Phillip December 11, 2025 No Comments

D224 Final Field Experience Log: Patient Care & Education Summary

Name

Western Governors University

E224 Global and Population Health

Prof. Name

Date

Description of Field Activity

During a 10-hour clinical shift, I shadowed a BSN-prepared nurse preceptor in an outpatient clinic setting. Throughout the day, the preceptor engaged in a range of patient care activities that showcased key nursing responsibilities such as patient education, interprofessional collaboration, effective communication, referral facilitation, and resource management. These tasks were all focused on improving patient wellness and preventive healthcare outcomes.

The nurse preceptor administered influenza vaccinations to more than 20 patients, ensuring patient safety by utilizing a vaccination screening checklist. Beyond simply providing immunizations, the preceptor took time to educate patients on the importance of flu shots, explaining how vaccination decreases the risk of illness, hospitalization, and mortality associated with influenza. This educational approach contributed to higher vaccine acceptance rates.

Focused patient assessments were also conducted, including evaluations of blood pressure. For example, two male patients aged 52 and 56 presented with blood pressure readings ranging from 120/70 to 137/90 mmHg. Following physician consultation, referrals were made for laboratory diagnostics and electrocardiograms. The preceptor provided thorough patient education on the risks linked to hypertension, such as retinal damage, stroke, and kidney failure, and recommended lifestyle modifications including exercise, weight management, and sodium restriction. Additionally, the preceptor managed medication prescriptions by liaising with pharmacies and handled patient inquiries via phone, offering guidance on medication use and health concerns.

How Does the Nurse’s Role Promote the Sphere of Care?

Nursing Activity	Sphere of Care	Rationale
Flu vaccine administration	Wellness and Disease Prevention	Immunizations prevent severe complications from influenza, reduce hospitalizations, and lower mortality rates (CDC, 2023).
Patient education on hypertension	Wellness and Disease Prevention	Lifestyle counseling supports blood pressure control, helping prevent cardiovascular diseases.
Blood pressure monitoring and referrals	Wellness and Disease Prevention	Early detection with diagnostic tests helps avoid hypertension-related complications.
Prescription management	Wellness and Disease Prevention	Timely access to medications ensures effective management and enhances patient safety.
Communication and patient support	Wellness and Disease Prevention	Clear communication improves adherence and overall health outcomes.

The nurse’s administration of flu vaccines directly supports disease prevention by safeguarding individuals from potentially fatal infections. Through patient assessments, referrals, and education about hypertension, the nurse helps minimize cardiovascular risks. Moreover, by coordinating care and ensuring medication access, the nurse maintains continuity of care, demonstrating the vital role nursing plays in promoting wellness and preventive health.

Description of Field Activity on January 26, 2024

On this 10-hour clinical shift, the BSN preceptor started by reviewing patient charts and laboratory results meticulously. Working closely with the clinic physician, the preceptor identified necessary interventions and coordinated referrals. Many patients were stroke survivors aged 37 to 70, most suffering from unilateral weakness.

One significant case involved a 67-year-old male experiencing mild headaches and muscle spasms on his affected side. Lab results indicated hyponatremia, with sodium levels at 131 mEq/L. After discussing with the physician, Lasix was discontinued, and Robaxin was prescribed to manage spasms. The preceptor provided medication education and arranged follow-up care to monitor the patient’s condition.

Another patient, a 45-year-old male diagnosed with iron deficiency anemia, faced challenges swallowing iron tablets. The nurse advocated for changing to a liquid iron supplement, secured a new prescription, coordinated with the pharmacy, and offered nutritional counseling. A referral to a dietitian was also made to support dietary improvements.

Additionally, a 63-year-old patient with traumatic brain injury needed assistance with health insurance modifications to continue rehabilitation services. The preceptor collaborated with a social worker to facilitate the necessary paperwork, ensuring uninterrupted care.

Education on fall prevention was provided to stroke patients and their caregivers. This included guidance on using assistive devices, modifying the home environment for safety, and recognizing warning signs that warrant medical attention. Patients were given pamphlets on stroke recovery to reinforce this information.

How Are These Nursing Activities Related to the Sphere of Care?

Nursing Activity	Sphere of Care	Rationale
Focused assessment and lab review	Regenerative/Restorative	Early diagnosis and treatment enhance recovery and prevent complications in stroke patients.
Medication advocacy and education	Regenerative/Restorative	Promoting medication adherence supports oxygen transport and addresses anemia complications.
Insurance assistance via social work	Regenerative/Restorative	Ensuring insurance continuity prevents care disruptions, facilitating ongoing rehabilitation.
Fall prevention education and referrals	Regenerative/Restorative	Safety education reduces injury risk and fosters patient independence during recovery.

The preceptor’s activities centered on restorative care, aiming to optimize patients’ recovery trajectories and prevent further health deterioration. This involved coordinating interdisciplinary care, managing medications, and addressing social factors like insurance, all critical for successful rehabilitation.

Description of Field Activity on January 30, 2024

During a 9-hour shift, I observed the BSN preceptor actively participate in an Interdisciplinary Team (IDT) meeting. The preceptor advocated for increasing therapy time, which would allow more comprehensive patient education concerning medication management and lifestyle modifications. Family members expressed support for these proposed care enhancements.

Throughout the day, the nurse administered both COVID-19 booster and influenza vaccines, distributing safety pamphlets and educating patients about vaccine benefits.

A critical incident involved a patient who presented with hypoglycemia (blood glucose 66 mg/dL) but had no prior diabetes diagnosis. The preceptor quickly followed hypoglycemia protocols, stabilized the patient, and arranged referrals for food assistance programs through local community resources, including the North Texas Food Bank and Temporary Assistance for Needy Families (TANF). The physician was informed, and laboratory testing, including HbA1c, was ordered to assess the patient’s glycemic control.

The preceptor also provided smoking cessation counseling, outlining the risks of tobacco use such as lung cancer and emphysema. One patient accepted a prescription for nicotine patches to support quitting efforts.

Colon cancer screenings were performed on four patients over the age of 60 using Cologuard kits. The preceptor explained the importance of early detection and collected stool samples for lab analysis.

Connection of Nursing Activities to the Sphere of Care

Nursing Activity	Sphere of Care	Rationale
IDT meeting participation and advocacy	Wellness	Modifying care plans enhances patient education, improving prevention and disease management.
Vaccine administration and education	Wellness and Disease Prevention	Immunizations protect against serious infections such as influenza and COVID-19.
Hypoglycemia management and referrals	Wellness and Disease Prevention	Prompt treatment and social support prevent complications and promote overall health.
Smoking cessation education	Wellness and Disease Prevention	Counseling reduces risk of chronic diseases related to tobacco use.
Colon cancer screening	Wellness and Disease Prevention	Early detection significantly improves outcomes for colorectal cancer, a leading cause of death.

These nursing interventions highlight the nurse’s vital role in promoting health and wellness through preventative care, patient education, and timely medical and social interventions, which together improve patient outcomes and quality of life.

References

Centers for Disease Control and Prevention. (2023). Influenza (flu). https://www.cdc.gov/flu/index.htm

National Heart, Lung, and Blood Institute. (2022). High blood pressure (hypertension). https://www.nhlbi.nih.gov/health-topics/high-blood-pressure