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Guide for Reflection

Guide for Reflection Using Tanners (2006) Clinical Judgment Model

Program Thread: Communication and Collaboration
Describe a nursing situation you encountered this week (See the instructions above.)
- This week I had a post-surgical patient who was hard of hearing. In addition to having trouble hearing, he seemed
to be somewhat agitated at times, and didnt really want to be bothered.
Describe your relationship to the patient at the time you noticed the situation (e.g. previous contact with patient
and/or family, the quality of your relationship)
- At the time, I had no previous contact with this patient, so I was unaware that he was hard of hearing.
Consider experiences you have had that helped you provide nursing care in this situation. Describe your formal
knowledge (e.g., physiology, psychology, communication skills, or other gen eds.) previous nursing experience
with a similar problem, and/or personal experiences that helped guide you as you worked with the patient.
- I used the skills that I learned in previous classes and experiences with other patients to effectively communicate
with my patient, such as speaking loudly and facing the patient when I spoke. Also, I used hand gestures and spoke
a little slower than I usually speak.
Describe your beliefs about your role as the nurse in working on the situation.
- In this situation I believe that my role as the nurse was to make sure my patient understood what I, and others were
trying to communicate with him and to make sure that he didnt feel bad because he couldnt hear well.
Describe any emotions you had about the situation.
- I felt bad for my patient because part of the reason he was so agitated with everybody was because he could not
hear everything they were saying.
What did you notice about the situation initially?
- Initially, I noticed that my patient was pretty reserved, not much of a talker, and was unwilling to take any
medication for the pain he was having when I took his vitals at 7am that morning.
Describe what you noticed as you spent more time with the patient and/or family
- As I spent more time with my patient, I noticed that he was pretty nice and easy to get along with and the reason
he didnt want any pain medications was because he was nauseas and didnt like the way they made him feel.
Describe what you thought about the situation (e.g., its cause, potential resolutions, patterns you noticed).
- I noticed that the only times my patient became agitated was when he couldnt hear what someone was saying
because they were talking to him with their back turned or not loud enough.
Describe any similar situations you have encountered in practice before. Describe any similarities and
differences you observed when compared with the current situation.
- I noticed that in other patients that I have taken care of in the past, when they couldnt hear something that was
being said to them they would just nod in agreement without fully knowing what was said. This patient I had today
did the same thing sometimes.
Your conclusion: What did your observations and data interpretation lead you to believe? How did they
support your response to the situation? Include pertinent pathophysiology and/or psychopathology. (concept

My observations lead me to believe that my patient was not a mean or bad person, he simply could not hear as
well as the rest of the staff and maybe he should have a HOH sign on his door.

List two goals for the next practicum experience:

1. Continue to get better at putting together patient signs and symptoms with disease process.
2. Get better at knowing what to say to comfort a patient.