Competency Standards - Assignment
Added on 2021-05-31
10 Pages3562 Words57 Views
Healthcare and Research
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Running head: COMPETENCY STANDARDSReflection of a Clinical ScenarioName of the StudentName of the UniversityAuthor Note
1COMPETENCY STANDARDSThe Australian College of Operating Room Nurses (ACORN) encompasses standards that shouldbe shown adherence by perioperative nurses for maintaining their accountability and staying trueto their responsibilities in perioperative practice (ACORN 2014). Perioperative nursing refers tothe nursingspecialty where the nursing professionals are expected to work with patients, who aresubjected to a wide range of invasive or other operative procedures (Rauta et al. 2013). Aplethora of challenges are most often encountered by perioperative nurses on a regular basis,while participating in patient operations. Their primary role is related to delivering healthcareservices in a way that addresses the surgical outcomes of the patients, who are being treatedunder sterile conditions (Neil 2013). Clinical experience and evidence based practice help theperioperative nurses to successfully carry out their roles. Hence, the ACORN competency standards have been formulated with the aim of enhancing theprofessional development of the perioperative nurses and improve their learning abilities,through continued competence and a journey of lifelong learning. The standards act as referencesthat assist the nurses to present formal evidences of their ongoing professional development andalso facilitate the nurses in demonstrating accomplishment of the intended clinical goals. Thisreflective essay will illustrate a clinical scenario that encompassed a challenging situation relatedto laparoscopic radial nephrectomy of a bariatric patient. The essay will utilise the theoreticalmodel of the Gibb’s reflective cycle that will act as a framework for this reflective writing(Husebø, O'Regan and Nestel 2015). The different elements of the cycle namely, a description ofthe scenario, my feelings, my evualation, analysis and the action plan will also helpdemonstrating my thoughts and perceptions that arose, while encountering the clinical scenario.DescriptionA bariatric patient, Ms. X (name withheld) was to be operated upon using the minimally invasiveprocess of laparoscopic radical nephrectomy for the presenting complaint of renal cancer. Thepatient had been suffering from renal cancer for over one year. Conduction of a CT scan, inaddition to USG helped in the detection of renal cancer. It also helped the concerned surgeon toget an estimate of the size of the renal carcinoma, and its extension. Prior to conducting thesurgery, a routine blood test was conducted. This was followed by conduction of liver and renalfunction tests that facilitated assessment of the contralateral renal function and patient fitness.The surgery began as decided earlier. However, at the middle of the operation, the surgeon found
2COMPETENCY STANDARDSit extremely difficult to proceed with the macroscopic procedure due to excess fat accumulationin the patient body. Thus, an immediate decision to switch over the operation to opennephrectomy was taken. Owing to the fact that the decision to change the mode of operation wastaken by the surgeon in haste, we could not inform the patient or her family members about thesudden change in the surgical procedure. The patient was changed from the lateral position to asupine position for this purpose. The surgeon made an incision in the side of the abdomen,generally referred to as the flank area. There was no need of removing a rib for the procedure.We assisted the surgeon to cut away the ureter and the renal blood vessels from the kidney,following which the kidney having carcinoma was removed. We used several sterilized and disposable surgical sponges (raytec), for absorbing liquids andblood from the surgical site. These sponges helped us in controlling bleeding. After removal ofthe kidney, we closed the incision with stitches. However, during wound closure, we failed tofind one raytec. This made us inform the surgeon and concerned nurse for conduction of anurgent x-ray that would help us to detect presence of the missing raytec in the patient body (ifany). Failure to locate the missing raytec following an x-ray made the surgeon put forth a requestfor CT scan at the concerned department, located downstairs. We closed the patient wound andtransferred her to the CT scan area, with the support of ventilators and found the raytec inside theabdomen. This helped us draw the conclusion that changing the patient position, while switchingfrom radical nephrectomy to the open surgery might have resulted in movement of the raytec tothe deeper tissues of the abdomen. Following obtaining an informed consent of the familymembers of the patient, we again operated upon the wound to retrieve the raytec. The seniornurse involved in the operation filled out the RiskMan form, as per the hospital policies. FeelingsThis kind of a scenario is quite common in surgical settings. My knowledge helped me gaininformation on the fact that approximately a dozen sponges and other harmful surgicalinstruments are left inside the body of patients, on a regular basis. This often results in 4,500-6,000 cases of retained surgical bodies, per year (Dieter 2013). Owing to the vast nature of thesurgeries that are conducted on a regular basis across all healthcare settings, I was initiallynervous and anxious about my participation in this nephrectomy surgery of the patient. Thisanxiety of mine got reflected as a direct manifestation of the shift from laparoscopic surgery to
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