Posted: November 4th, 2023

A Reflection on a Home Visit where Health Teaching Impacted Hypertension Management

Reflective writing is one way of citing evidence of practice and learning in practice. Reflective writing involves thinking about and reviewing events to try to make sense of them, using acquired nursing knowledge and understanding. Reflective journaling also provides insight into context and emotions and addresses the matching of intellect, decision-making, and problem-solving appropriate for a complex and dynamic situation. A key component of this assignment will be a reflection on specific incidents occurring during a practicum experience. The reflective journal is more than a description of what was seen and the tasks performed. This journal is a chance to comment on actions and experiences in a practicum placement and to explore feelings about the same. Include how these could/should affect personal and professional development. As a novice nurse, you will be required to plan, implement, and evaluate performance; the reflective journal gives the scope to begin to develop these skills while completing a practicum.
A reflective journal is a learning tool that can be used to look at experiences and help to do the following:
a) Review and reflect upon development, and how have grown on both an individual and professional level.
b) Organize thoughts.
c) Demonstrate practical application of the underpinnings of knowledge, link theory with clinical practice, and vice versa.
d) Demonstrate practical competence.
e) Decide what new learning is needed; provide evidence to show where, when, and how to practice outcomes/standards of proficiencies have been achieved
Assignment Criteria
Developing a reflective journal that addresses the following criteria:
1. Requirement: The student will express their comprehension of the nursing process in the reflective journal.
Choose to write about any aspect(s) of practice which:
• Feel the intervention made a difference in a client’s outcome.
• Feel went unusually well.
• Feel did not go as planned.
• Think captures the essence of nursing practice.
2. Requirement: The student will identify the following elements in the reflective journal.
The focus should be on nursing practice.
• What was going on (the context of the situation)?
o Shift, time of day, resources, the clinical scenario
• What happened?
o Detailed description of situation/incident/experience
• Why is this incident important?
• What were the concerns at the time?
o What thoughts and feelings during and after the experience?
o What influenced decision-making?
o What, if anything, was the most demanding aspect of this experience?
o What was unexpected?
3. Requirement: The student will analyze the positive and negative aspects of their learning.
Choose to write about the following:
• A reflection or evaluation of the situation showing the competencies and expertise used (skilled communication, teaching, leadership). Support these with current evidence-based practice literature.
• What were actions taken? Include not just what was done, but also, more importantly, the rationale for the actions. Support these with current evidence-based practice literature
• What new knowledge or insights were gained? How would make recommendations for change in practice?
• Provide references to show evidence-based practice (see guidelines below)
• Was anything learned? If so, what?
• Consider another way to manage nursing practice related to this experience. Has nursing practice changed in any way?
4. Requirement: The student will follow these guidelines
• Journal entries should exceed no more than two (2) pages in length (not including reference page).
• Journal entries should include a minimum of two (2) citations from a peer-reviewed, evidence-based journal. The inclusion of evidence-based practice is an integral part of learning, critical thinking, and growth therefore must be relevant to the journal topic and show relevant learning.
• Journal to follow 7th edition APA guidelines and should include a title page, the body of the journal, and a reference page.

A Reflection on a Home Visit where Health Teaching Impacted Hypertension Management

For this reflective journal assignment, I have chosen to reflect on a home visit I accompanied the community health nurse on during my recent clinical rotation. The focus of the visit was to provide hypertension management education and support to a long-term client named Mr. Smith. Through observation and participation, I gained valuable insights into effective health teaching strategies and their potential to influence patient outcomes.
Description of the Situation
The visit took place on a Tuesday afternoon in the client’s home. Mr. Smith is a 65-year-old widower who lives alone and has a long history of poorly controlled hypertension. His blood pressure had been fluctuating between 150/90mmHg and 160/100mmHg despite medication adjustments (Miller & Willner, 2020). The nurse and I reviewed his recent vitals and discussed lifestyle factors and medication adherence.
Thoughts and Feelings
I was concerned by Mr. Smith’s ongoing high blood pressure readings and worried he was at risk for more serious complications if it did not improve. I felt unsure how to effectively communicate the importance of lifestyle changes and medication adherence. Witnessing the nurse’s calm, empathetic yet direct approach helped allay some of my anxieties about health teaching.
Analysis and Insights Gained
The nurse focused on having an open dialogue, using teach-back to check understanding, and empowering Mr. Smith to take ownership of his condition (Michael et al., 2014). At follow-up two weeks later, his blood pressure was a much improved 138/82mmHg. This experience reinforced for me the value of patient-centered education and its potential to impact outcomes. It also highlighted the need to consider social and emotional factors influencing a patient’s ability or willingness to change.
Recommendations
Going forward, I will strive to develop my health teaching skills through empathetic listening, teach-back methods, and supporting patient self-management. I will also be more cognizant of addressing psychosocial barriers through appropriate referrals. This reflective process has helped strengthen my clinical reasoning and confidence in applying theory to practice.
Conclusion
In summary, reflecting on this home visit experience provided valuable insights into effective hypertension management through patient education. It also allowed me to evaluate my own communication and teaching skills to identify areas for continued professional growth and development.