Lafuente, Maryca Shaina M.

BSN III 2
JOURNAL NO. 1
Date: January 3, 2017
Its our first duty exposure in internal medicine
ward after a short break. Thats why Im still getting a
hard time coping with the new adjustments on my
daily routine. Since its our first day, our activity for
today is to only get the patients pertinent data and
practice our nurse-patient interaction while validating
the patients information. Honestly, Ive been skeptical
and really nervous in our first encounter. Fortunately,
Ive had a great time talking and helping my patient all
through out our shift. Shes very cooperatve and
approachable thats why it have been easier for us to
communicate well and help each other. There are a lot
of thins that Ive learned on this day but Ill just
highlight some things that have striked me the most.
First is on checking the patients chart; I should only
get the patients pertinent data to save time. While
scanning the chart, even Ive tend to copy even the
ECG findings and other laboratory findings of the
patient. Im really slow when it comes to finishing a
single task and this has been my greatest struggle
since I know that pursuing this profession would need
me to act faster that I usually do. Another thing, I
should give an adequate rest periods on my patient
especially when the patient has respi problems. Ive
noticed that ,from time to time, my patient is always

catching up her breath whenever Im having a

conversation with her. Ive not been considerate
enough on the first hours until we have been reminded
about it. So the second time I approched my patient,
Ive tried my best to be observant as much as
possibleand gave her time to rest. Keeping this things
in mind would help my patient to have adequate
amount of time to rest that would aid for her to
achieve comfort and fast recovery.

JOURNAL NO. 2

Date: January 4, 2017

It has been a tiring but fulfilling day today. My
main objective for today is to let my patient open up
more with her conditioon and to effectively render care
and health teachings not only to her but also to her
son. Weve been all out on duties unlike yesterday;
from doing the charting, monitoring and rendering care
unto the final activities at the end of the shift. I found
this day satisfying since its our first time to be
completely exposed on this kind of duty rotation
wherein were responsible for the charting for real.
Because on our previous duty rotations, we didnt
experienced writing on a nurses notes, on the KARDEX,
and even noting the I & O of the patients on the
chart, we only experienced plotting on a TPR sheet.
Moreover, Im more thrilled in practicing my writing
skills when it comes to nurses notes. Although the
usual nurses notes that we see on chart are just short
and brief, we are tend to practice writing sequentially
all the things that we have done to our patient
including the assessment, health teachings,
complaints, monitoring and interventions that we have
done to address certain problems. When it comes to
doing a daily NCP, we should only focus on the
patients problem for that day that we can solve, not
the problems that we cant achieve resolving within our
shift. Because every problems has solutions, and if
there is no solution, then dont make it a problem.
Another thing, when it comes to administration of
medication, its also important to take note about the
alternative or replacement for a medicaition in terms

of incidence of adverse reaction, not only the nursing

responsibilities before and after. We often neglected
this matter since were too focused on its mechanism
of action and other nursing responsibilities which are
also equally important, but knowing this alternatives
would help us a lot in certain emergencies or any type
of situations.

JOURNAL NO. 3

Date: January 11, 2017

Today, we have been assigned to new patients
since majority of the patients that we have handled
last week were already gone in the hospital. I've
received a patient having Hypokalemia which is
somehow challenging for me because its my first time
to handle a patient with a diagnosis focused on
Electrolyte Imbalance. Moreover, it caught me off
guard when I've realized that the patient has been
intubated and is on a mechinal ventilator. We've been
tackling the topic about this machines and
contraptions in our lecture but its still have great
difference when I've handled a patient on the actual
scene. My objective for today was to meet my
patient's needs and at the same time to learn more
about the interventions to be done on patient with this
particular condition. There has been an unexpected
incidence that have happened a while ago while the
patient has undergone weaning off. It turns out that
my patient has secretions right on the base of his
lungs. Not only secretion, but mucous plaque and with
him having an O2 saturation that goes down to 83% is

somehow an alarming sign. One thing that I've realized

that time is the importance of assessment and
continuous monitoring. If it would have been with
these noted signs, we wouldn't be able to notice that
there's already a problem on the process of weaning
off. Additionally, knowing how the mechanical
ventilationation works, its alarm system and knowing
its parts is also a big help. Another thing, health
teaching is one essential thing that we must do, not
only to the patient but also to the relatives. We've also
done health teachings in the past, but it was often
brief or is not the priority. But in this rotation, health
teaching is one intervention that is really stressed out
all through out the shift. Lastly, when encountering
this kind of case wherein the patient has a history of
V.tach and at the same time is on the need for
suctioning, I've learned the importance of weighing off
the consequences and deciding what's best for the
patient. Choosing intervention to have a winwin
situation , resolving different problems at once and
prioritizing the patient's immediate comfort is
essential when encountering this kind of situation.