NUR 460 Capstone

Practicum Log

Name__Madison McClafferty___________________________________________________________________
Practicum Agency_ChristianaCare_________________________________________________________
Department, Unit, or Division Location_2C_______________________________________
Preceptor__Geoff Shertzer________________________________________________________________
Please download and use this form to provide a thorough, detailed documentation of your practicum experience and how they helped
you meet the CCPOs/PGCs. (See example below). You may add rows as necessary to document your experiences. Students must
complete a total of 45 practicum hours. Students may submit the form periodically throughout the progression of the course. The fully
completed form is submitted in Week 13.
Date and Objectives Met Detailed Description of Experiences Hours
Times (CCPOs and/or
PGCs
9/2/23 12-2 PGC 1 Preparation for Practicum- I applied to this PGC as I gathered my knowledge that I 2
pm previously had and completed the requirements to start practicum so that I can
advance my nursing practice.
9/8/23 PGC 8 During my time this day with my preceptor, I attended a “falls meeting” where after 6
a patient falls, all those involved (nurse, provider, management) attend and discuss
how this fall could have been prevented and what lead to the fall to prevent falls in
the future. In this meeting, I was able to practice professionalism, listening to all
sides of the story and relating to my ethical teaching which I was able to see the true
reasons as to why the fall occurred and why that lead to the patients' injuries.
9/11/23 CCPO 4 I attended another meeting with my preceptor, this time it was about an ethical issue 4
regarding a TBI patient and whether the providers should be medicating him more
 to prevent further injuries to the staff. I was able to think about what I would do in
this situation as I have had a scenario like this happen to me before. Ethically, I
knew that we could not just give the patient more sedating medications, but it made
me think about how we can truly protect staff if that isn’t an ethical option.
9/14/23 CCPO 3 This day, I spent some time watching my preceptor participate in his units MDR 4
(multidisciplinary rounds) which brings together providers, social workers, and
nurses so that they can all give each other updates and discuss the care for every
patient on the unit. This happens every weekday. I was able to watch my preceptor
speak up for the patients and make sure that everyone apart of the team is doing
their part to make sure that the patient can acquire all the care they need and to be
safely discharged which is the end goal.
9/20/23 PGC 2 I sat in a meeting with my preceptor along with the head trauma doctor, physical 4
therapists, social workers, and education specialists and they discuss any issues that
were leading to any unsafe conditions to the unit how they can create better patient
outcomes. During this meeting, my preceptor discussed how many patients were
succumbing to falls because either bed exit alarms were not going off or people
were not placing them on. My preceptor decided to make an initiative to promote
patient safety by placing every patient on zone 2 bed exit alarm, so it is more
sensitive.
9/25/23 PGC 2 I attended another meeting, and my preceptor discussed the new plan with placing 6
patients on zone 2 bed exit alarm so that there is less chance for falls and injuries.
He had explained he also had a new idea to place these bed alarm pads under the
patients’ sheets that will go off as a backup if the bed exit alarm does not go off.
There is already chair exit alarm pads that are already being used and now my
preceptor wanted to start using these also for the patients safety.
10/18/23 CCPO 2 During my encounter with my preceptor this day, I attended a few meetings with 8
him. Before one of the meetings, he explained to me that this meeting was to discuss
with providers about how his unit can create change along with the providers to
increase positive outcomes with the patients. My preceptor had me think of any
 issues I was able to monitor on his unit during my practicum and any ideas I may
have that could improve these patients' outcomes. I had mentioned that I saw a trend
where there were providers who did not place correct weight bearing status orders
so nurses and PCTs were unable to ambulate patients properly which can lead to
decompensation of the patient. I stated that as a whole team (nurses, providers,
physical therapy) they should monitor the weight bearing orders so that they are in
par with the patients' recommendations.
11/16/23 CCPO 5 During this week, I was able to discuss with my preceptor what their lifelong 6
learning plan was so that I could use it as inspiration for my lifelong learning plan
that was due this week. I also monitored my preceptor attend a class that contributes
to his lifelong learning plan by continuing his education and leadership qualities.
11/22/23 CCPO 2 For my last day with my preceptor, I was able to sit in again to listen in on the MDR 5
that they do each morning. There was a specific scenario that was brough to my
preceptor’s attention causing us to have to sit in on another meeting. The scenario
was that a patient who suffered from a TBI was being sent over to the unit in the
middle of the night causing an increase in confusion for the patient. The ICU who
was sending the patient over also had just weened the patient off a Precedex drip
just that morning too. The patient ended up needing to have multiple calming
medications and restraints applied due to the increased agitation and confusion from
an unsafe overnight transfer. We attended another meeting with discussions to not
allowing this to happen again. My preceptor emphasized that it is hard to bring
patients over who already are confused to another unit during the night as it
increases the risk for agitation, confusion, and is overall not in the best interest of
the patient.