Purpose of the Assignment

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The purpose of this assignment is to provide the student an opportunity to integrate knowledge from the sciences, developmental theory and physical assessment data to the care of a pediatric patient and family in the acute care setting.  The student will utilize critical thinking and independent judgments in presenting a holistic plan of care in a formal oral presentation.

I chose this pediatric patient to present on for grand rounds due to the complicated nature of the patient’s history.

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Student Approach to Assignment

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The Pediatric Grand Rounds provided me the opportunity to provide care to a 17 year-old female patient who had been recently diagnosed with Myasthenia Gravis (MG) 2 months prior. This presentation allowed me to link my developmentally appropriate care for the patient with evidence based practice for pediatric patients with MG. I provided a concept map with prioritized care and rationale for the choices made. Nursing education was provided within the presentation by having peers practice different exercises that help to strengthen the muscle groups in the neck and torso that are often affected by MG.

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Reason for Inclusion of this Assignment in the Portfolio

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I chose this presentation for inclusion in my nursing portfolio because I believe it demonstrates my ability to think critically about my pediatric patient and because it allows for application of the “great 8s” of nursing practice that should be exemplified by all ODU student nurses.

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Nursing Practice

• Performs therapeutic interventions that incorporate principles of quality management and proper safety techniques.

  • One of the teaching points that I educated the patient on was the “One Dollar” Rule. Because patients with MG are frequently so weak, they should think of the energy that they have for throughout the day as if they had $1 to spend over the course of the day. Therefore, they should only engage in physical activities where they are willing to “spend.” Additionally, they should exercise in the morning and when medications are at their highest dosage.  I explained this technique to my patient before she went into surgery for a thymectomy and she verbalized her understanding.

 

Communication

• Expresses oneself and communicates effectively with diverse groups and disciplines using a variety of media.

  • In order to execute this grand rounds presentation, I wrote an essay on my patient, compiled all the data that I had accumulated, and planned and presented a slideshow to my peers. I communicated this presentation to my peers and my professors. I also presented much of the information that I learned to my patient and to the patient’s mother.

 

Teaching

• Provides teaching to patients and/or professionals about health care procedures and technologies in preparation for and following nursing or medical interventions.

  • Neither the mother nor the patient expressed complete understanding of the procedure involved in a thymectomy, so I was able to help them to better understand the procedure. I reexplained that the procedure would be laparoscopic in nature after hearing the surgeon detail the steps of the process. Although the mother and daughter had already signed consent for the procedure, I did alert the nurse that they still had questions for the surgeon even after I explained. This allowed us time to call the surgeon to come back and reexplain the procedure in order to ensure that neither the mother or child had any further questions.

 

Leadership     

• Articulates the values of the profession and the role of the nurse as a member of the interdisciplinary healthcare team

  • The role of the nurse in the care of this patient was vital because of the high quantity of interactions that the nurse and the nursing student had with the patient. We nurses encouraged the patient to maintain appropriate caloric intake, worked to prevent infection, met with the families to discuss boundaries to care and the altered family process, as well many other interventions. When the patient and the mother had questions about the procedure, the nursing staff facilitated another meeting with the surgeon before the surgery.