You are on page 1of 2

Guide for Reflection

Guide for Reflection Using Tanners (2006) Clinical Judgment Model

Program Thread: Communication and Collaboration

I truly enjoyed working with this patient. Despite his condition, he maintained a pleasant
demeanor, and had a good sense of humor. I learned a lot from working with him and Bonnie, his
nurse. This was a great opportunity for me to make the connection to what we are taught in the
classroom, and what we see on the unit. We learned about fistulas during lecture, but it was so
different to see it in person. Bonnie, the patients nurse, explained to me that he had had a small
bowel resection late last year. The patient was doing some house work on a ladder when he over-
exerted himself and accidentally re-opened the surgical incision, resulting in the formation of a
gastric fistula. I was surprised to see how big the wound was. I was also surprised at how little
drainage there was from the Eakins pouch (approx. 300 mL). I suppose I expected there to be
more drainage because of how big the wound was. I was also surprised to learn that it caused the
patient minimal discomfort. He only noted some slight tenderness around the site. This was also
my first experience with TPN. Bonnie was a great help, and explained to me that because the
patient was on TPN, he would have standing orders for sliding scale insulin, and must have his
blood glucose levels checked every 6 hours. Also, the patient was NPO, but could have ice chips.
I offered to get him some several times, but he declined. This both surprised and impressed me,
as every other NPO patient Ive ever had has always been desperate for something to eat or
drink.
Overall, this was a great clinical day, and a wonderful learning experience. It was a big
help to have this patient the day before our GI test! This patient was full of surprises, but taught
me so much. Not only about the clinical aspect of nursing, but also about the mental/emotional
side of it. He was always in a good mood, and maintained a good sense of humor, despite being
in a hospital and NPO for almost two weeks. He chose to look at the bright side of things, which
will definitely help him in his recovery process. Im grateful to have had the opportunity to work
with and learn from this patient, as well as for the opportunity to work with and learn from such
a skilled nurse.
Nielsen, A., Stragnell, S., & Jester P (2007). Guide for reflection using the Clinical Judgment
Model. Journal of Nursing Education, 46(11), p. 513-516.

You might also like