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Instructions of NURS 233 5-2 Flip 2
Flip #2 Making Meaning of the Information
- Due Sep 22, 2023 by 11:59pm
- Points 10
- Submitting an external tool
- Attempts 1
- Allowed Attempts 3
Purpose
We will take some time upon the completion of each step of the CCJF to reflect and practice the information you’ve gained. Self-reflection and deliberate practice are two ways to develop your clinical judgment skills to transition from a novice to advanced beginner nursing student. Stopping to reflect and practice new skills you’ve learned before moving on to the next step of the framework supports information retention and provides cognitive scaffolding for subsequent steps in the framework.
Task
Use the Flip interactive video program embedded below to apply your learning of the second step of the CCJF, Making Meaning of the Information to the following case study:
Making Meaning of the Information: (NP/Diagnosing) (NCSBN/Analyze Cues)
Melvin Keen, a 42-year-old caucasian male client who was recently seen at a local free standing clinic is being admitted to the hospital for shortness of breath. His wife is accompanying him and as you are settling him in his room he shares with you the following information. He’s been married for 20 years, was recently fired from his job, smokes 1 1/2 packs of cigarettes a day and mostly eats takeout food. He has 2 Cokes everyday, approximately 1-2 alcoholic beverage every week and denies exercising. He and his wife do not have children but live with 2 cats and 2 dogs. His wife appears frustrated and states she has no idea how they are going to be able to pay their bills now that he’s lost his job and also commented that he has to clean up his “bad habits” and loose some weight or he’ll be dead within the next 6 months.
Melvin tells you he has a history of high blood pressure, wears a bi-pap machine at night and is a Type 2 diabetic. He also states that he has “clogged arteries” and acid reflux. Melvin states that he is 5ft 8in tall and weighs approximately 250 lbs. He denies having received the Covid 19 vaccination or flu vaccination. His wife provides you with a list of the following medications he takes at home.
- lisinopril (Prinivil) 20 mg PO daily
- lovastatin (Mevinolin) 40mg PO daily
- lansoprazole (Prevacid) 15 mg PO daily
- metformin (Glucophage) 500 mg po BID
- glipizide (Glucotrol) 5 mg po daily
You quickly complete your assessment because you have a healthcare provider who is waiting for you to call them with lab results on another patient you are caring for today. Your assessment reveals the following:
- BP 145/84 mm Hg, heart rate 105, respirations 24, pulse oximetry 88% on room air, temp 96.2
- Sitting at bedside and leaning over the bedside table
- Alert and oriented but agitated and short tempered with his wife
- Pupils reactive
- Heart sounds normal
- Decreased breath sounds bilaterally with crackles noted in the right lower lobe
- Perspiration noted and he is warm to the touch
- Bowel sounds hypoactive
- +1 hand and ankle edema
- Moves all extremities
- Reddened area noted on left heal
Instructions
- Read the case study above.
- Do not recite the case study narrative within your Flip recording.
- Discuss the patient’s problems/issues then Identify which problem/issue is the priority.
- Briefly reflect on how the second step of the CCJF, Making Meaning of the information, affects your ability to provide safe care to your patients and impacts their outcomes.
- Briefly talk through your thinking process for the 9 Clinical Competencies within the 2nd step of Making Meaning of the Information by using the Cognitive Guidance Tools provided to you in Chapter 4 (Caputi, 2022) and embedded within the corresponding PowerPoints.
- Questions you can ask yourself for the 9 Clinical Competencies of Step 2/Making Meaning of the Information:
- Ask yourself what information is similar and can be grouped together to provide a clearer picture of your patients problem? (clustering related information)
- Ask yourself what personal biases or assumptions do you hold toward your patient based on their “story” or life experiences and how these feelings might influence your care? (identifying assumptions)
- Ask yourself if there are conflicting pieces of information that are not what you expected? (recognizing inconsistencies)
- Ask yourself if the information you’ve collected is relevant to your patient’s current problem and how this data will influence your care? (determining relevant from irrelevant information)
- Ask yourself if there is “wiggle room” for you to consider when determining what is and is not an acceptable information you gathered on your patient? (judging how much ambiguity is acceptable)
- Ask yourself if bilateral differences you see in your patient are relevant to your care? (comparing and contrasting)
- Ask yourself what might go wrong with your patient to worsen their current health status? (predicting potential complications)
- Ask yourself who else you should collaborate to positively influence your care and your patients health status. What information should you share with them? (collaborating with healthcare team members)
- Ask yourself what does your patient need based on the information you’ve gathered and then create a clear and concise problem statement that will guide your care? (determining patient care needs/healthcare environment issues)
Grading
Remember, you are a clinical judgment novice and our goal is to provide you with lots of low-stakes opportunities to further understand and practice your newly learned Clinical Competencies. Each Flip should be approximately five minutes and address the criteria identified within the directions and rubric. The Flip video platform will automatically place a link back to the Canvas assignment in this section.
Step-By-Step Guide on NURS 233 5-2 Flip 2
Introduction To NURS 233 5-2 Flip 2
This Owlisdom assignment of NURS 233 5-2 Flip 2 focuses on the second step of the Clinical Competency Judgment Framework (CCJF), which is “Making Meaning of the Information.” You will apply this framework to a case study involving a patient, Melvin Keen, to develop your clinical judgment skills. This NURS 233 5-2 Flip 2 guides steps that involve interpreting and synthesizing information to understand the patient’s condition better, identify priority issues, and plan effective care.
Introduction
- Describe that the focus is on applying the second step of the CCJF to a specific case study to enhance clinical judgment skills.
Example
“Hello, everyone. Today we’re focusing on Step 2 of the Clinical Competency Judgment Framework—Making Meaning of the Information, using the case study of Melvin Keen.”
Case Overview
We will discuss the case overview in this NURS 223 5-2 Flip 2 section.
- Summarize the case study.
- Include relevant medical history, medications, lab results, and current condition.
Example
“Melvin, a 42-year-old male, has been admitted with shortness of breath. He has a complex medical and social history including diabetes, hypertension, and a recent job loss, all contributing to his current health status.”
Identify the patients’ priority problem/issue.
Identifying Priority Issues
We will discuss identifying priority issues in this section of NURS 223 5-2 Flip 2.
- Based on the information provided, determine the patient’s priority problem.
Example
“Given Melvin’s symptoms and background, the priority issue seems to be his respiratory distress, as indicated by his low pulse oximetry at 88% and decreased breath sounds with crackles. This suggests an acute respiratory problem possibly exacerbated by his chronic conditions.”
Briefly reflect on how the second step of the CCJF, Making Meaning of the information, affects your ability to provide safe care to your patients and impacts their outcomes.
Reflecting On The Importance Of Making Meaning
We will discuss the case overview in this section of NURS 223 5-2 Flip 2.
- Discuss the significance of making meaning of the information gathered.
Example
“Making meaning of the information we gather is crucial. It helps us to see beyond the immediate symptoms and understand the interplay of Melvin’s lifestyle, chronic conditions, and acute issues, which is vital for providing safe and effective care.”
Briefly talk through your thinking process for the 9 Clinical Competencies within the 2nd step of Making Meaning of the Information by using the Cognitive Guidance Tools provided to you in Chapter 4 (Caputi, 2022) and embedded within the corresponding PowerPoints.
Discussing The 9 Clinical Competencies
This section of NURS 223 5-2 Flip 2 will discuss the 9 Clinical Competencies.
- Group similar information to form a clearer picture of the patient’s problem.
- Reflect on any personal biases or assumptions about the patient’s lifestyle or story.
- Note any conflicting information or unexpected findings.
- Determine which data is pertinent to the patient’s current problem.
- Evaluate how much uncertainty can be tolerated in the gathered information.
- Compare bilateral symptoms to identify significant differences.
- Identify potential complications that might worsen the patient’s condition.
- Decide which healthcare professionals to involve and what information to share.
- Based on the information gathered, formulate a clear problem statement to guide care.
Example
“First, by clustering related information, I group Melvin’s smoking and dietary habits with his chronic conditions to see a pattern that impacts his respiratory health.”
“Recognizing my own biases is crucial; I must ensure my views on his lifestyle choices don’t affect the impartiality of my care.”
“In analyzing inconsistencies, Melvin’s agitation contrasts with his normal heart sounds, suggesting stress or anxiety might be influencing his condition.”
“Determining relevance, his current medications and lifestyle choices are directly impacting his respiratory and overall health.”
“Judging the acceptability of ambiguity involves understanding that not all information will be clear cut, especially in complex cases like Melvin’s.”
“Comparing and contrasting his bilateral breath sounds revealed differences that are significant to diagnosing his respiratory issues.”
“Predicting complications, given his background, I am particularly alert to the risk of cardiac problems or worsening respiratory conditions.”
“Collaboration is key; I need to decide which healthcare team members to involve, like a pulmonologist or a cardiologist, to provide comprehensive care.”
“Finally, creating a problem statement based on Melvin’s needs, I focus on managing his acute respiratory distress while considering his broader health challenges.”
Application Of Competencies
This section of NURS 223 5-2 Flip 2 will discuss the Application Of Competencies.
- Show how you would use these skills in the patient’s scenario.
Example
“Using these competencies, I prepare to discuss Melvin’s immediate care needs with the healthcare provider, emphasizing a need for respiratory support, potential adjustments in his diabetes management, and addressing his psychological stress.”
Closing Reflection
We will discuss the Closing Reflection in this section of NURS 223 5-2 Flip 2.
- Emphasize the significance of each competency in enhancing clinical judgment and patient care.
Example
“Reflecting on this process enhances my clinical judgment by ensuring a holistic approach to Melvin’s care. It underlines the importance of synthesizing complex patient data to make informed decisions that significantly impact patient outcomes.”
CLOSING
By following these guidelines of NURS 233 5-2 Flip 2, you will effectively apply the second step of the Clinical Competency Judgment Framework (CCJF) to a real-world case study. This structured approach ensures comprehensive information interpretation and synthesis, which are essential for developing advanced clinical judgment skills. Practicing these competencies will enhance your ability to provide safe, effective, and empathetic patient care. In the next module of NURS 223, we will explore the 6-1 TICKET TO CLASS 4.
