The primary duties of nurses among many others include duties of care to all patients, autonomy, and confidentiality. Nurses therefore should always have a sound understanding of various legal, ethical, and professional issues concerning their careers. As a registered nurse I was tasked with providing palliative care and I knew I have to uphold professionalism, ethical and legal standards as expected of a registered nurse. I examined the patient to understand the physiologic realities so that I could get a basis for making an informed decision. From the examination the patient was likely to die soon. It was difficult to pass this information to the patient and the family and I had to involve a senior nurse. The nurse evaluated my report on a physiologic examination and guided me. I had to discuss with the patient and family members to inform them that the death was near and so identified options that were no longer beneficial to the patient but decision making was focused on patient and family preference (Dermaco et al., 2019)
In the health system nurses are critical in the provision and delivery of essential health services. Nurses act as first respondents of various clinical cases and therefore their communication skills are essential aspects in their career practice to ensure achievement of sound relationships, co-operation, and collaboration. On one of the occasions during my clinical attachment, I was assigned a role to provide care to a lady who had been admitted due to a history of falls. She looked very upset and so I was interested to know more about her illness. I engaged her with some open-ended questions including asking her to tell me more about herself and how does she experience the pain. I realized that she had a lot to tell and I promised assured her to be with her all the time. I went to her and touched her back and she could complain but instead I asked her if she felt the same pain during the accident. Eventually, I learned that the lady was a victim of physical abuse by the husband (Guerrero, 2019)
Nurses’ ability to reason, think and make judgement has a great significance in the quality of care provision. The complexity of care and patient acuity demands the application of knowledge and experience to identify patient problems and to provide clinical actions and judgment that will result in positive and better patient outcome. On one of the occasions, I had a patient who was diagnosed with Asthma. I had handled such cases before and so I knew the medication. However, upon lengthy communication with the patient and assessment of respiratory status including monitoring of breath sounds, peak flow vital signs, and pulse oximetry I could not find well-informed decision to choose a clinical model or decision for that case. Having identified medical problem, I asked for assistance and orders from a senior nurse. I was able to manage both the intended and unintended outcomes through theoretical knowledge of signs and symptoms associated with Asthma (Van & Williams, 2017).
Patient care is a significant service by nurses. To ensure the provision of best health care nurses must communicate with relevant professionals including physicians and doctors. For successful teamwork each professional must understand the role of each team member. During my first week of clinical rotations, I was supposed to be at the maternity but through that entire week I ended up in various departments. My colleague who was supposed to be at the critical care department was not in and so I had to do to handle patients in both departments. For all patients, I handed in both departments I made detailed reports and kept doctors informed of any significant changes. In one occasion, my fellow nurse was having a long queue of patients in the evening while we were leaving for home, I had to volunteer to step in to assist. Throughout those rotations, I ensured that I know all my colleagues and how each one of them works (Guerrero, 2019)
NSW health core values were build based on the public sector's core values of integrity, trust, accountability, and services (Lloyd et al,. 2019).
In all my clinical attachments patient care delivery I always ensure I provide clinical-based solutions to the patients and where I do not understand I ask my seniors. Besides, I managed my attitude while handling both my colleagues and patients.
I documented and recorded all the procedures I did to handle a patient then share it with the relevant departments. I did my best to ensure a patient and primary care providers speak up their voice concerns.
I always ensure good service delivery while adhering to treating patients with compassion, respect, and dignity. I took enough time to communicate with patients or with any other person who wants to express their opinion and even gave them room to make their proposals concerning patient care.
As a nurse I would always strive to provide the best possible patient care by assuming responsibility and accountability. I would engage patients and family members for decision making so that I can utilize available resources to meet patient and community expectations.
In all my health care provisions I would always think of the critically of the conditions and evaluate the clinical decision-making process that I will use to provide care. Besides I would think of additional knowledge, skill, or judgment that is needed because every care plan involves critical thinking and judgment. I would implement all these decisions in which I know I have authority based on the knowledge that for any decision I made to carry out the activity within the autonomous scope of practice and so I will solely accountable for the patient outcome. I would, therefore, offer my services based practice standards, guidelines, and legislation as I maintain core competencies. Finally, exploring solutions with the patient and health care team then document the issue including the patient’s perspective and actions taken to solve the problem (Srulovici & Drach-Zahayy, 2017).
DeMarco, J. P., Jones, G. E., & Daly, B. J. (2019). Ethical and Legal Issues in Nursing. Broadview Press.
Guerrero, J. G. (2019). Practice Rationale Care Model: The Art and Science of Clinical Reasoning, Decision Making and Judgment in the Nursing Process. Open Journal of Nursing, 9(2), 79-88.
Lloyd, B., Elkins, M., & Innes, L. (2018). Barriers and enablers of patient and family centred care in an Australian acute care hospital: perspectives of health managers. Patient Experience Journal, 5(3), 55-64.
Srulovici, E., & Drach-Zahavy, A. (2017). Nurses’ personal and ward accountability and missed nursing care: A cross-sectional study. International journal of nursing studies, 75, 163-171.
Van Graan, A. C., & Williams, M. J. S. (2017). A conceptual framework to facilitate clinical judgement in nursing: A methodological perspective. health sa gesondheid, 22(1), 275-290.
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