As I move towards graduation, licensure, and my first job, I am brimming with several emotions. For instance, I am incredibly excited to utilize all the knowledge and skills I have gained through lectures and clinical rotations to help those around me. I am grateful for the excellent education and experience I have had at UNE, as well as the pride that I am graduating with a degree in nursing. I also am feeling a level of anticipation for what will come with my new job but looking forward to starting this next chapter in my life.
With all that being said, I have some anxiety at the same time about all the upcoming changes and many adjustments in my life. As a new graduate, I will be encountering a new work environment and new colleagues, learning new skills, and applying skills I have learned throughout this program for the first time as a new nurse treating patients.
In addition, I am tentative about how long it will take me to adapt to the culture of my new workplace and whether my colleagues will be supportive. I worry about making mistakes, but I know I have the tenacity and committed to becoming an effective caregiver. Additional anxiety involves adjusting to the physical requirements with the long hours, shift changes, and sometimes a lack of staff. Still, I will care for myself by getting rest, eating well, and exercising whenever possible.
Although I have some anxiety about my future role as a nurse, I am incredibly grateful I am embarking on a journey to help others around me, which is my goal in life. That said, I need to focus on planning and preparing my weekly studies throughout this semester to stay on track to graduate and attain my licensure. In doing so, I will utilize the SMART goal method, which entails specific, measurable, achievable, relevant, and time-bound goals. Then, I will create a calendar to plan my weekly goals for completing assignments and other needs each week. Then, I will outline them daily with specific times applicable to complete required tasks while making them achievable and relevant to class material. Then, I will also include other obligations on the daily schedule to ensure that I meet my other responsibilities, personally and educationally, without getting overwhelmed, so it will be meaningful for me to leave time for mental, emotional, and physical health.
Regarding Nurse Logic 2.0, I will reflect on three new things I have learned from each module. Module one, “NurseLogic Knowledge and Clinical Judgement Advanced,” focused on the knowledge required for patient care and clinical judgment to ensure safe, high-quality client-centered care. Concerning the knowledge of patient care, I have learned that a nurse needs a fundamental understanding of many aspects that influence excellent patient care. I learned that considerations should be made when administering care to provide the most optimum care possible, which will help me excel in my future career in nursing. For example, one question focused on the proper application of benzocaine ear drops for pain relief in a child with acute otitis media. For this question, I was previously unaware that these drops were refrigerated; therefore, they need to be warmed to room temperature before installation. In this case, the ear drops are warmed to prevent the risk of further pain and trauma for the toddler. This is imperative information that a nurse should know, and with this new information, I will administer ear drops properly as a nurse. In addition, in this module, a question focused on the proper teaching a nurse should give to a client for dumping syndrome. Although I have previously learned about dumping syndrome, I was unaware of the appropriate education a nurse should give regarding diet. Thus, this module has taught me that a client should be encouraged to eat foods high in soluble fiber, such as peanut butter and toast, because it reduces the frequency and severity of dumping syndrome. Lastly, this module allowed me to review previous content surrounding active pulmonary tuberculosis. In this review, I learned that tuberculin is an effective screening tool for detecting a client exposed to tuberculosis who has developed antibodies. However, it is ineffective in distinguishing an active case of tuberculosis in someone previously exposed.
Likewise, for module two, “NurseLogic Nursing Concepts Advanced,” I have reviewed and learned valuable content that will significantly prepare me to become a nurse. For instance, I learned that when a client is having an allergic reaction by demonstrating urticaria and angioedema, the correct answer may only sometimes be to administer epinephrine based on what the question is asking. This question allowed me to reflect on my test-taking strategies. I need to read what the question is asking thoroughly. In this case, the question asked what the nurse should do first, with the correct answer being to determine the client’s respiratory rate. Although this question did not necessarily teach me new content, it taught me to reflect on and strengthen my test-taking strategies to excel in future exams. In addition, this module strengthened my understanding of the side effects of Betamethasone. For instance, I have learned that this medication does not affect neonatal vital signs, although it is used to prevent respiratory distress syndrome in premature infants. Instead, a complication the nurse should assess for is hypoglycemia in the neonate because this medication can lead to hyperglycemia in the mother, which thereby can predispose to hypoglycemia in the neonate within the first few hours following delivery. Lastly, this module strengthened my previous understanding of interdisciplinary collaboration among health professionals. For instance, if a client has undergone an amputation, I was previously aware that a social worker and physical therapist should be involved in coordinating care. However, I have now also learned that a dietician should also be involved in coordinating client care because they have the knowledge to help provide dietary contributions for wound and muscle repair and healing. Once again, this module allowed me the opportunity to better prepare for my future as a nurse.
Similarly, module three, known as “NurseLogic Priority setting Frameworks Advanced,” outlined the significance of priority setting and decision-making. It provided a good understanding of aids to good decision-making on prioritizing matters that could face us daily. For instance, this module enforced my education about triaging clients during a mass causality. It taught me that the highest priority of treatment is assigned to those with a life-threatening condition who also have a high probability of survival following treatment. Then, the second priority patients treated include those who have not life-threatening injuries but still have endured significant injuries. They can wait 30 minutes to 2 hours until a medical team is available to treat them. Lastly, unfortunately in a mass casualty situation, the lowest priority patients are those who do not have a high chance of survival.
Furthermore, this module taught me to utilize the “unstable versus stable priority setting framework.” This application technique gives unstable clients priority treatment because it threatens their survival. In addition, this module taught me nursing content, which is of utmost importance for nurses to know in their future careers. For instance, this module enhanced my understanding of the early manifestations of a fat embolism in a client, including a change in the client’s level of consciousness.
The final module, module four, “Testing and Remediation,” allowed me to deepen my knowledge of nursing content and skills. It also emphasized the significance of priority setting and decision-making in nursing. In addition, this module provided an opportunity to review content I have learned in past semesters that needed strengthening or provided me with new nursing knowledge I have not yet encountered. For instance, this module touched based on antihypertensive medications I learned in previous semesters, which was a helpful overview. Also, I learned that aspirin could potentially reduce the antihypertensive effects of Captopril. Therefore the patient must be educated to avoid taking aspirin if taking Captopril. Also, this module reinforced my understanding of mental health disorders that I have the potential to encounter with patients in my future career in nursing. For example, this module reviewed the manifestations of borderline personality disorder, and I learned that these include unstable relationships, impulsivity, unstable mood, and a distorted self-image. Lastly, one of the questions I was given focused on a client experiencing an anastomotic leak postoperatively following a gastric bypass, which is content material I had not encountered yet. Thus, this was an excellent learning opportunity that taught me that a gastric bypass is when the stomach, part of the jejunum, and duodenum, are bypassed by connecting the small intestine to a surgically created stomach, and an anastomotic leak occurs when gastric/ intestinal fluid leaks at the connection. Another piece of information that I have learned from this is that oliguria is a typical manifestation indicating that the client might be experiencing an anastomotic leak. Overall, this review allowed me the opportunity to better prepare for my future as a nurse.
