Observation Experiences: NUR 3112P

Adult Nursing Science II Practicum

Reflection:
1. Describe a situation when you were unsure of what to do today. How did you feel? What
additional knowledge or skills do you need in order to handle a similar situation in the future
and how do you plan to acquire that knowledge? (Minimum 1 paragraph.)

The Bon Secours Care-A-Van provides healthcare to the uninsured and the majority of
the population they see does not speak English. Today, I sat with the Nurse Manager/
Charge Nurse of the Care-A-Van and essentially spoke with patients as they came off of
the van about their medications, what they did, and ways to get their prescriptions at
the cheapest price. I was unsure about what to do in this situation today because there
was a language barrier. Fortunately, the majority of the staff is bilingual and the
registration assistant/PCT was with nurse manager and patients to facilitate
conversation. This was one of my favorite observation experiences thus far because the
environment is very different than the hospital and I was able to empathize with clients
who have limited healthcare coverage.

2. What have you observed or learned about nursing roles in the given experience? What have
you observed or learned about the intraprofessional team in this setting? What did you observe
about the communication and collaboration amongst the intraprofessional team members?
(Minimum 2 paragraphs.)

The charge nurse manger, Barshell, was very welcoming and informative. She
introduced me to all of the members of the team that include the registration assistant,
driver, social worker, financial assistant, PCTs and the provider. I came into Battery
Park Christian Church Sanctuary around 8am and at this time they were setting up
things for the day. Huddle was at 8:30am and they began seeing patients around 9am.
This team is very close and the communication between everyone is professional,
friendly and they all have the same goal, which is giving help to those in need.

Computers, phones and printers are divided between the staff and they have specific
serial numbers that they have to document. Vaccines that are in the van have very
specific temperatures and have to be followed very closely. The provider and other
members of the team all have open communication and it was humbling to see how
kind they are to the patients. The charge nurse began working with the Care-A-Van last
year, but has been a nurse with Bon Secours close to 20 years. She gave me a lot of
information about the overall history of the Care-A-Van and was eager to have someone
with her to observe for the day.

3. Provide an example of holistic care that you observed. (Minimum 1 paragraph.)

A Hispanic male patient was told he had severe allergies and the provider prescribed
him a specific type of eye drops. The nurse manager was going to call CVS pharmacy
to see the cost, but he said it was okay. We explained what the medication did and what
type of regimen to follow. Shortly after the individual left, the provider put a note into
Connect Care that Barshell did not see that stated we should look into the cost of the
Rev. 4/11/17
 Observation Experiences: NUR 3112P
Adult Nursing Science II Practicum
medication because it might be too expensive. After getting into contact with the
pharmacy, the eye drops without insurance was $467.99. I communicated this to the
provider and the provider said he could just get Visine Allergy Drops which is only $10.
We told the pharmacy to cancel the prescription and pull the allergy drops to have them
ready at the counter. The interpreter called the individual and let him know the situation
and he was relieved that he did not have to pay that much money. This was a confusing
situation, but I think the staff and myself handled the situation well and provided
holistic care to the patient and took his budget into consideration.

4. Identify the National Patient Safety Goals that were observed throughout the day. Discuss the
effect of the Goals on the patients outcome. (Minimum 1 paragraph.)

The following goals were observed today, improve staff communication, reduce risk of
infection, use medications safely and identify patient safety risks. Patient outcomes
with the incorporation of these goals give patients a better future because of more
evidence- based care. Patients who were thought to be sick wore masks and all
patients are explained the purpose of medication and the importance of compliance.
Staff communication is open and professional with the main goal of giving the best care
across the board.

5. Did you enjoy this experience? Why or why not? (Minimum 1 paragraph)

I enjoyed this experience because I learned a lot about the important roles of staff and
how different it is from working in a hospital. This experience made me a little upset
because I wish I could help patients get their medications and figure out a way to
remind them about the importance of compliance. A lot of the clients that come to the
Care-A-Van show up 2 3 hours prior to them opening so they are guaranteed to see
the doctor. I cannot imagine waking up at 4am, catching a bus and waiting to see a
doctor when I am sick. I have a new outlook of the uninsured population.

6. Compare and contrast a patient issue that you observed today with an evidence-based nursing
journal article from the Nursing Reference Center (NRC). (Minimum 2 paragraphs.)

Rev. 4/11/17