Four years ago, I started a journey into a brand new profession and a brand new life.

At
the start of this journey, I thought I knew what a nurse was. I could not have been more wrong.
I thought that being a nurse was only caring for patients, passing medications and cleaning up
after patients. This program taught me what a nurse was and guided me into my new profession.
This program taught me that nurses are the front line in health care. They assess the patients and
provide valuable teaching to them.
At the beginning of my clinicals, I was nervous when meeting a patient. I did not even
know the proper way to take a patients vital signs. I was afraid that I would make a wrong
move or decision and irrevocably harm the patient. As I moved forward in the program, I gained
more skills and more importantly, more confidence. I found myself relying less on other nurses
and my instructors and relying more on myself. I began to trust my judgment and skills. A good
example of this growth can be found in my clinical immersion practicum. I was assigned to the
Critical Care Unit and Memorial Regional Medical Center. The patients on this floor were very
sick and in dire need of medical attention. While I started out on the first day by merely
shadowing my preceptor, by the end of my immersion I was providing total care for all of her
assigned patients. This included assessing them, giving medications, and making decisions
based on the data that I gathered. An example of me assessing a patient and making a clinical
decision included when a patient started to become sicker. I assessed their heart and lung sounds
and monitored their vital signs. When I noticed their blood pressure was dropping and their heart
rate was increasing, I knew they were in trouble. With my preceptor by my side, I helped make
the decision to increase their vasopressors and give them additional vasopressors. Because of
this, we helped stabilize the patient and he lived.

I have gained other skills over the years other than assessing. I gained valuable
psychomotor skills that every nurse must know. As stated before, at first I was nervous even
taking a patients vital signs. By the time of my clinical immersion, I was confidently and
adequately performing nursing skills. For example, in my immersion I was inserting Foley
catheters and taking blood samples. I was also inserting IVs and performing wound care.
Another facet where I have grown is with medication administration and knowledge. At
the beginning of this program, I did not know the different medications. By my immersion, I
was able to recognize the medications I was giving, their side effects and mechanism of action.
A good example of this can be found with the cardiac medications. The patients on the CCU had
many cardiac medications and I had to know what they did and when to give them. An example
of this is a patient who was on a beta blocker for hypertension. I noticed their heart rate was
below fifty beats a minute and I knew that I had to hold the medication because I knew the
mechanism of action of the drug.
Even though I have grown tremendously during my time at this institution, I still have
areas where I need to grow. The biggest area that I must work on is public speaking. Nurses do
a lot of public speaking in their job. They must be able to communicate in mass with their fellow
nurses and the doctors. During rounds they must be able to adequately explain about their
patients problems and their recommendations. Nurses also teach a lot of classes during the
course of their jobs. They teach health promotion classes for the public and teach classes on new
skills for fellow nursing. I must be able to confidently, adequately and effortlessly be able to
speak in public. I have to work on this in to become a registered nurse.
Another skill I must work on my communication skills. I consider this different than
public speaking. Nurses must be able to communicate valuable and time sensitive information

quickly and completely. Patients lives depend on a nurse being able to give the correct
information to fellow nurses and doctors. I find myself sometimes either giving too much
information or not enough information to my fellow healthcare workers. I must work on my
ability to communicate effectively with other healthcare workers.