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Standards for Practice

Introduction to Professional Experience Placement

Reflection is an important practise that is nursing to evaluate and understand the past practise that is important to identify the flaws (Koshy et al. 2017). The Driscoll’s Model is the simplest of the reflective model and it utilizes the three questions that need to be incorporated to reflect over the practice (Dubé and Ducharme, 2015). 

What

That was a regular day for me before I encountered a man lying over the floor and his two friends were trying to call him as he seemed to be unconscious. I was not a first aid expert but as a nurse, I must help the patient in need and assist them during a difficult situation like these. I was a bit confused that I should interrupt into the situation or not but when I realised that both friends are panicking that is when I descried to help them. Before proceeding toward them, I first check for the danger and then I rushed toward them to help the man lying over the floor unconscious. The first thing that I followed is to take a response from the patient to understand his current state and after calling him multiple times he didn’t respond. The experience was challenging as I have to help both of them to sustain their friend’s life before any medical team can reach to us. I was a good experience as this is the actual exam of my clinical learning to save a life by using my clinical practice skills. During their period his both friends are equally involved to help me out to understand and follow my instructions that are important to provide right aid to Jake.

So What

During that very moment, I was using my critical thinking skills to judge the patient state and perform the right practice that can help him to breathe normally. I first tried to analyse his response after calling his name multiple time and shaking his shoulder but he does not responded. This makes me realise that may he has encountered cardiac arrest and I should open his airways to improve the breathing. The article presented by Newell et al. (2018) discussed that airways intervention is important before the CPR process to improve the breathing of the patient. When I lay down him on his back I realised that he is still not breathing properly then I realised that we should call the ambulance for assistance. I asked his friend to call the ambulance and to another friend, I asked her to bring a defibrillator. The study presented by Goyal et al. (2020) added that defibrillator is important during the cardiac arrest state as it helps to improve the cardiac impulse to improve the functioning. I was balancing my personal and professional values during the scene so there was no conflict of values I experienced during the period. On that movement, I was thankful to my mentor for the CPR session because due to the clinical knowledge during that session has helped me to assist the patient. According to Patil et al. (2015), CPR is the process that requires the right technique and skills for compression and hand position on the chest to help the patient. 

During the CPR I accurately placed my hand in the middle over his chest and started to press his chest to help him out. Before starting the CPR I pinch his nostril so that his lungs can expand and compress due to the breath. The article presented by Garg et al. (2017) added that during the CPR process nostril pinch is important to evaluate the lung rise during the breath process.

When Jake friend arrived I was still during the CPR and instructed them to open the defibrillator by following the instruction that is provided in the machine to help the patient. The study presented by Saiboon et al. (2016) added that following the defibrillator instruction is important to deliver the right procedure to help the patient during the shock delivery. Then I instructed them to put the pad one on the top of the chest and one of the downsides of the chest to start the shock process that is important to improve the breath and cardiac rhythm. The study presented by Liu et al. (2015) discussed that placing the pad in the right position is important to decrease the chances of any error that occur due to the misplacing of the pad.

I instructed them to set back from Jack and pressed the shock button without waiting for the ambulance to arrive. After pressing the shock button I followed the instructions that include starting the CRP process again. The study presented by Goyal et al. (2020) added that recuse should set back during the shock process to avoid any negative impact over the cardiac rhythm of the rescuer. During the meantime, the paramedic’s team arrived and take control to improve patient health.

Now What

This incident has helped me to utilize my clinical knowledge into practise and help the patient in the need. When I encountered with the patient laying over the floor I must provide the basic life support to improve his condition. The article presented by N C et al. (2017) added that health care professional is expected to provide basic life support to the patient in the life-threatening state like cardiac arrest. This scenario has helped me to understand the importance of critical thinking during the scenario has it help to judge the related aspects that are important to deal with the situation that is life-threatening to the patient. The study presented by Papathanasiou et al. (2014) added that critical thinking is important for the nurse as it helps to analyse the scenario which play important role in the decision-making process. The life-threatening state of the patient needs to be addressed by the right decision concerning the practice that is improved by critical thinking. The third aspect that I will use in my future practice is collaborating with the patient family members or friend that helped me to reduce the time of practice that are important for the patient to become conscious. The article presented by Micalizzi et al. (2015) added that partnering with the family members help the nurses to deliver the right care that is important to improve the quality of care which lead to better health outcome of the patient.

I was able to perform everything accurately without panicking due to the Nursing and Midwifery Board (2017) registered nurse practise standards that helped me to deliver the right care by utilizing my professional practise role. If I encounter the same scenario in future I will try to be more efficient do that care time can be reduced which is important to decrease the risk associated with cardiac arrest state. To better tackle this situation in future I will try to discuss this scenario with the mentor so that he can help me out to understand the gap in practice that need to be improved to deliver the right assistance to the patient. I think in this scenario time has increased due to the slow judgemental practise so in future I will try to improve my professional experience placement by improving my clinical practise that will help to improve my clinical practice. This incident is an eye-opener to me concerning my clinical learning and it helped me to improve future practise in a professional placement to justify the professional role.

References for Professional Experience Placement

Dubé, V. and Ducharme, F. 2015. Nursing reflective practice: An empirical literature review. Journal of Nursing Education and Practice, vol. 5, no. 7, pp. 91-99. https://doi.org/10.5430/jnep.v5n7p91 

Garg, R., Ahmed, S. M., Kapoor, M. C., Rao, S. C., Mishra, B. B., Kalandoor, M. V., Singh, B. and Divatia, J. V. 2017. Comprehensive cardiopulmonary life support (CCLS) for cardiopulmonary resuscitation by trained paramedics and medics inside the hospital. Indian Journal of Anaesthesia, vol. 61, no. 11, pp. 883–894. https://doi.org/10.4103/ija.IJA_664_17

Goyal A, Sciammarella J. C. and Cusick A. S. 2020. Cardiopulmonary Resuscitation (CPR). Treasure Island, United Kingdom: StatPearls Publishing.

Goyal, A., Chhabra, L. and Sciammarella, J. C. 2020. Defibrillation. Treasure Island, United Kingdom: StatPearls Publishing.

Koshy, K., Limb, C., Gundogan, B., Whitehurst, K. and Jafree, D. J. 2017. Reflective practice in health care and how to reflect effectively. International Journal of Surgery. Oncology, vol. 2, no. 6, pp. 1-3. https://doi.org/10.1097/IJ9.0000000000000020

Liu, J.-J., Gui, L., Chen, Z.-M., Xu, K.-Y., Li, Y., Zhang, J. and Zhou, L.-J. 2015. Effectiveness of combining manual external defibrillator and automated external defibrillator training for third-year nurse students. International Journal of Nursing Sciences, vol. 2, no. 1, pp. 105–109. https://doi.org/10.1016/j.ijnss.2015.01.011 

Micalizzi, D. A., Dahlborg, T. and Zhu, H. 2015. Partnering with parents and families to provide safer care: seeing and achieving safer care through the lens of patients and families. Current Treatment Options in Pediatrics, vol. 1, no. 4, pp. 298–308. https://doi.org/10.1007/s40746-015-0034-4 

N C, Sangamesh Vidya, K., Pathi, J. and Singh, A. 2017. Awareness, attitude, and knowledge of basic life support among medical, dental, and nursing faculties and students in the university hospital. Journal of International Society of Preventive and Community Dentistry. vol. 2017, pp. 161-167. h ttps://doi.org/10.4103/jispcd.JISPCD_240_17.

Newell, C., Grier, S. and Soar, J. 2018. Airway and ventilation management during cardiopulmonary resuscitation and after successful resuscitation. Critical Care, vol. 22, no. 1. https://doi.org/10.1186/s13054-018-2121-y 

Nursing and Midwifery Board. 2017. Registered nurse standard of practise. Retrieved from: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx

Papathanasiou, I. V., Kleisiaris, C. F., Fradelos, E. C., Kakou, K. and Kourkouta, L. 2014. Critical thinking: the development of an essential skill for nursing students. Acta Informatica Medica: AIM : Journal of the Society for Medical Informatics of Bosnia & Herzegovina : Casopis Drustva za medicinsku informatiku BiH, vol. 22, no. 4, pp. 283–286. https://doi.org/10.5455/aim.2014.22.283-286

Patil, K. D., Halperin, H. R. and Becker, L. B. 2015. Cardiac arrest: Resuscitation and reperfusion. Circulation Research, vol. 116, no. 12, pp. 2041–2049. https://doi.org/10.1161/CIRCRESAHA.116.304495

Saiboon, I. M., Qamruddin, R. M., Jaafar, J. M., Bakar, A. A., Hamzah, F. A., Eng, H. S. and Robertson, C. E. 2016. Effectiveness of teaching automated external defibrillators use using a traditional classroom instruction versus self-instruction video in non-critical care nurses. Saudi Medical Journal, vol. 37, no. 4, pp. 429–435. https://doi.org/10.15537/smj.2016.4.14833

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