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REFLECTION ASSIGNMENT

The end result should be a 1-2 page typedpaperOriginal Work, NO PLAGERIESM, APA Format.

Growth as a nursing student requires one to "return to" an incident or event (positive or negative) and reflect on the reasoning behind decision-making. Through critical reflection, nurses become aware of their personal beliefs, feelings and knowledge that influence their actions.

The student is to choose an incident that occurred during one of the clinical days this week. The issue can be from the patient's pathophysiology, education needs, psychosocial needs, socioeconomic conditions, cultural/religious concerns, or a combination of these factors. It can be an incident like a cardiopulmonary arrest, a procedure like a dressing change or bladder catheterization, or an interaction (positive or negative) with a family member, staff person, or physician.

Paragraph 1: Briefly describe the scenario.

I was assigned a patient who is 93 years old and 75 lbs with a blood pressure of BP 95/58 Right Arm I was assigned to take her vitals and rotate her every 2 hours due to impaired skin integerity. She was going to be discharged in a few days for dialysis and then will be transferred to hospice. She was admitted for acute ischemic stroke anterior/lateral left frontal lobe.Patient's secondary Diagnosis was AV Fistula thrombosis anemia. I read the patient's progress note from the physician and it statedthat here family members were apprehensive in regards to letting her go, however understood this is what's best for her. Quality of life would be poor;Pt. transferred to nursing home.

Paragraph 2: Explain the issue. Patient no longer speaks, cannot report pain and is being fed through a PEG tube. She has aphasia; due to stroke and age she is frail; she has limitations and requires assistance when moving. For fall risk nurse assessed w/Morse Fall free environment should be maintained

- High Risk 10-12 pt scored 11 on the Braden scale
- Aspiration precautions routine

Paragraph 3: Use the Critical Incident Analysis Model below, and reflect on what occurred. Address the relevant questions. The end result should be a 1-2 page typed paper, submitted to your clinical instructor each week by the deadline established by the instructor.

Critical Incident Analysis Model

1 What were the consequences of this for the patient, others, myself? Patient will go to dialysis than hospice for end of life care

2 How do I feel now about the experience? I felt hurt when I read her Progress Note. One of the family members did not want to let her go and ultimately made the choice to send her to hospice.

From Johns, C. (1995) Framing learning through reflection with Carper's fundamental ways of knowing in nursing. Journal of Advanced Nursing, 22(2), 226-234.

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