National Safety and Quality Health Service

RUNNING HEAD: NURSING
NURSING
Name of Student
Name of University
Author note

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One of the most important The National Safety and Quality Health Service (NSQHS)
Standards (Greenfield et al., 2015) is recognizing and responding to acute deterioration of the
patients and it is of imperative importance that nurses follow the each of the NSQHS
standards on a daily note, including this one (Gill, Leslie & Marshall, 2016). This standard
focusses on running the right protocols and measures that help the nursing professionals to
adhere to best practice guidelines in acute settings. This includes checking of the vital signs
regularly, applying the emergency medications on right time, taking pulse (White, Dudley-
Brown & Terhaar, 2016) and monitoring the breathing patterns for any distress on a frequent
basis (National Safety and Quality Health Service Standards, 2019). While different
department such as neurology, cardiology, CTVS and trauma care has different set of
protocols to check on the emergency signs and deterioration signals, I had my fair share of
experience from my last placement in a cardiac unit.
It was first day in the cardiac unit and my supervisor handled me with two myocardial
infarction patients. The beds of these two patients were placed head to head and I could
almost observe the vital sign of the other while caring for one patient. I began with regular
nursing duties like checking the patient’s prescriptions and relevant papers related to case
scenario. In the beginning, one patient was sleeping and the other was conscious but both had
normal vital signs showing on the monitor and there was nothing to get alarmed about. After
administering the IV medicine to the sleeping patient - I started to converse with awake
patient. I was just hearing about his family – when I heard monitor of the other patient started
blinking, got me alarmed. I ran to my asleep patient found out his oxygen saturation was
continuous dropping below eighty nine percent. The normal physiologically safe limit of
oxygen saturation is 90 to 100 percent and anything 90 per cent can prove very dangerous. I
checked the heart rate on the monitor was blinking at 105 beats/ minute. The patient was
deteriorating at a rapid rate and the patient was having tachycardia and respiratory distress at

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the same time. The supervisor told me that I have injected the wrong medicine and soon an
antagonistic drug has to be given if the patient has to be saved. Soon, after she injected the
right medication this time and after setting the ventilator parameter to clinically appropriate
levels, the deterioration was checked and the vital signs were brought under control.
The medication safety standard ensure that the clinicians are safely prescribing,
dispensing and administering the most suitable medications. The standard also make the
patients receive an informed care (National Safety and Quality Health Service Standards,
2019). The nurses in a daily practice should inform the patients about the need of the
prescribed patients and why they are receiving the same (Ongpoy et al., 2017). The nurses,
who are in constant touch with the patients, must be careful while administering the
medications to the admitted. They must use the clinical reasoning while taking decisions
(Monagle et al., 2018). They should apply critical thinking skills before administering a
medication to a patient in their ward (Schuelke & Barnason, 2017).
This experience remains one of the most anxious and thrilling situations of my life. At
first, as I mentioned, my feelings bordered on stress induced high anxiety levels. In spite of
knowing all the clinical guidelines by heart and mind, my thoughts were blotted with
confusion and fear to have failed the patient and myself as a nurse. As I focused more on
helping the patient professionally, something, I suppose my self-confidence, kept wavering
away from me and my hands and feet shook and shivered out of nervousness. May be, it was
observing such a rapid deterioration with one’s own eyes, affected me more as a person than
a nurse. When the supervisor came to my rescue, I felt must better and welded a positive
attitude thereafter to address the acute deterioration scenario.
My feelings about the abrupt deterioration scenario was mixed. The good part was
that the emergency nursing care experience to be delivered at a severe level came very early

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in my career and I am truly grateful to my first day of placement to have taught me, an
important lesson of my life which is to keep calm and to keep my intellect and senses open
while handling any case – chronic and acute, in a professional scenario. The bad part was that
I lost my composure and was frightened immensely which could have cost the patient his life.
It was terrible shortcoming from my side and I shall not repeat the same in the future.
As because it was my first clinical posting and that was too, in an acute clinical
environment and as because, I never witnessed such severe condition ever in my life, that is
why, I was shocked. The important part was I was aware of what was happening even it was
bad but this would definitely help me in the future to develop my self-awareness and self-
management skills as a competent clinical nurse.
Alternatively, as I think of it now, I could have been more firm and resolute as a nurse
and I could have at least adhered to my nursing principles in a more effective and truthful
way. I should have been more autonomous, integrated and beneficent with the patient by
administering him right medicine in the right time. While in that one scenario I had anxiety
attack but instead, I should have been more alert and oriented while checking the right
medicine prescribed and given him the right medicine. I should have my critical thinking
skills while deciding what’s right for the patient.
Firstly, I would guide by clinical guidelines no matter what it takes and never commit
a medication administration error and risk the life of a patient. Even if such an acute
deterioration situation such as this aforementioned one, arises – I would keep my nursing
principles straight at first and check the medication chart twice and only after clinically
reasoning if the medication is right for the scenario, I will administer the same. Moreover, I
will be more responsible while addressing the vital sign with proper ventilation technically
and medications.

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References
Gill, F. J., Leslie, G. D., & Marshall, A. P. (2016). Family initiated escalation of care for the
deteriorating patient in hospital: family centred care or just “box ticking”. Australian
Critical Care, 29(4), 195-200.
Greenfield, D., Hinchcliff, R., Banks, M., Mumford, V., Hogden, A., Debono, D., ... &
Braithwaite, J. (2015). Analysing ‘big picture’policy reform mechanisms: the
Australian health service safety and quality accreditation scheme. Health
Expectations, 18(6), 3110-3122.
Monagle, J. L., Lasater, K., Stoyles, S., & Dieckmann, N. (2018). New graduate nurse
experiences in clinical judgment: what academic and practice educators need to
know. Nursing education perspectives, 39(4), 201-207.
National Safety and Quality Health Service Standards. (2019). [Ebook] (2nd ed.).
Ongpoy Jr, R. C., David, P. P., Ongpoy, R. C., Dean, M. D. U., & Atienza, A. D. (2017,
December). Assessment of medication safety among Filipino pharmacists. In Unity in
Diversity and the Standardisation of Clinical Pharmacy Services: Proceedings of the
17th Asian Conference on Clinical Pharmacy (ACCP 2017), July 28-30, 2017,
Yogyakarta, Indonesia (p. 195). CRC Press.
Schuelke, S., & Barnason, S. (2017). Interventions used by nurse preceptors to develop
critical thinking of new graduate nurses: A systematic review. Journal for nurses in
professional development, 33(1), E1-E7.
White, K. M., Dudley-Brown, S., & Terhaar, M. F. (Eds.). (2016). Translation of evidence
into nursing and health care. Springer Publishing Company.

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