Hello, my name is Sandra Rischmiller.
I'm a clinical facilitator with the university.
In the following scenario, I'm doing a roleplay with one of our
student nurses in the nursing laboratories.
We hope to demonstrate to you the type of interaction and communication
that goes on between a Clinical Facilitator and a student nurse when they
are in the clinical situation.
We are looking at showing you the way in which the clinical facilitator tries to
assist the student nurse to really think about their Clinical Practice,
to identify what they've learned from that clinical practice,
and how to prepare themselves for their next clinical practice
by identifying their own goals and objectives that they would like to meet.
In this way, we hope that between
the two of us, the student nurse will actually have a clinical experience that is
very effective, and one which they will also enjoy.
Hello Jo --
have you had a good day today?
Yes, I have thanks, Sandra.
Yes? and I thought what we might do is just, you know, get you to have a look
at what you've been doing today with the patient you've got on your w... the
RN had several patients, but there was one in particular you were going to
focus on --
so maybe we could start with you just telling me a little bit about
the patient you had, and perhaps what you have learned about that patient
as a person.
Yeah, well today, I was paired with Mary Jones who is RN on the ward, and
she had four patients allocated in one room, but I sort of helped her out with
looking after a certain patient, and she was a lady, and she was, had come in
the n... last night for --
she was having her gall bladder removed this afternoon.
Ah right.
So, she had been, um, given a cannula this morning
at 6a.m. and was nil by mouth until the surgery this afternoon, so
one of the aspects of the care I had to give her was, um, the RN asked me to go
and assess the cannula site, because she had some maintenance fluids running,
and um, so we were checking the
new cannula that had been put in.
So I went in to talk to her, and introduced myself and things, and I asked if I
could look at her cannula site, and she looked at me very confused, and then
she --
I sort of subbed (? not sure about this word) that she
didn't really know what the cannula was or what it was doing,
why there was a bag hanging next to her, so I sort of explained to her
what it was --
and it sort of surprised me because I thought that, like, that somebody
would have told her this already, bec
ause --
Yes, you do tend to assume that, don't you?
Yeah, so she --
I think that she really liked that she was given an explanation,
and then after that she sort of seemed like she was very happy to work with
-- um
-- with me, and I think she could
see that I was going to explain what I was doing, which was good.
And so I explained the cannula site and I said there
was --
um --
there were no problems with it, she didn't have any pain, and
there was no swelling or anything.
So I tried to take her through what the
complications could be --
Oh great, yeah.
-- like, what I was looking for when I was assessing
a site, and yes, she didn't um
-- so I'd asked her at the beginning if she had
been explained that she was 'nil by mouth' and that she couldn't eat
or drink anything, and she said that yes, she hadn't been given breakfast
and that was, she understood that, but then she asked me if she could have a
cup of tea --
and so I'm --
Obviously something missing!
-- yeah, and um, so I think that she thought
a cup of tea would just be something simple that she could have
--
Mmm...
-- but then, so I had to sort of explain to her
that she couldn't
have a cup of tea, and why it was important that she couldn't
have ANYTHING in her stomach, and that the fluids should help her
not get dehydrated.
But I thought
that was really interesting because --
um, someone had told her not to
have anything to eat or drink, but she still asked for
a cup of tea, so I
think that showed me that, like, you need to sort
of reinforce things, or confirm that she understood exactly what that meant
-- could've been important.
Absolutely --
I think
you find that, don't you?
You can find that with a lot of patients
-- you explain something to them and then walk
away, assuming that they actually understood
--
Yes.
-- but if
you don't actually go back and perh... at
a later stage --
and ask the patient
something
that would allow them to explain what it is they actually
know, you often find out they really only understood part of what
you were saying.