Journal Log of Practicum Experience Essay

Journal Log of Practicum Experience Essay

Journal Log of Practicum Experience Essay

Assignment: Practicum Experience

Clinical Setting: Hospital Mentorship

Area of specialty: Nephrology and Cardiology

The MSN-FNP program allows nurses to gain a wealth of knowledge concerning their advanced nurse practice roles and career development. A core component of the program is having a practicum experience in a clinical setting to mentor one for their advanced practice roles and responsibilities. Through mentorship experience in enhancing interventions for patients in different settings, advanced practice nurses gain understanding of the importance of applying evidence-based practice (EBP) interventions to enhance care delivery. In this paper, I focus on my practicum experience conducted in a nephrology and cardiology unit of a hospital. The project of the hospital mentorship was self-management support for dialysis patients. The use of evidence-based practice interventions is essential in providing care for patient with terminal and chronic conditions like kidney disease that may progress to end stage renal disease (ESRD). The three weeks of preceptorship in hospital setting has demonstrated to me integrating evidence-based practice in self-management to support dialysis patients is essential as it improves care outcomes and overall ability of nurses to offer quality care.

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Relevant Evidence-Based Project Outcomes

During the practicum, I shared with the individuals in the setting concerning the significance of self-management support for patients requiring dialysis. Several studies highlight the importance of encouraging self-management support for patients with chronic kidney disease (CKD) who require dialysis. Self-management support is an integral aspect of attaining better outcomes (Peng et al., 2019). These patients need to get support from healthcare providers. At the core of these programs is the need to consult an involve patients and their families so that nurses and other providers understand their desires and needs that should be incorporated to enhance their outcomes. The principle of a patient-centered approach should frame the support that healthcare workers can offer when dealing with dialysis patients. Through sharing with those in the practice setting, it was evident that while many are aware of the important role that such support plays in care delivery, they are reluctant and not ready to implement the components of the interventions. I have learned that what hinders the application of knowledge and evidence in enhancing care for these patients is sufficient knowledge by health care workers, especially evidence-based practice interventions.

Studies by Ayat et al. (2021) and Donald et al. (2017) demonstrate the importance of self-management interventions to help patients with CKD. Al et al. (2021) through a randomized control study show that self-management interventions provides healthcare team and patients strategies to delay the progression of CKD and encourage the motivation for better home-based self-care at home. A key finding of the study is the integration of self-management education and psychological support with culturally relevant situations.  Donald et al. (2017) emphasize the need for patient engagement and involvement to enhance the efficacy of these interventions. The study implores providers to involve patients using relevant theoretical models and clinical evidence. Findings by Luawo et al. (2020) and Peng et al. (2019) demonstrate the effectiveness of self-management interventions like education and exercise in enhancing physical and mental health and wellbeing of CKD who require dialysis. Zimbudzi et al. (2018) observe that self-management programs improve self-care activities, systolic blood pressure and glycated hemoglobin in patients who have comorbidities like diabetes and chronic kidney disease. These findings have significant implications for providers and other individuals working with dialysis patients.

Based on our conservation with individuals in the practicum setting, they assert that these outcomes are critical to enhance quality care and ensuring that patients have better ways to manage their condition. A core aspect of this realization is that dialysis patients should be part of any care plans, especially at home. The individuals also assert that training will enhance their mastery of issues impacting patients and hindering integration of cultural competent care to attain quality outcomes. The individuals asserted that they can incorporate these measures as part of the evidence-based practice interventions for patients who suffer from CKD.

They also shared insights from other projects relating to the expected outcomes like reducing exacerbation and comorbidities, increased patient involvement in their treatment plans, and use of inter-professional approaches and collaboration to enhance care delivery. The practicum experience shows that the individuals, especially nurses and physicians, understand the impact and importance of integrating self-management support to enhance adherence to treatment interventions by patients at home. The approach also ensures that patients use available community resources to enhance overall care.

Post-Graduation Plan for Professional Growth and Development

The practicum setting provided an opportunity to engage healthcare workers on a host of issues apart from care provision to patients. A core aspect of this experience was sharing with the individuals about the essence of a plan for professional growth and development after graduation. I asked for advice from the individuals on skills development and expansion of my areas of expertise in my career.

My plan for professional growth and development includes enrolling for a terminal nursing degree, probably a Doctorate of Nursing so that I can integrate evidence and findings into clinical settings. I aspire to finish the program, get a new practice environment and focus on my specialty, especially dealing with patients suffering from chronic conditions like CKD. The individuals in the setting emphasized the need to specialize and attain additional training as well as seeking partnerships and working in inter-professional and multidisciplinary teams (Peng et al. 2019). Enhancing one’s core skills, abilities, knowledge and competencies are essential in delivering quality care for patients like those with CKD who require dialysis.

Conclusion

Practicum experiences in different settings are essential for nurses to advance their knowledge and expertise from a hands-on approach. The clinical setting offered me an opportunity to understand the importance of self-management support to help dialysis patients attain better outcomes. Through this practicum in week 3, I have developed a professional plan after graduation to specialize and attain a terminal degree in nursing.

References

Ayat, A., A. S., Lim, S. K., Tang, L. Y., Rashid, A. A., & Chew, B. H. (2021). The effectiveness

of nurse-led self-management support program for people with chronic kidney disease stage 3-4 (CKD-NLSM): Study protocol for a randomized controlled trial. Science Progress, 104(2), 00368504211026159. doi: 10.1177/00368504211026159.

Donald, M., Kahlon, B. K., Beanlands, H., Straus, S., Ronksley, P., Herrington, G., … &

Hemmelgarn, B. R. (2018). Self-management interventions for adults with chronic kidney disease: a scoping review. BMJ open, 8(3), e019814. http://dx.doi.org/10.1136/bmjopen-2017-019814

Luawo, H. P., Permata, Y. I., Rohmah, U. N., Waluyo, W., & Andini, S. A. (2019). Summary of

Self-Management Program for Patients with CKD: A Systematic Review. Critical Medical and Surgical Nursing Journal, 8(2), 70-74. DOI:10.20473/cmsnj.v8i2.17507

Peng, S., He, J., Huang, J., Lun, L., Zeng, J., Zeng, S., … & Wu, Y. (2019). Self-management

interventions for chronic kidney disease: a systematic review and meta-analysis. BMC

            nephrology, 20(1), 1-13. DOI: https://doi.org/10.1186/s12882-019-1309-y

Zimbudzi, E., Lo, C., Misso, M. L., Ranasinha, S., Kerr, P. G., Teede, H. J., & Zoungas, S.

(2018). Effectiveness of self-management support interventions for people with comorbid diabetes and chronic kidney disease: a systematic review and meta-analysis. Systematic reviews, 7(1), 1-14. DOI: https://doi.org/10.1186/s13643-018-0748-z

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Please write 3 pages Journal Log of Practicum experience in clinical setting (Total of 3 weeks preceptorship)

Clinical setting: Hospital Mentorship
Project: Self-Management Support program for Dialysis patients
Area of specialty: Nephrology and Cardiology
3 weeks of Preceptorship in Hospital setting

Assignment: Practicum Experience
As a nurse engaged in advanced practice, you are likely to find that discussing findings of an evidence-based project with your mentors and colleagues can expand your awareness of the implications.

Continue to discuss relevant evidence-based project outcomes with individuals in your practicum setting. Ask what implications they would draw from the findings, and what insights they can share from other projects that may relate to your project outcomes.

In addition, discuss your Post-Graduation Plan for professional growth and development with individuals in your practicum setting. Ask for advice on developing skills or expanding your areas of expertise throughout your career.

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