1. Appelhof, Steven
Professor Wilson
Ballard Rehabilitation Hospital
Inpatient Rehabilitation
Clinical Journal #3
During my third set of three rotations at Ballard Rehabilitation Hospital with
Melissa, I continued to perform routine assessments, oral medication administration,
subcutaneous medication administration as well as intramuscular medication
administration. An additional skill that I was able to perform in these particular days
includes an intermittent catheterization that was due every 4 hours on a patient who was
in a motorcycle accident with paraplegia and a neurogenic bladder. During my rotations I
was also able to sit in on another staff patient conference. This was a really positive thing
to experience a second time because it shows and reinforces how a collaborative team can
arrange for good measures to be implemented to change the outcome of a patient in a
strict interdisciplinary setting. 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 recent surgeries. Some patients requested more pain medication before as
well as after their time in therapy to control their pains caused from the exercises.
Humanbecoming theory was utilized during my plan of care when one of the patients
with a spinal cord injury from a motorcycle crash who was under our care required total
care for feeding, transferring, changing and nursing interventions. My personal
background involves motorcycles as well as people who love to ride and live to ride. I

2. felt incredibly called to help this client because I would want all the help I could get if it
were a colleague who rode motorcycles or even myself. To further improve my skills and
strategies I would make it a smart goal by improving my comprehension and recollection
of the intermediate catheterization to where I could perform the activity as a second
nature approach with using the information I possess as well has continuing practicing
the proper techniques to make the procedure go more smoothly and get the procedure
without breaking sterile technique on the first try. I would be able to perform this by
refreshing my knowledge of the intermediate catheterization and watching the online
videos of how it is done properly. Clinical activities and actions that synthesized
knowledge from nursing would include the use of the IMC catheter that was used on
today’s patient. It is meant to be sound knowledge that an intermediate catheter is to be
used for neurogenic bladders to extract the urine with knowledge of physical anatomy
and physics in general. Our competency is based off of proven interventions that have
solidified evidence to improve a client’s situation through our actions and practice.
Reflection question utilized: 2.