Before virtual instruction, in-person clinicals was so much fun and provided me with so much opportunities to apply the knowledge I learn from lecture to an actual patient. At the end of each clinical, I felt like I would understand material taught in class or what I read from a textbook so much better. Of course, when I first started my clinical journey, I was so nervous and anxious to have an actual patient. I was concerned about making mistakes or feeling incompetent. As the weeks went on, not only did my nursing skills improved, but my confidence skyrocketed. During my time working at the OSUWMC, I felt that my communication skills with the staff and patients improved as I learned helpful skills from therapeutic communication course. For example, I learned the importance to acknowledge the patient’s feelings and using silence if you are not sure how to respond to a patient. Throughout clinical I utilized this technique since many of my patients were hospitalized for a multiple weeks and they expressed their longing to be home. Since I did not know when they could potentially discharged, I would try my best to comfort and acknowledge their feelings. I felt that this technique helped as most of the time the patient really just wanted me to listen to them and talk with them about the tough time they have gone through. Another useful skill that I started utilizing is ISBAR. During my last in-person clinical, I did my first ISBAR report to my patient’s nurse before I left the unit for that day. My ISBAR definitely was not the best but I was able to practice this skill and I realized what I needed to continue to work.

Even though we do not have in-person clinicals anymore, I also have been finding virtual clinical interesting and as well a place to further my learning. For example, this week we went more in depth with ISBAR and I feel that I have a better understanding/improved ISBAR reports due to my clinical instructor allowing us to work on this skill several times during virtual clinical. Even though virtual clinicals meets my academic needs, the one thing about in-person clinical that I really do miss is interacting with patients. In future clinicals, I hope to continue growing skills such as using the silent technique when appropriate with patients. As well, I want to continue expanding the confidence that I have gained this past semester in clinical. I am looking forward to continue applying the skills learned in this course to future patient interactions.

Recently, I found this youtuber who is a 3^rd medical Canadian resident named Siobhan. Her channel is called Violin MD. I have been binge watching her vlogs on her on call shifts lately and I find them very interesting. I get to see what a day in a doctor looks like and after watching a couple of her videos, I can appreciate more what doctors do. I see how much teamwork goes in when taking care of a patient. Also, after watching her videos, I realized that doctors do a lot of writing!

For this assignment, I decided to watch Siobhan’s “26 Hour Call Shift: Day in the Life of a Doctor, Intensive Care Unit.” Immediately at the beginning of Siobhan’s shift, there is a team meeting between residents, attending physician, nurses, dietitian, respiratory therapist, and pharmacist. As we learned in class, they performed a briefing to map out the care plan, heighten awareness of certain circumstances, and plan for unexpected with each patient. As Siobhan says in the video, the briefing takes a while since they conduct one for each patient and make sure that each staff member had a chance to give their input and recommendations.

At around 11 pm, Siobhan gets a page from a critical care response team nurse who has identified that one patient had a very low oxygen levels. Patient vitals were 120 beats per minute but blood pressure was normal. Siobhan ordered for a stat x-ray, which revealed that the patient had a collapsed lung, and the patient was placed on 100% oxygen. Immediately after assessing and treating the patient, Siobhan calls the attending physician and fellow to further discuss which course of action to take. It is interesting how the various different roles of the medical care team come together to identify a problem quickly and resolving the issue at hand as fast as they can or stabilize the patient until further consideration with other members is taken. This effective teamwork and communication were able to avoid a huge red flag.

In addition, Siobhan received an admission to the ICU from a patient got out of the operating time. The physician and anesthesiologist communicated with Siobhan about the procedure and how it went. One of the most important information disclosed was that this patient had a difficult airway resulting in it being difficult to intubate patient due to their anatomy. Siobhan shortly after states that she is definitely going to communicate this information about the patient to the morning team. This shows how Siobhan is making sure critical information is being passed on to the other team members to prepare a plan if patient needs intubation.

Overall, this video really focuses on how effective communication between staff and having teamwork can improve a patient’s care. I really enjoy watching Siobhan’s videos and hope she continues to post more about her experience as an ICU doctor.

My clinical experiences thus far have provided me with plentiful educational opportunities. I feel like I am able to apply the things that I learn from class into real-life situation. Therefore, most concepts that were fuzzy in class become very clear after clinicals. On an educational side, I have been making huge progress but I have come across communication problems during my clinicals that I am currently addressing to fix.

My first communication challenge that I faced is being hesitant when I am uncomfortable or unsure with what my next steps are when caring for my patient. Often times when we were buddy up, it was common for me to let my partner overtake with talking. Yet, I believe that when I get my own patient, then I will not have the tendency to let others take over. Since I will be responsible for my own patient this week, I have to take responsibility because I do not have a buddy to rely on. As well, to further combat my hesitation, I have been running through my assessment with friends. I know when I am with a patient, I get a bit scared since I do not want to look like I do not know what I am doing. Thus, to combat this, I have been practicing outside of class on my nursing skills such as a head to toe assessment.

My second communication challenge that I have is forgetting to elaborate when I find an abnormal finding. For example, my patient would rate their pain and I have the tendency to forget to ask them to describe how their pain felt (dull, sharp, consistent, painful with activity, etc.). I am overcoming this challenge by using the STAR method. Before I enter my patient’s room to complete a task, I always stop, think, act, and review. For example, I would stand outside for a minute thinking what I want to complete and reviewing my notes. In my notes, I have added to make sure to elaborate. Also, conducting this STAR method has helped me from forgetting certain tasks such as forgetting to asking my patient to rate pain level when taking vitals.

Overall, I love clinical. They are a time for me to really be engaged with my learning. Even though it has been challenging adjusting to this type of role of being the healthcare provider in the patient-provider relationship, I feel like I have been making small strides. I am super excited to keep learning and overcoming other challenges.

On Saturday January 25, my boyfriend and I went to Roosters for dinner, where I casually observed how others communicated. I was able to clearly see verbal and nonverbal forms of communication amongst other individuals. Also, I noticed how dependent we are on our technology.

First, I will be discussing about our waiter. Her nonverbals included: eye contact when speaking, casual tone of voice, and soft and smiling facial expression. Her verbal communication was asking us what we wanted to eat. She was clear and concise, and she performed feedback to make sure that she got the correct order.  Therefore, I felt like our waiter was very well engaged with our conversation and had confidence in that she will get our order right. Comparing our waiter to nurses, it is critical to perform feedback to make sure that our patient understands what we taught them with patient education or what we just said.

Another observation I made was of a father and his young daughter sitting across from us. The father used nonverbal gestures that included: pointing at words or items, gentle and endearing facial expression, and tone of voice was soft and loving. The father’s verbal communication was explaining to his daughter what each item on the menu consist of in terms that she will understand. This technique used in verbal communication is similar to what medical professionals do because when speaking to our patients, we do not want to use medical jargon. We want to have clear and effective communication; thus, we need to communicate in layman terms.

The final observation that I made showed how dependent our society relies on technology. Next to us, a couple were engaging in conversation until the lady got up and left the table. When the man was left alone, he immediately grabbed his phone. Once she returned, he put his phone down and engaged in conversation again with her. This demonstrates how we learned as a society to fear silence or looking like you are not communicating. As a nurse, we need to overcome the urge to break the silence at times. Silence can allow patients to collect their thoughts, understand what is going on around them or the ability to express their feelings. Therefore, silence can be a good thing at times. Also, another observation I made with technology is the use of cellphones at the table amongst a group of individuals. Instead of communicating with each other, the group were on their phones. This observation shows how technology can get in the way of being in the moment. It is crucial that as nurses we do not let technology interfere with our communication with patients. For example, moving the computer monitor to make eye contact with your patient while they are talking can build trust in patient-provider relationship.

Overall, these observations that I made can be applied to what I could face during clinical and during my career as a nurse. Also, observing others made me realize what I do on a daily basis without thinking, and what I could possibly change to help my communication with others.

Hi Cristina!

My name is Kathy Cordova and I am a third year. Before deciding to switch my career to nursing, I was majoring in biochemistry and was on the pre-med track. After learning more about nursing and how nursing takes a holistic view on the healthcare, I realized how much nursing aligned with my values. Also, I really appreciated how nursing has flexible hours and shifts, thus allowing me to be more involved with my family. Another huge plus in the flexible hours is having the ability to travel. I follow an ICU nurse on Instagram, and almost every week she is traveling to a new country. I love traveling; thus, I would definitely love to broaden my horizons with experiencing new cultures, new experiences, and new food.

My interests in nursing lie in working with infants. Before making the switch to nursing, I had the ability to shadow a neonatologist. I remember that day so clearly because I came into realization how much I wanted to work in the NICU. I felt such a strong connection working with the ill infants and seeing how the medical staff did everything in their power to make them better. Also, the stories I heard that day made me realize that the NICU has the ability to build strong connections with the patients and family members due to the long hospital admissions. Therefore, one of my career goals is to become a neonatal nurse practitioner.

Another career goal of mine is to work part time at the NIH and work on research projects pertinent to the NICU. I have been involved in research since I was 17 years old. The first research project that I was involved was at Nationwide Children’s Hospital working on looking at the metabolic shift of aerobic respiration to anaerobic respiration in preeclampsia cells. At the age of 18, I became a published author on the research project. Even though I loved the research I was conducting in the lab, I was starting college and I decided to leave. The second research project that I was involved was with Dr. Mei Wei Chang on weight management of pregnant and postpartum women. During this project I learned how to interact and work with research subjects, whereas my work at NCH was more wet lab and coding. Now, I am working with Dr. Toni Harrison on infants’ feeding with congenital heart disease. I am very excited about working with this research project due to it lying within my interests.

That is a little bit about me! I am looking forward for this semester!

-Kathy