Jan. 28th Refectlion

Reflection on Mr. Oquitoa's Case Study
Dean Oquitoa's case study was a good exercise in understanding how people's lives vary in circumstance. A lot of individual's have life easy in comparison. As is the case of 95% of the people I know, they have homes, jobs and means to take care of their medical and physical needs. I hate being out in the cold for too long and know that I always have a place to come back to to get warm. I can't imagine being homeless and not having family around. We are always doing things with family and helping one another out. My parents have had to come live with us for a couple years and my mother in law has had to take care of a homeless nephew she's had, etc. For people that don't have family resources or friends, it's nice to know what options are out there. As nurses, we can help these individuals.

One of the most important things we can do to develop our critical thinking and clinical reasoning abilities is to reflect or think about our thinking and reasoning.  For this purpose, please recall a clinical experience in which the patient needs or issues turned out to be different from what you first expected, and reflect on your thinking and reasoning and what you learned from this experience. 

This may be a silly example, however, it's the first example that came to mind. As a new nurse, a patient's oxygen level on the O2 Sat monitor read 77% with a nursing diagnosis of impaired gas exchange. I turned her oxygen level up by 1 liter. The oxygen level only went up slightly. I kept increasing the liters of oxygen, however, couldn't get the oxygen reading above 90%. I auscultated her lungs; she had diminished sounds in the bases of her lungs. I grabbed a rebreather mask, but she had no symptoms of impaired oxygen exchange. I put a new oxygen sensor on and got the same readings. After further assessment, I found the patient's fingers and toes were cold. After sufficiently warming them, her oxygen level reached the 90s. I learned form this experience so now that's one of the first things I check if readings are low and there are no signs of altered gas exchange.