussion compared to the

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meeting I went to. At VCU, the providers said they were the new rules, so the nurses did not have much say while
the nurses at the meeting got to discuss and vote.

Responding

Describe stresses (both positive & negative) you experienced as you responded to the new learning or the challenge.

I was uncomfortable at one point when one nurse said the idea presented was pointless and would be an
extra step for nurses. I thought it was a good idea to increase positive patient outcomes, but this one nurse obviously
did not. She got really aggressive with her responses and almost sounded selfish. She had some nurses agreeing with
her while others just did not pay attention. It was like they were used to her complaining or being negative towards
new ideas and just toned her out.

Reflection-in-Action

What role would you take being assigned to represent your unit in this group? What subcommittee would you like to
participate with and why?

My unit was not involved in much of the discussion actually. They even said a few things did not apply to
the pediatrics department, the emergency departments and even the pediatric emergency itself. So I am not sure why
I would actually do. I would like to sit in on a meeting that did apply to my unit to see if I agree or disagree with
ideas. I was interested in the night shift committee, safe patient handling, and new grad committee. The night shift
committee is trying to make food available throughout the night. Right now my shift is 11:30am to midnight and if I
do not bring my own food I would not have anything to eat. The safe patient handling is a big part of nursing to
prevent injuries. And as a soon to be new grad, I am very interested in how they plan to keep the turnover rate lower.
It is not good where I work at VCU and does not seem to be good in some units at St. Mary’s. I know at VCU a lot
of it is the nurses that have been there longer are not approachable or they are condescending to new grads.

Reflection-on-Action and Clinical Learning

What written evidence is available to support professional nursing groups and their impact on the development of
evidence based practice and improved patient outcomes. Cite/reference all journal articles that contributed to the
evidence.
Anna Schneider, Markus Wehler and Matthias Weigl wrote an article on the effects of work conditions on
the mental well-being of providers and the quality of care. They discussed how they had 10 professional meetings
involving everyone one involved in the care teams in the emergency department. In these meetings, nurses and
physicians solutions to stressors. These solutions were them tested and studied to see how it affected the nurses,
physicians and patient outcomes. The results showed that the inconsistent results. The mental health decreased even
though there were improvements to work conditions. But, they did say the research could lead valuable insights.
Schneider, A., Wehler, M., & Weigl, M. (2019). Effects of work conditions on provider mental well-being and
quality of care: a mixed-methods intervention study in the emergency department. BMC Emergency
Medicine, 19(1), N.PAG, https://doi.org/10.1186/s12973-018-0218-x
What is the value of professional nursing meetings both as a part of a healthcare system and within a professional
organization?
I think professional meetings are very valuable. It not only works on patient outcomes but allows the nurses
to advocate for themselves. Discussing how to make the quality of care for patients better is always a good idea. But
doing it in an environment where the people who are doing most of the care can discuss and give their own ideas is
better than just implementing the ideas without any say coming from the nurses.
Describe any changes in your values or feelings as a result of this experience.

There were no changes in my values or feelings as a result of this experience.

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Nielsen, A., Stragnell, S., & Jester P (2007). Guide for reflection using the Clinical Judgment

Model. Journal of Nursing Education, 46(11), p. 513-516.

Professional Nursing Meetings

St. Mary’s Hospital

NOC: first and third Wednesday of each month. Let me know when you would like to attend.

Shared governance council meetings:

Professional Practice Council-Second Wednesday 8a-12n

Strategic Planning Council-Second Thursday 8a-10a

Applied Research Council-Third Thursday 10a-12n

Education Council: third Thursday from 12n-4p (the meeting part lasts for 2-2 ½ hours and then
the members work on unit education)

Memorial Regional Medical Center

Third Tuesday of each month (Room 3008, Net Center)

Nursing Practice council 0800-0930

Nursing Quality Council 0930-1100

Nursing Recruitment & Retention Council 1100-1300

Nursing Education/Research 1300-1430

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