Emma's Nursing Portfolio

Emma's nursing portfolio.

"As a nurse, we have the opportunity to heal the heart, mind, soul and body of our patients, their family and ourselves. They may not remember your name but they will never forget the way you made them feel"

  • MAYA ANGELOU
Hi, my name is Emma Lanthier, I am a nursing student at Trent University in my third year of studies.
My Philosophy and Beliefs of Nursing

Nurses are caring, passionate, hard working and play an important role in healthcare. For me, a nurse means being selfless, kind, dedicated and strong. Throughout a nurse's career, they will be exposed to many happy moments but also many challenges. Throughout these challenges, nurses need to face adversity and ensure they have effective coping mechanisms to aid their own health. Another important aspect of nursing is effective communication and collaboration with peers and patients. I think that being able to work as a team is a very important skill in nursing to essentially provide quality care for patients. Furthermore, nurse-patient relationships are a large component of quality care; these components include equality, cultural implications, respect, etc. In nursing it is important to understand and apply these characteristics and skills into the workplace all while following the code of ethics and implementing proper nursing practice.

I chose nursing as a career because I have a need to care for people. Furthermore, I have a sense of leadership, high communication skills, I am empathetic, and like to bring positivity into my surroundings through my humour and happy personality. In addition, I have earned a bachelor's degree in Neuroscience and Mental Health prior to entering nursing school. After my degree I wanted to use the knowledge and skills learnt and apply them to helping individuals in the healthcare profession. With my background and my desire to help, I believe that I can develop the proper nursing skills, be a great team member, and provide quality care to patients.

My Values

Four personal values that align with my style of nursing.
Accountability

Accountability is the ability to take responsibility for one’s actions. I think being accountable aligns with my core values because I am an honest person who wants to provide quality care while following the code of ethics.

Promote Health & Wellbeing

Promoting health and wellbeing is the ability to provide positive resources and tools to those in need. I believe that promoting health and wellbeing is an important value to have because it provides positivity and good health behaviours in the workplace and in care.
Leadership

Leadership is when one or multiple individuals have the ability to impact, guide and motivate those surrounding them. Leadership is one of my core values because I find many leadership qualities in myself. I like to demonstrate proper care, have good communication/ collaborative skills with peers and provide motivation to achieve tasks.
Justice

Justice is the ability to treat everyone with equal treatment and fairness. Having a value such as justice in the workplace is very important nowadays, given the high rates of diversity and cultures in Canada. I believe it is important to treat everyone with the same morals and level of care, to be able to achieve justice in the workplace.

SMART goals

During my clinical placement in 2022, I will be giving myself 2 SMART goals that will be set to be accomplished by the end of the 2022 winter semester. My two SMART goals involve organization and patient assessments.

By the end of the 1020 clinical placement, I want to be able to improve my organizational skills. In clinical placements, it is important to organize your time, documents, and patients to be able to work efficiently and effectively. I will achieve this goal by preparing my assignments and documents before class and inputing important dates and study sessions into my calendar. Organization is a skill that can be beneficial with my studies, in the workplace and in everyday chores.

By the end of the 1020 clinical placement, I want to gain the ability to perform head-to-toe assessments on multiple patients. Head-to-toe assessments are critical in every nursing position and I want to be able to perform this task with perfection and without help. I will achieve this goal by implementing study sessions in my schedule before placement to review each head-to-toe assessment. In placement, I will practice implementing my learning with the patients and practice charting their values. By mastering this skill, I will be more prepared for future placements and classes.

Reflection

Reflection is a large part of nursing practice. Nurses must reflect on their work by looking at their strengths, weaknesses and feedback from others. Reflecting as a nurse can help achieve short and long-term goals, and ultimately help improve patient and self care.
When I think of why I entered the nursing profession, I wanted a career that makes a difference in society. Without nurses, healthcare systems would not be functional. Additionally, nurses are the ones that spend the majority of the time with the patients and provide the care. With my neuroscience background, I wanted the element of making a difference with the information I learnt. Ultimately I decided that nursing would give me that opportunity of making a difference with individuals suffering from neurological disorders. I am a very passionate person, who loves to help others and be collaborative. This being said, nursing will allow me to learn the hands-on experience needed.
With the first school semester almost completed, I already feel like I have strong moral values and nursing identity. Having a good sense of identity and values in nursing is important for work satisfaction and health promotion (Peter et al., 2018). This being said, I feel as though I am a nursing student that already has strong values and identity due to my undergraduate degree in neuroscience. One aspect of nursing that does worries me, is whether I will like to work with patients on the neurology floor. This concern stems from not having the hands on experience of working with these patients. I think I will need to incorporate self-reflection when starting clinical placements, especially when I will be working with patients on the neurology floor. Studies have shown that by self-reflecting during placements, nursing students have decreased anxiety and increased nursing competencies (Pai et al., 2017). Additionally, by controlling my anxiety, I will be able to better assess how well I like working on the neurology floor. I need to remind myself that a degree is never lost knowledge and whether I continue my path in neuroscience or explore other nursing departments, I will still have achieved something I am proud of.

Pai, H-C., Ko, H-L., Eng, C-J., & Yen W-J. (2017) The mediating effect of self-reflection and learning effectiveness on clinical nursing performance in nursing students: A follow-up study. Journal of professional nursing, 33(4), 287-292. https://doi.org/10.1016/j.profnurs.2017.01.003

Peter, E., Simmonds, A., & Liaschenko, J. (2018). Nurses’ narratives of moral identity: Making a difference and reciprocal holding. Nursing Ethics, 25(3):324-334. https://doi.org/10.1177/0969733016648206

Artifacts

These images are a collection of achievements, values, and characteristics that define me and my personality. Click on the images to learn more about me.
NURS 1002

PERSONAL LEARNING BLOGS

Within the Winter 2022 semester, I've learnt many concepts relating to the older adult population and got experience providing care to this population through my long term clinical placement. From these learning experiences, I chose to discuss three personal learnings; The gentle persuasive approach in dementia care, caregiver support, and palliative care. Each of these personal learnings have impacted my nursing knowledge, experience, and future practice.

GENTLE PERSUASIVE APPROACHES IN DEMENTIA CARE (GPA)

The gentle persuasive approach in the dementia care model was an excellent learning tool that encompassed the major hallmarks of dementia. I also found this topic to be very relatable to my current clinical placement in the long term care facility. Within the dementia care model, the most important learning module to me was the verbal redirection/reality orientation. I found this learning to be the most impactful because several years ago, my Opa passed away from Alzheimer's Disease and more recently my Oma was diagnosed with Dementia. Because of this, I have witnessed within my own family (as displayed in the above picture) the consequences and benefits of using the verbal redirection and reality orientation method. After reviewing the concept, I found verbal redirection to be very effective and I personally think that entering the reality of the person does not dismiss their feelings and emotions instead, it makes them feel more comfortable in their environment because you become present in the moment with them. Chui et al., (2018) conducted a study that showed how reality orientation therapies improved cognition in older adults suffering from dementia. Within the therapy sessions, older adults attended social gatherings that included calendars, clocks, and other members. These sessions allowed for the older adults who suffer from dementia to orient themselves to the present reality without them needing to be verbally redirected. These sessions were held 2-3 times per week and the overall result were improved cognition (Chui et al., 2018). This research highlighted the importance of reality orientation and allowed me to better understand how reality orientation can be used as an intervention method for improving cognition with individuals suffering from dementia. Furthermore, I understood the bigger picture of reality orientation, when we spoke of the three D’s of cognitive impairment in my NURS 1002 course. In NURS 1002, we covered the concept of delirium, dementia, and depression. As it relates to dementia, there were examples of what are appropriate and inappropriate ways of validating and redirecting conversations. For example, if a resident were to become worried and said that she must pick up her kids from school, you could reply “No, you don’t need to pick up your kids from school.” as oppose to saying “Your kids aren’t in school anymore, they visited you yesterday.”. These examples gave me a better understanding of how to communicate effectively with someone suffering from dementia, and how I would incorporate verbal redirection within my nursing practice. As a result of this, I now that I have a deeper understanding of the benefits of reality orientation and how to effectively use verbal redirection, I must now practice this skill set within my nursing placements.

Those with Dementia are still people and they still have stories and they still have character and they are all individuals and they are all unique. And they just need to be interacted with on a human level.

Carey Mulligan

CAREGIVER SUPPORT

Many individuals will associate care with healthcare workers. Although this is true, other unpaid or volunteer caregivers exist everywhere around the world. For example, you could care for your grandparents, parents, spouse and children without having a healthcare background. In the picture above, you can see my clinical placement team, we supported each other, encouraged each other, and learnt many things together. Each one of us will aspire to be nurses in various fields and some may choose to work with the 20% of paid caregivers who care for older adults. The one thing that stood out to me the most about this topic is that 80% of the older population is cared for through unpaid caregivers. Although I am a strong advocate for supporting the mental health of healthcare nurses, it is also important to recognize the caregivers who do not get paid and who also need support. Furthermore, in nursing school, we are taught about healthcare burnout, what resources are available, and the different coping mechanisms that could work for us. Conversely, unpaid caregivers might not have courses, teachers, or other resources that prepare them for caregiving. One research study looked into low and middle income countries and the health of unpaid caregivers (Magana et al., 2020). Magana et al., (2020) found increased anxiety and depression amongst unpaid caregivers versus the general public. In addition, they found that certain social determinants of health impacted these results. I personally think one major social determinant of health is the individuals accessibility to healthcare. If a caregiver does not have the proper resources and access to care, then it can cause increased stress on the caregiver and the individual receiving care. With this in mind, further learnings in NURS 1002 helped me see the bigger picture through recognizing the signs of caregiver distress. As a future nurse, it is important to recognize common signs and symptoms of caregivers distress. Furthermore, if common caregiver distress signs are evident, then assessments such as The Zarit Burden Assessment can be used to determine the severity. If I were to come across an individual who is experiencing caregiver distress, it could be beneficial to provide them with resources and coping mechanism that could be useful to them, "When caregivers become immersed with the needs of others, they often forget to take into account their own emotional and physical health" - Home care assistance. One question that I still have about caregiver support is; what if a caregiver is severely burnt out and can no longer care for the individual but does not have the funds to seek other help? I do believe there are some financial aids to support these individuals, however, most aren’t sufficient enough as a long term method. Within my future nursing practice, I will continue to support paid and unpaid caregivers to ensure they have proper resources and strategies to support their overall health. For inspiration to all caregivers, here is a video of Rise Up by Andra Day.

PALLIATIVE CARE

Many individuals believe they know what palliative care entails. To be completely honest, so did I. After completing the “Taking Ownership in Palliative Care” module, I became increasingly aware of the false associations people make with this type of care. I chose this topic because palliative care is an excellent healthcare resource for individuals suffering from long term diseases. The majority of the population associates palliative care with dying, however, the most important lesson that I took away from this module was that individuals who took an early approach with palliative care have an increased quality of life, live longer compared to others with the same disease, and have decreased anxiety and depression. Fliedner et al., (2017), found that it is difficult to introduce palliative care to an individual because they feel like palliative care accentuates the fact that they are nearing the end of their life. However, those who took part in palliative care, experience the benefits of early interventions. The researchers of this study explained how healthcare workers should introduce palliative care depending on the individual, their personality, and their diagnosis. Although it can be an emotional topic, introducing and explaining to the individual the support that palliative care has to offer can be beneficial towards their health (Fliedner et al., 2017). Within the NURS 1002 course, I learned that transition periods can occur at any stage in life, however, health changes and illnesses can trigger a transition period that causes grief. As a nurse, you can play an active role in facilitating certain transition periods. This can be a difficult task since so many individuals grieve in different ways. This helped me understand that palliative care is a person-centered practice. Now that I have a better understanding of palliative care, I will be able to apply it in many different settings such as long term care homes, hospitals, and at home. As displayed above, there are 5 generations still alive on the paternal side of my family. After my grandmother was diagnosed with cancer, she took an early intervention to care. My family saw the health benefits that came from palliative care and because of this, it encouraged them to take early interventions with their own care. Therefore, I want to promote the wellness and supportive care that comes with introducing palliative care to a patient. Furthermore, I will ensure that I use proper language, empathy, and behaviours to support individuals when introducing the concept of palliative care within my future nursing practice "We cannot change the outcome, but we can affect the journey" - Ann Richardson.

References

  1. Chiu, H.-Y., Chen, P.-Y., Chen, Y.-T., & Huang, H.-C. (2018). Reality orientation therapy benefits cognition in older people with dementia: A meta-analysis. International Journal of Nursing Studies, 86, 20–28. https://doi.org/10.1016/j.ijnurstu.2018.06.008

  2. Fliedner, M., Zambrano, S., Schols, J.M.G.A., Bakitas, M., Lohrmann, C., Halfens, R.J.G., & Eychmuller, S. (2019). An early palliative care intervention can be confronting but reassuring: A qualitative study on the experiences of patients with advanced cancer. Palliative Medicine, 33(7), 783–792. https://doi.org/10.1177/0269216319847884

  3. Magaña, I., Martínez, P., & Loyola, M. (2020). Health outcomes of unpaid caregivers in low‐ and middle‐income countries: A systematic review and meta‐analysis. Journal of Clinical Nursing, 29(21-22), 3950–3965. https://doi.org/10.1111/jocn.15450

NURS3020: Clinical practice in Acute care 

CLINICAL PLACEMENT

For the Winter 2023 semester, I was placed on the Medical unit at the Ross Memorial Hospital in Lindsey, ON. This acute placement provided me with multiple opportunities to build and enhance my nursing skill set. Throughout the semester, I was able to care for individuals with an array of health complications such as gastrointestinal bleeds, supplemental oxygen needs, chronic obstructive pulmonary disease, dementia, and much more. By working closely with these patients, I have been able to enhance my nursing skills such as suctioning, priming lines, administering medication, documenting, aseptic wound dressing changes, gastrostomy tube feeds, and more. Every clinical day, I gain more and more confidence in myself and in my critical thinking skills, which has allowed me the opportunity to grow and flourish within my student nursing journey.

rnao membership

Since the beginning of nursing school, I have been part of the Registered Nurses' Association of Ontario (RNAO). RNAO provides voices for nurses in Ontario and promotes healthy public policy. Being a member of the RNAO promotes my nursing values such as being a leader, an advocate, and promoting health and justice. This membership sends me current and relevant information about nursing in Ontario which makes me feel apart of the community and up to date on the current literature. 

silo smart goals

At the beginning of the Winter 2023 semester, I was asked to provide four SMART goals that were to be completed by the end of my clinical placement. The SMART goals I chose were the following; to improve my time management, documentation skills, confidence, and critical thinking skills. Throughout the acute care placement, I was able to effectively manage my time to go on lunch breaks, execute proper documentation skills, improve my level of confidence, and share effective critical thinking skills to my peers and preceptor. Overall, I believe that I have reached each SMART goal throughout my acute care placement.  

simulation lab reflections

During the Winter 2023 semester, I attended four laboratory simulations to test my skills and knowledge of multiple acute illnesses. Throughout these simulations, my peers and I worked collaboratively to assess, intervene and manage the acute illness presented to us. Furthermore, we were able to practice hands on skills such as medication administration, priming lines, setting up infusion pumps, chest tube assessments, assess total body surface burn percentage, and much more. These simulations also required a post-reflective analysis using Gibbs reflective cycle. These reflective analysis' allowed me to provided feedback on my performance and areas for improvement. Overall, these simulations were effective at implementing acute theory into real life scenarios, which has helped solidify my learning outcomes for acute illnesses. Furthermore, the post-reflections highlight the importance of reflecting throughout nursing careers because it helps to identify areas of improvement and areas of achievement. 


NURS 3021H:

Clinical Practice

Chronic Disease

Midterm Evaluation


Over the course of this clinical placement, I have been able to expand my knowledge and skills. I've been able to remove staples, change wound dressings, and administer a variety of medications. In each domain, I've demonstrated accountability, reliability, and leadership qualities. Each week, I feel like I have more confidence, and I am continuing to learn everyday. Some areas of development for my final includes connecting my patients diseases to their health history and supporting this information to the literature. It's always important to reflect on the patient as a whole and connect everything together. 

Reflections

Care Plans

Throughout this clinical practice, I've created a care plan every week. These care plan consist of a thorough analysis of the patients health history, nursing diagnosis, laboratory values, and patient evaluation/goals. I've picked different patients each week to cover more areas of health related issues. I ensure to use peer reviewed literature to interpret the findings. 

Significant Event Reflection

I picked a significant event during the chronic placement and wrote a reflection on it. In this reflection, I spoke of the day I spent on the palliative care unit. During my time on the unit, a patient passed away and I assisted the primary nurse with post-mortem care and all the legal procedures that followed. 

Developing practice competences

& 

Chronic Disease practice

Simulations

Throughout the semester, I attended simulation labs that helped solidify hard skills such as sliding scale for diabetes, focused head to toe assessments, and post mortem care. In addition, all the students would collaborate together to work on soft skills. 

Medication Administration

During placement, I was able to administer medications to multiple different patients. I was able to research the medication the night prior to our clinical day, and was able to correctly identify the rights of medication administration with each medication. 

Documentation on EPIC

I was able to confidently document my head to toes assessments, in and outs, safety protocol, etc. on EPIC. I've gained confidence in my charting skills throughout the semester and was able to care and document for two patients by the end of the term. 

Growth & Development
My chronic clinical placement has allowed me to grow and expand on many hard and soft skills. Hard skills that I have learnt during this placement is medication administration, documentation, and patient safety. Firstly, I've had the opportunity to expand on my medication knowledge by researching my patients medication each week. Furthermore, I've gained confidence in pulling medication from the ADU, and scanning the medication on EPIC. I've encountered scenarios in which I've needed to hold medication and I've also had patients refuse medication. In each scenario, I have been able to document each scenario and provide rationals for why the patients did not take their medication. Secondly, I have gained experience in documenting on EPIC. Specifically, the importance of monitoring the intake and output of the patients on the rehab unit. Thirdly, I was able to implement patient safety skill on the rehab unit. Since most of these patient were recovering from surgery, it was important to teach these patients how to ambulate and transfer in a safe manner.
Some soft skills that I acquired from this placement was collaboration, team report, and taking initiative. Firstly, I was able to collaborate with my peers and help them with transfers. In addition, I was able to collaborate with the primary nurse to care for the patient and provide interventions when necessary. Secondly, I was able to participate in team reports, home care reports and other resource reports such as OT and PT. Additionally, I practiced giving hand off reports to the nurses at the end of the shift. Lastly, I increased my confidence on the unit and began to take initiative with caring for my patients and answering call bells.   
Learning goals for my next placement would be to continue expanding on my medication knowledge, learning how to document on Meditech, and continuing to increase my confidence with different diseases. Each of the listed skills comes with practice and therefore I must continuously learn and immerse myself into situations throughout my next placement. 

ARTICLES IN NURS3021

Throughout the NURS3021 clinical placement, I was able to use peer reviewed articles in my care plans to solidify my patients diseases, health history, and medications. Below are a few of the articles that helped me make connections during my clinical practice. 

Devinsky, O. (2002). What do you do when they grow up? approaches to seizures in developmentally delayed adults. Epilepsia, 43, 71–79. https://doi.org/10.1046/j.1528-1157.43.s.3.2.x

Lubitz, S.A., Benjamin, E.J., Ellinor, P.T. (2010) Atrial fibrillation in congestive heart failure. Heart Fail Clinic, 6(2):187-200. doi: 10.1016/j.hfc.2009.11.001.

Masterson, J.H., Woo, J.R., Chang, D.C., Chi, T., L'Esperance, J.O., Stoller, M.L., Sur, R.L. (2015). Dyslipidemia is associated with an increased risk of nephrolithiasis. Urolithiasis, 43(1):49-53. doi: 10.1007/s00240-014-0719-3. 

References

  1. [FOUR HANDS BONDED TOGETHER]. YOLA,HTTPS://WWW.YOLA.COM/
  2. [HANDS HOLDING FLOWER]. YOLA,HTTPS://WWW.YOLA.COM/
  3. [MOUNTAINS, FOREST AND WATER]. YOLA,HTTPS://WWW.YOLA.COM/
  4. [SHAKING HANDS]. YOLA,HTTPS://WWW.YOLA.COM/
  5. [SPIDER PLANT AND DELL LAPTOP]. YOLA,HTTPS://WWW.YOLA.COM/
  6. [SPIDER PLANT AND DELL LAPTOP]. YOLA,HTTPS://WWW.YOLA.COM/