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Please break your paper into 3 paragraphs with headings addressing the 3 parts of the rubric. I understand it was difficult if you were in child development centers, but you still need to explain how you demonstrated leadership, interprofessionalism, and basically how it helped you grow as a nurse. Your simulation also offers quite a bit of opportunities for you to think like an RN and prioritize and delegate. If you cannot match the rubric topics to your experience than say that and describe. (Reminder that a paragraph should be no more than 3/4 a page). This paper should be about 1 page in length. (ok if longer)i was at valley presbretarian hospital from 6:30-6:30 with clinical professor kathryn vick so please include that and theory instructor was mrs.dyer and mention that peds was the hardest class and was overwhemeled with school and family
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Running head: NURSING EVOLUTION
Nursing Evolution
Nicollete Juarez
NURS 307 – Developing Family and Community
West Coast University
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NURSING EVOLUTION
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Nursing Evolution
The theory class helped me understand the foundation of nursing pediatric care by
learning the basic information that served as my basic foundation knowledge I significantly
needed to become successful in my clinical experience during this term. Learning how children
transition through different stages of development, acquiring knowledge about major health
promotion and disease prevention concepts, application of nursing process to pediatric patient
population suffering from different types of acute and chronic diseases, nutritional requirements
for pediatric requirements and current issues regarding health care in theory class allowed me to
apply the concept of nursing process and critical thinking during patient care and support and
performed the therapeutic nursing interventions specific for the patients and families assigned to
me during clinical rotations.
During my clinical rotation this term, I have provided holistic patient centered care by
utilizing therapeutic communication not only with my patient but also to their family members. I
was able to prioritize their needs and provided it with the highest quality of care that meets the
standard protocol of my clinical site. I was able to participate in a collaborative care for the
patient assigned to me. I was assigned to an eight-year-old male patient who was admitted to the
pediatric intensive care unit of the hospital. The charge nurse asked me to take the patient’s
temperature and assisted her in providing personal care to the patient such as removing the soiled
diaper and changed it to a new one, provided oral care, and repositioned the patient. During the
care, the patient had an episode of seizure which lasted about three minutes. The charge nurse
who was with me at that time, instructed me to watch the clock to remember when the seizure
started and asked me to time the duration of the seizure. She also yelled out for the rest of the
staff to inform them that the patient was having a seizure. She asked me to help her turn the
NURSING EVOLUTION
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patient to the left side while she gave instructions to the LVN and another RN nurse in the room.
The charge nurse also gave instructions to the Respiratory therapist as the patient’s oxygen
dropped to 72 %. I have never witnessed a child had a seizure prior to that day and it was really
intense. After the seizure stopped, the nurses and Respiratory therapist worked on the patient to
stabilized him. I assisted by attending to their every request such as getting them new towels,
diaper, wipes, etc.
I have seen a lot of situations where the application of leadership concepts and skills and
decision making were done to ensure that high quality nursing care, healthcare team coordination
and collaborative care happens. In addition to the seizure episode event that I already described
above, I wanted to share that the same team I mentioned above had shown excellent care to the
same patient while I was there throughout the day. They were able to assess the patient and
quickly identify that his health status was declining really fast. They were able to render and
implemented therapeutic nursing interventions by constantly and effectively communicating with
the primary doctor, the pharmacy, the laboratory and diagnostic department, and family. The
patient had three more episodes of seizure lasting about three to four minutes and the last
episode, the patient became unstable and unresponsive. The team followed protocol on what to
do during a seizure on every seizure episode the patient had. After the last seizure, they were
quick to determined that the patient’s status became unstable and the doctor decided that he
needed to intubate the patient. As soon as the doctor told them the plan, everyone worked into
action. The charge nurse called the pharmacy to order the medications needed for intubation, the
respiratory therapist gathered her equipment for ventilation support, the LVN and other RN
started another IV line on the patient and the primary doctor provided oversight and made sure
that everyone is up to the task. I witnessed how quickly everyone moved to gather all the
NURSING EVOLUTION
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necessary tools, equipment and medications needed and completed the intubation procedure. The
situation was intense, emotional and chaotic but I would say that it was an organized chaos. I
could tell from everyone’s faces who collaborated in that patient’s care that they were under a lot
of pressure and stress, but they worked cautiously, effectively and safely trying to save the
patient’s life. The doctor took charged of the situation by respectfully telling his team on what
they needed to do. The team which included of two RNs, one LVN and one Respiratory
therapist, effectively communicated with one another, did the tasks assigned to them by the
doctor and most importantly, they showed support to one another during the entire ordeal and
setting their differences and emotions on the side.
Running head: NURS307 WEEK 9 NURSING EVOLUTION
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The Joy in Pediatric Nursing
Vivian Toma
West Coast University
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NURS307 WEEK 9 NURSING EVOLUTION
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The Joy in Pediatric Nursing
Pediatric nursing is a specialty that requires patience and a special touch because it
involves children ranging from infants to adolescents. Their physical, mental, and emotional
needs vary throughout the different stages of growth and development. I, myself, have a 5-yearold son, and this class along with my clinical experience at Children’s Hospital of Los Angeles
(CHLA) have allowed me to gain insight on his growth and development. Understanding each
stage of growth and development from infancy to adolescence as taught by Professor Dyer
during the first week of class has been the key to providing effective holistic care to children. In
the short clinical rotation I had at CHLA, I experienced the most at 5 West and 6th floor. I was
able to care for toddlers and school-age children from different cultural backgrounds such as
Hispanics, Caucasians, and Arabs. I was also able to meet their parents who were at the bedside.
As discussed by Professor Dyer in class and reiterated by Professor Harris at the clinical site,
pediatric nursing not only involves the children but also the family/guardians. The family
dynamic differed depending on the cultural background of the patients which was concurrent
with my experiences from other nursing specialties such as maternal-newborn and medicalsurgical nursing from previous terms. I have noticed that the Hispanic families were frequently at
the bedside that includes the extended family such as the aunts and grandparents while Caucasian
families mostly involved just the mother and the father. At CHLA, many of the patients came
from foreign countries (Iraq, South America) to seek a second opinion regarding their child’s
condition. Meanwhile, my pediatric experience was way different from my maternal-newborn
experience in a way of communication and the skills to care for children with different
developmental levels. The infants and toddlers were unable to communicate verbally what was
bothering them especially their pain level so the FLACC scale had to be used for infants while
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the FACES pain scale may be used for children ages 3 years old and older. Besides the pain,
pediatric vital signs also vary based on their growth and development stage which was very
challenging both during classroom lectures as well as during clinical rotations. Infants, toddlers,
preschoolers, school-age children, and adolescents have different heart/respiration and blood
pressure rates. I have noticed that the nurses I shadowed have a vital sign reference card along
with their ID badges to assist with determining an abnormal vital sign. This was extremely
difficult for me especially because I mostly dealt with adult vital signs as an LVN. Another
difference in my experience during this rotation has to do with physical assessment. Each
childhood stage has different growth and development features which meant that physically, an
infant’s physical characteristics will be different from a toddler or an adolescent. Learning these
differences during class lectures were helpful and applying them during the clinical rotation were
a great experience. Medication administration also seemed to be a struggle with the pediatric
population because most of them were not fond of taking off tasting medicines. Offering toys to
a toddler during the medication administration was a helpful distraction while allowing a schoolage child to involve himself in taking the medicine was a good solution for medication
adherence. Besides the nurses I shadowed at CHLA, I was also able to work with respiratory
therapists who administered breathing treatments, BIPAP/CPAP machines, and dealt with
respiratory issues. It was also a pleasure to speak with activity personnel who provided some
music therapy to a 2-year-old toddler with Down Syndrome. She played the ukulele and sang to
him to which the toddler enjoyed and fell asleep too afterwards. During this rotation, the parents
were expected to be involved during bedside care and even with medication administration when
they were present. The nurses provided so much parent education about the medications and
procedures while they were in the hospital to prepare them before patient discharge.
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My first day of clinical rotation at CHLA was full of learning experiences. I was given
the assignment to take care of a 7-year-old s/p kidney transplant of the right kidney. He was a
courageous little kid who have experienced multiple surgical experiences since he was born and
was on dialysis for about 2 years prior to being given a new kidney. When I first met him, he was
suffering from a UTI and was on IV antibiotics, but he continued to remain happy. The nurse I
was assigned to shadow was receptive of me assisting her in taking care of this particular patient.
When I went to his room, he was sleeping and mom was at the bedside. He became furious when
he had to be awakened for the administration of his due antibiotics and was encouraged to use
the bathroom. He was crying, screaming, and fighting his mother including the nurse and myself.
The nurse and I were able to calm him down by showing him a drawing of a picture of his new
kidney whom he named “Tom.” Mom performed intermittent catheterization and halfway
towards the procedure, we were able to encourage him to urinate in the urinal to which he did.
Though the mom was at the bedside, she lacked the initiative to provide care to the patient. When
we came into the room, she was laying on the pull-out bed and talking on her phone. She was
already given a list of the medications the patient was taking and yet she seemed to forget the
medications’ indications and the frequency in which they have to be taken. I assisted my nurse in
getting an interpreter, since she was Spanish speaking, to explain to her again the importance of
being involved in her son’s care and the consequences of not following the orders. Along with
the interpreter, we explained to her the importance of encouraging the patient to urinate in the
toilet or in the urinal every 2 hours as well as defecating in the toilet instead of the diaper. My
nurse also contacted the provider in charge and explained to her the reasons to discontinue the
order for intermittent catheterization every 4 hours especially that the patient has a UTI, and that
the patient was able to urinate in the urinal and was not retaining urine based on bladder scan
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results. Other nurses in the units helped tend to my nurse’s other patients as she was educating
the mother and speaking with the provider. The unit’s teamwork was remarkable and it was an
enjoyable experience. Documenting the pain assessment, nursing checklist, vital signs and intake
and output in ADHOC was also a great encounter because along with the nurse in charge, I was
considered to be a part of the team caring for the patient. Working in a pediatric unit was
definitely not easy because it was a new experience, however, it was memorable and unyielding.
These children were so brave because even though they were sick, they remained resilient and
continued to smile and play.
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