Be sure you address all of the bulleted items. Use each bullet as a heading for your journal entry.
- Explain what most excited and/or concerned you throughout your pediatric clinical experience.
- Discuss how your personal definition of family and family roles has changed or stayed the same.
- How has your understanding of family and family roles influenced your assessment of children and their families?
- Explain how your understanding of culture (both the culture of the provider and that of the child and his or her family) has changed and how it may have influenced the assessments you conducted during your practicum.
- Assess how you did with accomplishing the goals and objectives you developed in Week 1 for the Practicum experience.
- Based on your Practicum experience, refine your existing goals and/or develop new goals for your continued education and professional practice. Be sure to consider the NAPNAP Position Statement on Age Parameters for Pediatric Nurse Practitioner Practice Found in the Week 1 Learning Resources. See link below
National Association of Pediatric Nurse Practitioners, Professional Issues Committee. (2019). NAPNAP position statement on age parameters for pediatric nurse practitioner practice Links to an external site.. Journal of Pediatric Healthcare, 33(2), A9–A11. https://doi.org/10.1016/j.pedhc.2018.10.007
Journal Entry #1
MSN, Walden University
Dr. Mariah Morris
What excites me most?
I am most excited about my pediatric clinical experiences because I can see how our health system works, especially in a public health setting. The hospital is large and has many different departments. There are nurses and doctors on every floor, and they work together to care for patients admitted at the hospital. It will be interesting to see how hard it is to care for people who need it the most, like children with cancer or other serious illnesses.
Strengths and weaknesses
My strengths include being patient and kind, knowing how to use my time wisely and efficiently, and staying calm under pressure while working with others in difficult situations such as an emergency room or pediatric ward. My strengths of being patient and kind might impact my practicum experience as a practitioner by allowing me to understand the patients’ needs more, which will help me get through this process better than someone who does not have those qualities.
My weaknesses include having difficulty dealing with abrupt scheduling changes or getting frustrated quickly when someone does not understand what I am trying to tell them or when there are problems in scheduling services or medications at different times of the day because of staffing changes during the day or week. The weaknesses might impact my practicum experience as a practitioner because it can make things difficult for me as a nurse where I might cause significant medical errors.
The primary function of the family is to provide emotional support to its members and make them feel secure. Parents also play an essential role in developing the personality of their children. The family roles enabled nurses to provide comprehensive assessments to children. For instance, a child whose family have neglected them might suffer from depression and stress.
Challenges working with families
The most challenging part of working with families in the pediatric department is that they are often under stress and have many fears about their children’s health. Parents want to be sure that what they do is the best for their children. However, our job as practitioner is to reassure them that their children are safe and healthy and that vaccinations are essential for everyone’s well-being.
In my clinical experience, many parents do not want to vaccinate their children because they believe vaccines can cause autism or other severe conditions. I would handle this situation by having an open discussion with them about how vaccines work, how safe they are, and what risks there are (Shen & Dubey, 2019). It will help them understand why we feel it is essential for them to get their children vaccinated as well as allow them to make an informed decision.
Culture is the knowledge and understanding of the beliefs and practices that are a part of a particular community, culture, or society. Cultural factors can also influence how families manage their children’s illnesses. For example, certain cultures emphasize traditional healing practices more than others.
Cultural Competence theory is the most effective in guiding my profession. It is defined as the ability to provide healthcare services with consideration for the patient’s race, ethnicity, culture, gender identity, language preference or socioeconomic status (Danso, 2018). As healthcare providers, we are responsible for our patients and our communities.
Danso, R. (2018). Cultural competence and cultural humility: A critical reflection on crucial cultural diversity concepts. Journal of Social Work, 18(4), 410–430.
Shen, S. C., & Dubey, V. (2019). Addressing vaccine hesitancy: Clinical guidance for primary care physicians working with parents. Canadian Family Physician, 65(3), 175-181.
Journal Entry #2
MSN, Walden University
Dr. Mariah Morris
Nursing in general is a career of challenging an obstacle while still performing with a high level of professionalism. This scenario is undoubtedly the case as I entered my first clinical rotation in adolescent primary care. My strengths were IM injections, assessments, and speaking to parents. Many pediatric patients’ families get nervous when they first come in for their appointment. I try to make them feel comfortable and give them the chance to warm up to me and the environment around them. My weaknesses include communication with pediatric patients, gaining trust from pediatric patients as I tend to be for a lost of words or it may just be my nerves.
In this clinical rotation, we had a patient arrive with his mother who was 6-years-oldwith leukemia. If I remember correctly, he was very energetic and had the greatest smile, I thought he must be here for something simple like diarrhea or flu symptoms since that is what I have seen most as of late. I looked at his chart and my smile turned upside down, he had leukemia with an unknown prognosis.
So, most of the things that I found challenging were related to me maintaining my professionalism, gaining the trust of pediatric patients, and not letting my emotions get the best of me. I understood that once I let my emotions get the best of me and focus on only the child. Talking to the parents was very taxing because their health education was extremely limited. I did my best to explain to them the purpose of the medications, and the assessments we were doing and emphasized that we are doing our utmost to care for their child.
My preceptor is used to seeing sick children, so he was able to treat this just like any other visit while not getting emotionally attached. My preceptor spoke to the parents, and he also spoke to the child about happy topics which has the child smiling and laughing. Nevertheless, if I was to encounter another case like this one, I would do things a bit differently because simple actions like making the child feel comfortable can go a long way when caring for a terminally ill patient (Zisk et al.,2015).
During my rotation, I had a bit of trouble making the parents of the child understand the nature of the disease and why the child might have acquired it. They had a firm belief and at times those beliefs became a barrier for the healthcare team to provide effective care and treatment.
The parents stated they gave up accepting that it is the will of God. Putting faith in God is ok but the parents gave up on the little time the child had, time that could be used to show their love for the child, make him amazingly comfortable and make meaningful memories, which could give meaning to the child’s life before death (Rempel et al.,2004).
The belief that someone put a curse on the child: This is quite common in Filipino culture, especially in rural areas where the health education of the people is extremely limited. I remember talking to the parents and they told me that when the child began showing symptoms, they bought him to see a “witch doctor” in hopes of curing him. In the back of my mind, I thought that what if back then they brought him immediately to the hospital. That could have been detected earlier and his life might have been different from today. At the end, I spoke to my preceptor about how to handle parents and very ill children and he advised it’s a fine line you have to feel the parents out as each case is different.
Rempel, G. R. (2004). Technological advances in pediatrics: Challenges for parents and nurses. Journal of Pediatric Nursing, 19(1), 13-24.
Zisk-Rony, R. Y., Lev, J., & Haviv, H. (2015). Nurses’ report of in-hospital pediatric pain assessment: Examining challenges and perspectives. Pain Management Nursing, 16(2), 112-120.