D224 Final Field Experience Log: Patient Care & Education Summary

Grace J.
November 11, 2025November 11, 2025
BSN, D224, Western Governors University

Student Name

Western Governors University

D224 Global and Population Health

Prof. Name

Date

Description of Field Activity

During a 10-hour clinical shift, I shadowed a BSN-prepared nurse preceptor at an outpatient clinic. Throughout the day, the preceptor engaged in various patient care activities that highlighted essential nursing roles such as patient education, interprofessional collaboration, communication, referral facilitation, and resource allocation. These efforts collectively aimed at enhancing patient wellness and preventive care.

The preceptor cared for over 20 patients by administering influenza vaccines, ensuring patient safety with a vaccination screening checklist. In addition to giving shots, the preceptor emphasized the importance of flu vaccination, explaining how it lowers the risk of illness, hospitalization, and mortality related to influenza. This educational approach led to a higher acceptance rate of vaccines among patients.

The preceptor also conducted focused assessments, such as reviewing patients’ blood pressure records. For instance, two male patients, aged 52 and 56, presented blood pressure readings between 120/70 and 137/90 mmHg. After consulting with the physician, referrals were arranged for laboratory tests and electrocardiograms. Patients received education on hypertension risks, including retinal damage, stroke, and kidney failure, and were advised on lifestyle changes such as regular exercise, weight control, and sodium intake reduction. The preceptor managed medication prescriptions by contacting pharmacies and handled patient phone inquiries to provide guidance on health and medications.

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

Nursing Activity	Sphere of Care	Rationale
Flu vaccine administration	Wellness and Disease Prevention	Immunization prevents severe flu complications, reduces hospital admissions, and lowers mortality (CDC, 2023).
Patient education on hypertension	Wellness and Disease Prevention	Lifestyle counseling aids blood pressure control, preventing cardiovascular diseases.
Blood pressure monitoring & referrals	Wellness and Disease Prevention	Early detection and diagnostic testing help avert complications related to hypertension.
Prescription management	Wellness and Disease Prevention	Timely medication access supports effective disease management and patient safety.
Communication and patient support	Wellness and Disease Prevention	Clear communication enhances patient adherence and improves health outcomes.

The nurse’s flu vaccine administration directly supports disease prevention by protecting individuals from potentially fatal infections. Managing hypertension through patient assessments, referrals, and education reduces cardiovascular risks. Furthermore, efficient communication and coordination with healthcare providers and pharmacies maintain continuity of care, illustrating the nurse’s pivotal role in promoting wellness and preventive health.

Description of Field Activity on January 26, 2024

On this 10-hour shift, I observed the BSN preceptor begin the day by carefully reviewing patient charts and laboratory results. Working alongside the clinic physician, the preceptor addressed needed interventions and referrals. Many patients were stroke survivors aged between 37 and 70 years, most experiencing unilateral weakness.

One notable case involved a 67-year-old male presenting with mild headaches and muscle spasms on his weakened side. Laboratory results revealed hyponatremia (sodium 131 mEq/L). The preceptor discussed this finding with the physician, who ordered discontinuation of Lasix and prescribed Robaxin for spasms. The preceptor educated the patient regarding medication changes and arranged follow-up care.

Another patient, a 45-year-old male with iron deficiency anemia, had difficulty swallowing iron supplements. The preceptor advocated for switching to a liquid form, obtained a new prescription, contacted the pharmacy, and provided nutritional counseling. A referral to a dietitian was also arranged to support the patient’s dietary needs.

Additionally, a 63-year-old traumatic brain injury patient required help with health insurance changes to maintain ongoing rehabilitation. The preceptor collaborated with a social worker to assist the patient with paperwork and ensure continuity of care.

The preceptor also educated stroke patients and their caregivers about fall prevention, emphasizing the use of assistive devices, home safety modifications, and warning signs that require medical attention. Each patient was given a stroke guide pamphlet to reinforce this education.

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 identification and treatment support optimal recovery and prevent complications in stroke patients.
Medication advocacy and education	Regenerative/Restorative	Ensuring medication compliance aids oxygen transport and prevents anemia-related issues.
Insurance assistance through social work	Regenerative/Restorative	Helping with insurance continuity prevents care disruption, supporting rehabilitation and recovery.
Fall prevention education and referrals	Regenerative/Restorative	Education on safety reduces injury risk and promotes patient independence during recovery.

The preceptor’s focus was on restorative care, aiming to optimize patient recovery and prevent further health decline. Nursing roles included coordinating care, managing medications, and addressing social determinants of health such as insurance, all essential for regenerative care.

Description of Field Activity on January 30, 2024

During a 9-hour clinical shift, I observed the BSN preceptor participate in an Interdisciplinary Team (IDT) meeting. The preceptor advocated for increasing therapy time to allow comprehensive patient education regarding medication management and lifestyle changes. Family members supported these proposed changes.

Throughout the shift, the preceptor administered COVID-19 booster and flu vaccines, providing patients with safety pamphlets and education on vaccine benefits.

A critical incident involved a patient exhibiting hypoglycemia (blood glucose 66 mg/dL) without a history of diabetes. The preceptor promptly followed hypoglycemia protocols, stabilized the patient, and arranged referrals for food assistance programs through the North Texas Food Bank and Temporary Assistance for Needy Families. The physician was notified, and laboratory tests, including HbA1c, were ordered.

The preceptor also provided smoking cessation counseling, explaining risks such as lung cancer and emphysema. One patient accepted a prescription for nicotine patches to aid quitting.

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

Connection of Nursing Activities to the Sphere of Care

Nursing Activity	Sphere of Care	Rationale
IDT meeting participation and advocacy	Wellness	Adjusting care plans ensures patients receive needed education, improving disease prevention and management.
Vaccine administration and education	Wellness and Disease Prevention	Immunizations protect against viruses like influenza and COVID-19.
Hypoglycemia management and referrals	Wellness and Disease Prevention	Early intervention and social support prevent complications and promote overall health.
Smoking cessation education	Wellness and Disease Prevention	Counseling reduces chronic disease risks associated with tobacco use.
Colon cancer screening	Wellness and Disease Prevention	Early detection improves treatment outcomes for colorectal cancer, a leading cause of morbidity in older adults.

These nursing activities emphasize the nurse’s critical role in promoting health and wellness through preventive measures, education, and timely interventions, thereby enhancing 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

American Stroke Association. (2023). Stroke recovery and rehabilitation. https://www.stroke.org/en/about-stroke/recovery