Reflection, coupled with evidence-based theory and practice, helps to develop professional skills in providing the best health care services to the patients. The Gibbs (1988) Reflective Method, helps to develop the skills to determine and navigate through the process of identifying areas of weakness or susceptibility, and layout a platform to improve the strategy to address these shortcomings (Husebø et al., 2015).
A female patient around 40 years of age got admitted to the ENT department for a routine operation. She was anaesthetized and put in operation theatre, after 6- 8 mins she underwent respiratory depression. Her oxygenation levels were less than 40%. The ENT surgeon was attempting to reoxygenate the patient. The patient's oxygenation levels were still low. The emergency code was raised and three registered nurses from the adjacent room came to help the patient. The medical emergency ‘can't incubate and can't ventilate’ arise in 10 mins after admission to OT. The patient became blue and the oxygenation levels were still less than 40%. The ENT surgeon had 30 years of experience and was a diligent professional. After 15 mins the patient oxygenation levels were brought up to 90 %. And the doctors made a call of not operating the patient and made her shift to the ward where she can wake up naturally from anaesthesia. The patent did not respond even after one and half hour and was declared dead.
Initially, seeing the whole condition of the patient, and the tense situation in the operation theatre made me very nervous. I felt helpless as the whole team was not able to achieve the oxygenation level of the patient. When we were asked to respond to the emergency code, I had sensed the tension in the situation. My other colleagues were also feeling the same. The surgeon was not able to figure out the reason for the low oxygenation levels. After the whole situation, I thought the team lacked the awareness about the health condition and could not coordinate well for the positive outcome.
The nurses knew the situation that was going in the operation theatre. I had arranged for the tracheotomy equipment for the patient which should have been used to provide oxygen directly to the lungs artificially. My colleague had also booked a bed in the intensive care unit for the patient. The ENT surgeon was confused about the condition of the patient as in what step should be taken next. Although after many attempts the patient oxygenation levels were reached to 90% but the doctor decided to cancel the operation went against the patient conditions. We tried to communicate with the doctor but restrained ourselves from breaking the professional boundaries of decision making. I later criticized myself that I should have laid more emphasis on my perspective and should have conveyed it to the team (Kourkouta, & Papathanasiou, 2014).
The team lacked awareness and did not understand the seriousness of the situation as it led to a tense environment in the OT. The ENT surgeon and the anesthetist did not communicate and discussed the medical condition of the patient. The whole team lacked the interprofessional communication, which was important for the benefit of the patient’s condition. The communication prevents medication errors, improve the patient experience, and deliver better patient outcomes (Foronda, MacWilliams & McArthur, 2016). The situation required the shared decision-making approach were in the healthcare team and the patient collectively take decisions (Babiker et al., 2014). The nurses were aware of the situation but could communicate with the doctor as they did not know to approach the situation (Bramhall, 2014).
Reflecting back, the nurse has to provide care to the patient by getting the equipment and room ready for medical procedures according to the health conditions. The team should have displayed an interdisciplinary approach in handling the situation would have led to a positive outcome. The team members must communicate and put their perspective regarding the health of the patient. This can help in solving the medical problems in a better way. The nurses should have conveyed the solutions which they had analyzed and should have mentioned the consequences of the situation, also could have escalated the issue.
I think if I ever had to face this kind of situation in the future, I 'd be more conscious of my patient needs, and my approach will be to communicate the same with my team. I will also discuss the conditions with my senior colleagues and doctor to get a better idea about the situation. Rather than criticizing myself, I would escalate the patient conditions. I will try to apply the newly acquired knowledge to my upcoming professional experience.
Babiker, A., El Husseini, M., Al Nemri, A., Al Frayh, A., Al Juryyan, N., Faki, M. O., Assiri, A., Al Saadi, M., Shaikh, F., & Al Zamil, F. (2014). Health care professional development: Working as a team to improve patient care. Sudanese Journal of Paediatrics, 14(2), 9–16.
Bramhall, E. (2014). Effective communication skills in nursing practice. Nursing Standard. 29(14), 53-59. https://doi: 10.7748/ns.29.14.53.e9355
Foronda, C., MacWilliams, B., & McArthur, E. (2016). Interprofessional communication in healthcare: An integrative review. Nurse Education in Practice, 19, 36–40. https://doi.org/10.1016/j.nepr.2016.04.005
Husebø, S. E., O'Regan, S. & Nestel, D. (2015). Reflective practice and its role in simulation. Clinical Simulation in Nursing. 11 (8) 368-375. https://doi.org/10.1016/j.ecns.2015.04.005
Kourkouta, L., & Papathanasiou, I. V. (2014). Communication in nursing practice. Materia Socio-medica, 26(1), 65. https://doi.org/10.5455/msm.2014.26.65-67
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