Assignment 2: Journal Entry #1

On any given day, a nurse can play a pivotal role in someone’s life. Experienced nurses often share stories of previous experiences and draw upon these experiences when circumstances warrant.

Hence, reflection can be a valuable tool. It serves as a tool for not only recalling experiences but also for applying lessons learned from those experiences. Keeping a nursing journal provides these benefits and more.



Photo Credit: [Photography by Angela – TGTG]/[Moment]/Getty Images

To prepare:

• Refer to the current Clinical Guidelines found in this week’s Learning Resources and consider how these guidelines inform your clinical experience.
• Refer to your FNP or AGPCNP Clinical Skills and Procedures Self-Assessment Form you submitted in Week 1, and consider how your self-assessment might inform your Assignment.
• Refer to your Patient Log in Meditrek and reflect on Weeks 1–5 of your clinical experience. Consider your observations and experiences with patients during this time.

Journal Entry #1 (450–500 words):

In your journal entry, answer the following questions:

Learning from Experiences

• Reflect on the 3 most challenging patient encounters and discuss what was most challenging for each.
• What did you learn from this experience?
• What resources did you have available?
• What evidence-based practice did you use for this patient?
• What new skills are you learning?
• What would you do differently?
• How are you managing patient flow and volume?

Communicating and Feedback

Respond to the following reflective questions:

• How might I improve on my skills and knowledge, and how to communicate that back to my Preceptor?
• How am I doing? What is missing?
• What type of feedback am I receiving from my Preceptor?

• challenging patient
• #1 A 38-year-old female presents for an annual wellness and pap smear Denies any other issues She denies taking any medications Last pap smear was 2021 she reports having a mammogram done at age 35 Annual awareness pap smear, CBC, CMP, Vit-D, B12, T3, T4, and TSH Advise on breast self-exam Mammogram after age 40 Advise on lifestyle modifications F/U in 3 days to discuss labs

• #2 A 23-year-old female present today with the c/o dysuria and discomfort in the suprapubic area The issue started 3 days ago She has been taking Azo OTC but to no avail She denies vaginal discharge and foul smell Upon assessment, she reports pain pressure in suprapubic area The pt has a history of recurrent UTI The pt was unable to stay for the test today Start nitrofurantoin macrocrystal 100mg PO every 12 hours #14 refill 0 Take cranberry tab OTC as directed Advise to increase fluid intake Advise to void frequently every 2-3 hours Apply a heating pad over the suprapubic areas to relieve pain and relax muscle Return to the clinic if symptoms persist for U/A with C&S

• #3 Pt is a 57 y/o here for a follow-up on prostatic hyperplasia and related urinary symptoms Pt’s history includes urinary retention, hesitancy, incomplete voiding, and dribbling for the past 6 months Pt was seen a month ago and started on Tamsulosin with some improvement in symptoms but not good progress Pt states that he would like to try alternatives for better control of symptoms He denies burning, painful urination, fever, and chills in the recent past Denies any other symptoms today. Continues with current medication Urinalysis with C&S, CBC, CMP, and HgbA1c Return for labs results in 3 days