1

Sarah Ross
Trent University
NURS 3021
Date: November 7th, 2016
Clinical Reflection #2
Throughout my 6-weeks of placement on the Palliative Care Unit at PRHC (D2), I
have acquired numerous skills and knowledgeable advice that I believe will benefit my
future practice as a nurse. The skills that I accomplished in this placement include
subcutaneous injections through a subcutaneous catheter and direct skin, taking patient
blood sugar and administering insulin accordingly, wound care, reconstituting IV
medications and administering them, G tube feedings and also post-mortem care for
deceased patients. I have encountered a wide range of patients that range from Complex
Continuing Care (CCC) patients that have been there for months, to complex patients that
only have a few days left. Most recently I had a patient who required a great deal of care.
He had a tracheostomy tube, G tube with flushes and feedings, on antibiotics and he was
also very un-kept and un-sanitary. My nurse for that shift had told me he was usually
pretty tired and didnt say too-too much but did by pressing the button on his tube. When
I first went in to meet him he would not answer any of the questions that I had asked him
and he barely even acknowledged my presence in the room. This interaction made me
feel very uncomfortable and unsure of what to expect for the rest of the day.
When I went to give him his medications with my instructor later on, he was more
alert. As we came into the room he ended up receiving a phone call and was trying to find
his button on his tube to talk, which was when we realized he was missing the cannula for

2
his tracheostomy tube. Reflecting back on this experience, I should have assessed the
patient more thoroughly when he was not answering me earlier in the shift as it could
have lead to earlier retrieval of his cannula. We then proceeded to look for the tube,
which ended up taking 10 minutes and was found inside his bed underneath him. The
patient had his tracheostomy tube for quite some time before coming to PRHC and
insisted that he did his own tracheostomy care to the nurses earlier in the shift but my
instructor was able to clean the cannula before the patient re-inserted it back into his tube
and once back in, he was a lot more vocal. The patients room was very un-kept and
cluttered, making it hard to provide treatment to this patient. He would get angry if I
didnt understand him or his instructions, which made me also feel a bit intimidated. I
tried my best to respond to each of his requests fast and correctly to try and build up some
rapport with him. This worked as he began to be less sour towards me throughout my
shift. He was very helpful when administering fluids or medications into his G tube,
which helped me feel calmer about everything also. Although this patient needed further
education on cleanliness and care of his illness, he seemed to have a good understanding
of how to manage it in his own personal way. I learned a lot from the complexity of this
patient and his care, which now can prepare me for future patients who require similar
care, as I have the first experience out of the way.