NURS 3020

Self-Identified Learning Objective #1

Learning Gap #1: Based on my recent experience in acute care, I would like to improve my skills when performing a head-to-toe assessment. Specifically, I would like to build confidence when asking questions, be able to better landmark cardiac and respiratory sounds, and become familiar with organ placement when I am palpating the abdominal area.

SMART Goal #1 (Code Principle 3): I will be able to perform a head-to-toe assessment without external prompts by practicing in the unit and at home using the references Jovette provided. By March 18th, Jovette or the nurse I am shadowing will validate my head-to-toe assessment. By meeting this goal, I will be able to identify changes in a patient’s condition and notify members of the healthcare team to prevent critical situations.

Learning Goal #1:

Complete 6 head-to-toe assessments on the unit by March 17th
Watch a head-to-toe assessment on YouTube every week until March 17th
Have a nurse evaluate and provide feedback on my head-to-toe assessment on March 3rd/4th

Reflect on the Plan: It will be completed on April 8th, 2022

Self-Identified Learning Objective #2

Learning Gap #2: I feel overwhelmed in terms of the advice and education I should provide to my patients around various diseases. I would like to become more confident and knowledgeable when teaching clients about diabetes, asthma, or cardiovascular disease.

SMART Goal #2 (Code Principle 2): I will confidently provide patient education about diabetes, asthma, and cardiovascular disease by using evidence-based practice and research to gain competence around the risk factors, signs and symptoms, and how to manage these common conditions. By March 18th, I will have provided three different health teachings and have clients state back what they have learned to confirm they understand. By meeting this goal, my patients will be able to better contribute in managing their illness and be able to identify any concerns they have when managing their disease.

Learning Goal #2:

Develop “cheat-sheets” for diabetes, asthma, and CVD by February 11th
Share my cheat sheet with Jovette to ensure the information is correct and relevant by February 11th
Become familiar with the information and prepare for possible questions by practicing on a family member by March 3rd

Reflect on the Plan: It will be completed on April 8th, 2022

Self-Identified Learning Objective #3

Learning Gap #3: Although SafeMedicate has been a safe place for me to practice and test my skills when calculating dosages, I have little experience using automated medication dispensing systems and giving injections. I would like to maintain a 0% medication administration error rate throughout my acute care placement and remaining nursing career.

SMART Goal #3 (Code Principle 3): I will maintain a 0% medication administration error by taking my time with calculations and asking for clarification from other staff members before I administer any medications. I will also ensure the 5 rights of medication administration are met before dispensing any drugs. On March 18th, this rate will still be at zero. Being able to properly administer medications without error is realistic as it is a necessary skill all nurses should aim for to ensure patient safety.

Learning Goal #3:

Practice SafeMedicate modules weekly until March 18th
Double-check each medication calculation with a nurse on the floor until March 18th
Ensure the 5 rights of medication administration (patient, drug, route, time, and dose) are met with each medication until March 18th

Reflect on the Plan: It will be completed on April 8th, 2022

NURS 3021

Learning Needs:

Insertion of a subcutaneous line
Strengthen my understanding between illnesses and treatments
Understand cultural and ethical procedures during post-mortem care
Accurately chart patient findings in EPIC with as much detail as possible

Learning Goal 1: By June 3, I will successfully insert a subcutaneous line that will be used for medication administration to provide comfort to a palliative patient and will be measured by the absence of blood, leaking, bruising and other abnormal characteristics.

How I will Achieve Learning Goal 1:

Review, test, and practice the steps required to insert a subcutaneous line through Elsevier videos and lab practice by April 29th.
Observe a nurse on D2 insert a subcutaneous line into a patient by May 19th
Gain additional practice inserting a subcutaneous line at an open lab session by May 23rd
Attempt inserting a subcutaneous line on a patient by May 27th

Learning Goal 2: By June 3rd, I will have participated in culturally safe and ethical post-mortem care where I will feel comfortable preparing the body for viewing and for the morgue, understand the organ donation process, and fulfill the family's unique wishes.

How I feel Achieve Learning Goal 2:

Review the Elsevier post-mortem checklist and videos by May 5th
Reflect on any personal thoughts and feelings that may hinder my ability to properly engage in providing post-mortem care
Become familiar with PRHC’s post-mortem process by reviewing their policies regarding care after death by May 6th
Assist in at least 2 post-mortem care services by June 3rd

How I will Achieve Learning Goal 2:

Review the Elsevier post-mortem checklist and videos by May 5th
Reflect on any personal thoughts and feelings that may hinder my ability to properly engage in providing post-mortem care
Become familiar with PRHC’s post-mortem process by reviewing their policies regarding care after death by May 6th
Assist in at least 2 post-mortem care services by June 3rd

Learning Goal 3: By May 19th, I will accurately chart on my patients with as much detail as possible using the templates created by EPIC and will do so immediately following each interaction so I can ensure I am not forgetting any details to minimize the risk of patient safety issues.

How I will Achieve Learning Goal 3:

On May 5th, I will ensure I have access to EPIC and refresh my memory by navigating through the program to become familiar with the different areas to be charted in (i.e. different flowsheets, intake/output, etc.)
Between May 5th-May 13th I will make practice charting on my patients with the help of my nurse to ensure I am accurately recording my findings and providing enough detail
Between May 5th-May 13th, I will make notes about the areas I am unsure of (e.g. the autofill selections regarding the appearance of a wound) and do research to strengthen my knowledge of what these characteristics actually look like
On May 19th, I feel begin charting independently based on my findings and interventions and understand what the different flowsheets/autofill boxes indicate

How do my learning goal support my commitment to continuing competency?

My learning goals relate to the competencies of my practice in palliative care as they are essential for overall patient wellbeing. For example, the first goal will promote comfort and quality of life as inserting a successful subcutaneous line will allow for medication to be administered with little pain. Secondly, performing ethical post-mortem care demonstrates dignity and sensitivity to both the patient and their family. Finally, accurate and detailed charting will allow for better communication and for any changes in the clinical state to be observed.