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?
St. Mary’s Shared Governance Council, Nursing Quality Outcomes Council (NQOC). Located in St. Marys,
Room 163.
Background

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

To identify and establish priorities for the Nursing Division to advance professional nursing practices and
impact outcomes. To empower Unit Councils by providing a mechanism for their chairpersons to share and
receive information.

The agenda began with; call to order/ prayer/reflection followed by the chair report, announcements, and
review of minutes and wrapped up with an announcement from the nigh shift committee. Throughout the
rest of the meeting, different leaders spoke about topics from the falls committee, with updates about RCAM-
CAUTI and C-Diff, and then guest speakers from Aramark and professional development spoke with the
leaders about concerns. The guest speakers from professional development spoke about the not so new
initiative with Informed consent, basically giving that responsibility back to the physician and providers.

Noticing

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

The meeting from the start seemed to be very casual, with a lot of positive recognitions to individual leaders
and their units. Although some of the reports for the fiscal year 18 did not meet their goals for the year, the
leaders were still able to recognize the positive goals that were achieved. The floor was open throughout the
entire meeting for anyone to chime in and contribute to a solution or be the voice of change. While the guest
speakers from Aramark were discussing possible solutions to issues nurses and hospitals have had in the past,
the topic became a little heated. The representatives from this company were simply there as a voice, not as a
solution. I felt that the nurses’ frustration and anger was well warranted, however I don’t think some of the
nurses handled themselves in a professional manner. I truly felt bad for the gentlemen from Aramark,
however they stood strong and agreed that these issues needed to be addressed and made it their goal to fulfill
those goals.

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.

The information being presented followed along perfectly with all of the goals for hospital, which was very
interesting to hear about on a nurse leadership perspective. All of these topics have been hot points of
conversation on the units in the hospital, especially that of CAUTIs and Falls. I know that on the unit I work
as a PCT we have been CAUTI free for a few months, and that’s simply because we have all been following
the policy of CHG bathing every 24 hours for all of our patients. St. Mary’s seems to have difficulties

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acquiring working beds from Aramark, however from my clinical experience at Memorial Regional that does
not seem to be the case. Although, there are times we encounter beds that are not working and have to wait a
little for a bed to be swapped out, those events seem to be far and few between. I notice more often nurses
tracking down IV pumps and poles at Memorial Regional. I’m curious as to why there is a difference in
supply needs, and whether or not some of the supplies at St. Mary’s is simply just outdated.

Responding

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

The nurses expressed a strong push back after the meeting with the guest speakers from professional
development regarding informed consent. These stressors were both a positive, because legally nurses should
not be the ones filling out the informed consent, but also negative because of the push back nurses are going
to receive from physicians. All the nurses in the room agreed that this was something that was well over due
to be given back to providers and physicians, but at the same time it was one of those practices that have been
done for so long that it was going to be a huge culture change. I was interested to learn that on the informed
consent form, technically the physician or providers are responsible for filling in all the blanks on the form.

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?

I would love to be apart of the sepsis committee and aid their mission in preventing sepsis fatality. Algorithms
have been put in place to first identify septic patients and then carry out life saving measures to prevent
organ involvement or to reverse severe sepsis. Through the new protocols, sepsis is being caught and treated
earlier with much better outcomes. I know personally in the ED we have implemented several code sepsis and
began treatment. It was stated during the meeting that the ED does an excellent job starting the sepsis
protocol, however the ball sometimes gets dropped once the patient reaches the floor. I would love to be apart
of this committee to help increase awareness to the public and continue to implement change.

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.

Nurse leaders use EBP to implement change and further their research to support the
best practices to be implemented in the hospital. EBP are the goals that drive hospitals to
achieve Magnet status, further driving the nurse leaders to focus their goals on what is
known to be the best practices.

https://www.ncbi.nlm.nih.gov/books/NBK2659/

What is the value of professional nursing meetings both as a part of a healthcare system and within a professional
organization?

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Professional nursing meetings implement the change and goals for the hospital organization as a whole
through communication and empowerment. From the meetings, the leaders then go back to their units within
the healthcare system and spread their wealth of knowledge regarding the best practices and ways to achieve
their goals.
Describe any changes in your values or feelings as a result of this experience.

After attending this meeting, I think I would like to eventually work my way to a nurse leader role so that
way I can eventually be the one that is the voice for change.

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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