Professional Documents
Culture Documents
Reflection 1
Marissa Brown
Trent University
REFLECTION 2
Reflection 1
Performing an assessment on a patient for the first time can be stressful. On my first day
of placement in an acute care setting – an inpatient surgical floor – I was expected to perform a
head to toe assessment on a patient for my instructor. In the past, I have performed specific
previous placement. This was the first time that I was expected to complete a full assessment on
a patient. Going into the assessment, I had prepared by practicing in lab and on my peers. When
performing the assessment on my patient, I was very nervous. Throughout the assessment, there
were a few aspects where I made mistakes. For example, I forgot to auscultate before palpating
during the GI assessment. I remembered half way through and started to auscletate. I also feel as
if I was all over the place and seemed disorganized not only to myself but to the patient and my
instructor as well. After the assessment was completed, I felt as if I could have done it better and
Going into the assessment I was very nervous and not confident about my ability to
perform this assessment. I wanted to feel confident and organized to defy the expectation of the
patient and my instructor but when I actually started to perform the assessment, anxiety and
nervousness got the best of me and I forgot what I had previously learned. I also felt as if I was
being pressured to succeed because I did not want to seem like a student who was not sure of
what they were doing. This pressure was placed on me by myself as I did not want to embarrass
myself in front of the patient or seem incompetent to my instructor. Since the patients are used to
the confidence that the registered nurses have when they perform their assessments, I feel as if I
was expected to be nervous and make mistakes my first time. Throughout the assessment, my
REFLECTION 3
patient was very talkative and seemed relaxed. This made me feel a little more confident in my
abilities. Looking back on my experience, I realized that I was probably not the only one feeling
Analysis
I believe that it was the lack of confidence in myself that precipitated my mistakes and
disorganization during my first assessment. Although I had practiced the head to toe assessment
in lab and on my own time, performing the assessment on a real patient felt a lot different.
Confidence in nursing is important because we have patients in our care that rely on us for their
well-being. If a nurse appears to not have confidence, this may make the patient feel uneasy and
clinical placements, only 61.9% of nursing students surveyed felt confident about their ability to
practice safely and competently and only 61.3% felt confident in applying their knowledge and
skills (Panduragan, Abdullah, Hassan and Mat, 2011). The same study suggests that nurses
should be given more or extra training when needed in order to help them improve their
confidence. I believe that If I had practiced my head to toe assessments more prior to this
According to Jarvis’ health assessment textbook, the rationale for auscultating before
palpating is that palpation may cause bowel sounds to appear when they are not there due to
increased peristalsis (Jarvis, 2014). The reason I may have palpated first is because in the
respiratory assessment, also outlined by Jarvis, suggests palpation before auscultation (Jarvis,
2014). Understanding now the reason and rationale for the sequence of the two assessments, in
From this experience, I have learned that in order to feel more confident in myself in new
situations and to prevent mistakes, I should familiarize myself with the procedures and sequences
before I complete them. If I had practiced the head to toe assessments more before, I may have
felt a little more comfortable and not have made the mistakes that I did. This experience was
helpful to me to realize what I can do to help me feel less anxious in new situations, and that the
only way to learn is through making mistakes. The College Nurses of Ontario’s (CNO)
guidelines for the learner suggests that the learners can recognize their knowledge and skills in
nursing situations (CNO, 2017). In this situation I feel as if I have recognized that my knowledge
going into the assessment was lacking and for future situations I should make sure I am confident
in the theory so I can be confident in the practice. In the future, if I am expected to perform a
skill in practice for the first time outside of the lab at school, I will make sure that I know
everything there is to know about the procedure and the process in which to do it. I could do this
by reading my textbooks as well as watching the Mosby videos posted on the blackboard site. If I
have further questions after that, or still feel uncomfortable, I can ask my professors, colleagues
or even my instructors. Watching the procedure be done in the clinical setting by another nurse
It is also important to take away from this experience the idea that no matter how much
knowledge I may have, there will still be situations where I will be nervous and there will still be
situations where I will make mistakes. I have learned that by recognizing my shortcoming, I can
reach out for assistance from my colleagues and instructors in order to help me to succeed. By
reflecting on how I feel and the mistakes that I made, can help me to learn and grow into a better
References
College of Nurses of Ontrio. (2017). Practice Guideline: Supporting Learners. College of Nurses
http://www.cno.org/globalassets/docs/prac/44034_supportlearners.pdf
Jarvis, C. (2014). Physical Examination & Health Assessment (2nd ed.). Elsevier Canada.
Panduragan, S. L., Abdullah, N., Hassan, H., & Mat, S. (2011). Level of Confidence among
Nursing Students in the Clinical Setting. Procedia - Social and Behavioral Sciences,18,
404-407. doi:10.1016/j.sbspro.2011.05.059