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According to the Nursing and Midwifery Board of Australia, (2017) first standard from the registered nurse standards for practice is relevant and applicable for the given scenario. The standard says that the registered nurses must use a range of strategies based on critical thinking along with using the best available facts in decision-making to provide safe & good quality nursing practice within the evidence-based and person-centered framework. In the given scenario, I will first calm the patient by building good therapeutic communication and showing him empathy and will make him understand the severity of his condition and need of being in bed along with the impacts of smoking on his health at this stage. As the patient is agitated that means he is dealing with psychological issues and it has been reportedly seen that smoking deteriorates the physical as well as mental health outcomes. It also reduces the efficiency of various psychiatry medications among the agitated patients and increases the long term risk of respiratory, cardiovascular diseases, and cancers along with contributing to the worsening of the mental illness (Patwardhan & Driscoll, 2020). The very next moment I would go to my senior doctor and will tell him the whole scenario and will ask if any medication is required or not as it is my core duty to inform my seniors regarding the patient’s situation. Afterward, following the doctor’s instructions, I will provide a safe, suitable, and an approachable quality nursing practice in order to get the best health outcomes of the patients.
In the given scenario, the situation seems to be quite panicking as one of the patients was having difficulties in breathing and this condition require immediate action while simultaneously another patient was trying to climb out of the bed and it could lead to any kind of injury to the patient. In such a situation I will immediately ask for help as there are two different patients with different behaviors and both need immediate actions. Then, I’ll look after the patient who was finding difficulties in breathing. The proper assessment of the patient will be done and in this Remember ABC i.e., Airway, Breathing, and Circulation will be observed and checked along with the respiratory rate followed by ensuring a clear airway, providing oxygen, checking the oxygen saturation, maintaining the oxygen saturation between 95–100%, raising the head of the bed, suction for maintaining patient’s airway, giving pain medications if required, providing antibiotics as prescribed by the MD, and most importantly providing the maximum emotional support to the patient. On the other hand, will visit another patient who was trying to climb out of the bed and was being handled by the other nurse. I will observe his pattern of behavior and build an effective therapeutic communication with the patient by letting him know the impact of doing such activities on him as well as the other patients. This act of him could turn into an accident or injury that can be severe.
In my course of the placement, I was being placed in a rehab ward, where one of the patients was from the aboriginal community who was highly addicted to heroin consumption and it is quite difficult to communicate with them. During my placement, I used effective communication skills while dealing with culturally diverse people. According to Younis, Mabrouk & Kamal, (2015) an effective therapeutic communication is the foundation of patient-centered care in the healthcare system. Therapeutic communication is considered as the basis of a synergistic relationship between patients and healthcare providers. It helped me in bridging the cultural gap between the patient and me as it helped me in creating an effective collaborative work which is considered as an important aspect of care management. I used to observe the behavior of the patient and listen to him, this built a trust and compassion between us and helped me in learning the uptake of formal as well as informal learning opportunities that extended my professional competence by including viewpoint and has enhanced my institutional knowledge along with the self-regulatory skills that were associated with cultural diversity. I handled the whole scenario by developing cultural competences in me, this helped the patient to be comfortable and enable him to share and talk about fears. The cultural competence encompasses the knowledge, attitude, and skills (MAS Medical staffing, 2018). The techniques that I used during that time that has enhanced the level of competency in me are asking questions to the patient and learning about each response of the patient means indifferent, using descriptive communication, employing various techniques and skills during occasional arise of any conflicts in nursing practice and seeking help from the colleagues and seniors who belong to different cultures. All these approaches helped me in learning more about communicating as well as respecting the cultural differences. I also become able in assisting cultural assessment and conducting effective communication, this improved state of the patient, and his heroin addiction was also getting diminishing day by day. Dealing with a culturally diverse person has given me insights into the cultural sensitivity. Through this, I have learned the significance of adaptations in the provision of health service to culturally diverse people and helped in plummeting the disparities and increasing the positive health outcomes of the patients (Rittle, 2015).
Being a registered nurse (RN) comes with a great sense of responsibility, even after completing my graduation and becoming a licensed RN. Lifelong learning is something that will run throughout my nursing career which will develop my skills and fulfill the standards of care and the scope of my practice. Even after getting employed, continuous learning at my workplace from my seniors and colleagues will keep me updated with new approaches, techniques, procedures and policies and this will build a strong corporative relationship with patients and co-workers, and will reduce the rate of errors, and improves the outcomes of patients. Continuing professional development (CPD) is my ultimate goal as it aims to prepare nurses for maintaining and enhancing the professional knowledge, competence, and specialization in order to encounter their responsibilities for the provision of effective, ethical, legal, and safe practice. A successful CPD plan directs the positive evidence-based learning outcomes and practice (Nursing and midwifery board of Australia, 2017). Being a registered nurse, my aim is to involve planning as well as reflection for making my continuing professional development more effective. Planning for my effective CPD will enable me to assess and enhance my level of competency, treatment plan, delivery of best service along with enhancing my practice to meet the best practice standards.
According to me, a good CPD plan is very important for development and positive outcomes in nursing. To attain this, given below are the key points that I will include in my CPD:
MAS Medical Staffing. (2018). How to Strengthen Cultural Competence in Nursing Practice. Retrieves from: https://www.masmedicalstaffing.com/2018/02/13/cultural-competence-in-nursing-practice/
Nayak, S. G. (2018). Time management in nursing- hour of need. International Journal of Caring Science, 11(3), 1997.
Nursing and Midwifery board of Australia. (2017). Continuing professional development. Retrieved from: https://www.nursingmidwiferyboard.gov.au/Registration-Standards/Continuing-professional-development.aspx#:~:text=Continuing%20professional%20development%20(CPD)%20is,required%20throughout%20their%20professional%20lives.
Nursing and Midwifery board of Australia. (2017). Registered nurse standards for practice. Retrieved from: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx
Patwardhan, P., & Driscoll, R. (2020). 'Quit during COVID-19'-staying smokefree in mental health in-patient settings. Ecancermedicalscience, 14, ed102. https://doi.org/10.3332/ecancer.2020.ed102
Rittle, C. (2015). Multicultural Nursing: Providing better Employee Care. SAGE Journals, 63(12), 532-538.
Younis, J. R., Mabrouk, S. M. and Kamal, F. F. 2015. Effect of the planned therapeutic communication skills of pediatric nurses. Journal of Nursing Education and Practice, 5(8), pp. 109. doi:10.5430/jnep.v5n8p109
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