PRAC 6541 JOURNAL ENTRY 2 PAPER

Journal Entry
The clinical experience has been so far successful. I have encountered challenging cases that demand the use of best practices to improve care outcomes. I have also participated in a range of interdisciplinary care activities that have improved my collaboration knowledge and skills. My preceptor has also been supportive. I am learning a lot from her. Therefore, I would like to share an interesting experience from my clinical experience in this paper.

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Description
Recently, parents brought an 11-year-old female child for assessment and treatment. The child complained of fatigue, headache, and shortness of breath. Examination findings revealed that the patient was pale, weak, and dehydrated. The patient also has low blood pressure capillary refill, and an elevated pulse. Laboratory investigations showed that the patient had a hemoglobin level of 2 mg/dl. A diagnosis of microcytic anemia was made. The patient received treatments that included intravenous fluids and pain medications. Blood was taken for grouping and a blood transfusion was ordered.
Challenging
After receiving the medication and fluids, the parents were informed that their daughter had to be admitted for blood transfusion and further management. However, the parents strongly opposed their child to be transfused. They expressed their concerns that blood transfusion was unwelcome in their tradition. They considered blood transfusion evil. The parents were also concerned that their daughter would be receiving blood from an unknown person (Flores et al., 2020). The father expressed fears that their daughter could be infected with other diseases from the transfused blood. The preceptor educated the family about the benefits of blood transfusion. She also informed them about the safety of the blood being transfused and the low risk of adverse events or infection from the transfusion (Crowe & DeSimone, 2022; Hawkins et al., 2020). The parents finally agreed for their daughter to be transfused after a long period of family education.
What I Would Do Differently
One of the things that I would do differently is use case studies to demonstrate the safety of blood transfusions. I will provide the family with the statistics on blood transfusion-related adverse events and infections (Hawkins et al., 2020). I will also show them data from credible databases such as the Centers for Disease Control and Prevention on the benefits of blood transfusion and its minimal risks. I will also educate the parents about the strategies to promote adequate nutrition and iron supplementation for the family. This includes educating them about the different foods rich in iron such as red meat, soya beans, dried fruits, nuts, liver, and beans.
Cultural Differences
Cultural values, beliefs, and practices affect the uptake of blood transfusion and donation services in society. Communities have myths concerning blood transfusion and donation. Greater knowledge of the benefits of blood transfusion lowers the influence of myths on the decisions that patients, individuals, families, and communities make about blood transfusion. Some religions such as Jehovah’s Witnesses are against blood transfusion. Believers hold that Jehovah will consider those who receive blood sinners (Braester et al., 2020; Crowe & DeSimone, 2022; Mohammed et al., 2020; Ryan & Rosengart, 2022). Therefore, nurses should be competent in addressing culture-related differences that affect the uptake of blood transfusion services in their practice.
Conclusion
Overall, the clinical experience exposed me to the ethical issues that nurses encounter in their practice. I learned about the importance of patient and family-centered education to increase the uptake of healthcare services. The experience also expanded my understanding of the influence of culture on healthcare. Therefore, I will use this experience to develop competencies in addressing ethical issues in my future practice.

References
Braester, A., Akria, L., Yakir, O., Shelev, L., & Barhoum, M. (2020). Blood Myths and Ethnic-Cultural Background as Impediments in Patient Blood Management Education. Journal of Religion and Health, 59(6), 2918–2927. https://doi.org/10.1007/s10943-020-01015-6
Crowe, E. P., & DeSimone, R. A. (2022). When blood transfusion is not an option owing to religious beliefs. Annals of Blood, 7(0), Article 0. https://doi.org/10.21037/aob-21-58
Flores, C. J., Lakkundi, A., McIntosh, J., Freeman, P., Thomson, A., Saxon, B., Parsons, J., Spigiel, T., Milton, S., & Ross, B. (2020). Embedding best transfusion practice and blood management in neonatal intensive care. BMJ Open Quality, 9(1), e000694. https://doi.org/10.1136/bmjoq-2019-000694
Hawkins, L. M., Sinha, C. B., Ross, D., Yee, M. E. M., Quarmyne, M.-O., Krishnamurti, L., & Bakshi, N. (2020). Patient and family experience with chronic transfusion therapy for sickle cell disease: A qualitative study. BMC Pediatrics, 20(1), 172. https://doi.org/10.1186/s12887-020-02078-w
Mohammed, A. D., Ntambwe, P., & Crawford, A. M. (2020). Barriers to Effective Transfusion Practices in Limited-Resource Settings: From Infrastructure to Cultural Beliefs. World Journal of Surgery, 44(7), 2094–2099. https://doi.org/10.1007/s00268-020-05461-x
Ryan, C. T., & Rosengart, T. K. (2022). Commentary: Culture trumps (transfusion) guidelines. The Journal of Thoracic and Cardiovascular Surgery, 163(3), 1025–1026. https://doi.org/10.1016/j.jtcvs.2020.04.129

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JOURNAL ENTRY #2

Critical reflection of your growth and development during your practicum experience in a clinical setting has the benefit of helping you identify opportunities for improvement in your clinical skills while also recognizing your clinical strengths and successes.

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This week, you will write a Journal Entry reflecting on your clinical strengths and opportunities for improvement.

Journal Entry (2–3 pages):?

Based on your experience,

Describe an interesting case or a case that you have never seen before.

Explain what you found challenging.

Explain what you would do differently from your Preceptor.

Explain the cultural differences you found challenging.

RESOURCES

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

LEARNING RESOURCES

Required Readings

Mold, J. W., Fox, C., Wisniewski, A., Darby Lipman, P., Krauss, M. R., Harris, D. R., Aspy, C., Cohen, R. A., Elward, K., Frame, P., Yawn, B. P., Solberg, L. I., & Gonin, R. (2014). Implementing asthma guidelines using practice facilitation and local learning collaboratives: A randomized controlled trial.Links to an external site. Annals of Family Medicine, 12(3), 233–240. http://doi.org/10.1370/afm.1624Links to an external site.

National Heart, Lung, and Blood Institute. (2012). Expert panel report 3 (EPR3): Guidelines for the diagnosis and management of asthma (EPR-3), 1–12.Links to an external site. https://www.nhlbi.nih.gov/health-topics/guidelines-for-diagnosis-management-of-asthmaLinks to an external site.

Ralston, S. L., Lieberthal, A. S., Meissner, H. C., Alverson, B. K., Baley, J. E., Gadomski, A. M., Johnson, D. W., Light, M. J., Maraqa, N. F., Mendonca, E. A., Phelan, K. J., Zorc, J. J., Stanko-Lopp, D., Brown, M. A., Nathanson, I., Rosenblum, E., Sayles, S., III, & Hernandez-Cancio, S. (2014). Clinical practice guideline: The diagnosis, management, and prevention of bronchiolitis.Links to an external site. Pediatrics, 134(5), E1474–E1502. https://go.openathens.net/redirector/waldenu.edu?url=https://doi.org/10.1542/peds.2014-2742.

Links to an external site.

Note: This resource is the most current clinical practice guideline.

Practicum Resources

HSoft?Corporation. (2019).?Welcome to MeditrekLinks to an external site.. https://edu.meditrek.com/Default.html

Note: Use this website to log in to?Meditrek?to report your clinical hours and patient?encounters.Links to an external site.

Walden University. (2019). MSN nurse practitioner practicum manualLinks to an external site.. https://academicguides.waldenu.edu/fieldexperience/son/formsanddocumentsLinks to an external site.

Walden University Field Experience. (2019a). Field experience: College of Nursing.Links to an external site.?https://academicguides.waldenu.edu/fieldexperience/son/homeLinks to an external site.

Walden University Field Experience. (2019b). Student practicum resources: NP student orientationLinks to an external site..

https://academicguides.waldenu.edu/StudentPracticum/NP_StudentOrientation

BY DAY 7

Complete your Journal Entry #2 Assignment.

SUBMISSION INFORMATION

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

To submit your completed assignment, save your Assignment as WK5Journal2+last name+first initial.

Then, click on Start Assignment near the top of the page.

Next, click on Upload File and select Submit Assignment for review.

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Rubric

PRAC_6541_Week5_Journal2_Rubric

Criteria

Ratings

Pts

This criterion is linked to a Learning OutcomeAssimilation and Synthesis: Content Reflection

50 to >49.0 ptsExcellent

Reflection demonstrates a high level of critical thinking in applying and integrating key course concepts and theories from readings, lectures, and/or discussions. Insightful and relevant connections are made through contextual explanations and examples.

49 to >39.0 ptsGood

Reflection demonstrates a moderate level of critical thinking in applying and integrating key course concepts and theories from readings, lectures, and/or discussions. Connections are made through explanations and/or examples.

39 to >30.0 ptsFair

Reflection demonstrates minimal critical thinking in applying and integrating key course concepts and theories from readings, lectures, and/or discussions. Minimal connections are made through explanations and/or examples.

30 to >0 ptsPoor

Reflection lacks critical thinking. Superficial connections are made with key course concepts and resources, and/or assignments

50 pts

This criterion is linked to a Learning OutcomeAssimilation and Synthesis: Personal Growth

30 to >29.0 ptsExcellent

Expresses solid evidence of reflection on own work. Demonstrates substantial personal growth and awareness of deeper meaning through inferences, well-developed insights, and significant depth in awareness and challenges. Synthesizes current experience into future implications.

29 to >19.0 ptsGood

Expresses moderate evidence of reflection on own work. Demonstrates satisfactory personal growth and awareness through some inferences, insights, and challenges. There is mention of the future implications of student’s current experience.

19 to >9.0 ptsFair

Expresses minimal evidence of reflection on own work. Demonstrates less than adequate personal growth and awareness through limited or simplistic inferences made, insights, and/or challenges that are not well developed. Minimal thought of future implications of student’s current experience.

9 to >0 ptsPoor

Expresses inadequate evidence of reflection on own work. Personal growth and awareness are not evident and/or demonstrate an impersonal experience. Lacks personal insights, challenges, inferences, and/or future implications are overlooked.

30 pts

This criterion is linked to a Learning OutcomeWritten Expression and Formatting

15 to >14.0 ptsExcellent

Well written and clearly organized using standard English, characterized by elements of a strong writing style and basically free from grammar, punctuation, usage, and spelling errors.

14 to >10.0 ptsGood

Above average writing style and logically organized using standard English with minor errors in grammar, punctuation, usage, and spelling.

10 to >5.0 ptsFair

Average writing style that is sometimes unclear and/or with some errors in grammar, punctuation, usage, and spelling.

5 to >0 ptsPoor

Poor writing style lacking in standard English, clarity, language used, and/or frequent errors in grammar, punctuation, usage, and spelling. Needs work.

15 pts

This criterion is linked to a Learning OutcomeAPA

5 to >4.0 ptsExcellent

No APA errors

4 to >3.0 ptsGood

Contains 1-2 APA errors

3 to >1.0 ptsFair

Contains 3-5 APA errors

1 to >0 ptsPoor

Contains > 5 APA errors

5 pts

Total Points: 100

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PRAC 6541 JOURNAL ENTRY 2 PAPER

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PRAC 6541 JOURNAL ENTRY 2 PAPER