REFLECTIVE JOURNALING
Reflective Journaling
Rosalinda Paula
08/12/2022
Dominique Paschal
, 2
REFLECTIVE JOURNALING
Patient Narrative
Sarah, a 66-year-old vintage white woman was my patient today. On July 24th of this year
2022, she was admitted to the hospital in which some of her diagnosis to consider were chronic
obstructive pulmonary disease (COPD), chronic anemia, chronic constipation, peripheral
neuropathy, and type 2 diabetes mellitus. Duplex ultrasonography is used to rule out peripheral
arterial disease. She had her left shoulder replaced 1 year ago because of a fall, which forced her
to use a wheelchair to get around. She is now at high risk for falls. Mrs. Sarah is on a weight loss
program and weights 98 kg. She is alert and oriented to person and place, and occasionally
forgets recent events. Vitals signs fall within the normal range. When I informed my patient
today about the importance of improving body repositioning every 2 hours to prevent
compromised skin integrity, I felt as though I had put my nursing expertise to use. The patient’s
legs were elevated, and compression stockings were applied to increase circulation and lessen
edema.
Reflection of Nursing Process
Starting with the phases of the nursing process- assessment, diagnosis, planning,
implementations, and evaluation- I first started working with this patient. Based on clinical
judgment, critical thinking, and evidence-based practice, these five elements were put into place.
For her to go from her wheelchair to her bed, a nursing assistance was required, thus I used the
nursing process to develop a nursing diagnostic of decreased skin integrity associated to non-
ambulatory status. In addition, she has a poor diet and frequently experiences breathlessness I put
the patient in a high sitting position, raised her legs, and put on compression stockings to
encourage venous return using my critical thinking and judgment. I enhanced patient education,
dietary and lifestyle adjustment weight loss, leg elevation, better range of motion, and