CLINICAL ACTIVITY: 1

Date / Time:
Workplace / Unit:
Title of Learning Activity / Task: COMMUNICATION SKILLS

Summary:

The process of communicating ideas, thoughts, views, information, and facts such
that the message is received and comprehended with clarity and purpose is known
as effective communication. One of the very first things I learnt on this clinical day is
that body language plays an important role in communication, especially for patients
with hearing or cognitive impairments. Their body language can convey care, trust
and love. For an elderly patient who can no longer hear so well, the message you
convey with your body language is of great importance. Speaking to a patient at eye
level and using an open gesture can make that person feel comfortable, safe, valued
and cared for. One of the mistakes I make in the clinic is that I unconsciously put my
hands in my pockets because it's so cold, but this gesture can make me look
unprofessional and uncomfortable, shy and avoid contact.

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Summary:

One of the best leadership skills that fosters activity is being the ward manager for
certain shifts. Nurses rely on their ability to motivate and inspire teams and nursing
staff to develop high quality practices. Nurse management is the process of leading
nursing teams and departments to maintain best practice and organisation. Nurses
play leadership roles throughout a medical organisation, such as leading changes in
departments and facilities, developing innovative methods to provide better patient
care, and pioneering how their organisations meet goals and align with core values.
I was delighted and happy to have very supportive supervisors and teammates who
taught and guided me along the way. I also updated myself by attending webinars
and workshops related to chronic disease management. I had the opportunity to
follow doctors' consultations in the clinic as part of my onboarding programme, which
allowed me to go deeper and learn and become familiar with disease processes and
treatment plans. During this activity, I get to manage my time doing multiple tasks in
a day and also work along with other teammates to accomplish clinical goal.
Hospitals also have meetings with senior management that help to address many of
the issues and challenges that staff face at work. I participated in one of them and
realised that good eadership skills are developed through experience and continuous
learning.
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CLINICAL ACTIVITY: 3
Date / Time:
Workplace / Unit:
Title of Learning Activity / Task: EVIDENCE-BASED PRACTICES

Summary:

Bedsores or pressure ulcers are a serious public health problem throughout the
world. Evidence-based initiatives play an important role in the prevention of pressure
ulcers. Risk assessment, skin care, nutrition, position change and education are
among the essential practices that form the basis of care. The development of
pressure ulcers can be rapid. Although most wounds heal with treatment, some
never heal completely. Nurses can take measures to prevent this. In designing the
repositioning protocol, consideration should be given to the patient's tissue tolerance,
degree of mobility, health status and treatment goals, as well as the available
positioning surface.

During my clinical attachment, I managed a patient with pressure ulcer. The nursing
care plan that I engaged including the prophylactic measures against pressure ulcers
such as regular rolling of the patient. Necrotic tissue promotes bacterial growth and
impairs wound healing. Hence, I monitored the wound carefully and dressed as per
ordered by doctor on time. Wounds should be cleansed at baseline and at each
dressing change. The wound dressing include the use of a 35-ml syringe and 19-
gauge angiocatheter provides a level of force that is effective yet safe; the use of
normal saline is preferable. Wound cleansing with antiseptic agents such as
povidone-iodine [Betadine], hydrogen peroxide, acetic acid should be avoided as
they destroy granulation tissue.
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CLINICAL ACTIVITY: 4
Date / Time:
Workplace / Unit:
Title of Learning Activity / Task: REHABILITATION GERIATRIC AND PALLIATIVE
CARE MANAGEMENT
Summary:

Physical activity is an essential component of care management for all older adults,
including frail older adults with multimorbidity. All physical activity, no matter how
small, has the potential to influence functional independence and quality of life.
Partnering with the older adult and caregivers along with interprofessional providers,
such as a physical or occupational therapist and community-based resources,
facilitates the development of successful goals and plans and the implementation of
activities to promote physical activity across the continuum of care.

During this process, I engaged in lifting the patient to sit up straight with some back
support. I also helped the patient to take short walks, such as going to the toilet from
the bed. In addition, I encourage patients to stretch and use a cane to gain
confidence in walking around the ward. The intervention consists of exercises
specifically targeting their deficits in strength, balance and coordination, and
endurance.

Work with older people includes being patient, talking to them and treating them with
care. Every physical activity, no matter how small, can help maintain or improve
function and quality of life. Since no single provider can meet all of a person's needs,
especially for older people, it is essential to work with an interprofessional team and
community resources.
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CLINICAL ACTIVITY: 5
Date / Time:
Workplace / Unit:
Title of Learning Activity / Task: Team Building / Collaboration
Summary:
The management of ward stock involves a wide range of activities, such as
interpreting prescriptions, ordering and receiving stock, and managing expired
medicines. Most of these activities are carried out by the ward nurses. Following the
administration of the morning dose to the patient at 8 a.m. every morning, the
medication trolley is sent to the pharmacy unit to replenish the ward's stock of
medicines. Furthermore, so that the pharmacist can process new prescriptions.
Medications from the ward stock and prescriptions can be processed by the junior
pharmacist or the pharmacy assistant in the inpatient unit or satellite pharmacy, after
which the pharmacist checks and verifies the medications before they are picked up
by the nurses. This trolley will be collected by the ward nurse usually before the next
administration dose at 12pm. During this activity, it is my turn to send the medication
trolley to the pharmacy. In this activity, I was able to communicate with the pharmacy
staff and learn about the preparation of the medication trolley. Prior to collection of
medications, I will check the supply received and informs the pharmacist if there is
any discrepancy. Counterchecking is done by a different pharmacist from the one
who perform the medication filling. All filling errors must be documented accordingly.
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