D224 Final Field Experience Log: Patient Care & Education Summary

D224 Final Field Experience Log: Patient Care & Education Summary

D224 Final Field Experience Log: Patient Care & Education Summary

Name

Western Governors University

E224 Global and Population Health

Prof. Name

Date

D224 Final Field Experience Log: Patient Care & Education Summary

Description of Field Activity

During a 10-hour clinical shift at an outpatient clinic, I shadowed a BSN-prepared nurse preceptor who demonstrated essential nursing roles encompassing patient education, interprofessional collaboration, communication, referral facilitation, and resource management. These activities were integral in supporting patient wellness and preventive care.

The nurse preceptor administered influenza vaccines to more than 20 patients, utilizing a vaccination screening checklist to ensure patient safety. Beyond the technical task of vaccination, the preceptor provided education on the importance of flu shots, highlighting their role in reducing the incidence of illness, hospital admissions, and mortality associated with influenza. This educational effort contributed to increased vaccine acceptance among patients.

Focused assessments were conducted, including blood pressure reviews for patients. For example, two male patients aged 52 and 56 had blood pressure readings ranging from 120/70 to 137/90 mmHg. After consulting the physician, the nurse arranged referrals for laboratory tests and electrocardiograms. Patients were educated about the risks of hypertension—such as stroke, kidney failure, and retinal damage—and counseled on lifestyle modifications, including regular exercise, weight management, and reducing sodium intake. Additionally, the preceptor managed medication prescriptions by coordinating with pharmacies and addressed patient phone inquiries related to medication and health guidance.

How Does the Nurse’s Role Promote the Sphere of Care?

Nursing ActivitySphere of CareRationale
Flu vaccine administrationWellness and Disease PreventionImmunization prevents severe flu complications, reduces hospital admissions, and lowers mortality (CDC, 2023).
Patient education on hypertensionWellness and Disease PreventionLifestyle counseling supports blood pressure control and helps prevent cardiovascular disease.
Blood pressure monitoring & referralsWellness and Disease PreventionEarly detection and diagnostic testing prevent hypertension-related complications.
Prescription managementWellness and Disease PreventionEnsures timely access to medications, supporting effective disease management and safety.
Communication and patient supportWellness and Disease PreventionClear communication improves patient adherence and health outcomes.

The nurse’s role in administering flu vaccines actively contributes to disease prevention by protecting individuals against serious infections. By performing hypertension assessments and facilitating referrals, the nurse reduces cardiovascular risks. Efficient communication and collaboration with healthcare providers and pharmacies ensure continuity of care, reinforcing the nurse’s vital role in promoting overall wellness and preventive health.


Description of Field Activity on January 26, 2024

During a 10-hour clinical shift, I observed the BSN nurse preceptor carefully review patient charts and laboratory results alongside the clinic physician to identify necessary interventions and referrals. The patient population mainly included stroke survivors aged 37 to 70 years, most presenting with unilateral weakness.

One significant case was a 67-year-old male patient experiencing mild headaches and muscle spasms on his affected side. Laboratory results showed hyponatremia with a sodium level of 131 mEq/L. Following discussion with the physician, Lasix was discontinued, and Robaxin was prescribed for muscle spasms. The nurse preceptor educated the patient about these medication changes and arranged follow-up care.

Another patient, a 45-year-old male with iron deficiency anemia, reported difficulty swallowing iron tablets. The nurse advocated for a switch to liquid iron supplements, coordinated with the pharmacy for a new prescription, and provided nutritional counseling. A referral to a dietitian was also organized to support dietary needs.

Additionally, a 63-year-old patient with traumatic brain injury needed assistance with health insurance changes to continue rehabilitation. The nurse collaborated with a social worker to facilitate paperwork and ensure uninterrupted care.

The preceptor provided education to stroke patients and caregivers focusing on fall prevention, including the use of assistive devices, home safety modifications, and recognition of warning signs warranting medical attention. Patients received stroke guide pamphlets to reinforce this information.

How Are These Nursing Activities Related to the Sphere of Care?

Nursing ActivitySphere of CareRationale
Focused assessment and lab reviewRegenerative/RestorativeEarly detection and treatment optimize stroke recovery and prevent complications.
Medication advocacy and educationRegenerative/RestorativePromotes medication compliance, supporting oxygen transport and preventing anemia-related issues.
Insurance assistance through social workRegenerative/RestorativePrevents care disruptions, supporting continuous rehabilitation and recovery.
Fall prevention education and referralsRegenerative/RestorativeEnhances patient safety and promotes independence during recovery.

The preceptor’s focus during this shift was restorative care, prioritizing patient recovery optimization and prevention of further health deterioration. Activities included care coordination, medication management, and addressing social factors such as insurance—critical components of regenerative nursing care.


Description of Field Activity on January 30, 2024

On a 9-hour clinical shift, I observed the BSN nurse preceptor participate in an Interdisciplinary Team (IDT) meeting, advocating for increased therapy time to allow comprehensive patient education on medication management and lifestyle modifications. Family members supported these proposed adjustments.

Throughout the day, the nurse administered COVID-19 booster and influenza vaccines, providing safety pamphlets and educating patients on vaccine benefits.

A critical event involved a patient presenting with hypoglycemia (blood glucose level of 66 mg/dL) without a diabetes history. The nurse promptly followed hypoglycemia management protocols, stabilized the patient, and arranged referrals to food assistance programs such as the North Texas Food Bank and Temporary Assistance for Needy Families. The physician was notified, and laboratory tests including HbA1c were ordered.

The nurse also delivered smoking cessation counseling, explaining the risks of tobacco use such as lung cancer and emphysema. One patient accepted nicotine patch prescriptions to support quitting.

Colon cancer screenings were conducted for four patients over age 60 using Cologuard kits. The nurse explained the importance of early cancer detection and collected stool samples for laboratory analysis.

Connection of Nursing Activities to the Sphere of Care

Nursing ActivitySphere of CareRationale
IDT meeting participation and advocacyWellnessAdjusting care plans ensures patients receive necessary education, improving disease prevention and management.
Vaccine administration and educationWellness and Disease PreventionImmunizations protect against influenza and COVID-19.
Hypoglycemia management and referralsWellness and Disease PreventionEarly intervention and social support prevent complications and promote health.
Smoking cessation educationWellness and Disease PreventionCounseling reduces risks of chronic diseases linked to tobacco use.
Colon cancer screeningWellness and Disease PreventionEarly detection enhances treatment success for colorectal cancer, a major health concern in older adults.

These nursing activities demonstrate the nurse’s critical role in advancing health and wellness through preventive care, patient education, and timely interventions, thereby improving patient outcomes and quality of life.


References

Centers for Disease Control and Prevention. (2023). Influenza (flu)https://www.cdc.gov/flu/index.htm

National Heart, Lung, and Blood Institute. (2022). High blood pressure (hypertension)https://www.nhlbi.nih.gov/health-topics/high-blood-pressure

American Stroke Association. (2023). Stroke recovery and rehabilitationhttps://www.stroke.org/en/about-stroke/recovery

American Diabetes Association. (2023). Hypoglycemia (low blood sugar)https://www.diabetes.org/diabetes/complications/hypoglycemia

National Cancer Institute. (2023). Colorectal cancer screeninghttps://www.cancer.gov/types/colorectal/patient/colorectal-screening-pdq