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Clinical Reflective Journal

Erin Collins
NURS-3021-A-F09
Rebecca Johns
November 19, 2021
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Clinical Reflective Journal

During my clinical rotation, there was a specific clinical practice experience that I

encountered that stuck with me. During our last shift on the unit, we were asked to assist with a

patient who was thought, at the time, to be coughing up blood. We got to witness all of the

nurses working together as a team to provide care to the patient, including speaking to them and

coaching them through the experience as well. We then came to find out that the patient was

once on the COVID-19 unit and was thought to be experiencing adverse effects from the disease.

Watching all of the nurses work as a team and remaining calm during a hectic situation was very

eye-opening and interesting to see in real life. The patient was quite upset, being that she was in

a lot of pain and genuinely scared. The nurses worked so well as a team, even though many of

them did not work together often, if at all. This proved to me how much of nursing is a team

effort, as they could not have gotten all the interventions they did completed, if it weren’t for

them working together.

This experience was shocking to me and honestly quite sad to witness when thinking of it

through the lens of the patient’s eyes. The patient was extremely scared and making many

comments that I had never heard people say in real life. For example, they kept saying things like

“Please don’t let me die”, “Please God take the pain away”, and other comments such as those.

We are taught about these types of situations and the things to say or ways to respond in school

but seeing it in real life was much harder than I thought it would have been. From an esthetic

knowing standpoint, the patient must have been extremely scared and probably kind of confused.

They had beat COVID-19 and were now on a rehab floor, so I think it was kind of jarring to

them to be having these effects. From an ethical knowing standpoint, the patient kept saying that

they did not want to die. A nurse promised the patient that they were not going to die, and that
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we were not going to let them die. This stood out to me ethically, as we were always taught to

stay away from definitive statements about situations that we cannot control such as the one this

nurse was saying to the patient. I know that the nurse had nothing but good intentions, this is just

something that I noticed ethically that stood out to me. It is so hard to know what to say in

situations like the one I witnessed, so I think everyone was just doing their best in the moment to

help the patient.

When relating this back to learning I have had previously, I think it differed in ways

compared to what we have been previously taught. I believe that this is inevitable, as there are

only so many things that can be “taught” per say, as many things need to be experienced to fully

learn. We are taught different nursing interventions and things we would physically do for the

patient. But being in the situation and having to work as a unit with numerous other nurses

without overstepping anyone or confusion, really showed me that you learn that kind of stuff

with experience. So, although I knew the interventions and the physiological aspects, we learn

about in nursing school, watching all of the events and roles of the nurses really taught me a lot.

It was an eye-opening experience to see the overlap between what we are taught in school and

what is actually real in practice.

This experience made a difference in my practice by showing me how much of a team

profession nursing is. It showed me that having good coworkers and people you can lean on is

extremely important, especially in the profession that we have chosen. I do feel like this aspect

needs to be spoken about more throughout nursing school, as it is mentioned but not really

deeply discussed. Patient care is directly affected by the performance of the healthcare team and

how they work with one another, so improving teamwork skills will in turn save lives (Barton et

al., 2018). This includes the aspect of delegation, as in a high paced situation like the one I have
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described, it is important that everyone have a role and understand that role. To safely provide

patient care, nurses and the healthcare team must work as a holistic group with good teamwork

and strong communication skills, as it could decrease unanticipated events and adverse outcomes

for the patient (Campbell et al., 2020). Consequently, this experience taught me a lot in terms of

how nursing teamwork looks in practice and the effect that good teamwork has on the patient and

those around them. From a chronic illness standpoint, it helped me to understand that although

the patients may have a chronic illness, they can also have acute exacerbations. This is

something that I now further understand, which will better me and help me to be prepared for my

future practice as a registered nurse.

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References

Barton, G., Bruce, A., & Schreiber, R. (2018). Teaching nurses teamwork: Integrative review of

competency-based team training in nursing education. Nurse Education in Practice, 32,

129-137. https://doi.org/10.1016/j.nepr.2017.11.019

Campbell, A. R., Layne, D., Scott, E., & Wei, H. (2020). Interventions to promote teamwork,

delegation and communication among registered nurses and nursing assistants: An

integrative review. Journal of Nursing Management, 28(7), 1465-1472.

https://doi.org/10.1111/jonm.13083