Reflection On Clinical Rotation
1SA1a. During my clinical rotation a significant change I noticed in a patient was a decrease in blood pressure while exercising. Prior to exercise my patient had a blood pressure of 115/60mmhg. While running on the treadmill his blood pressure had dropped to 82/55mmhg. I alerted the nurse of his blood pressure immediately after taking the blood pressure. The nurse was aware and said it has been ongoing. We assessed the patient who was lightheaded, gave him some water and told him to stop exercise for the time being and sit down. His doctor was then informed of what was going on and ultimately was told not to go to the next couple exercise classes and his medication was changed. After his workout his blood pressure increased to 105/59mmhg.
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Since she does have down syndrome she has a hard time articulating and expressing her feelings in a calm manor especially when she feels scared or threatened. I think that at times she used an assertive style of communication by having good eye contact, letting her feelings be known while eventually being open to the idea of a shot. For example, she calmly asked “will it hurt” while marinating eye contact and expressed a worried facial expression. I also think that she used an aggressive communication style as she yelled “I’m scared” “I want (nurse name), Please get her!” “Don’t touch me!”, she also expressed the aggressive communication style non-verbally by crisscrossing her arms and shrugging away when approached.
c. Barriers to effective communication: The barrier that my patient had was a developmental barrier as she had down syndrome. This barrier was overcome by having someone she trusted there with her to make her feel more comfortable, moving her to a private room to reduce distractions and an overstimulating environment. My patient seemed very overwhelmed and anxious this is a psychosocial barrier and was overcome by sitting eye level with the patient, explaining everything that was going to be done and addressing the patients fears and feelings directly. The nurse stated, “What makes you scared?”
Since she does have down syndrome she has a hard time articulating and expressing her feelings in a calm manor especially when she feels scared or threatened. I think that at times she used an assertive style of communication by having good eye contact, letting her feelings be known while eventually being open to the idea of a shot. For example, she calmly asked “will it hurt” while marinating eye contact and expressed a worried facial expression. I also think that she used an aggressive communication style as she yelled “I’m scared” “I want (nurse name), Please get her!” “Don’t touch me!”, she also expressed the aggressive communication style non-verbally by crisscrossing her arms and shrugging away when approached.
c. Barriers to effective communication: The barrier that my patient had was a developmental barrier as she had down syndrome. This barrier was overcome by having someone she trusted there with her to make her feel more comfortable, moving her to a private room to reduce distractions and an overstimulating environment. My patient seemed very overwhelmed and anxious this is a psychosocial barrier and was overcome by sitting eye level with the patient, explaining everything that was going to be done and addressing the patients fears and feelings directly. The nurse stated, “What makes you scared?”