NR 305 Week 3: Debriefing of the Week 2 iHuman Wellness Assignment (Graded)

Luciana Gonzalez and I did start off well until I started asking questions. Being an A type personality and being provided by the program all those questions, I assumed better to ask it all. So, as I am questioning my patient the answer I receive is “I’m not answering anymore”. Confused I thought I asked improperly so asked it again. Luciana in no uncertain terms said, ” I’m not answering that question, you ask too many questions and cut me right off”. How rude I thought. I even told all my coworkers that the computer yelled at me. We all got a chuckle. So, I started my second round, thinking to myself (only being allowed 120 questions), I have all the answers to these, so I’ll continue where I left off. Big mistake, at the end evaluation I was docked points, apparently, I missed pertinent questions with information as per the program I needed, but I had those necessary answers already, according to me. The computer did not answer me back. I will not make the same mistake again. I’ve learned from that experience to ask the major questions and expand according to answers provided by the patient. 

The only other issue was the constant breathing. I don’t know if that bothered anyone else, but it was quite interrupting to me. Quess I could have put the volume down but was afraid too just in case Luciana went into respiratory arrest. As a computer program it was far better than taking the NRP exam. That simulation scenario only gives you 2 minutes to drag everything over to assess a newborn baby. This program does allow you the time to count the heart rate, check BP’s, assess appropriately without a limited time frame. Which is critical and more to realism. But once you leave that page you cannot go back to it, so you must take the time to write all the information down before going forward or backward. In a non-emergent situation in real life, it can be done, and is a crucial part in a health care physical.

Realistically it does give the student a basic understanding as to what to look for in a full health assessment. And as to deviations like Luciana and UTI, the specific questions and possible findings you would obtain. Such as the bacterium E.coli, what is looks like, how you come by the germ, rationale, and treatment. The EHR was a challenge. If I missed a lab value, I was not able to go back to retrieve it. In real life situations labs are easily obtainable and can be printed and placed in a chart for a doctor to see. And any abnormal critical reading would also be called to the nurse from the laboratory department giving their name and obtaining yours to ensure immediate acknowledge so that a PCP can be notified, and treatments can be instituted immediately.

The SBAR part of the assessment was well done. I felt upon writing the assessment down you were able to point out the necessary elements such as labs, vital signs, pain. Analyze and recommend any treatments needed so the patient can reach their optimum state of well-being.  

Debriefing of the Week 2 iHuman Wellness Assignment (Graded)

Hi Class,

This week’s discussion is called a “debriefing.” Debriefing is an activity that involves thinking critically about your own experiences related to the virtual simulation you completed. Once you have considered your personal experience, you will be able to read the experiences of others and share commonalities and differences.

In Week 2, you completed a wellness assessment on your virtual patient, Luciana Gonzalez. Please respond to the debriefing questions as they relate to this experience. Please follow the suggested format for what to include in each paragraph.

Feel free to reach out by email if you have questions.

Discussion

Purpose

The purpose of this debriefing is to re-examine the experience completing the Week 2 iHuman wellness assessment assignment while engaging in dialogue with faculty and peers. In the debriefings, students:

• Reflect on the simulation activity
• Share what went well and consider alternative actions
• Engage in meaningful dialogue with classmates
• Express opinions clearly and logically, in a professional manner

Course Outcomes

This assignment enables the student to meet the following course outcomes:

• CO 2: Differentiate between normal and abnormal health assessment findings. (PO 4)
• CO 3: Describe physical, psychosocial, cultural, and spiritual influences on an individual’s health status. (PO 4)
• CO 4: Demonstrate effective communication skills during health assessment and documentation. (PO 3)

Due Date

• During the assigned week (Sunday the start of the assigned week through Sunday the end of the assigned week):
  • Posts in the discussion at least two times, and
  • Posts in the discussion on two different days

Total Points Possible

50  points

Directions

• Debriefing is an activity that involves thinking critically about your own experiences related to the virtual simulation you completed. In debriefings students:
  • Demonstrate understanding of concepts for the week
  • Engage in meaningful dialogue with classmates and/or instructor
  • Express opinions clearly and logically, in a professional manner
• Use the rubric on this page as you compose your answers.
• Scholarly sources are NOT required for this debriefing
• Best Practices include:
  • Participation early in the week is encouraged to stimulate meaningful discussion among classmates and instructor.
  • Enter the debriefing often during the week to read and learn from posts.
  • Select different classmates for your reply each week.

 Debriefing

Use the following format to reflect on the Week 2 iHuman Wellness Assessment. This was the Luciana Gonzalez case.

• Paragraph One: What went well for you in the simulation? Provide examples of when you felt knowledgeable and confident in your skills. Do you feel the scenario was realistic? Why or why not?
• Paragraph Two: What would you do differently next time if you were caring for a patient similar to Ms. Gonzalez? Describe at least one area you identified where improvements could be made, specific to Ms. Gonzalez’ assessment. Were you surprised by any of the feedback you were provided by iHuman? If yes, please explain.
• Paragraph Three: What did you learn from this simulation that you could apply to nursing practice? Or, what did this simulation reinforce that you found valuable? Do you have any questions related to the scenario?’

In the simulation exercise of Ms. Gonzalez, I felt the ease of going through each tab of the EHR went well. I am a detail-oriented person and felt like I spent a lot of time going through the notes carefully. During my ASN education, it was engrained in my brain to look for clues that may lead to dangerous patient situations. Sometimes I feel like reading the reports more than once to ensure I am not overlooking important medical information. I felt confident that I knew basic facts about my patient before I started my physical assessment. I do feel like the scenario was realistic due to many of my real-life patients having a high BMI and needing education and referrals on how to best deal with medical concerns. It is also typical for many patients to not have an HCP, leaving much to be desired when it comes to medical records.

     Next time, if I encounter a patient like Ms. Gonzalez, I will ensure her full birth date is on her armband. It was very difficult for me to accept just her birth month and date with no year given. I have had patients on the same floor before with the same name and same month of birth. The full date of birth and full name should be used to identify the patient even in a computer scenario. I would like to have more family information about chronic diseases and ailments. I feel there was an underlining reason for the recurrent UTI’s and wanted further workup. I was disappointed to find that my feedback was just the most important findings of the scenario but cut out all the problematic concerns I found. I was sure my findings were noteworthy, but not to the expert apparently. I am not bitter.

I am happy to report that I learned a lot while completing the simulation. I can apply the thoroughness of the history and physical review with subjective and objective assessments to provide the best possible care for the patient. This simulation reinforced the importance of patient education along with referrals. I appreciated the reminder to educate the patient on the next steps to be proactive while awaiting their next appointment. As nurses, we all know how long most patients must wait for simple appointments to continue their care. I do not have any questions about this scenario.

Grading

To view the grading criteria/rubric, please click on the 3 dots in the box at the end of the solid gray bar above the discussion board title and then Show Rubric. See Syllabus for Grading Rubric Definitions.

RNBSN_50_Point_Debriefing_Discussion_Rubric_1_21

Criteria	Ratings	Pts
This criterion is linked to a Learning Outcome Answer Post•Answers each required debriefing question in a detailed manner, •Reflects on the correct scenario, and •Provides examples from student’s own perspective	28 pts 100% ExcellentMeets all criteria •Answers each required debriefing question in a detailed manner, •Reflects on the correct scenario, and •Provides examples from student’s own perspective 25 pts 88% GoodIncludes all three criteria but answer is not detailed. 22 pts 80% FairMeets two of three criteria 11 pts 38% PoorMeets one of three criteria 0 pts 0% MissingDoes not answer the discussion question(s).	28 pts
This criterion is linked to a Learning Outcome Reply Post•Replies to a classmate’s and/or instructor’s post, •Reply post provides additional information or clarification, and •Reply post adds excellent depth to the discussion.	14 pts 100% ExcellentReplies to a classmate’s and/or instructor’s post by providing additional information or clarification. Reply post adds excellent depth to the discussion. 12 pts 88% GoodReplies to a classmate’s and/or instructor’s post by providing additional information or clarification. Reply post adds good depth to the discussion. 11 pts 80% FairReplies to a classmate’s and/or instructor’s post. Limited information or clarification provided. Brief reply post adds fair depth to the discussion. 5 pts 38% PoorReplies to a classmate’s and/or instructor’s post. Reply does not provide additional information or clarification. Brief reply post does not add depth to the discussion. 0 pts 0% MissingNo reply post to classmates or instructor.	14 pts
This criterion is linked to a Learning Outcome Communicates ProfessionallyAll posts: •are clear and concise, •are respectful, civil, and caring, and •contain excellent English grammar, spelling, and punctuation.	8 pts 100% ExcellentAll posts are clear, concise, respectful, civil, and caring. Posts contain excellent English grammar, spelling, and/or punctuation. 7 pts 88% GoodAll posts are clear, concise, respectful, civil, and caring but contain good English grammar, spelling, and/or punctuation. 6 pts 80% FairAll posts are respectful, civil, and caring but are not clear or concise. Posts contain fair English grammar, spelling, and/or punctuation. 3 pts 38% PoorAll posts are not clear and concise, AND contain poor English grammar, spelling, and/or punctuation. 0 pts 0% MissingAll posts are not respectful, civil, and caring.	8 pts
This criterion is linked to a Learning Outcome ParticipationDuring the assigned week (Sunday the start of the assigned week through Sunday the end of the assigned week): •Posts in the discussion at least two times, and •Posts in the discussion on two different days	0 pts No Points DeductedDuring the assigned week (Sunday the start of the assigned week through Sunday the end of the assigned week): •Posts in the discussion at least two times, and •Posts in the discussion on two different days 0 pts Points Deducted (-5 Points)During the assigned week (Sunday the start of the assigned week through Sunday the end of the assigned week): •Does NOT post in the discussion at least two times AND/OR •Does NOT post in the discussion on two different days	0 pts
Total Poi