Running Head: LEARN REFLECTION 1

LEARN Reflection

Michaela McRae

Trent University
LEARN REFLECTION 2

LEARN Reflection #1

During the first week of placement I performed a head to toe assessment on a patient who

had a total hip surgery. I was very nervous because I wasnt one hundred percent sure how to

perform an assessment on a patient who just had a hip surgery. I wasnt exactly sure what I was

looking for in terms of a patient in this condition, and how I was suppose to move the patient so

that I didnt hurt their hip. I did read an information booklet that is given to all the patients about

their surgery. That did help me feel more comfortable in knowing how to ambulate a patient

post-op. I started my assessment by making sure my patient was oriented to person, place and

time, I then took her vitals. I noticed that her oxygen was a little low so I told her to take a few

deep breaths and put her nasal cannula back on. This increased her oxygen level so that it was

within a normal range. I was scared that I was going to forget parts of my assessment so I made a

list to refer to, however I still had awkward pauses, to remember what I had to look for. Then I

listened to her lungs, abdomen, and then looked for capillary refill, edema and pedal pulses. I

looked at her incision site and noticed that it was bleeding a little bit, I took my pen and outlined

the bleeding. When I went back I noticed that the bleeding went beyond the pen outline so I got

the nurse and together we reinforced the incision site with an abdominal pad and mefix tape.

When asking my patient about pain, I only asked general questions about pain and did not

ask further questions about the detailed characteristics of the pain my patient was experiencing.

According to the RNAO additional questions to consider during a pain assessment includes

asking what they understand about why they are having pain, any concerns they have, any help

they need to deal with their pain and if they have any fears about using any medications for pain

(RNAO, unknown). Next time I will try to incorporate some of these questions during my

assessment of pain.
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Not being able to control pain properly puts the patient at risk for complications and

chronic pain. It is important to monitor patterns in pain so pain treatment can be adjusted to the

patients needs. It is also important to know the intensity of pain during movement (Roger Chou

et al., 2016).

I also did some patient teaching and I told the patient to do calf pumps to get the blood

moving as well as about ten breaths and coughs every hour to get rid of any phlegm in the chest

from the anaesthesia during surgery. I think I can improve on patient teaching by including more

information about post-operative care.

I felt very professional caring for a patient and being responsible to recognize any

irregular findings in the assessment.

Since this first head to toe assessment I have performed for a post-operative patient, I feel

that after a few more assessments I will feel more comfortable than I did the first time. This is

realistic because I will have lots of opportunities to practice and learn. Overall, I knew more

than I thought I did and I feel more comfortable in knowing what to look for during a head to toe

assessment in a post-operative patient.

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References

RNAO (unknown). Assessment of Pain: supplementary Questions to Consider during

Assessment of Pain. Nursing Best Practice Guidelines. Retrieved from

http://pda.rnao.ca/content/assessment-pain-supplementary-questions-consider-during-

assessment-pain

Roger Chou et al., (2016). Guidelines on the management of postoperative pain. Elsevier, 17(2),

131-157. Retrieved from https://journals-scholarsportal-

info.cat1.lib.trentu.ca/pdf/15265900/v17i0002/131_moppacaecaac.xml