Nursing Journal Entry

The second week of my preceptorship brought many new experiences for me, and I can honestly say that each day I spend with my preceptor is better than the last. This week I focused on time management of a full patient load with continued documentation practice as well as admission and discharge procedures. I’ve had brief experiences in my past rotations assisting with discharge teaching and admission assessments however I have never been able to fully take charge and complete the process from start to finish, so this was a great learning opportunity for me. My first day with my preceptor this week (Wednesday October 26, 2011) was cut short due to a school obligation and personal situation. Although I only spent five hours on my unit, I did my best to make them count. I was particularly excited for my patient assignment today because I was caring for two infants which is truly my passion. My first patient was the same patient I had cared for the previous week, a now 21-day-old baby boy admitted with a positive urine culture and blood culture. I was glad to have this patient again because I was able to further build on my relationship with the patient’s Mother and reinforce the education I had provided previously. While caring for this patient I think I demonstrated the clinical competency of evaluating the effectiveness of the patient’s plan of care utilizing critical thinking and the nursing process and revising the patient’s plan of care. For example, this patient was responding well to his antibiotic treatment every six hours, as well as consistently taking in adequate amounts of formula with each feeding. While calculating the intake and output I noticed that the patient was urinating excessive amounts. After assessing the hydration status of the infant, I questioned the primary physician regarding the need for the client to be receiving maintenance fluid at a rate of 10ml/hr. The doctor agreed that this was excessive for such a small infant and requested the