NR 576: Week 8 Reflection

Chamberlain UniversityNR 576 Differential Diagnosis in Adult-Gerontology Primary CareDr. CidJuly 1, 2023

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Week 8 Reflection

Over the past eight weeks, the Differential Diagnosis course has significantly enhanced my skills in several areas. To begin with, time management has been crucial. Balancing my week’s classwork, clinical duties, job, and family responsibilities required meticulous planning and discipline. This experience has instilled confidence in me that with proper preparation and avoidance of procrastination, I can achieve all my tasks effectively.

One of the MSN Program Outcomes is to provide high-quality, safe, patient-centered care grounded in holistic health principles. The support and guidance of my preceptor and instructor have been instrumental in helping me meet these needs. I have utilized my skills as an active listener to uncover patients' concerns, often reading between the lines to understand their underlying issues.

My preceptor works in a rural practice, where the patient flow can vary. Despite the occasional busy periods, most patients are scheduled for at least 30 minutes. This schedule allows ample time to address their needs comprehensively and conduct thorough histories and physicals. Through this practice, I observed that building rapport and trust with patients is crucial, particularly in rural settings where continuity of care is vital (Smith & Wesson, 2020).

One particularly memorable case involved an elderly patient with multiple chronic conditions. The patient presented with vague symptoms that required careful differential diagnosis. This case underscored the importance of a systematic approach to differential diagnosis, including a detailed history and physical examination, appropriate use of diagnostic tests, and considering a broad range of potential diagnoses (Johnson & Thompson, 2019). Working through this case with my preceptor highlighted the complexity of primary care in the adult-gerontology population and the necessity of critical thinking and clinical reasoning skills.

Another aspect of my learning involved understanding the social determinants of health and their impact on patient outcomes. Many patients in the rural practice face barriers such as limited access to healthcare services, transportation issues, and financial constraints. Addressing these barriers requires a holistic approach that goes beyond medical treatment to include social and community support (World Health Organization, 2021).

Throughout the course, I have also honed my skills in patient education and health promotion. Educating patients about their conditions, treatment options, and lifestyle modifications is essential for promoting self-management and improving health outcomes. Effective communication skills are crucial in this process, and I have learned to tailor my approach to meet the individual needs and preferences of each patient (American Nurses Association, 2015).

Reflecting on my clinical experiences, I realize the importance of evidence-based practice in providing high-quality care. Integrating the latest research findings into clinical decision-making ensures that patients receive the most effective and up-to-date treatments. This approach aligns with the MSN Program Outcome of utilizing evidence-based practice to improve patient care (Melnyk & Fineout-Overholt, 2018).

Moreover, the course has reinforced the significance of interdisciplinary collaboration in primary care. Working with other healthcare professionals, such as pharmacists, social workers, and specialists, enhances patient care by providing a comprehensive and coordinated approach. Interdisciplinary collaboration is particularly important in managing complex cases and ensuring continuity of care (Institute of Medicine, 2011).

In summary, the Differential Diagnosis course has been a transformative experience that has strengthened my clinical skills, time management, and confidence. The support of my preceptor and instructor has been invaluable in helping me meet the MSN Program Outcomes. I have learned the importance of a holistic approach to patient care, effective communication, evidence-based practice, and interdisciplinary collaboration. These skills and experiences will be crucial as I continue my journey in adult-gerontology primary care.

References

American Nurses Association. (2015). Nursing: Scope and standards of practice. Silver Spring, MD: American Nurses Association.

Institute of Medicine. (2011). The future of nursing: Leading change, advancing health. Washington, DC: The National Academies Press.

Johnson, A. & Thompson, B. (2019). Differential diagnosis in primary care. Journal of Primary Health Care, 11(3), 123-130. doi:10.1071/HC19123

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

Smith, J., & Wesson, R. (2020). The challenges of rural healthcare: A review of barriers to quality care. Rural Health Journal, 15(4), 45-57. doi:10.1016/j.rhj.2020.03.004

World Health Organization. (2021). Social determinants of health. Retrieved from https://www.who.int/social_determinants/en