Nursing Clinical Skills Essay

This essay will discuss a clinical experience in which I feel more competent in practicing. I will use a reflective model to discuss how I have achieved the necessary level of competence in my nurse training programme.The reflective model I have chosen to use is Gibbs model (Gibbs 1988). Gibbs model of reflection incorporates the following: description, feelings, evaluation, analysis, conclusion and an action plan (Gibbs 1988). The model will help facilitate critical thought process as it relates theory to practice. Discussion will include the knowledge underpinning practice and the evidence base for the clinical skill. A conclusion to the essay will then be given which will discuss my reflection skills, acknowledge my competence and show my personal and professional development. Trigger Event

The clinical skill I have chosen to reflect on within this essay is my first IV start. I have chosen this as my first clinical placement is on a surgical unit, where Intravenous therapy is a widely used to administer medication. I was very happy to finally be able to start developing this skill as I have seen it done several time and was ever able to acquire the process in which is needed to start an intravenous. Appraisal

The first stage of Gibbs (1988) model of reflection requires a description of events. As a transitioning Registered Practical Nurse to a Registered Nurse the expectation are that I will have develop this scope in my practice. I had observed this clinical skill on a variety of occasions and had previously administered IV medication and antibiotics under supervision. On this occasion I was being observed by my clinical educator. I had gathered all the necessary things I needed which included a bag of normal saline. My clinical educator was talk me through the procedure step by step and informed me that I should never place the tape on any surface as tit leads to cross contamination, and I should always clean blood from around the IV site. The facility also uses chlorhexadine instead of alcohol as eliminates stinging sensation.

The second stage of Gibbs (1988) model of reflection, which is a discussion about my thoughts and feelings. I was aware of being under the supervision of my educator and other classmates this made me feel very nervous and self- conscious. Once my professor said I am in do not advance I realize how truly nervous and under pressure I was feeling. I held my breath as I did not want this vain to blow and have to stink the patient again. This patient was an elderly gentlemen and I did not want the patient to feel that I did not know what I was doing. I thought that as I had been observed this clinical procedure on many other occasions it would be easy for me to do but it was very challenging, finding an appropriate vain, the right size of needle and wanting to get success on my first try made this a very trying experience. Exploration

Evaluation is the third stage of Gibbs (1988) model of reflection and requires the reflector to with state what was good and bad about the event. This experience was filled with emotion because for many years I have been an rpn and I always wanted to be able to start an IV and I finally got to do just that. I think the best thing about this experience is I got it the first time and my instructor made it seem so effortless. So many times I had place tape on the hand rail of a bed in preparation of taping a dressing, I never thought of the fact that I was taking all the germs from that rail onto the patient. This one little thing has caused me to change my present practice. Integration

Stage four of Gibbs (1988) is an analysis of the event, where Gibbs encourages the reflector to make sense of the situation. I will do this by exploring the skill and look for other opportunities to get more starts that I will feel more confident in my practice. In conclusion the use of this model of reflection has helped me to structure my thoughts and feelings appropriately. My level of awareness concerning evidence based practice, and its importance, has been enhanced with the use of critical reflection. My competence, within this clinical skill, has been further developed and I now feel that my personal and professional development is progressing. Using this reflective model has helped me to realise that my learning is something which I must be proactive in. Furthermore as a student nurse I have recognised that reflection is an important learning tool in practice.

Clinical rotations are a critical component of your nursing education. Your nursing clinical experience presents the opportunity to work with real patients, experience work environments you may want to pursue once you have earned your Bachelor of Science in Nursing, and learn how you will work with fellow nurses, physicians, and other members of the health care team.

It may sound intimidating, and maybe even frightening, but your clinical experience offers you a learning opportunity to build the foundation of your nursing education. Today’s guest blogger shares her clinical experience as a nursing student and how it prepared her for her life as a registered nurse and how it helped her serve as a preceptor to future generations of registered nurses. 

My Nursing Clinical Experience

The clinical experience is often times the cornerstone of the nursing student’s career.

I had a year of coursework before I began my clinical experiences. And I could. Not. Wait. I was overly enthusiastic—I had my (overly priced) starch white uniform pressed, my brand new pair of white sneakers ready to go, my trusty, never-been-used plastic mannequin named “Bob” in the nursing lab, and my stethoscope. I was ready to go.

My Very First Clinical Experience

My first clinical experience was at an extended care facility for my Adult/Geriatric Nursing class. I was there at 6:30 sharp—a feat for me even then, as I’m chronically on “Becky Time,” which is a beautiful experience of always being five to ten minutes late everywhere I go. I didn’t know anyone, as I had recently transferred into the program from a different city, and to say that I was nervous would be an understatement.

The first few days at clinicals were, in my mind, fun. Taking blood pressures, charting on my paper care plan maps; it was great.

However, a lot of my classmates did not share in my excitement. Was it 12 hours of mundane learning? Well, truthfully, yes. The nurses didn’t exactly treat us as “nurses in the making” so much as “nurses’ helpers.” We gave a lot of baths, took a lot of blood pressures, and did a lot of patient turns. I enjoyed my time, but years later, this single experience has taught me how to treat my nursing students.

Intimidating Clinicals

I tried to go into each clinical experiences with an open mind, despite any reservations I had on the branch of nursing I was studying. The coolest, scariest, most exciting part was absolutely my psychiatric nursing clinicals.

Overall it was fascinating. I loved every minute of it.

I went to a state psychiatric hospital, where I did clinicals on a floor where people were criminally declared insane, and most had been convicted of heinous crimes. However, this clinical experience, although scary (please note, I was incredibly safe), I learned so much. I learned how you can have compassion for someone who has done some things you only read about because they were in a deep state of psychosis. I was able to interview patients who had different life factors that contributed to their mental health. Overall it was fascinating. I loved every minute of it.

Using My Clinical Experience to Get a Job

My very first job as a registered nurse stemmed from a nursing clinical experience, actually.

I was in my final clinical—critical care. It was in a busy ICU, very fast passed. The nurses were kind, thoughtful, and wanted us to be there so they can teach us.

On my first day, a patient coded. Watching the staff come together in an effort to save the patient was truly a pivotal moment in my nursing career. On our lunch break that very afternoon, I went to human resources. I was interviewed for a student nursing position a few days later, and a week after that, I was offered a job on the critical care unit that I had witnessed the first code.

It was the blessing of a lifetime; I learned so much that year, and it helped me be a better student. To this day I tell student nurses to try and get a job, doing anything, in a setting that interests you. My experience also led to my first job: As soon as I graduated and passed my boards, I segued into my first job in that exact same unit.

Today I Work as a Preceptor

I am now in a position where I have student nurses. Several times a week you see the crisp white uniforms, all matching, smiling, eager faces, and always, always a clipboard.

I mostly try to teach the students critical thinking skills. I ask a lot of questions—sorry students, yes, I am that preceptor. But what I am really trying to teach my student nurses is the why of how we understood, or figured out, a specific problem. It’s the foundation of critical skill set. And it’s the role of a preceptor.

Please note: I don’t like to call you a nursing student. You are practicing and learning the art of nursing. A degree and license isn’t what makes a good nurse, it just makes a legal nurse. A real nurse is someone who cares for the sick with compassion and kindness, and knowledge behind all of that.

Clinicals are an exciting time in nursing school. It gives one the ability to experience lots of different branches of nursing. I suggest you be open and excited to be there and learn. Let your preceptor know that you’re there to learn and you’re excited to be there.

Nurses are teachers by nature; we love to teach! Be excited, and ask a lot of questions. Above all, treat your patients as you would if you were already their nurse…because a good nurse starts with kindness and goodness.

Your nursing clinical experiences are a rewarding aspect of your nursing education that teaches you so much more than the details of being a nurse. At Utica College, you will complete clinicals at top health care facilities, allowing you to build your knowledge-base and create your professional network in highly recognized facilities.

If you are ready to learn more about completing your clinicals or the online learning and simulation lab components of the Accelerated BSN program at Utica College, speak to an advisor today.

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