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As I reflect upon the objectives, I have been able to meet, review points where I have failed to perform properly during my nursing clinical practicum. I believe this process is vital in helping me realize my level of competency and will enable me identify new goals that I can work on to further my career growth and development (Chang et al., 2022). This exercise is essential in making my learning experience meaningful, ensuring it is valuable.
During my stint in the practicum, I focused on cardiology, and I learnt many things about the heart and cardiac diagnostics and processes. For example, I studied in depth about the 12 lead EKG and how each lead affects different parts of the heart. I also practiced how to interpret the EKG changes which I observed during the rounds. Another thing that I have interacted with is STEMI, along with NSTEMI, and I can now identify chest pains which are related to the cardiac. The other cases that I was able to see were stenosis cases, and how they exhibit. I also learnt how to read the CT of the heart, alongside the chest x-ray. Additionally, I learned about different cardiomyopathy and various treatments recommended for them. Furthermore, my practicum, focused on identifying the various forms of dysrhythmias, pace makers, different blocks and line of treatment. I was able to see the different types of pace makers and how they work as well as the antiplatelet therapy.
I can say that I am totally confident at performing CPR and vital sign measurements, and I can do them without any supervision. However, I am mostly confident in carrying out procedures such as presenting the history of present illness, alternative drug administration, and advanced circulatory management like placement and removal of central line placement. Additionally, I can place and remove intraosseous and arterial lines, perform arterial puncture for ABDs and interpret 12 lead EKG. Lastly, I am now able to place, remove, and manage chest tubes under supervision.
Nevertheless, there are procedures in my list of objectives which will require more practice to improve my performance. I think I need supervision in ventilator settings, analyzing BDGs settings, and managing AC, SIMV, and CPAP. Additionally, I think I should be supervised when interpreting radiology reports like CT, X-Ray, and MRI. Moreover, I still need guidance when dealing with nasal packing, thoracentesis, and epistaxis management. I will allocate more time for practice and put more effort to perfect my skills in doing these procedures. I strongly believe that in the near future I will be competent enough to perform all these procedures on my own.
Considering the objectives of the practicum, my weaknesses, and strengths during my Clinical practicum, I can confidently say that I have gained much knowledge. The knowledge grants me the chance develop my vital nursing skills. Even though I have gained the skills for interpreting a 12-lead EKG results, performing CPR, and arterial puncturing for ABGS, I still have some areas of improvement before I can be fully confident in cardiology (Crawford, 2021). The areas of improvement include cardioversion, epicardial pacing and management, and permanent pace maker, among others (Bates, 2018). I will work hard to master the vital skills so that I can be confident in my next cardiology practicum.
References
Bates, J. (2018). Our focus on the task in hand should never obscure the person. Nursing Standard, 32(22), 32–33.
Chang, Y., Huang, S., Shun, S., & Lin, P. (2022). Core competence in fundamental nursing practicum scale: A validity and reliability analysis. Nurse Education in Practice, 62, 103352.
Crawford, D. (2021). Compassion and empathy in basic medical science teaching: A suggested model. Cureus, 13(12), e20205.
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