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Being a student of nursing, as I am asked to do a set of vital signs I will use standard 4 of registered nurse standards to document my findings accurately. In the context of this standard I need the ability to conduct assessments comprehensively.
The first stage of the procedure of nursing is Extensive assessment. In the case of rehabilitation nursing, it provides a foundation of care that allows individuals to better control their lives and improve their health. Extensive health assessments provide insights into the patient’s health through the observation of the nurse, critical symptom measurement, and self-reporting symptoms. This includes a history of treatment, a general study, and a complete physical examination.
General studies include patient age, weight, height, physique, posture, gait, and hygiene. Nurses use health assessments to obtain baseline data about patients and to establish relationships with patients who can ease anxiety and build confidence (Smolowitz, et al. 2015).
Admission to an intensive care unit or a comprehensive health assessment is usually performed at the first visit to an outpatient clinic. The nurse can use the following strategies to evaluate:
This is the most used evaluation method. Nurses use eyes, ears and nose to get symptoms of health problems. They can not only examine skin color, aches, pains and rashes, but also pay attention to unusual sounds and smells.
A stethoscope diaphragm or bell on the patient's bare skin is placed by the nurse and hears abdominal sounds.
Nurses apply different types of pressure to patients with different parts of their hands. Palpation allows nurses to determine texture, softness, temperature, humidity, pulsation, and appearance.
The nurse presses the distant part of the patient's body firmly with the middle finger of the non-dominant hand. This technique is used to directly assess the patient's level of discomfort at the suspected tender site.
By means of these steps I will be able to conduct a comprehensive analysis and record my findings accurately.
As my buddy nurse ask me to not to tell anyone about the unusuality I noticed about the patient, I will use standard 1 of registered nurse standards, i.e. thinks critically and analyse the practice of nursing. Critical thinking is applied by nurses in order to solve the problems of the patients. In addition, at the time of decision making critical thinking is as well used by the nurses to maximize impact. Ability of critical thinking is regarded as the Steps necessary for safe, efficient and skilled nursing intervention. According to Scriven and Paul, critical thinking is the process of collecting, or subtly acknowledging, analyzing, synthesizing, and evaluating information from communication, the process of spiritual activity and observation, of experience.
This is why some positions must be adopted by the nurses to encourage critical thinking, acquire critical reasoning skills, and make new meaningful assessments and decisions about hospital admissions and the use of limited resources where any of these work is done. the ability of critical thinking must be applied by the nurses because they have vast knowledge for handling a number of situations which are encountered by them at the time of providing care to the patients. Nurses can be able to make important decisions by thinking critically about the situation and interpreting the data. This means that nurses can find specific solutions to specific creativity problems that do not work with specific therapeutic interventions. Even by means of critical thinking nurses can quickly come up with new ideas, become flexible and natural, create their own solutions to problems, work individually and confidently even under stress, and be unique (Plohal, et al. 2017).
In order to talk freely with the patient I will use standard 2 of registered nurse standards, that is engage with therapeutic and professional relationships. A medical relationship or medical alliance is regarded as a focused, cohesive organization that exists between at least two people. In addition, the main aim of a therapeutic relationship is to improve a person's quality of life through treatment. This type of relationship is essential, because the person being treated is often the first setting to share intimate thoughts, beliefs and sensations about the problem in question. Thus, it is important for the therapist to create a safe, open and conducive environment where the affected person can feel comfortable.
Three major aspects of good therapeutic relationships are harmony, congruence along with Trust. Therapists are encouraged to show empathy and credibility. Like other social relationships, therapeutic relationships also have limitations that help define acceptable and unacceptable behavior. The balance of power in the physician relationship is sufficient to support the physician and the treated person must believe that confidential matters remain confidential and that he or she is safe from injury or exploitation at the hands of the therapist. Once a therapeutic relationship is established, the treated person becomes emotionally free and provides details about his or her concerns. This, in turn, helps the physician better understand the victim's attitudes, emotions, and motives. With a more complete understanding of the situation, the doctor can provide the most appropriate treatment to solve the problem and adopt the most effective strategy (Craig, 2019).
As the patient move to ICU, I will use standard 6 of registered nurse standards that is “Provides safe, appropriate and responsive quality nursing practice”. Quality nursing care is preferred by patients and performed by nurses. However, the complexity and ambiguity that has been highlighted in the literature goes far beyond ensuring that nurses take care of the delivery. The root cause of this complication is the result of a lot of conceptual effort and a lack of con conditionality. A review of the literature shows that many alternatives are used interchangeably with quality alternative nursing. Another reason why quality care is difficult to define is that the differences between patients and nurses are important when it comes to defining and delivering quality care. Quality healthcare is not just a simple sentence. As a shift to value-based care, the focus shifts to patient care and away from volume. Patient health outcomes are more important to individual physicians than the number of patients during the day.
The Healthcare Quality Guide refers to two definitions of quality published by nationally recognized organizations by the National Standards Recognition Committee (NCQA). The first, established by the Institute of Medicine (IOM) of the National Academy of Sciences, defines quality healthcare as "safe, effective, patient-centered, timely, efficient and impartial." The Healthcare Research and Standards Agency (AHRQ) also defines quality healthcare as "the right path for the right patient, the right way to achieve the best possible outcome." (Saunders & Vehviläinen‐Julkunen, 2017).
Quality standards are published by “The Centres for Medicare and Medicaid Services (CMS)” in the year 2016, and also outlined six goals for delivering quality healthcare.
Makes care more secure by reducing the loss of care delivery.
Strengthen personal and family engagements as caring partners.
Communication combines effective communication and care.
Promotes effective prevention and treatment of chronic chronic diseases.
Work with the health community to promote the best habits of healthy living.
It is an evident fact from the given situation that the buddy nurse of the trainee is under the influence of the heavy intoxication during the time of the practice due to the in taking of the high dosage of the drug and that finally leads to the improper treatment of the concerned patient and from this it can be well concluded that Mandatory Notification is well applicable to this. In addition to this the extent of the mandatory notification is going to be quiet high in nature as the concerned patient went under high risk condition (Jeffries, 2019).
The main duty that the trainee or the practicing nurse needs to do in this case is that to report the matter of the buddy nurse (that is intoxication during the time of the duty) to the co0ncerned senior authority of the concerned hospital and needs to make a file of the Mandatory Notification so that strict action can be taken against the buddy nurse for the wrong treatment that she had conducted because of herself being under the influence of the heavy dosage of drugs. In addition to this by taking such kind of action it can be well assured that such kind of situation is not going to occur in the coming future (Cho, 2019).
The concept of the Mandatory Notification in the field of nursing came in the year of 2010 and that is firstly going to put an impact on the registered health and the allied professionals including the nurses those who are practicing. The main objective behind the framing of the Mandatory Notification is to improve the condition of the concerned patient and also to reduce the public risk that in turn is associated with the health practitioners and the impairment. There are certain grounds on which the Mandatory Notification can be made and they are as follows: Firstly comes to the aspect of the impairment, then coming to the aspect of the high dosage of intoxication because of drug in taking and that also while performing the duties, then comes the factor of the significant departure from the standards that are being laid down and the last but one of the crucial ground for the filing of the Mandatory Notification is the sexual misconduct. In addition to this it is also an evident fact to state that Mandatory Notification is going to be surely raised under the situation where because of the wrong treatment provided by the concerned nurse the patient is undergoing through a risky situation (Petignat, 2019).
Other than the above mentioned facts it is also an evident fact to state that there are certain exemptions in the Mandatory Notification and they are as follows: Training practitioners and the student those who have being newly inducted for the nursing training are very much exempted from the aspect of the Mandatory Notification but still this practitioners and the students needs to have some amount of moral values and ethical values when they are performing their assigned duties as they are associated with the health factor of the concerned patient. In addition to this it is an evident fact to state in this concerned report that the existence of the Mandatory Notification is there because to ensure protection of those public who all are prone to the health risks because of the ill treatment of the concerned nurse. Now coming to the procedures of the filing a Mandatory Notifications the steps that are involved are as follows: Firstly it can be filed to the concerned Regulatory Body of the hospital or the Medical Council, secondly it can also leads to the legal action whose extent can be up to huge level and can be strict as well in fact it can also leads to the cancellation of the license also and in addition to this it is also an evident fact to state that NHS complaint procedure can also be followed in order to file the Mandatory Notification (Aebersold, 2019 ).
The concept of the mandatory reporting is quite prevalent in the flied of nursing and that is generally done by the nurse when the scenario reaches up to certain level that is requires the legal support or assistance in order to solve the issue in an effective manner. It also includes the cases where the nurse or any other patient is at risk and can be harmed. Now coming to the case where the concerned nurse had failed to file the Mandatory Reporting and that if cause any body harm or any kind of death then in that case the concerned nurse is going to be behind the bars for a minimum period of a year and it also includes the heavy penalization amount somewhat round about $ 5000 dollar and some other fines may be added to it and there is also a chance that the concerned nurse might get suspended for a short span of time. In addition to this it is also an important fact to mention in this report that there are certain grounds on which the Mandatory Reporting is done and they are as follows: Firstly the grounds at which there is certain amount of negligence in the medical care of the children or the elderly person, then comes to the ground at which there is any kind of abuse had took place in the concerned hospital or the nursing home (Kim, 2019).
Impact of Mandatory Notification on the Health Care and Public Services
Yes, it is an evident fact to state in this report that Mandatory Notification surely plays an evident role in protecting the public and also to the health care services. The reasons in the support are as follows: Firstly comes to the aspect of the impairment, then coming to the aspect of the high dosage of intoxication because of drug in taking and that also while performing the duties, then comes the factor of the significant departure from the standards that are being laid down and the last but one of the crucial ground for the filing of the Mandatory Notification is the sexual misconduct (Bryant, 2019).
Bryant, K., Aebersold, M. L., Jeffries, P. R., & Kardong-Edgren, S. (2019). Innovations in Simulation: Nursing Leaders' Exchange of Best Practices. Clinical Simulation in Nursing.
Craig, L. (2019). The role of the registered nurse in supporting frailty in care homes. British Journal of Nursing, 28(13), 833-837.
Einboden, R., Rudge, T., & Varcoe, C. (2019). Beyond and around mandatory reporting in nursing practice: Interrupting a series of deferrals. Nursing inquiry, 26(2), e12285.
Kim, T.H. and Cho, K.J., 2019. Perception of child abuse and attitudes towards mandatory reporting among 119 emergency medical technicians. The Korean Journal of Emergency Medical Services, 23(2), pp.43-59.
Plohal, A., Dumont, C., Perry, C., Biddix, V., Bird, D. B., Darst, T., ... & Pugh, M. (2017). The Role of the Registered Nurse in the Insertion of Nontunneled Central Vascular Access Devices. Journal of Infusion Nursing, 40(6), 339-345.
Qalla-Widmer, L., & Petignat, C. (2019). Assessement of the influenza burden in nursing homes during two influenza seasons: Delphine Hequet. European Journal of Public Health, 29(Supplement_4), ckz187-073.
Saunders, H., & Vehviläinen‐Julkunen, K. (2017). Nurses’ evidence‐based practice beliefs and the role of evidence‐based practice mentors at university hospitals in Finland. Worldviews on Evidence‐Based Nursing, 14(1), 35-45.
Smolowitz, J., Speakman, E., Wojnar, D., Whelan, E. M., Ulrich, S., Hayes, C., & Wood, L. (2015). Role of the registered nurse in primary health care: meeting health care needs in the 21st century. Nursing Outlook, 63(2), 130-136.
Wójtowicz, E. Occurrence of adverse events in the activity of hospital wards in the opinions of doctors and nursing management staff.
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