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Clinical Placement Reflection #2
Taylor Hyrtle
Trent University
NURS 3020
Jan Scott
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Clinical Placement Reflection #2
One day at clinical placement, I made the mistake of not immediately telling the
nurse I was assigned to that my patient was having 3/10 “chest” pain at rest and 5/10
“chest” pain on exertion. I was assigned to two patients that day, and I was also looking
after and doing assessments on another student’s patient, as she left the floor to go to the
Cath Lab that day. Although this is no excuse, I felt a little overwhelmed, as it was one of
the first weeks we were assigned more than one patient. I ended up finding my nurse
about a half an hour later to tell her about the patient’s “chest” pain. The nurse was very
furious and decided it was best to raise her voice at me in front of the nursing station. I
also witnessed her go into the medication room and begin to talk about me to another
nurse and she continued to talk about me at the nurse’s station after the situation was
already resolved. The patient ended up having diaphragmatic pain that she also
experienced the night before, and it was written in the progress notes of her chart. After
having an in-depth conversation with my clinical instructor on what to do if someone is
experiencing chest pain, I went to apologize to the nurse.
I was really taken aback by the way the nurse reacted in this situation. It was very
unprofessional of her to lose her temper with me while there were a number of people
around us. However, on the other hand I can rationalize with her response. As a nurse,
you are responsible for making your patients as comfortable as possible, such as
administering pain medication, and even more importantly, keeping your patients alive.
Therefore, I can understand her reaction because having chest pain is such a serious
situation and has to be responded to very quickly. Although this is true, I felt very
threatened and bullied in this scenario. I feel that the nurse I was assigned to should have
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reacted more professional and understanding because I am a student and I am learning. I
believe she should have had a little more patience with me and should have taken the
time to explain the importance of reporting chest pain and what I specifically should have
done in that situation, instead of acting inappropriate in the way she did. From analyzing
this experience, I realize now that having chest pain is a situation that has to be taken
very seriously. I now know that there is a limited amount of time to react to someone
having a cardiac concern, because it could be an indication of a more serious condition,
such as an MI. Therefore, the sooner a problem is identified, the faster individuals can
respond to the situation and reduce a complication.
I believe the BPG of Professionalism in Nursing can directly be applied to this
situation. There are three elements to professionalism as mentioned in this BPG, the first
element is physical and structural policy components, the second element is cognitive,
psycho-social, and cultural components, and the third element is professional and
occupational components (RNAO, 2015). At the individual level, the nurse includes the
personal attributes, skills, and knowledge that determines how she/he responds to the
physical, cognitive and psycho-social demands of work (RNAO, 2015). Included among
these factors are commitment to patient/client care, the organization and the profession;
personal values and ethics; reflective practice; resilience, adaptability and selfconfidence; and family work/life balance (RNAO, 2015). I believe that if the nurse did
not display her personal reaction and feelings toward the situation, it would have resulted
in a better learning experience for myself. Although I did learn the extreme seriousness of
cardiac pain, I would have respected her more as a RPN if she reacted differently.
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Another reference that could have been applied in this situation is Ida Jean
Orlando’s contribution to nursing theory: Deliberative Nursing Process. This theory
encompasses how the nursing process is set into motion by the behaviour of the patient
(Petiprin, 2015). In this situation, once the patient told me about her “chest” pain, I
immediately should have gathered all important information pertaining to her pain, such
as the “PQRST” pain assessment tool and then reported this information to her nurse, or
my clinical instructor, or the charge nurse. By implementing the nursing process, it would
allow me to think through the problem and implement important steps needed to reduce
her “chest” pain and determine the underlying cause of it.
In conclusion, I have learned a lot from this situation that will only allow me to
grow as a future nurse. I now know that if someone is experiencing chest pain and I
cannot locate my nurse, I am to tell my clinical instructor, the charge nurse, or the nurse I
am assigned to’s partner. Chest pain is a very serious condition, especially on the unit
that we are located on that specializes in cardiac care. I know now that there is only a
limited amount of time that will be effective when responding to cardiac pain, because it
could be a possible indication of a serious emergency situation, such as an MI. If a
similar situation arose, I now know to immediately tell someone and react aggressively
towards an identical situation, because the results could potentially be a lot more serious
than the specific situation that I experienced.
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References
Petiprin, A. (2015). Nursing theory. Retrieved from http://www.nursing-theory.org/
nursing-theorists/Ida-Jean-Orlando.php
RNAO. (2015). Best practice guideline of professionalism in nursing. Retrieved from
http://rnao.ca/sites/rnao-ca/files/Professionalism_in_Nursing.pdf