1. The Graduate Nurse Program is provided by “The Women’s” and it is dedicated to improving the health status of the women with new-borns. The graduate nurse provided by the organization aims to improve the learning of the nurses regarding different strategy and method that can be applied to improve the health of the women and neonatal in hospital. The duration of the program is 52 weeks for the part-time that will start in February or May. The different placement option provided by the graduate nurse program includes gynaecology and women cancer services, Neonates including special care and high dependency and perioperative suites. The placement provided by the program is for 12 months in one or combinations are which is according to the preference filled by the nurse (The Women’s, 2020).
Gibbs reflective cycle helps the individual to utilize their interpersonal skill to critically analyse the situation (Wain, 2017). During enrollment to graduate nurse program, I realized that how important is to choose the correct graduate nurse program according to the interpersonal skill of the individual. During the graduate nursing program, I was able to understand different aspects that are important during women and neonatal care. As a nurse, I have good communication skill but after the program, I released that effective communication is important but therapeutic communication play a major role during patient care.
During the program, I was so overwhelmed with the gesture of the teaching staff as they helped me to increase my clinical skill like patient assessment, pain management and epidurals skill. The program helped to improve the skill that can be utilized during my clinical placement which will help to provide the quality care to the patient. After the program, I analyzed that how this program has helped me to improve as a nurse by increasing my clinical skills and these skills can be applied in future to improve the working procedure.
2. The first step that should be performed after the nurse finds a patient unconscious on the bathroom follow and he was administered to the hospital for seizure investigation is to increase the ventilation of the patient. The nurses are expected to improve the breathing of the patient and call for help to start the immediate assessment of the patient. The article presented by Sawaf & Murr, 2020 describe that during encountering with seizure patient nurses re expected to loosen their cloth, remove the entire surrounding item that can cause issue and call for help to place the individual in a lateral position on the bed. The step before the assessment process is to increase the comfort and ventilation of the patient to reduce the chances of complication that can occur.
The first assessment that should be performed after increase comfort of the patient includes an ABCDE assessment that helps to understand the reason behind the irrelevant unconsciousness by using a holistic approach. The ABDCE assessment helps to identify different functioning unit of the body to understand the issue with patient health status. As per Fernández-Méndez et al. (2019), ABCDE assessment utilizes the systemic approach during patient assessment and it should prefer during the assessment of the Seizure patient. The ABDCE assessment starts with airways assessment that includes analysing responsiveness of the patient, skin colour of the patient, breath sound and mouth inspection.
The second step in the breathing assessment which understands the respiratory rate, chest wall movement, chest percussion, lung auscultation and pulse. The third aspect is the circulation that includes skill colour, sweating, capillary refill time, palpate pulse rate, blood pressure, and electrocardiogram monitoring and heart auscultation. The disability is the fourth aspect that includes the level of consciousness, pupillary light reflexes, alertness, voice response, and pain response and limb movement. The last step includes exposure that analyses temperature and exposes skin (Dixon, 2018).
The next aspect of the assessment that can be used to understand the consciousness of the patient includes the use of the Glasgow Coma Scale. The nurses are expected to perform the accurate assessment during dealing with the patient but and dealing with seizure patient requires extra attention during the patient assessment. The study provided by Cooksley et al. (2018) describes the importance of the Glasgow Coma Scale after ABCDE assessment while dealing with seizures patient as he is unconscious.
The Glasgow Coma Scale covers three aspects during the patient assessment that include eye movement which is the rate on the scale of 1 to 4. The next aspect is the movement of the patient that is measured over the 1 to 6 range. The last aspect includes the verbal activity of the patient that is measured from 1 to 5 during patient assessment. The health care professional sum the response of the patient by using the score provided in the scale to understand the level of consciousness of the patient. The Glasgow Coma Scale helps to understand the level of consciousness of the patient that will help during patient treatment and managing the complication of the patient (De Sousa & Woodward, 2016).
3. After analysing the condition all the four patients, the first patient to be addressed will be Mr Yoing as he is on the infusion pump. The infusion pump alarm is ringing and the IV flask of the patient is empty that require urgent attention. The carelessness toward the refilling of the IV flask that results in air embolism which increases the complication by interfering in the gaseous exchange and can lead to severe chest pain (Ibrahim et al., 2018). The major consequences associated with air embolism include increase circulation pressure that leads to difficulty in breathing, increased blood pressure that may result in cardiac failure (McCarthy et al., 2017).
The patient addressed by the nurse will be Mr Stavropoulous because he is due for Ventolin because of acute asthma. The medicine is utilized to increase respiratory comfort of the patient that helps in respiration because it is a bronchodilator. The increased discomfort of the patient if not address by the medicine it can lead to many complications for the patient like the development of bronchospasm, respiratory depression, decrease oxygen availability and decrease oxygen supply lead to organ damage (Almadhoun & Sharma, 2020). The increase complication of asthma can occur due to the ignorance of the proper medication. The health care professional can help the patient to reduce the chances of exacerbation by providing accurate medication according to the scheduled time (Castillo et al., 2017).
The third patient will be Mrs Peterson as she is having left hemiplegia that increases her risk for falls and recently encountered the stroke. The nurse will help Mrs Peterson bowel as fall is one of the most common issues in the adult that lead to severe injuries. The elder individuals are more fragile and fall can lead to multiple complications like injury, death and fracture which can increase the complication of the individual (Pi et al., 2016). The restricted movement of Mrs Peterson is due to the left hemiplegia that is paralysis which directly increases the need for assistance for the assistances. Nurses are expected to the patient in need to improve is the efficiency that leads to better health outcome (Bjartmarz et al., 2017). The patient was preferred on the third number as a student nurse can also assist Mrs Peterson and student nurse can assist her during bowel.
Mrs Walters will be last in the priority list as she needs assistance to get ready for the theatre. The patient need can be put secondary if it does not cause a physiological issue. The nurse should help the patient in need as this is included in the competent care excepted from the nurse. The nurse should utilize their critical thinking skill to prefer the patient need to reduce the chances of harm that can occur due to delay in care process (Manoochehri et al., 2015). The patient can be assisted by the student nurse as she only wants to get ready this decrease her order in the priority list.
The final priority will be provided to the pre-operative checklist as it is also one of the important documents that are required before transferring the patient to theatre. The pre-operative checklist contains all the necessary information that is required by the patient thus it should as importance (Pugel et al., 2015). The student nurse can also help to find the document thus it is settled at last in the priority list.
4. The first step I will try to is to effectively communicate with RMO to increase understanding toward the situation. This will help to work in collaboration to reduce the chances of harm that occur to both the patient due to delay of the treatment. I will try to improve the understanding of the RMO regarding the health status of both the patient so that we can make the collaborative decision during the care. The healthcare system requires effective communication between the different health care professional to provide quality of care.
The collaborative work of the health care professional helps to improve the team to understand patient care that will help to improve the health status of the patient (P et al., 2018). The second step I will utilize is to utilize my professional skill to analyze the situation by using the reflective method to understand the priority of the patient as per the health status to provide the safe and quality care to both of the patient. I will try to follow the proper guideline during the patient to reduce the chances of complication that can occur due to the carelessness of the health care professional.
According to the Nursing and Midwifery Board (2016), registered nurses are expected to follow the professional standard during the care process. The first standard proposed in the professional standard for the registered nurse state that nurses are expected to utilize their thinking strategy by utilizing the evidence-based method for decision making regarding patient care. The nurses are expected to utilize the professional skill to improve the quality of care by utilizing the person-centred approach.
The third step that can be used to improve patient care is reducing the conflict with the RMO to improve the working practice. Conflict reduction help to analyse the patient condition and then prioritizing the patient according to the health status need of the patient. I will try to use the conflict resolution technique during the conversation that helps to prioritize the patient and provide accurate care to both of the patient timely. According to Piryani & Piryani (2019), conflict resolution utilizes the interpersonal skill of the individual to coordinate with other individuals to set a particular goal to improve health care quality. The Thomas and Kilman method of conflict resolution utilizes the different aspect of individual behaviour that can help to decrease the chances of a conflict.
The first aspect includes assertiveness that includes the individual skill to satisfy his or her concern during the conflict. The next aspect of the method includes cooperativeness which includes individual behaviour to cooperate with other individuals during the conversation. The third aspect collaborating that includes understanding other individual perspectives to work together. The last step that I will utilize in the patient care includes the use of professional behaviour by utilizing the shared decision-making skill with RMO to improve the working practice by utilizing the clinical skill of both the individual that help to provide quality of care to both of the patients in need.
According to the Nursing and Midwifery Board (2016), nurses are expected to follow the code of conduct during the patient care process to provide the quality of care to the patient. The second aspect of the Principle second state that nurses are expected to utilize the shared decision-making skill by providing other health care professional to participate in the decision making regarding the care process. The nurses are expected to promote the sharing of the idea with health care professional that help in shared decision making which directly improve the quality of care provided to the patient.
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