1. Appelhof, Steven
Professor Wilson
Ballard Rehabilitation Hospital
Inpatient Rehabilitation
Clinical Journal #2
During my second set of three rotations at Ballard Rehabilitation Hospital I continued to
perform routine assessments, oral medication administration, subcutaneous medication
administration as well as intramuscular medication administration. During my rotations I was
also able to sit in on a staff patient conference. The patient conference consisted of a doctor,
occupational therapist, physical therapist, speech therapist, nurse and finally a case manager to
evaluate the patient information provided by the others to correctly evaluate each person and
assign an estimated discharge date based on progression and insurance capabilities. This was
really informative to experience as it shows how a collaborative team can come together for the
greater good of the patients as well as to get the patient efficiently rehabilitated in a timely
manner. The day from the nursing point of view continued to change as our load lightened up
there were more people that we could assist with for other nurses. Dressing changes were also a
major part of the day with our patients having wounds from recently surgeries. Some patients
requested more pain medication from their time in therapy, which takes a major toll on the body
so we had to control the pain for him to be comfortable enough to continue other therapy
sessions that were scheduled for the day. Humanbecoming theory was utilized during my plan of
care when one of the patients with a Spanish speaking only patient. My Spanish is very
unrehearsed so it was very difficult to convey the information to the patient but by taking time
and patience I was able to convey enough to them to get the point across to her about our plan of

2. care for her. To further improve my skills and strategies I would make it a smart goal by
improving my comprehension and recollection of the Spanish language to where I could carry a
full basic conversation about the basic plan of care for procedures that I am performing for the
patient. I would be able to perform this by refreshing my knowledge of the language as well as
researching specific phrases that I could use to convey the message to patients like these that are
Spanish speaking only. Health care system change tends to favor efficiency and patient safety.
Our current change towards better and efficient healthcare delivery is currently moving towards
solely patient satisfaction. Nurses are having a lot of burnout because the demand for comfort
services rather than life saving measures are creating a turnover with the surveys of patient care.
Reflective question number 1 was utilized.