NU140CL Unit 10 Final Clinical Reflection Example

Alone, With Prompting, Not Yet: A Final Clinical Reflection Sorting a Composite Student's First Rotation Into Skills Performed Independently, Skills Still Needing a Cue and Skills Not Yet Attempted, With Evidence From Earlier Journals

[Student Name]

Purdue University Global

NU140CL: Nursing Fundamentals Clinical

Unit 10 Final Clinical Reflection

[Instructor Name]

[Date]

The student and patients are composite; skills are drawn from the course's earlier units, and no hours, logs or instructor evaluations are reproduced.

How I Sorted the Skills

I went back through my prep sheets, journals, care plans and the case presentation, and for each skill I asked one question: on my last two shifts, did I do it correctly without anyone reminding me? If yes, it went in the first group. If I did it but needed a cue, it went in the second. If I never had the chance, it went in the third. The record of when I performed each skill belongs to my program file; this reflection is about what the evidence in my own writing shows.

Group One: Performed Independently

Vital signs, including manual blood pressure. My Unit 4 journal about the twenty-point discrepancy is the turning point; since then I check cuff size and arm position every time without being told, and my last six manual readings matched my nurse's recheck.

Hand hygiene and isolation precautions. My Unit 6 post shows I understood droplet precautions, and I have not missed hand hygiene on entry or exit since week three.

Head-to-toe assessment and its documentation. My Unit 3 write-up was returned with one comment, to quantify bowel sounds, and I now record measurements rather than words like "normal."

Group Two: Still Needs Prompting

Timing care around medications. My Unit 8 journal shows that I planned a first walk for the time on the schedule rather than around the patient's pain medicine and fluids. I now remember to check, but on my last shift my nurse still had to ask me when the last opioid was given before I helped a patient up.

Knowing what to check is not the same as checking it automatically, and that gap is exactly what the middle group measures.

Prioritizing when two patients need me at once. I can rank problems on paper, as my care plans show, but on the unit I still tend to finish the task in front of me before answering a call light that might be more urgent. My instructor has had to cue me twice.

Teaching with teach-back. I use it when I plan teaching, as in my Unit 7 handout, but I forget it during informal moments, such as explaining a new medication on the way out of a room.

Group Three: Not Yet Attempted

Inserting a urinary catheter, which I have practiced only in the lab. Giving a subcutaneous injection to a patient, since my assigned patients' injections were all given at times I was in conference. Caring for a patient with a wound drain, a skill our fundamentals text covers in detail that I have seen only once (Potter et al., 2023). I will ask to be assigned these in the next rotation rather than waiting for them to happen.

A Skill That Moved Between Groups

One skill moved during the rotation, and tracing it shows how the groups work. In week two, documenting my assessment in the facility record sat in the second group: my first entries needed corrections from my nurse, mostly for vague words and missing times. By week five my entries were co-signed without changes, so the skill moved to the first group. What moved it was not more practice alone but the habit from my Unit 3 write-up of recording measurements. I expect the prompted skills to move the same way, one habit at a time, and I will record when each one does.

What I Learned About Myself

I learned that I am more confident than accurate at first and more accurate than confident once I slow down. Benner described beginners as relying on rules because they do not yet see the whole situation (Benner, 1984), and my second group is full of moments where I followed the task rule and missed the situation. Using a structured reflective cycle after hard shifts helped me turn those moments into changes (Gibbs, 1988).

Plan for the Next Rotation

Before each shift, I will list one prompted skill I intend to do without a cue and tell my instructor at the start of the day. I will ask for one of my not-yet-attempted skills each week. And I will keep checking medication timing before any mobility, until it moves into the first group. At the end of the next rotation I will repeat this sorting with the same question, so the two reflections can be compared side by side and the movement, or lack of it, will be visible.

References

Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing practice. Addison-Wesley.

Gibbs, G. (1988). Learning by doing: A guide to teaching and learning methods. Further Education Unit, Oxford Polytechnic.

Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. M. (2023). Fundamentals of nursing (11th ed.). Elsevier.