Journal # 2

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To prepare:

  • Refer to the current Clinical Guidelines found in this week’s Learning Resources and consider how these guidelines inform your clinical experience.
  • Refer to your FNP or AGPCNP Clinical Skills and Procedures Self-Assessment Form you submitted in Week 1, and consider how your self-assessment might inform your Assignment.
  • Refer to your Patient Log in Meditrek and reflect on Weeks 6–10 of your clinical experience, and reflect on your observations and experiences with patients during this time.

Journal Entry #2 

In your journal entry, answer the following questions:

Learning and Experiences

Reflect on the 3 most challenging patient encounters and discuss what was most challenging for each.

  • What did you learn from this experience?
  • What resources did you have available?
  • What evidence-based practice did you use for this patient?
  • What new skills are you learning?
  • What would you do differently?
  • How are you managing patient flow and volume?
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  • Refer to the Most challenging patients I have encounter in the OB-GYNE clinic:

-33 years old patient who is a previous c-section and refused to be examined by a male provider and has other underlying issues yet sets limitation on which test and procedures she allows to be done.It was also hard for her to trust me as a nurse practitioner student to do my physical assessment, history taking and other procedure such as vaginal exam because she has doesn’t trust student she also does not keep her appointment and scared about everything about her pregnancy.

 

-Second patient is a Cash pay only patient who is a 2 weeks post partum patient who left the hospital against medical advice 2 week ago because the doctor advised her to get a blood transfusion and she refused it because she doesnt wanna pay more but she presented to the clinic with syncope and passing blood clots and still refused to be readmitted.

 

Third patient is a 14 years old who presented to the office c/o abdominal cramps and left breast redness, swelling  and tenderness.Who was accompanied by her other in the exam room and is afraid to talk during history taking and assessment. 

 

Communicating and Feedback

Ask yourself the following self-reflective questions:

  • How might I improve on my skills and knowledge, and how do I communicate that back to my Preceptor?
  • How am I doing? What is missing?
  • What type of feedback am I receiving from my Preceptor?

RESOURCES:

Fowler, G. C. (2019). Pfenninger and Fowler’s Procedures for Primary Care (4th ed.). Elsevier.

  • Section 10, “Obstetrics”
    • Chapter 162, “Dilation and Curettage” (pp. 1093–1099)

Fanslow, J., Wise, M. R., & Marriott, J. (2019). Intimate partner violence and women’s reproductive health. Obstetrics, Gynaecology & Reproductive Medicine, 29(12), 342–350. https://doi-org.ezp.waldenulibrary.org/10.1016/j.ogrm.2019.09.003

(Previously read in Week 2)

Lockwood, C. J. (2019). Key points for today’s ‘well-woman’ exam: A guide for ob/gyns. Contemporary OB/GYN, 64(1), 23–29. https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=134229869&site=eds-live&scope=site

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