Last week with the Michael Granger assignment I felt a lot more comfortable going through the history questions. I knew what base questions to ask and then pinpointed the areas that I needed more information on to perform the rest of the assessment. For example, Mr. Granger said that he had an 8-lb weight gain, leg swelling, and shortness of breath during the history questioning, so I made sure to focus on those areas and ask more in-depth questions. I was trying to figure out when the symptoms started, if he had tried to treat any of them, and if they got worse at certain times. This then helped in the physical assessment because I knew the areas I wanted to really focus on for abnormalities. I feel like this is a very realistic scenario because I have had several patients with these exact symptoms and experiences when I worked in the ICU.
One thing I would like to have done differently is to get a second opinion on the sounds in the heart. I have a terrible time distinguishing between different heart sounds, no matter how many videos I watch or audios I listen to. So, I would have liked to grab another nurse or even my charge nurse to listen to the sounds to verify what I was hearing, because the first time around I diagnosed the sound as a heart murmur. Listening to heart sounds and being able to differentiate between them is something that I have and will continue to work on. It is a necessary skill for our job, it’s just a tough one for me. I did receive feedback from iHuman on this one, which did not surprise me, because I labeled the heart sound incorrectly. The other piece of feedback that I received that did surprise me a little bit (but in retrospect shouldn’t have) was that I labeled the blood pressure as normotensive, and it was supposed to be high. I have been a nurse for a few years now and I know that the textbook blood pressure is 120/80, but I have had patients with blood pressures all over the place and we tend to not balk too much at a blood pressure that is like 138/88 or something along that line. Yes, that is high and coupled with Mr. Granger’s other symptoms is not ideal, so I understand why I got the feedback on that one.
From this simulation, I learned the importance of distinguishing between heart sounds and realizing that if I can’t figure it out, I need to ask for help in that area. I also learned that even though I have been doing this for a while now I still need to pay attention to all my patient’s symptoms collectively. I tend to focus on symptoms that are very severe and diminishing symptoms that I feel can be treated quickly. While this may work for a few patients it’s not good practice to maintain. I need to evaluate everything that is going on with my patients to figure out why they are having certain symptoms, be able to communicate with the doctor about what the patient may need, and, most importantly, for patient safety. I tend to get into a daily routine when I have patients with a lot of similar symptoms, and I need to remember that it is important to differentiate between my patients and treat their symptoms individually.
Debriefing of Week 3 iHuman Cardiovascular Assessment (Graded)
The purpose of this debriefing is to re-examine the experience completing the Week 3 iHuman Cardiovascular Assessment assignment while engaging in dialogue with faculty and peers. In the debriefings, students:
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- 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
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 1)
- CO 4: Demonstrate effective communication skills during health assessment and documentation. (PO 3)
- 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
- 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.
Use the following format to reflect on the Week 3 iHuman Cardiovascular Assessment. This was the Michael Granger 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 Mr. Granger? Describe at least one area you identified where improvements could be made, specific to Mr. Granger’s 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?
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.
In the Week 3 iHuman Cardiovascular Assessment simulation featuring Mr. Michael Granger, there were several aspects that went well for me. I felt knowledgeable and confident in my ability to perform a thorough cardiovascular assessment. For instance, I successfully gathered Mr. Granger’s medical history, including his risk factors such as hypertension, which helped me formulate a comprehensive picture of his health. Additionally, I was able to accurately assess his vital signs, including blood pressure, heart rate, and respiratory rate, and interpret them in the context of his condition. Overall, the scenario felt realistic, as it presented a patient with common cardiovascular issues, and the information provided was consistent with what one might encounter in a real clinical setting.
Looking back on the simulation, there are a few things I would do differently if I were caring for a patient similar to Mr. Granger. One area where improvements could be made is in my communication skills. I realized that I could have been more empathetic and patient-centered in my interactions with Mr. Granger. Additionally, I should have provided more education and counseling on lifestyle modifications, such as quitting smoking and adhering to a heart-healthy diet. I was somewhat surprised by the feedback from iHuman, particularly in terms of my communication skills. It highlighted the importance of effective patient-provider communication and how it can impact the overall quality of care. This feedback reminded me that in nursing practice, it’s not just about the technical skills but also about building trust and rapport with patients.
This simulation reinforced the importance of holistic patient assessment and individualized care planning in nursing practice. It emphasized that a patient’s medical history, lifestyle, and risk factors are crucial in determining their cardiovascular health. Moreover, it underscored the need for clear and empathetic communication with patients, as this can significantly affect their understanding of their condition and their motivation to make positive lifestyle changes. Moving forward, I plan to apply these lessons by focusing on patient-centered care, actively listening to patients’ concerns, and providing them with the necessary information and support to manage their cardiovascular health. I also have a question related to the scenario: How can I improve my skills in delivering difficult health-related messages to patients in a compassionate and understanding manner, especially when discussing topics like smoking cessation or lifestyle changes?
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