Evaluation of the Practicum Experience
Practicum experience is a way in which nursing students can appreciate the theory through applying what has been taught in class into a real life situation. It is a period when the student develops practical skills and competencies as a professional. Apart from technical skills, the student can also develop soft skills like problem solving, decision making, interpersonal, leadership, and effective communication capabilities among others.
This paper analyzes and evaluates the practicum experience that was undertaken at the Kaiser Palliative and Hospice Care department. It describes the activities that were carried out and the personal learning objectives that were achieved. I undertook my practicum at Kaiser Permanente, which is an integrated health group with headquarters in Oakland, California. This health conglomerate was founded in 1945 by Kaiser J. K and Garfield S. R. and operates a series of Kaiser Hospitals and medical factions in nine states in the United States of America.
Summary, analysis and evaluation of practicum experience
I started the practicum experience by interviewing significant palliative care experts from Kaiser: Dr. M. M, Dr. J. M, and M C who is a registered nurse (RN). All these participants had more than 5 years of experience in their related fields. The interview results were then discussed. Utilization of research findings in nursing practice is a professional practice of the modern nurse.
I then attended a web based learning module that was presented during one of the continuing medical education (CPD) sessions. The module provided a broad overview of death and dying in the United States, the growing need for quality palliative care, current gaps in care, present definitions to introduce palliative care, and the scope of palliative care. One of the ideas that were introduced in this module is the fact that palliative care is quickly becoming a standard in American health care plans.
I learnt that the Medicare mostly rules palliative care requirements and slight deviation from accepted practice could bear harsh consequences for the department and jeopardize licensing from accredited bodies. With Ms Becky’s (quality department Registered Nurse) assistance, I reviewed Medicare requirements and “rules of computer charting”. Additionally, we reviewed common mistakes nurses make during charting on palliative care patient and actions to correct those mistakes.
Further, I had a chance of observing the department educator, Adela T. (RN), conduct an introduction, and orientation session to newly hired nurses. I was able to take part and acknowledge the teaching style and tools she used during the session. I assisted Adela to brainstorm and take new nurses through Kaiser Programs and departments. I also learnt induction and orientation of new employees which is part of human resource management that is carried out by the head of the hiring department. However, this activity can be delegated to another nurse who is experienced.
I learnt that Kaiser was introducing a new improved computer program charting for palliative care nursing home visits. In-service was mandatory and all palliative care, nurses, and managers had to attend. The new computer program was developed to improve and simplify nursing charting. I tried to use the computer program but found that it was not easy to master. In fact, the program had little to do with making nurses charting easier and time efficient.
I was given a duty to conduct literature research and review of seven (7) peer reviewed journal articles as well as existing Kaiser Policies regarding Palliative care.
Doing the literature review enhanced my knowledge and I was able to compare problems that existed in palliative care five years ago and now. I found out that most of the articles have no apparent distinction between palliative care and hospice care. In fact, they are used as “end of life care”. This is because Kaiser Permanente looks at palliative care and hospice care as two different programs that admit different patients and administer different levels of care.
I then discussed my research with my mentor who suggested inclusion of some new Kaiser policies on Palliative care that came out over the previous two months. Those policies reflected recent changes in the field of Palliative care and current Medicare requirements for Palliative care providers. I realized that the challenge medical providers have is the impending change in health care administration and care generally referred to as Obama care. I also engaged in the review process of current policies to reflect what the impending changes carry for health care services. The process of conducting a review of literature and compiling bibliography was a beneficial experience. This is because I learnt how to do a systematic review of literature and conduct peer reviews which is an essential aspect of health research.
My mentor mentioned that palliative care nurses are rarely aware of new evidence – based research findings and practice with basic work related knowledge. We then deliberated on the possibility of including about 10 minutes for research review in the interdisciplinary weekly meetings as a continuing medical education practice that can enhance and improve evidence-based practice .
In another experience, I was given a task to design a draft of the palliative care guide. It was really a challenging task. I had to do additional research online on how to design an educational guide.
Simplification, I learnt, is an essential component to designing a nursing program. Significant components included, Introduction to palliative care; Purpose of the guide; key points of evidence- based research; Overview of palliative care program at Kaiser Permanente; Kaiser policies, Medicare requirements; Quality charting; Palliative care and Health care reform resources . I later presented the preliminary draft to my mentor and department educator for review, critique, and further development.
The department educator suggested, instead of using “Guide to Palliative care”, the written guide to be named “Palliative Care Self –Study Module”. She also proposed that I should develop digital Module that can be viewed as power point presentation especially for new nurses joining the department. I knew this would be a challenging and lengthy assignment to perform. However, I faced the bull by its horns since I wanted all nurses to have the ability to access the same information either digitally or on paper.
Later on, I met with my mentor and presented my final draft of the written Self-Study Module based on all corrections and previous inputs from my mentor and department educator.
She stated that it would be a valuable tool to use when palliative care education was provided to a new nurse. She also mentioned that even nurses who work for the department for a long time would benefit from the material included in the Learning Module. This motivated me and raised my esteem as I was influencing the conventional way of doing this and introducing new dimensions.
She liked the materials that I included at the end of the module and gave a positive feedback regarding design and format of the Module. We also talked about my digital presentation development and inclusion of things like humor. This, I learnt, is a good attribute as a nurse educator or trainer.
My department was impressed with my progress and offered me a department educator position. This enabled me gain respect and confidence. As a department educator, I did a presentation on ‘Guide to Palliative Care’, which turned out to be a long one, contrary to my expectations. I realized that the speaker notes should reflect what I would say if I was the one to present the power point. I had developed both hard and soft copies, which I could not wait to present to my mentor and department educator. I shared the Power Point content and design for the Digital version of the Module with educator and my mentor. This project and presentation empowered me with excellent organization, management, and efficient communication competencies which I continued to apply throughout the experience.
An experience that enabled me to develop professional confidence and skills in management of human personnel were when my newly designed Palliative Care Self-Study Module was to be reviewed by three new hired nurses. Before the review session, I was very nervous and even went to the room two hours before the scheduled time. The educator suggested making a “Round Table” review session so that I could be close to the nurses and be viewed as a friendly peer, unlike a formal teacher. This, I learnt, is a teaching strategy and human relations technique.
The session was very interactive and exciting. It later turned out that none of my three students have had experience with palliative care. The content was very new to them and they expressed stunning interest to learn. I encouraged them to ask questions during the session if something was confusing. After the introduction, I went over the objectives for the session and introduced the Study Module to them.
On evaluation of the session, I received positive verbal feedbacks from all the three nurses. They found that self –Study module is a helpful resource that they can refer to when they have questions about Palliative Care philosophy and primary concepts. My experience after the session was very satisfying. I was also proud of the project and myself. I obtained several positive feedbacks as well as constructive criticism regarding my project from my mentor, department educator, quality assurance staff, and department nurses. During this project, the most challenging part was the development of the project itself.
Conclusion
I tried to incorporate Evidence- based research on my project and share my findings with others. I did not realize that only a few nurses were aware of the recent research finding in Palliative Care. I found that sharing the knowledge with others is very rewarding and essential task.
This experience helped me to connect with people in my department and opened other opportunities, including that of the department educator. It further enabled me to apply knowledge into skills through teaching, facilitating, researching, and program design and evaluation. In addition, an understanding of the significance of evidence-based practice was enhanced. I completed my practicum experience a happier person since I was able to challenge the palliative care process by developing the Palliative Care Self-Study Module which was a new concept in palliative care. Thus, I was able to appreciate evidence-based practice.
References
Jha, N. K. (2008). Research methodology. Chandigarh: Abhishek Publications.
Kochan, T. A. (2009). Healing together: The labor-management partnership at Kaiser Permanente. Ithaca: Cornell University Press.
Leong, S. (2010). How to develop a talent for training: A very practical guide for trainers. Massachusetts: Global Management Enterprises.
Liang, L. L. (2010). Connected for health: Transforming care delivery at Kaiser Permanente. California: Jossey-Bass.
Polit, D. F., & Beck, C. T. (2008). Nursing research: Generating and assessing evidence for nursing practice. Philadelphia: Lippincott Williams & Wilkins.
