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 attended the Nursing Quality Outcome Council meeting scheduled from 8:00 AM to 12:00 PM at St. Mary’s
Hospital in the education center auditorium.
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 purpose of the professional nursing meeting was to identify and establish priorities for the Nursing Division to
advance professional nursing practice and impact outcomes, and to empower unit councils by serving as a means for
their chairpersons to share and receive information. The agenda of the group is to report on quality outcomes, best
practice updates, plans of action, and communicate progression towards established goals. The desired outcomes of
the meeting included the following: identify information to implement on units to decrease falls and staff injury;
learn and understand the correlation between increase in fall rate and decrease in patient perception of hourly
rounds; develop a greater understanding of the AHRQ Culture of Safety Survey; learn Strategic Planning Council’s
plan for nurse preference communication to staffing office. Many issues were addressed and discussed throughout
the meeting, such as the Magnet status of St. Mary’s Hospital, enhancing cafeteria experience, nursing shortage,
PCT career fair at local schools of nursing, icons added to the bedside Schmid tool, purposeful hourly rounding,
employee injuries and prevention, Culture of Patient Safety Survey, and working relationships with new graduate
nurses.

Noticing

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

I initially noticed that several nursing students attended the meeting. There were as many students present as there
were staff members. The staff members present at the meeting were highly engaged in the discussion, and
contributed thoughtful questions and solutions. Staff reached out to students for opinions on topics, such as
recruiting patient care technicians, barriers to working throughout nursing school, and the difficulties associated
with applying for an RN position as a new graduate. I actively listened during the meeting, discussed related topics
with peers, and took notes on the information presented.

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 topics discussed are real issues occurring in the clinical setting that nurses can greatly influence, such
as a culture of patient safety. I feel it is important to assess current practice, and identify ways in which it can be
improved for better patient outcomes. In personal previous experiences as a student nurse, promotion of patient
safety is a topic that I have discussed. Assessment is a vital component of nursing, including assessment of the
patient’s surroundings. I have discussed dangers in the patient’s immediate environment that increases their risk of

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falling, such as lines/cords, slippery floors, clutter, etc. Additionally, I have considered medications my patients
receive as a risk for falling. A multitude of factors must be taken into consideration when striving to maintain patient
safety.

The correlation between the increase in patient fall rates and decrease in purposeful hourly rounding was discussed.
A staff member highlighted that not only do patients receive significant benefit from hourly rounds, but so do
nurses. This proactive approach increases patient safety, improves perception of patient care and satisfaction,
reduces skin breakdown, decreases patient anxiety and pain, increases efficiency, decreases call bells, creates a calm
unit environment, and proactively addresses patient needs.

Responding

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

I did not experience negative stress while attending the professional meeting. I found it to be very informative,
productive, and engaging. Staff members were very welcoming of students, and encouraged our participation by
asking us questions and inviting us to future meetings. The atmosphere of the meeting was very relaxed and calm.
No one individual did the majority of the talking, several individuals shared throughout the meeting. Questions, new
ideas, opinions and feedback were all welcome at any time, and acknowledged.

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?

If I were to present my unit in this group, I would be fulfilling a representative role. Nurses at the meeting from
various units presented statistics on patient safety in their working environment, information for practice
improvement, plans of action, etc. I would participate in the night shift committee, as I will be working night shifts
starting my career as a new graduate RN.

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.
Tolson, D., Mcaloon, M., Hotchkiss, R., & Schofield, I. (2005). Progressing evidence-based practice: An effective
nursing model? Journal of Advanced Nursing, 50(2), 124-133. doi:10.1111/j.1365-2648.2005.03371.x

The authors of the cited journal article above discuss factors that hinder and promote nurses’ involvement in the
development of evidence-based practice. The findings of the discussed evaluation conclude that participating in a
community of practice, such as a committee, strengthened the sense of professional identity and facilitated
progression of evidence-based practice and patient outcomes. Challenges included lack of a learning-at-work
culture, insufficient time, and feelings of geographic and/or professional isolation.

What is the value of professional nursing meetings both as a part of a healthcare system and within a professional
organization?
Professional nursing meetings are of great value as they serve a purpose of fostering regular communication among
nurses, sharing and promoting evidence-based practice updates, discussing plans of action based on gathered data
within the clinical setting, and identifying areas for improvement.

Describe any changes in your values or feelings as a result of this experience.

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I feel further motivated to attend professional nursing meetings in my future career as a result of this experience. I
found the meeting to be very insightful and informative. I enjoyed conversing about areas for improvement in
response to issues within the clinical setting. It seems the issues discussed are universal, affecting several of the
hospital units. I believe the meetings are truly beneficial in improving nursing practice and ultimately patient
outcomes.

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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