Running head: MY PRACTICUM EXPERIENCE 1

My Practicum Experience in A Pediatric Unit

Student’s Name

Institutional Affiliations
MY PRACTICUM EXPERIENCE 2

My Practicum Experience

Last semester, I had the privilege of working in a pediatric facility and interact with

critically ill infants, children and teenagers. The experience shaped and influenced my nursing

experience as the amount of knowledge I gained was immeasurable. The practicum experience

developed my knowledge and skills in pediatrics through the guidance of preceptors. The clinical

practice that took in the other pediatric unit, including observation of children in day care setting

provided me with an opportunity to build acquired skills and knowledge, develop skills in

communication, and apply nursing principles in meeting the needs of pediatric patients.

I was placed in a pediatric intensive care unit (PICU) under the guidance of a pediatric

intensivist, nurses, and respiratory therapists. The pediatric intensivist was known as Sarah

Lindsey. One of the reason I enjoyed the learning experience as because of Mrs. Lindsey. By

watching and observing what she did, I realized what it meant to be an excellent pediatric nurse

practitioner. She possessed excellent unit management skills, and led the unit efficiently and

productively. The culture implemented in the unit was influenced by clinical judgment that

guided practicing nurses and nursing students in balancing intuitive and evidence-based thinking

when making clinical decision.

Mrs. Lindsey as my preceptor first introduced me to general practices. I started

performing textbook observation and reported the findings to my preceptor or any nurse if Mrs.

Lindsey was busy or unavailable. Based on the data I acquired from observation and learning, I

analytically contemplated the physical state of children and reconsidered the observation items.

By repeating the examination and analysis processes, I gained the necessary observation item to

identify the state of body. The analytical understanding of the state of illnesses enabled me to

connect the clinical experience I had experienced for the first time with the knowledge I had
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learned in theory. I was also able to link data from personal observations and medical records to

class theories to develop a comprehension of the state of disease of a child though etiology,

symptoms, and importance of treatment. In children with complex illnesses, I requested further

information from Mrs. Lindsey who in some instances explained the scenario or directed me to

medical books and other references. Such explanations and readings enabled me to make

connection between a disease and the pathology.

During the third week of my practicum, I was introduced to Michael Toms, a respiratory

therapist in the unit. The role of a respiratory therapist is to educate, assist in diagnosis and treat

children suffering from lung and heart problems. Dr. Toms had specialized in pulmonary and

cardiac care, and often collaborated with nurses, doctors, and other PICU consultants in the unit.

The role of Dr. Toms was to guide me through the tracheostomy. However, before I was

introduced to this delicate process, I familiarized with simulation because safety was a key

priority when this vulnerable population. Incorporation of simulation into my clinical experience

improved the process as I felt better prepared as it broadened the overall clinical experience in a

short time. Also, simulation also gave an opportunity to participate in clinical situations that I

may face in clinical situations when caring for medically frail pediatrics.

First, Dr. Toms informed me that a child may need a tracheostomy in various

circumstances. The most common circumstance included when upper airway is blocked. When

there is a blockage in the upper airway, a trach tube in inserted to help a child breath since air

cannot get to the lungs. Blocking of the upper airway may be caused by narrowing of the trachea,

polyps, or weak tracheal muscles. Another circumstance in which a tracheostomy is required

when a child is unable to cough mucus out of the lungs and airways. Lungs produces mucus that

pick dirt and dust, thereby protecting the lungs from irritation and infections. Therefore, the
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inability to clear the mucus may necessitate a tracheostomy. Lastly, Dr. Toms informed that a

tracheostomy is needed when a child needs long-term help with breathing. The child may use a

ventilator at home after trach is inserted. Safety was vital when taking care of children with trach

tubes because one could not walk or talk when the tube is in place. However, special devices

were used to let a child, and therefore, I could communicate with them. Another consideration

that had to be put in place was protecting the child’s lungs from dry, cool, or dirty air. This is

because the air that passed through the tube was not cleaned, humidified or warmed.

Dr. Toms educated parents about insertion of trach tubes because most of them had

mixed feelings about the procedure. However, the doctor examined the specific needs of a child

before advising a parent to decide about the tracheostomy for the child. As a nursing student

aiming to be a pediatric nurse practitioner, working close to Dr. Toms was influential in my

practice. I learned how to clean the tracheostomy site and tube, suction to remove mucus plugs

that the child may be unable to cough, change tubes and shower. Cleaning was a key part of the

tracheostomy cleaning since I was responsible for the daily cleaning. This process was hectic as I

was needed to clean the stoma and trach to avoid the build-up of the mucus. I also cleaned the

area around the neck and stoma 2-3 times a day to prevent excess moisture and dried mucus.

Another important skill that I learned was the process of suctioning to eliminate the

mucus that could not be coughed out. During this process, any change in the color of mucus was

reported to the nurse in charge. Tube changing was an area that I did not have an opportunity to

acquire much skills because I only witnessed three patients being changed tubes. During the

process, Dr. Toms guided the team of nurses in the unit, explaining each step and answering any

question that any member of the team could be having. For patients who were transitioning in the

care, the home care providers were available to learn the process because some patients stayed
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with the trach tube permanently. Going home with a tach necessitated one to be in possession

with various pieces of equipment. These patients needed a ventilator, an ambu-bag, a catheter,

and a saline solution. Dr. Toms trained each caregiver on how to use the equipment before going

home.

Although the experience during the practicum was wonderful, the major source of stress

was adjusting my communication with children. Adjusting and communication with children in

the viewpoint of a minor was challenging process because I often used medical jargon that made

them feel confused. For example, I remember talking to a six-year-old boy and told him about

how a bacteria work. The boy was left confused as he did not understand what I saying. Later, I

realized my mistake and corrected by telling him how a bug works, instead of using the term

bacteria. I also taught myself to be humble, which was reflected by wearing a pediatric uniform

with a little bear on it. When children saw the bear, the atmosphere relaxed and most of them

were free to talk to me.

During the last part of the practicum, I worked in the kindergarten where I learned

popular subjects among children as well as conversed with them about drawing cartoons.

Participating in these practical activities enhanced by communication with children. Lastly,

working at the bedside provided me with interaction skills that could enable me strike

conversations with parents. Even though facing parents worried about their children was

stressful, the guidance of my preceptor enabled me to overcome this stress and communicate

effectively with patients. By the time, my practicum came to an end, I had gained first

knowledge of what happen in a pediatric unit. It is difficult to describe everything that I learned

in this paper, but I can conclude it by saying that the experience helped develop both

professionally and personally.