I am a type of person who loves learning and studying.

I could actually consider

myself before as an achiever. When I started my Masters degree in 2015, I was at a phase
where I had backed down from my previous self trying to be humble and acknowledging that
maybe I am not that person I considered great anymorethat after 5 years of being stuck
away from my nursing career I'm already as clueless (or maybe even more) as a beginner. But
this step I took, enrolling for a master's degree was somehow my move to re-opening myself
to knowledge and embracing new learning experiences which I believe will help me to
eventually be more confident about myself and my abilities as a nurse. In the same year, I
also took the scary move to finally apply for a nursing job at a hospital and be trained by
senior nurses who are younger than me. And now, my journey has been more than a year and
counting. I've already learned and explored a lot, yet everyday there's always new things to
learn and avenues to explore. As part of our requirement for the masters degree in nursing, we
need to complete our advance nursing practicum. And so here follows, my everyday learning
activities and insights during our 3-week stay at Perpetual Succour Hospital in Cebu City.

Date and time: March 6, 2017 (7 AM 3 PM)

Activities: General Orientation and quick tour to some parts of the Hospital

Insights/Learnings:
We have arrived at Perpetual Succour Hospital before seven oclock in the morning. Actually,
yesterday, I and 2 of my classmates tried the route from our dormitory to the hospital. We
have learned to not hesitate asking directions and be willing to talk to the locals about which
jeepney we should take since there are routes designated to jeepney thru letters +numbers.
We had to wait a little bit for Sister Gau because at that time she was a little busy. We were
entertained first by Sister May, who I've heard was once a dean of Nursing for 4 years at
SPUP. We also met Sir Christian who is an Ilocano and lived in Gattaran, Cagayan. It was so
nice to meet and talk to people who can relate to topics regarding our city and province.
On this day I have learned the vision and mission of PSH, its history and development the 80
years of existence and service. The Nursing service training officer, Ma'am Line Abellana,
was the one who gave us the birds eye view of the hospital. She also mentioned some
guidelines and important reminders for employees, staffs and interns. After which, Sidter Gau
came to us and gave more input about our stay and practicum in PSH. She has emphasized
the importance of team work, compassion and faith.
Today, I have learned that things doesn't happen the way I expected it. First, I should have not
expected a well coordinated agreement between my school and PSH. Despite that, I am
greatly thankful to Sister Gau and the rest of the Nursing division for giving us a warm
welcome.
Finally today, I have learned to be more familiar with the surroundings and how to get to the
hospital from our dormitory and back.

Problems Encountered/ Action Taken:

We were truly shocked when Sister Gau told us that she was not expecting our arrival on that
day. And because of that, she said that they were not prepared. The surprise was clearly seen
on her face. Apparently the email from our school has just arrived on that day. She told us
that had already talked to the administrator of the Asilo for our accommodation from March
8-13 and afterwards we would transfer to the hospital dorm for free. However, since it was
not coordinated well and followed up earlier, plus we were not aware of the plan, we already
have paid a month of accommodation at the dormitory we have found online. I was kind of
upset since I could have saved a lot of money for our accommodation. We have tried to talk
to our dormitory if we could withdraw some of our money so we could transfer to the dorm,
they won't allow us since we've already signed a contract. All we were left to do was accept it
and move on.

Suggestions:Recommendations:

Primarily, I suggest that next time the school initiates and mandates graduate school students
to finish their practicum at a certain location very far from the University, they should at least
make sure that it is well coordinated with the institution. They should also explore and
present the resources and options to students ways they can be able to save some money like
on accommodation or other stuff. I have felt manipulated and was left with no choice, it
would be a shame should there be more graduate school students that would feel the same
way in the future.

March 7, 2017 (8Am-8pm)

Activities: Orientation for CVL and General In-patient Wards

Insights/Learnings:

For the first 3 hours, we had an orientation regarding the General in-patient wards and the
cardiovascular lab, with the presenters Maam Christy Hisoler and Maam Pearly Pulgo
respectively. Ma'am Christy mentioned all the wards in the General in-patient and what each
unit cater to. We asked her a few questions like the structure of nursing responsibilities in the
ward, the division of labor and etc,. She was very enthusiastic in answering all our questions.

I also learned what procedures they perform in their CVL unit. Ma'am Pearly explained the
procedure both the invasive and non-invasive cardiovascular procedures. After the
discussion/orientation, we were told to proceed to our respective area of assignment. We were
divided into three groups. Our group was assigned to the General in-patient first. Ma'am
Cheska Sta. Ana, one of the Head Nurses of the General in patient met our group and she
toured us around the wards. I have learned how the aerocom (pneumatic system) basically
works, the set-up of the units among other things. She showed us the very high tech CBS
monitoring kit they use, which needs a QR code so they always wear it with their IDs. She
also showed us the forms and explained to us the use of the forms and how they're being
filled up. I have truly enjoyed the tour. Ma'am Cheska had been so nice and patient in
answering our questions.

After the tour, she assigned 2 of us at the 4 th floor/oncology ward and the other 2 at the 3 rd
floor. We were introduced to the staff and then she left us on our own. There, we were able to
witness firsthand their endorsement process. Although we were not able to go with them with
their rounds because we have not noticed when they went. Apparently, we haven't noticed
them because they didn't go together earlier because the station was so busy. I was a little
confused of the endorsement and the rounds but I know that in a few days, I'll get to
familiarize myself with their routine.

March 8, 2017

Time: 6am 6pm

Activity: Unit observation and interviewing patient for casestudy

Insights / Learnings:

Today I have learned to be brave and commute alone from our

dorm to the hospital, since my classmates/dormmates
schedule was at 7am and mine was at 6am. Today we were able
to witness full-scale endorsement and we also went with the
nursing rounds. I learned at 4th floor ward, usually there are 2
charge nurses and 2 primary nurses, and they distribute patients
accordingly to the census. I was kind of confused about their
medication endorsement since it seemed that medications on
the medication table dont lessen. I appreciate the way all nurses
take notes of special endorsement of all patients and they also
have their own notebooks. I was amazed to see a lot of resident
doctors doing their rounds. I learned that they are the ones who
refer patient's status such as lab results and other stuffs. I saw
how the charge nurse and primary nurse respond to situations like
when their patient went restless. Today I was able to find a case
for DM and a case for Oncology. I was only able to interview my
patient for DM. I have realized how cebuano's can be so
accommodating. Im just so glad that the patient can understand
and speak the Tagalog language well.

Problems / Actions taken: There has not been a particular problem

except when I cant find anything to do but stand by and look
around. Also the problem is talking to staff and
nurses cause they are not comfortable talking in Tagalog.

Suggestions / Recommendations: Same recommendation /

suggestion as yesterday
March 9, 2017

Time: 6am 6pm

Activity: Station observation and patient - interview

Insights / Learnings:

Today I was able to be a little more familiar o the set up at the

Oncology Ward. I have joined the endorsements and the rounds
again. I have learned that the charge nurse takes care of all the
chart and doctors orders and carries them out and then endorses
the orders to the primary nurse. Today, there was only one charge
nurse since the census was not that high. I have reviewed the
patients charts and studied the forms and how they are being
arranged. They have a 24-hour patient assessment and care
record which includes assessment per shift and the nurses
notes. I'm also amazed that aside from the charge nurse
reviewing the charts prior to endorsement to the incoming
shift, the head nurse also reviews them one by one. I also envy
them a little because a pharmacist goes to the station, checks the
chart and reviews if a patient is for discharge, if so the pharmacist
then makes a discharge instruction plan and be the one to
instruct the patient or the significant other. I was able to review
my patients case for Oncology and interviewed her for data. I
also helped one of the OJT nurses in verifying and double
checking a PRBC for transfusion.
Problems / Actions taken: When I find myself getting bored just
sitting and stand by looking around, I try to help by answering
phone calls and handing out charts to doctors.

Suggestions / Recommendations: Same suggestion as previous.

March 10, 2017

Time: 6am 6pm

Activity: Station observation

Insights / Learnings:
 For three consecutive days I have been traveling to and from
the hospital, I can coffee say that I am already familiar with the
way. The past few days, primary nurses were so busy that I
couldnt ask them with their medication routine but today I had
the chance to do so apparently, as I was told, the p.m. shift
nurses prepare for all medications for the next day, they are the
ones who request for the medicines and other things needed by
the patients. Primary nurses also lay the medicines for the next
shift but there is still medication endorsement prior to start of
each shift. I realized that outgoing shifts cant go home if they still
have back logs, I.e. out/dislodged IV lines that needs to be
reinserted. also learned how to manipulate the???, Also I still get
a little startled every time an??? Capsule is Being ???.Today, I also
went to the medical??? To copy one lab results of my???? Patient,
since he has been discharged yesterday but I was not able
to copy all the data but before that, I went tonursing office to ask
permission. I learned that they are really accommodating with our
request as long as it is accommodated properly.

Problems / Actions taken: Same as previous.

Suggestions / Recommendations: Same as previous.