D224 Final Field Experience Log: Patient Care & Education Summary

D224 Final Field Experience Log: Patient Care & Education Summary

Student Name

Western Governors University 

E224 Global and Population Health

Prof. Name

Date

Description of Field Activity

During a 10-hour outpatient clinical rotation, I observed and worked alongside a BSN-prepared nurse preceptor who demonstrated a comprehensive range of professional nursing responsibilities. The shift emphasized health promotion, preventive care, and coordination of services within an ambulatory care setting. The preceptor’s role extended beyond direct clinical interventions to include patient education, interdisciplinary collaboration, referral coordination, and effective use of healthcare resources. Collectively, these activities were directed toward improving patient wellness outcomes and reducing preventable health risks.

Throughout the shift, the preceptor provided care to more than 20 patients, primarily through the administration of seasonal influenza vaccinations. Prior to vaccine delivery, the nurse utilized standardized screening checklists to ensure patient eligibility and safety. In parallel, the preceptor offered individualized education on the benefits of immunization, including reduced risk of influenza-related complications, hospitalization, and mortality. This evidence-based education significantly increased patient acceptance and adherence to vaccination recommendations.

In addition to immunization services, the preceptor conducted targeted health assessments, particularly related to cardiovascular risk screening. Two male patients, aged 52 and 56, presented with blood pressure readings ranging from 120/70 mmHg to 137/90 mmHg. After collaborative discussion with the clinic physician, referrals were initiated for diagnostic testing, including laboratory studies and electrocardiograms. Patients received education regarding the long-term risks of uncontrolled hypertension, such as cerebrovascular accidents, renal impairment, and retinal damage. Lifestyle modification strategies—including increased physical activity, dietary sodium reduction, and weight management—were discussed to support long-term blood pressure control. The preceptor also managed prescription coordination with pharmacies and responded to patient telephone inquiries, ensuring continuity of care and medication adherence.

How Does the Nurse’s Role Promote the Sphere of Care?

Nursing Activity	Sphere of Care	Rationale
Influenza vaccine administration	Wellness and Disease Prevention	Immunizations reduce the incidence of severe influenza-related complications and decrease hospitalization and mortality rates (Centers for Disease Control and Prevention [CDC], 2023).
Patient education on hypertension	Wellness and Disease Prevention	Lifestyle counseling supports blood pressure regulation and reduces the risk of cardiovascular disease.
Blood pressure monitoring and referrals	Wellness and Disease Prevention	Early identification and diagnostic follow-up prevent progression of hypertension-related complications.
Prescription coordination	Wellness and Disease Prevention	Timely medication access promotes therapeutic effectiveness and patient safety.
Therapeutic communication and patient support	Wellness and Disease Prevention	Clear communication enhances treatment adherence and improves health outcomes.

The nurse’s involvement in vaccination, chronic disease screening, and patient education illustrates the central role of nursing practice in disease prevention. Through collaboration with providers and pharmacies, the preceptor ensured continuity of care, reinforcing nursing’s contribution to population health and wellness promotion.

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Description of Field Activity on January 26, 2024

During this 10-hour clinical shift, the BSN preceptor began the day by systematically reviewing patient medical records, laboratory values, and prior treatment plans. Working in close partnership with the clinic physician, the preceptor identified required interventions and facilitated timely referrals. The majority of patients were stroke survivors between 37 and 70 years of age, many presenting with residual unilateral weakness requiring ongoing rehabilitation and monitoring.

A significant clinical encounter involved a 67-year-old male reporting mild headaches and muscle spasms on his affected side. Laboratory analysis revealed hyponatremia, with a sodium level of 131 mEq/L. The preceptor promptly communicated these findings to the physician, resulting in discontinuation of Lasix and initiation of Robaxin for muscle spasm management. Patient education focused on medication changes, symptom monitoring, and the importance of follow-up care.

Another case involved a 45-year-old male diagnosed with iron deficiency anemia who experienced difficulty swallowing oral iron tablets. Acting as a patient advocate, the preceptor requested a medication formulation change to liquid iron, coordinated the prescription with the pharmacy, and provided nutritional counseling focused on iron-rich foods. A referral to a registered dietitian was arranged to further support dietary management.

Additionally, a 63-year-old patient with a traumatic brain injury required assistance navigating changes in health insurance coverage to maintain access to rehabilitation services. The preceptor collaborated with a social worker to complete required documentation, thereby preventing interruption of essential therapies. Education on fall prevention was provided to stroke patients and caregivers, emphasizing environmental safety, use of assistive devices, and recognition of warning signs requiring medical attention. Educational stroke guide pamphlets were distributed to reinforce learning.

How Are These Nursing Activities Related to the Sphere of Care?

Nursing Activity	Sphere of Care	Rationale
Comprehensive assessment and laboratory review	Regenerative/Restorative	Early detection of abnormalities supports recovery and prevents secondary complications in neurologic patients.
Medication advocacy and patient education	Regenerative/Restorative	Ensuring appropriate medication forms and understanding improves compliance and physiologic recovery.
Insurance coordination with social services	Regenerative/Restorative	Continuity of coverage prevents care disruptions and supports rehabilitation outcomes.
Fall prevention education	Regenerative/Restorative	Safety education reduces injury risk and promotes independence during recovery.

These activities highlight restorative nursing care aimed at optimizing functional recovery and preventing further decline. The preceptor’s role extended beyond clinical treatment to include advocacy and addressing social determinants of health, which are critical components of regenerative care.

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Description of Field Activity on January 30, 2024

During a 9-hour clinical shift, the BSN preceptor actively participated in an Interdisciplinary Team (IDT) meeting, advocating for increased therapy time to allow comprehensive patient education related to medication adherence and lifestyle modification. Family members participated in the discussion and expressed agreement with the proposed care plan adjustments, reinforcing a patient- and family-centered approach.

Throughout the day, the preceptor administered influenza and COVID-19 booster vaccinations, providing patients with educational pamphlets outlining vaccine safety, efficacy, and expected side effects. Emphasis was placed on the role of immunization in reducing viral transmission and severe disease outcomes.

A critical clinical situation involved a patient presenting with hypoglycemia, evidenced by a blood glucose level of 66 mg/dL, despite no known history of diabetes. The preceptor immediately implemented hypoglycemia management protocols, stabilized the patient, and notified the physician. Laboratory testing, including HbA1c, was ordered to further assess glycemic control. Recognizing food insecurity as a contributing factor, the preceptor facilitated referrals to community resources, including the North Texas Food Bank and Temporary Assistance for Needy Families.

The preceptor also provided smoking cessation counseling, outlining the risks of tobacco use such as chronic obstructive pulmonary disease, lung cancer, and cardiovascular disease. One patient agreed to initiate nicotine replacement therapy using prescribed patches. Additionally, colorectal cancer screenings were conducted for four patients over the age of 60 using Cologuard kits. Education focused on the importance of early detection, and stool samples were collected for laboratory analysis.

Connection of Nursing Activities to the Sphere of Care

Nursing Activity	Sphere of Care	Rationale
IDT participation and care advocacy	Wellness	Collaborative care planning enhances education and supports long-term disease prevention.
Vaccine administration and education	Wellness and Disease Prevention	Immunizations protect against preventable infectious diseases such as influenza and COVID-19.
Hypoglycemia management and community referrals	Wellness and Disease Prevention	Early intervention and social support reduce complications and promote stability.
Smoking cessation counseling	Wellness and Disease Prevention	Education and pharmacologic support reduce chronic disease risk associated with tobacco use.
Colorectal cancer screening	Wellness and Disease Prevention	Early detection improves treatment success and survival outcomes in older adults.

These activities underscore the nurse’s essential role in promoting health through prevention, education, advocacy, and timely clinical interventions, ultimately improving patient outcomes and quality of life.

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References

American Diabetes Association. (2023). Hypoglycemia (low blood sugar). https://www.diabetes.org/diabetes/complications/hypoglycemia

American Stroke Association. (2023). Stroke recovery and rehabilitation. https://www.stroke.org/en/about-stroke/recovery

Centers for Disease Control and Prevention. (2023). Influenza (flu). https://www.cdc.gov/flu/index.htm

D224 Final Field Experience Log: Patient Care & Education Summary

National Cancer Institute. (2023). Colorectal cancer screening. https://www.cancer.gov/types/colorectal/patient/colorectal-screening-pdq

National Heart, Lung, and Blood Institute. (2022). High blood pressure (hypertension). https://www.nhlbi.nih.gov/health-topics/high-blood-pressure