Current Challenges For Hypertension Management Discussion

Reflective Journal

Daily Objective: For my specific learning goal in the current clinical situation, I wanted to enhance my knowledge and skills in efficient and detailed patient evaluations, mainly concentrating on the history and physical examination parts that are most relevant to primary care.

Clinical Objective: The above patients mainly visit the facility for numerous ailments, which may be chronic, preventative, or acute. The setting offers an opportunity to work with patients of different social statuses and backgrounds after retirement, thus appreciating the various socio-demographic factors that affect patients’ health outcomes. Current Challenges For Hypertension Management Discussion

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Patient Encounters: In today’s clinic, I noticed several exciting cases as follows: Two of the patients had significant histories of hypertension and diabetes, with poor control of the former condition. Some of the critical health issues explored were patients’ adherence to their medication, changes in their diet and other habits, and the care of other illnesses they might have (Parati et al., 2021). I assessed and scrutinized most lab findings and coordinated with the attending physician to modify the clients’ management plan. The latter patient was a recent immigrant, so the patient needed help orienting in the health care system, emphasizing the concept of cultural sensitivity and effective patient counseling.

Challenges Faced: One of the main difficulties I experienced was the time structure during patient meetings and the ability to discuss all the health issues. The clinics’ workload and assigned checklists sometimes perplexed students about performing comprehensive tasks while maintaining clinic efficiency and optimizing time-management skills.

Successes and Achievements: I was also able to conduct a patient education plan to educate a patient with diabetes on how to manage the condition using simple diction and illustrations. This helped to enhance patients’ compliance with expert advice and create a good patient-doctor relationship.

Applied Knowledge: The day was informative, and I could implement the theory taught in my NP program throughout the day. For instance, knowledge in pharmacology and pathophysiology helped me change medication dosage, whereas knowledge in evidence-based practice helped me decide about changes to treatment protocols. Current Challenges For Hypertension Management Discussion

Collaboration and Communication: I ensured an excellent rapport with corpsmen, nurses, physicians, and social workers through teamwork in coming up with good care plans and was able to meet the patient’s requirements. Good communication and staff respect allowed the realization of extensive interdisciplinary cooperation and, therefore, effective patient-centered care.

Ethical and Cultural Considerations: An ethical conflict emerged when assessing the patient’s preferences regarding end-of-life care in the patient’s elderly age. The issue of patient values, particularly patient’s clinical autonomy and cultural beliefs, influenced our discourse by leaning on patient-centeredness and applying empathy while handling delicate subjects (Oliveros et al., 2020).

Professional Development: To learn as a professional, I have the following learning objectives: I intend to improve my knowledge of conducting motivational interviewing and patient counseling. Also, health promotion research priorities for people with chronic diseases will improve my grasp of existing chronic disease management guidelines and evidence-based interventions.

Feedback Received: My preceptor provided me with constructive behavior and suggestions to enhance documentation correctness and ASP sensitivity. Regarding this feedback, I will improve the arrangement of assessment findings and write differential diagnoses based on the analysis of the relevant data.

Goals for Improvement: Non-negotiable short-term objectives include improving physical assessment skills, especially in spotting obscured clinical signs. Extended objectives imply broadening the number of subjects of interest and obtaining further certifications in various primary care subfields. Current Challenges For Hypertension Management Discussion

Overall Reflection: I believe today’s clinical experience helped me regain the desire for patient-centered care and strengthened my resolve to demonstrate competency in the future as a competent NP. The impact on the diverse patient cases seen during the practice and the practical implementation of theoretical knowledge certainly facilitated personal development.

Action Plan

Organize extra sessions for the practical skills in the physical examination.

Enter a chronic disease management workshop to improve the clinic experience.

Use feedback about documentation in day-to-day practice.

Resources Consulted:

EBP guidelines operationalized by the National Institutes of Health

Some of the clinical guidelines that have been recommended by the American Academy of Nurse   Practitioners

Other available pharmacological sources include Micromedex for medication information.

References

Oliveros, E., Patel, H., Kyung, S., Fugar, S., Goldberg, A., Madan, N., & Williams, K. A. (2020). Hypertension in older adults: Assessment, management, and challenges. Clinical cardiology, 43(2), 99–107. https://doi.org/10.1002/clc.23303 Current Challenges For Hypertension Management Discussion

Parati, G., Lombardi, C., Pengo, M., Bilo, G., & Ochoa, J. E. (2021). Current challenges for hypertension management: From better hypertension diagnosis to improved patients’ adherence and blood pressure control. International journal of cardiology, 331, 262-269. 

The most impactful idea in this term of advanced practice nursing was patient-centered care, especially regarding multi-morbidity. The real-life examples helped me broaden my knowledge about this concept, for instance, adjusting care plans to patients’ needs and ensuring that all the necessary information is conveyed to the patient and other interdisciplinary team members. This strengthened the need to blend theory with practice to offer comprehensive, quality care.
An aspect I plan to apply in future undertakings is the continuation of promoting patient-centered care. I will use motivational interviewing techniques and other evidence-based interventions to address patients’ complex needs to achieve my goals (Bischof et al., 2021). By implementing this approach, the health outcomes of patients will be enhanced; at the same time, healthcare delivery will be improved due to the development of trust and support between the key stakeholders.

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Studying remotely this term was a good learning experience concerning how flexible I can be. Although the class was not a regular classroom setting, I could follow everything and interact with my fellow students and the instructors through the online platforms (Rahiem, 2020). This proved how crucial it is for students and teachers to practice discipline, time management, and communication when learning remotely. Current Challenges For Hypertension Management Discussion
This term made me more prepared to take the NP licensure exam. The reflective journals and clinical practice brought me to a good place regarding knowledge and clinical skills in preparation for the exam (Smith, 2021). To prepare more, I will keep on reading clinical guidelines, attending study groups, and using practice exams. This has been a valuable term in which theoretical knowledge has been put into practice in solving practical problems in the future practice of a Nurse Practitioner.
References
Bischof, G., Bischof, A., & Rumpf, H. J. (2021). Motivational interviewing: an evidence-based approach for use in medical practice. Deutsches Ärzteblatt International, 118(7), 109. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8200683/
Rahiem, M. D. (2020). The emergency remote learning experience of university students in Indonesia amidst the COVID-19 crisis. International Journal of Learning, Teaching and Educational Research, 19(6), 1-26. http://ijlter.net/index.php/ijlter/article/view/301
Smith, T. (2021, April). Guided reflective writing as a teaching strategy to develop nursing student clinical judgment. In Nursing forum (Vol. 56, No. 2, pp. 241-248). https://onlinelibrary.wiley.com/doi/abs/10.1111/nuf.12528 Current Challenges For Hypertension Management Discussion