Week one –
Health care is a new journey for me, and in all honesty have really not paid too much thought to the aspect of the Clinical Supervision part. My initial thought, was “oh neat! I get to be inside clinical facility learning!” I am amazed that Stenberg offers such a huge amount of hours dedicated to the CS and Perceptorship, and it is shedding light on how much there is to learn. Having a course dedicated to the CS part, I wonder how we are going to fill our weeks learning about it. It seems that it is fairly cut and dried – this is how it is, and this is what your role will be within it. How can we possibly fill 13 weeks up???
I thought it would shed some light on the subject (and it’s seemingly more complexity than first glance) to look throughout my textbooks. I am amazed that it is not a practice that is mandatory – and I wonder why not all educational institutions and hospitals do not have a CS practice. What aspect of it do they not agree with? I would think, in my limited knowledge, that it is the perfect teaching ground, with the knowledge that is found within RPN staff, and the years that they have worked in the field, it would be a breeding ground for students to come in and learn from them. I did not see it as a burden, as pointed out in Psychiatric and Mental Health Nursing, Chapter 64, “the horror stories that such experiences (no prior notice and little or no training) generate and travel quickly, causing other PMH nurses to resist clinical supervision, seeing it as a form of managerial inspection and control.” (Barker, 2003).
My hope in the next few weeks is to broaden my outlook on reasons behind the resistance to CS. Is it budget cutbacks? Staff shortages? Overworked nurses? Students who are seen as a burden? One more thing that nurses have to do in their already busy client filled day? There is more to this puzzle of just placing students.
Friday
Week 2
Week 2 –
Some aspects of journaling are becoming clearer, and I can begin to see how it is a positive and affirming aspect of nursing. I re-read the article given to us and found that Stoltenberg and Delworth (1987) state that there are eight growth areas –
*intervention
*skills competence
*assessment techniques
*interpersonal assessment
*client conceptualization
*individual difference
*theoretical orientation
*treatment goals and plans
*professional ethics
What I am beginning to realize is that journaling is more than words on paper – it is a summary of what happened in your day; dealing with clients, dealing with co-workers, dealings with supervisors, dealing with families – and it becomes a place to put it all down. Our emotions affect our choices, and if we journal it may aid in releasing these emotions by putting them on paper. I believe that this becomes part of the ownership of nursing.
My fear with journaling is that it will become a “dear diary” of sorts. While I continue to grow and mature in my professional career, my hope is also to develop the skills to be as professional in my journal. This way I can return to it and see strategies and different ways to perform my tasks, and see it less as a “here is what I did today” and more of a “here is what I can learn from today”.
This is my first venture into a true profession, and I wonder how experienced nurses feel about journaling. Will I be working with a CS that embraces this idea? Will they understand the merits of it? Will it be looked upon as a learning tool? Although this is only week two, I see journaling as a way of measuring growth – and my hope is that journaling will also increase my mental health. As I help others find balance in their lives, I also will find it in mine through reflection, introspection, emotional outlet and skills that I am learning that journaling will provide for me.
Some aspects of journaling are becoming clearer, and I can begin to see how it is a positive and affirming aspect of nursing. I re-read the article given to us and found that Stoltenberg and Delworth (1987) state that there are eight growth areas –
*intervention
*skills competence
*assessment techniques
*interpersonal assessment
*client conceptualization
*individual difference
*theoretical orientation
*treatment goals and plans
*professional ethics
What I am beginning to realize is that journaling is more than words on paper – it is a summary of what happened in your day; dealing with clients, dealing with co-workers, dealings with supervisors, dealing with families – and it becomes a place to put it all down. Our emotions affect our choices, and if we journal it may aid in releasing these emotions by putting them on paper. I believe that this becomes part of the ownership of nursing.
My fear with journaling is that it will become a “dear diary” of sorts. While I continue to grow and mature in my professional career, my hope is also to develop the skills to be as professional in my journal. This way I can return to it and see strategies and different ways to perform my tasks, and see it less as a “here is what I did today” and more of a “here is what I can learn from today”.
This is my first venture into a true profession, and I wonder how experienced nurses feel about journaling. Will I be working with a CS that embraces this idea? Will they understand the merits of it? Will it be looked upon as a learning tool? Although this is only week two, I see journaling as a way of measuring growth – and my hope is that journaling will also increase my mental health. As I help others find balance in their lives, I also will find it in mine through reflection, introspection, emotional outlet and skills that I am learning that journaling will provide for me.
Week 3
Week 3 –
This week we are studying the History and Background of Clinical Supervision, and it got me thinking about when journaling came into play. I could not find any tangible information on this, but what I did find helped me to concrete the idea of journaling in my mind. The why to journal I understand. I get that it is a measuring tool, and a reflecting agent. That part I do understand. What I am still attempting to wrap my brain around is why a professor/CS/nurse who I don’t really know tells me to review my day and then grade me on what my perception of this is? How can I be graded on something that is supposed to come from a place of no judgement? “Guided reflective journals are a form of exploratory writing whose purpose is to stimulate student thinking about both theoretical and clinical concepts” (Bean). We are not being graded on the information – but on how we can apply this information. It is, essentially, an explanation of how we determined the outcome of our day – not just a dialogue we would have with ourselves, but an awareness of how we were influenced by our actions.
It suddenly made sense. Journaling is not something that is reflective of your day ONLY. It is a place where the connection is made between what we study and how we apply this knowledge. A light bulb moment for me. It is where theory meets practice, and how we either successfully apply this knowledge or where we can learn from it. Our journal writing needs to be more than descriptive – it also needs to come from a place of reflection. If I only recorded events of the day, this would not help me to learn how to effectively care for my clients. It would be clinical and not therapeutic. I do not wish my journal to be a step by step care guide, but instead be a place of refection of my day, my successes and my failures, and where I can go to learn from these.
Reference:
Bean, John C. Engaging Ideas: The Professor’s Guide to Integrating Writing, Critical Thinking, and Active Learning in the Classroom. SanFrancisco: Jossey, 2001. Print. Jossey-Bass Higher and Adult Educ. Ser.
This week we are studying the History and Background of Clinical Supervision, and it got me thinking about when journaling came into play. I could not find any tangible information on this, but what I did find helped me to concrete the idea of journaling in my mind. The why to journal I understand. I get that it is a measuring tool, and a reflecting agent. That part I do understand. What I am still attempting to wrap my brain around is why a professor/CS/nurse who I don’t really know tells me to review my day and then grade me on what my perception of this is? How can I be graded on something that is supposed to come from a place of no judgement? “Guided reflective journals are a form of exploratory writing whose purpose is to stimulate student thinking about both theoretical and clinical concepts” (Bean). We are not being graded on the information – but on how we can apply this information. It is, essentially, an explanation of how we determined the outcome of our day – not just a dialogue we would have with ourselves, but an awareness of how we were influenced by our actions.
It suddenly made sense. Journaling is not something that is reflective of your day ONLY. It is a place where the connection is made between what we study and how we apply this knowledge. A light bulb moment for me. It is where theory meets practice, and how we either successfully apply this knowledge or where we can learn from it. Our journal writing needs to be more than descriptive – it also needs to come from a place of reflection. If I only recorded events of the day, this would not help me to learn how to effectively care for my clients. It would be clinical and not therapeutic. I do not wish my journal to be a step by step care guide, but instead be a place of refection of my day, my successes and my failures, and where I can go to learn from these.
Reference:
Bean, John C. Engaging Ideas: The Professor’s Guide to Integrating Writing, Critical Thinking, and Active Learning in the Classroom. SanFrancisco: Jossey, 2001. Print. Jossey-Bass Higher and Adult Educ. Ser.
Week 4
Week 4 –
This week was a critical week. We read articles on effective journaling and how to effective journal as a tool for learning. I honestly feel that I write in this journal every week, and it is more of a inner reflection, and less of a teaching tool. I wonder how I will achieve this more advanced knowledge. Is it through continued practice? I still feel so uncomfortable in the mere thought of being on a Psychiatric unit – the unpredictability of it all. It is one thing to say that you are going to school to “be” a RPN, but once we “are” an RPN still fills me with anxiety. To add on this anxiety the aspect of journal writing, seems more stressful. I don’t want to go through the motions only, instead I want to be able to effectively reflect on the day, and discover the meaning behind the actions that are happening around me. I am very afraid that my journal will only record my mistakes, and that I will feel less inclined to record my successes.
In the assigned reading this week entitled, “Reflective Journaling as Assessment and Teaching”, the case studies discussed were developed from the nursing student in their final semester of learning. We are in the first semester of our learning, and so have to understand this and put the reading into a perspective of a new student. Instead of judging how I don’t measure up, I am concentrating this week on what I have to learn from them. How to effectively journal is not something that I can expect of myself to learn overnight, the nurses in the reading have completed many semesters, had many interactions with CS and professors, and in the end, still will continue to learn. How egotistical of me to think that I have to be perfect right away?
“Reflection allows the practitioner to methodically discover meaning and apply these insights in new and different situations” (Johns, C). It is a way of being, something that will come more easy when I learn to live in a constant state of reflection, learning and applying what I know. What I need to work on is to take the pressure off how I think I should be and instead just be myself. That is where I will truly learn and be free of this perfectionist burden to fully reflect on my journey.
References:
Johns, C. Reflective practice: Revealing the art of caring. Int J Nurs Pract. 2001;7(4):237-245.
This week was a critical week. We read articles on effective journaling and how to effective journal as a tool for learning. I honestly feel that I write in this journal every week, and it is more of a inner reflection, and less of a teaching tool. I wonder how I will achieve this more advanced knowledge. Is it through continued practice? I still feel so uncomfortable in the mere thought of being on a Psychiatric unit – the unpredictability of it all. It is one thing to say that you are going to school to “be” a RPN, but once we “are” an RPN still fills me with anxiety. To add on this anxiety the aspect of journal writing, seems more stressful. I don’t want to go through the motions only, instead I want to be able to effectively reflect on the day, and discover the meaning behind the actions that are happening around me. I am very afraid that my journal will only record my mistakes, and that I will feel less inclined to record my successes.
In the assigned reading this week entitled, “Reflective Journaling as Assessment and Teaching”, the case studies discussed were developed from the nursing student in their final semester of learning. We are in the first semester of our learning, and so have to understand this and put the reading into a perspective of a new student. Instead of judging how I don’t measure up, I am concentrating this week on what I have to learn from them. How to effectively journal is not something that I can expect of myself to learn overnight, the nurses in the reading have completed many semesters, had many interactions with CS and professors, and in the end, still will continue to learn. How egotistical of me to think that I have to be perfect right away?
“Reflection allows the practitioner to methodically discover meaning and apply these insights in new and different situations” (Johns, C). It is a way of being, something that will come more easy when I learn to live in a constant state of reflection, learning and applying what I know. What I need to work on is to take the pressure off how I think I should be and instead just be myself. That is where I will truly learn and be free of this perfectionist burden to fully reflect on my journey.
References:
Johns, C. Reflective practice: Revealing the art of caring. Int J Nurs Pract. 2001;7(4):237-245.
Week 5
Week 5 –
The Code of Conduct and Standards of Practice was a lot to digest this week. I have never been part of any organization with a formal, written Standard of Practice and so I found this to be very interesting. I have been blessed to run a daycare out of my home, and in doing so, have been accountable to the families that I provide care for, as well as protection of my reputation in the community, but have not had a governing body that looks after me. It will be such a great environment to be in, surrounded by like minded individuals, with common goals and standards, as well as a standard level of education and training. All of us will graduate from Stenberg with the same expectations placed on us, the same amount of clinical hours, theory and practice. We will be equals in the field that we chose to work in. While some of us may excel at certain aspects of the job, others will learn from this. Our outcome should be the same – effective therapeutic relationships that we build within our clients, co-workers, and team members. When someone is acting outside of the Standards of Practice, there are concrete, written disciplinary measures that can be made.
This is different from any job that I have had. I have been in a job with a boss, that at any time can be transferred, and another boss comes in to replace them. The interpretation of my job changes with who is in charge, not with any written conduct and standard that is being followed. So in turn, there becomes grey area, areas that are expected to be achieved, but with no guideline of how to accomplish this, nor any time frame in which the job needs to be completed by. I believe this is the number one reason for job dissatisfaction. The lack of communication that is evident in the work force.
Now, I may be looking at the Standards of Practice with rose coloured glasses, and it may be more complex and diverse than that first glace, but that is not taking away my excitement of having a body of like minded individuals working alongside of me.
The Code of Conduct and Standards of Practice was a lot to digest this week. I have never been part of any organization with a formal, written Standard of Practice and so I found this to be very interesting. I have been blessed to run a daycare out of my home, and in doing so, have been accountable to the families that I provide care for, as well as protection of my reputation in the community, but have not had a governing body that looks after me. It will be such a great environment to be in, surrounded by like minded individuals, with common goals and standards, as well as a standard level of education and training. All of us will graduate from Stenberg with the same expectations placed on us, the same amount of clinical hours, theory and practice. We will be equals in the field that we chose to work in. While some of us may excel at certain aspects of the job, others will learn from this. Our outcome should be the same – effective therapeutic relationships that we build within our clients, co-workers, and team members. When someone is acting outside of the Standards of Practice, there are concrete, written disciplinary measures that can be made.
This is different from any job that I have had. I have been in a job with a boss, that at any time can be transferred, and another boss comes in to replace them. The interpretation of my job changes with who is in charge, not with any written conduct and standard that is being followed. So in turn, there becomes grey area, areas that are expected to be achieved, but with no guideline of how to accomplish this, nor any time frame in which the job needs to be completed by. I believe this is the number one reason for job dissatisfaction. The lack of communication that is evident in the work force.
Now, I may be looking at the Standards of Practice with rose coloured glasses, and it may be more complex and diverse than that first glace, but that is not taking away my excitement of having a body of like minded individuals working alongside of me.
Week 6
Week 6 –
This week we further discussed the Standards of Practice, but one of the threads that was subsequently created was dealing with Nursing Care Plans. I did not comment on this thread, as I had honestly never heard of a care plan, nor did I understand the significance of this. It was very interesting to read some of the discussions, especially from my fellow students who come from a LPN background. While it is something that is completely daunting to me, to develop a plan for a client, I also know that it is something that I am going to have plenty of opportunity to watch, be supervised over, and have my questions answered while still a student.
While working in the school board (over 10 years ago now), I was part of a team of professionals that worked on IEP’s. This is Individualized Education Plans, and I kept thinking of the parallels of these two plans. As with IEP’s, a multidimensional team made up of psychiatrists, teachers, student assistants, counsellors, and administration would come together and assess the student. Together we would provide knowledge, insight and history to develop the IEP. We would take into account the student’s learning style, any personal care they need, any medications they are on, their level of education, as well as any community involvement that they need. No two IEPs looked alike, as each student is individual, requiring different levels of care. I believe this to be true with nursing care plans as well. This would be why there is no standardized form – but instead a list of guidelines to follow, questions to ask, and information to gather so that the care plan can be created for care, resolutions and evaluation.
Wikipedia explains it this way:
A nursing care play outlines the nursing care to be provided to a patient. IT is a set of actions the nurses will implement to resolve nursing problems identified by assessment. The creation of the plan is an intermediate stage of the nursing process. It guides in the ongoing provision of nursing care and assists in the evaluation of that care.
1. It focuses on actions which are designed to solve or minimize the existing problem.
2. It is a product of a deliberate systematic process.
3. It relates to the future.
4. It is based upon identifiable health and nursing problems.
5. Its focus is holistic.
6. It focuses to meet all the needs of the service user.
References:
http://en.wikipedia.org/wiki/Nursing_care_plan
This week we further discussed the Standards of Practice, but one of the threads that was subsequently created was dealing with Nursing Care Plans. I did not comment on this thread, as I had honestly never heard of a care plan, nor did I understand the significance of this. It was very interesting to read some of the discussions, especially from my fellow students who come from a LPN background. While it is something that is completely daunting to me, to develop a plan for a client, I also know that it is something that I am going to have plenty of opportunity to watch, be supervised over, and have my questions answered while still a student.
While working in the school board (over 10 years ago now), I was part of a team of professionals that worked on IEP’s. This is Individualized Education Plans, and I kept thinking of the parallels of these two plans. As with IEP’s, a multidimensional team made up of psychiatrists, teachers, student assistants, counsellors, and administration would come together and assess the student. Together we would provide knowledge, insight and history to develop the IEP. We would take into account the student’s learning style, any personal care they need, any medications they are on, their level of education, as well as any community involvement that they need. No two IEPs looked alike, as each student is individual, requiring different levels of care. I believe this to be true with nursing care plans as well. This would be why there is no standardized form – but instead a list of guidelines to follow, questions to ask, and information to gather so that the care plan can be created for care, resolutions and evaluation.
Wikipedia explains it this way:
A nursing care play outlines the nursing care to be provided to a patient. IT is a set of actions the nurses will implement to resolve nursing problems identified by assessment. The creation of the plan is an intermediate stage of the nursing process. It guides in the ongoing provision of nursing care and assists in the evaluation of that care.
1. It focuses on actions which are designed to solve or minimize the existing problem.
2. It is a product of a deliberate systematic process.
3. It relates to the future.
4. It is based upon identifiable health and nursing problems.
5. Its focus is holistic.
6. It focuses to meet all the needs of the service user.
References:
http://en.wikipedia.org/wiki/Nursing_care_plan
Week 7
Week 7 –
Wow. Half way through the semester already. I have taken the time this week to look back over my journal entries, and really do some self-reflecting. I find myself a bit negative, concentrating on what I don’t know instead of praising what I have learned. I have learned a lot! I do find myself in a different state of mind than I did seven weeks ago. I am learning every day to be in a state of reflection, learning from my day to day activities, mistakes and successes and how to actively be aware of how they all are connected. Usually when I feel self doubt come on, I look on the articles that I have researched, reflecting on my own unique contribution to this course. I have insight, thoughts and skills that are gifts that I give to myself. I am not a LPN, nor am I actively involved in the health care field right now. What I am, though, is a student of learning how to be an RPN. Focussing on this has allowed be the freedom to fully learn. This concept alone has granted me the freedom to be more self-aware, something that I may have seen eventually, but in journaling every week, has enabled this to be even revealed to me now.
I expected this to be an arduous task. And it started out this way. I really disliked having to write down my thoughts, and struggled with “what was expected of me to say”. In seven short weeks, I have changed my thought pattern – to a place of retrospection and learning. Journaling has grounded me, has lessened the self doubt, and allowed me to embrace where I am at right now. This is what I have control over – the right now. It has been the key to unlock some of the fears that I had over clinical supervision, and has reiterated to me that when I come from a place of reflection, learning will naturally come.
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