Reflective Journal: The Nursing Profession

Reflective Journal Name Institution Reflective Journal Introduction The nursing profession comes with a burden of responsibility which demands an undivided attention and commitment to details when carrying out the diverse duties stipulated in the profession’s day to day activities. Lives are indeed at the hands of the nurses in any healthcare facility. However, the burden of responsibility is much heavier for nurses assigned to, specializing, or dealing with Neonatal Intensive Care Unit (NICU). The nurses have the duty of attending to the needs of newborns experiencing various problems including premature births, infections, malformations or birth defects in their first month of life. A day’s work for a NICU nurse involves the monitoring of IV fluids, charting of vital signs, administering the recommended medications, and documenting of all the activities involving the assigned patients during a particular shift. It is often said that nurses hold lives in their hands in pertinence to their responsibility towards the patients admitted to their care in various healthcare facilities around the world. Nurses bridge the gap between the patients and the healthcare industry in its entirety as they convey the latter’s medical or healthcare demands in the best way possible for an equally articulate response required for effectively dealing or rather diagnosing the wide range of problems or medical challenges (Austin, 2014). The observatory eye of the nursing profession is integral for the smooth running of operations within a healthcare facility as it is through their coordination with other stakeholders involved that patients are attended in the most effective and efficient ways. A reflection on the experience during a nine-week externship in the Neonatal Intensive Care Unit reveals some key insights into personal development both as an aspiring nurse and as a human being. Contrary to common belief, nursing care in the Neonatal Intensive Care Unit is more than changing diapers and bottle feeding the debilitated infants all day long. It is a rather intensive unit that requires a lot of dedication and commitment from the nurses as the infants are almost totally dependent on them. Personal Skills learnt (Healthcare Delivery and Clinical Systems) During the nine-week externship with the intense NICU, a lot has been achieved regarding career development at the personal level. The fact that not all the infants under the special care programs are prematurely born played a significant role in widening the breadth of knowledge gained during the nine weeks. Handing off a shift is utmost importance in the NICU as all the information regarding the progress of a patient and their medical demands are carefully documented and thus any clarification needed should be made at this crucial time to endangering the lives of infants through misconceptions. Handing off is in itself a crucial skill whose importance cannot be fully emphasized but is well understood by NICU nurses who seem to handle the process with all the dedication and commitment it requires (Anibaba, 2017). Planning of the daily activities in the Neonatal Intensive Care Unit is usually on the basis of the time to feed the infants, changing their diapers, and administering medications. Assigned to two infants who were no longer on oxygen and IV fluids for the first week was more of a welcoming gesture as the third infant on my assigned list suffered from respiratory distress syndrome (RDS) (Anibaba, 2017). The latter demanded close attention in monitoring their intake of the IV fluid while also checking on the CPAP device for regulating the pressure of oxygen reaching the weak lungs of an infant. Some of the skills learnt during the monitoring of the patients with RDS included how to effectively insert intravenous lines into the veins of the patients’ hands or feet. Another important skill that I learnt from the experience with the infants was regulating and monitoring the pressure of the CPAP to maintain compatibility with the amount required for the infant’s weakening lungs to function effectively. Feeding of infants in the NICU also requires specialized skills in the methods or techniques used. Infants who are no longer on oxygen and IV fluids are referred to as feeders and growers who eat after every three hours (Austin, 2014). During the feeding time, I learnt how to conduct a head to toe assessment as is mandatory at the time, change diapers and administer medication. The category of infants that are no longer on oxygen would most likely be breastfed by their parents or bottle fed. However, it was evident that most infants in the NICU were fed through a nasogastric process. Inserting of the nasal feeding tubes also required one to learn the technique through careful observation and participating when invited by the doctors or nursing practitioners. I also honed my interpersonal skills as I learnt the importance of team playing in delivering quality services and streamlining the operations of the NICU. In week six the charge nurse asked me to attend a vaginal delivery in labour and delivery and thus had to hand over my assigned patients to another nurse who willingly included them in his assignments. I attended both the vaginal delivery and the admission of a 36-week preemie into the NICU. Another skill set that I gathered was on how to set my admission bed for the premature baby. Once the baby is delivered I also learnt how to dry and stimulate the body, and with the help of my colleagues conducted a comprehensive assessment of the vital signs, take the necessary measurements at birth and conduct other laboratory tests on the well-being of the patient (Austin, 2014). I embraced the concept of working as a team from an enlightened perspective. Personal strengths and weaknesses that surfaced Dealing with or rather holding an infant’s life in one’s hand is indeed a scary responsibility that requires a lot of emotional and mental strength to handle emergency situations involving the patients. Among my personal strengths that surfaced during my short tenure in the NICU was boldness in the face of insurmountable pressure during operational procedures on the infants. I also established myself as a pillar of faith with the ability to connect with distressed parents agonizing over the fate or frailties of their babies. Compassion came out as a personal strength and proved to be instrumental in my interaction with the infants’ parents. However, the same compassion also bred a personal weakness of getting too attached to the patients and their parents alike. At one instance I could not stomach the site of a mother’s uncontrolled cry of joy as she successfully delivered, albeit prematurely, after three previous conceptions failed to miscarriages. I also shared in the joy by crying in front of the patient and other colleagues though the latter did not seem to mind my company. I also realized that I do not take well to failure in activities involving the progression of my career and thus breeding fear of trying out new concepts or activities such as inserting the endotracheal or nasal tubes into the infants. It took me a while before I could gather the courage to insert even the IV cannulas into the patients. Population Health Concerns Working in the NICU requires that one focuses on infants and nothing alone. However, as a nurse, it is indeed essential to stay informed on the population or public health concerns. Working in the medical field requires that one is always updated and equipped with appropriate information at all times. I realized that no one will push me or expect me to learn or study medical trends or any issues within my spectrum. However, I am expected to always have answers whenever called upon to answer. Working at NICU exposed me to several public health concerns and these include food safety (especially where infants are concerned), alcoholism or alcohol related effects, healthcare-associated infections, as well as stroke and heart disease. New Practice Approaches Achieving optimal results will require enough preparation of the candidates enrolled in the NICU on their expected tasks during the period of their internship. Thus, students with an interest in becoming nurses in the NICU should make a point of regularly checking and reading publications such as the National Association of Neonatal Nursing to familiarize themselves with what is expected of them in the specialized nursing profession. The nursing educational institutions should also laisse with...