Community-Based Practicum Reflective Journal Guidelines

Bon Secours Memorial College of Nursing

NUR 4143 - Clinical Immersion
Community-Based Practicum

Professional nursing meeting experience (4 hours)

Guide for Reflection Using Tanner’s (2006) Clinical Judgment Model
Introduction

What professional nursing meeting(s) did you attend and where was it located?
I attended an Impella class at St. Mary’s hospital on August 21, 2018.
Background

Describe the purpose of this professional nursing meeting? Describe the agendas of the group and subgroup.
What type of issues did they address?

The purpose of this meeting was to inform the nurses on the Coronary Care Unit about a new device that the patients
on the unit may have. The Impella is a temporary ventricular support device in people with depressed heart function.
Therefore it would be used in patients with cardiogenic shock following a heart attack or open-heart surgery when
the surgeon decides to rest the left ventricle. A representative from Impella was there presenting the information
about what to expect post-op in patients with the device and also what the nurses need to verify with the doctors
when they bring up the patient to the floor, such as verifying the numbers on where the tubes, the numbers on the
machine and other various information.

Some of the issues the nurses stated about the device were who would they call when there is an issue with the
Impella because it is new and not a lot of people have been trained with the machine yet. Another issue was the
nurses getting clarification about the difference between the Impella and the balloon pump. And the last issue the
nurses brought up was the different size impellas and where they would be inserted and how to manage them when
they come up from the cath lab. The Impella 5 would be inserted in the upper part of the body near the armpit while
the 2 and 3 Impella would be inserted through the groin. I am sure there will be many more issues with the new
device but these were just a few they brought up in the meeting.

Noticing

What did you notice about the professional nursing meeting initially? Describe what you saw, heard and did
during the meeting?

Initially I was very nervous to attend the meeting. I had only been in my immersion for one day and my preceptor
asked me if I would like to attend the meeting since I could possibly be taking care of patients with this new device.
Since the Impella device will only be on the Coronary Care Unit, everyone attending the meeting worked on the
unit. During the meeting, the rep from Impella was teaching about the device. I was trying to take notes and
understand what was being said but a lot of the information was over my head. My preceptor was explaining and
breaking down most of the information for me. After the presentation was over, we were allowed to test out an
impella machine and see the device that would be sitting in the patients’ heart, along with comparing the different
sizes of the impella.

Interpreting

Describe what you thought about the information being discussed. Have you been involved in similar
discussion during your previous student nurse experiences? Describe the similarities and/or differences to
those encounters.

I thought the information was very well put together. The nurses who work on the CCU seemed to understand the
information. I have not been involved in a similar experience but I think I will in the near future. Since I want to

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 Community-Based Practicum Reflective Journal Guidelines

work in an ICU setting, companies are always trying out new equipment or doing research with new equipment.
Hopefully next time I will understand the information a little better than this previous experience I had.

Responding

Describe stresses (both positive & negative) you experienced as you responded to the new learning or the
challenge.

Reflection-in-Action

What role would you take being assigned to represent your unit in this group? What subcommittee would
you like to participate with and why?

There were only a few stressors I experienced during the meeting. I knew from the start I was most likely not going
to understand all the information that was being presented about the impellas. Therefore before the lecture started
my preceptor gave me a brief explanation of the impella machine, which was very helpful! But during the lecture I
was getting a little stressed out because I was really trying to understand the machine but I could not follow all of
the information that was being presented. Some of the nurses were asking questions about the machine and that
somewhat stressed me out even more because I did not understand how they were able to come up with these
questions.

Reflection-on-Action and Clinical Learning

What written evidence is available to support professional nursing groups and their impact on the
development of evidence based practice and improved patient outcomes. Cite/reference all journal articles
that contributed to the evidence.
What is the value of professional nursing meetings both as a part of a healthcare system and within a
professional organization?
Describe any changes in your values or feelings as a result of this experience.

There are many clinical trials going on about the Impella device to see if using the device is obviously beneficial to
the patient so they do not have to have an LVAD for life and have to pay the many cost of having LVAD surgery
and pay for all of the equipment needed for it. They are able to still have a normal lifestyle if an Impella is used to
rest the ventricle and it is able to go back to normal function! “Mechanical support with the Impella RP device in
patients with RVF resulted in rapid hemodynamic improvement with reversal of shock and favorable survival
(Anderson et. al 2018).”

The value of having these informational meetings are very important to making sure the transition of a new device
on the unit goes smoothly. Nurses receive the best information about the new device since the presentation is usually
a rep from the company. They are able to ask questions and also have an opportunity to play around with the device
and make sure they know how to use it and get familiar with the all the buttons. These sessions are very valuable!
My feelings did not change about having these meetings because I agree that they are important to have. Without
these meetings, things could go wrong on the unit very fast.

Anderson, M., Morris, L., Tang, D., Batsides, G., Kirtane, A., Hanson, I., & O'Neill, W. (2018). Outcomes of
Patients with Right Ventricular Failure Requiring Short-Term Hemodynamic Support with Impella RP. The Journal
of Heart and Lung Transplantation.

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 Community-Based Practicum Reflective Journal Guidelines

Nielsen, A., Stragnell, S., & Jester P (2007). Guide for reflection using the Clinical Judgment

Model. Journal of Nursing Education, 46(11), p. 513-516.

Professional Nursing Meetings

St. Mary’s Hospital

NOC: first and third Wednesday of each month. Let me know when you would like to attend.

Shared governance council meetings:

Professional Practice Council-Second Wednesday 8a-12n

Strategic Planning Council-Second Thursday 8a-10a

Applied Research Council-Third Thursday 10a-12n

Education Council: third Thursday from 12n-4p (the meeting part lasts for 2-2 ½ hours and then
the members work on unit education)

Memorial Regional Medical Center

Third Tuesday of each month (Room 3008, Net Center)

Nursing Practice council 0800-0930

Nursing Quality Council 0930-1100

Nursing Recruitment & Retention Council 1100-1300

Nursing Education/Research 1300-1430

BSMCON NUR4143