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NSG 123 Reflective Summary: Post-Surgical Patients

Daniel Pompa

St. Joseph’s College of Nursing

NSG-123: Health & Illness Across the Lifespan

Amanda Brigandi

February 20th, 2024

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Mission Reflection

My mission statement in NSG 110 was to act in accordance with a professional who

provides all-encompassing, compassionate, excellent care to patients. I agree with this, but I

would like to elaborate on it in my second semester. I would like to behave consistently with

constant improvement of care, skills, assessments, and other tasks associated with care. As I have

begun to learn more about nursing, I have learned more about nurses' niche skill sets. For

example, wound nurses are precious, and this is one certification I will be pursuing after

graduation that I would not have had any interest in pursuing if not for my clinical experiences.

My revised mission statement would read as follows: My mission statement in NSG 123 is to

stay committed to constant self-improvement and the pursuit of knowledge to improve patient

care and outcomes.

Theory Objectives

As a nursing student, I am responsible for being the registered nurse’s eyes and ears for

my assigned patient. I can document my learning and the assessment findings I observe as a

student by completing a care plan guide. The nursing student is typically only assigned to one

patient, while the registered nurse is assigned to several patients. This gives me a unique

opportunity to provide constant one-on-one care and develop a strong rapport with each patient

despite the short two-day length of care. This constant care also helps develop a holistic view of

the patient’s situation as it helps them tend to their activities of daily living and manage the

medical problems they have been hospitalized for. Being in or near the room allows an excellent

opportunity to speak with the doctors and relay important information or advocate for the patient.

The RN and doctor are rarely in the room at the same time; it is less rare that the nursing student
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and doctor are in the room at the same time. I am expected to understand the fundamentals of

nursing and when to provide simple care. For example, as a novice nursing student, I am

expected to know to hold antihypertensives if a patient's systolic is below ordered parameters. I

am also expected to know not to administer an anticoagulant to a patient with platelets of 50,000.

I am expected to understand intervention prioritization. I am also expected to understand the

basic process of administering medications, including learning about unknown medications,

reviewing each medication, its indication, whether administering it at this time is ordered and

appropriate, verifying the patient, scanning the meds, and adequately documenting

administration. The nursing student is also expected to know to take blood pressure and heart

rate before administering blood pressure medications. As a nursing student, I must also

understand basic assessment skills and when assessments may be contraindicated. For example,

deep palpation is contraindicated in patients with an abdominal aortic aneurysm. I am also

expected to know what situations not to give a patient what they are asking for; for example, an

NPO asking for water must be told no. The novice nursing student is expected to be able to

therapeutically communicate to the patient why they cannot have water while also

acknowledging their emotional status, perhaps being influenced by sleep deprivation, lack of

food, water, or pain. I learned the most about the selected patient population: the postoperative

gastrointestinal or genitourinary patient. These patients are usually in significant pain from their

procedures and often require analgesia. Still, the risks of administering analgesia in this

particular patient population must also be weighed against the risk of causing a postoperative

ileus. This patient population also often needs a calorie and high-protein diet. Still, it is often

unable to tolerate large amounts of food due to abdominal procedures or pain. This is a crucial

area where I can intervene and find ways to supplement the patient's diet with additional calories
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to facilitate wound healing. Examples may include oral hygiene before and after meals to

improve salivation and taste perception, assessing a patient's dietary preferences, ordering

different flavors of high-calorie protein shakes, placing meals in a clean and tidy environment,

and administering prophylactic antiemetics are some nursing interventions to increase caloric

intake.

Clinical Objectives

As a nursing student, I plan to execute my mission statement by constantly improving my

assessment skills. One skill that I would like to continue to improve on is the assessment and

care of wounds, particularly venous and arterial ulcers. In NSG 123, I was able to build a

foundation for wound care as I was opposed to many different wounds and was able to begin

using the nursing process to care for wounds. Assessment and diagnosis of different types of

wounds, planning care and consulting (asking for a consult) wound care, implementing the plan

with the attending nurse and clinical instructor, and evaluating the plan afterward. The nursing

student has a unique opportunity to evaluate the effectiveness of the intervention and report

abnormal findings to the RN, as the RN may be forced to prioritize another intervention that may

be more important. This close and careful assessment by the nursing student helps contribute to

safe, effective, and high-quality patient care. The nursing student is also a presence for families

that may be anxious and may have simple questions regarding the patient's care. I have become

familiar with some basic concepts of wound care, hydrocolloid occlusive dressing, transparent

dressing, mepilex, and in what situations some may be more beneficial for the patient. For

example, hydrocolloid occlusive dressing creates a barrier that may be helpful for patients with a

high-risk dry wound.