Importance of Computer Lecturer Lyteracy in Emergency Department

[Surname, first name, student number; scheduled lab time/day, tutor full name] [Surname, first name, student number, tutor full name, scheduled lab day/time] IMPORTANCE OF COMPUTER LITERACY by [NAME] Course Professor’s Name Institution Location of Institution Date Part 1 Identification I am an enrolled nurse in in charge of care at the emergency department. I think the patient has deep second-degree burns and he is admitted to the Medical Assessment

[Surname, first name, student number; scheduled lab time/day, tutor full name]
IMPORTANCE OF COMPUTER LITERACY
by [NAME]
Course
Professor’s Name
Institution
Location of Institution
Date
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[Surname, first name, student number; scheduled lab time/day, tutor full name]
Part 1
Identification
I am an enrolled nurse in in charge of care at the emergency department. My patient;
Mr Lewis a 22-year-old male patient from Fraser Island.
Situation
Mr Lewis is admitted at the hospital with deep a mixed burn to both feet. I think the
patient has deep second-degree burns and he is admitted to the Medical Assessment
and Planning Unit. He is awaiting a transfer to the Royal Brisbane and Women's
Hospital via the Queensland Ambulance Service. Mr Lewis needs a surgical review to
determine the extent of the burns. The patient seems to have lost a lot of fluids and he
also shows signs of hypovolemia due to excessive loss of blood from the burns.
Background
Mr Lewis lives alone after his mother died two years ago due to diabetes-related
complications. His father passed on when he was just 6 years old due to after he had a
seizure next to a well in their home due to peripheral neuropathy. He is a FIFO worker
in an occupation that requires him to be exposed to fire. The company has measures
to reduce the risks of injuries and accidents related to fire but the measures are not
adequate. The safety measures for petrol are particularly inadequate. Mr Lewis is a
smoker and smokes at least one packet of cigarettes every day at work. He confirmed
that he had been smoking close to the petrol reservoir when the fire broke out. Lewis
has been suffering from epilepsy from a young age but he has been managing it with
medication. He currently takes Acetazolamide 250mg Tablets and Epilim 100mg
crushable tablets. He also takes Neurontin 900mg per day. He has also been in the
past diagnosed with type 2 diabetes and he takes metformin to help with his condition.
Assessment
Mr Lewis has mixed burns on both feet from the knees down. He appears unstable
when he is presented at the hospital. He, however, communicates effectively and
states everything that occurred leading to the fire. On presentation, his wound is
seeping and some parts of his feet have blisters. Additionally, the skin is deep red. He
is very sensitive to touch and he appears to be under intense pain. He develops a
fever after some time as he waits to be transferred to RBWH. There is also a drop in
his alertness and his skin becomes pale as he waits which could be a sign of shock.
On assessment, his vital signs are; heart rate of 142 beats per minute, blood pressure
o 82/42 mmHg, a temperature of 37.5℃, respiratory rate of 35 breaths per minute,
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[Surname, first name, student number; scheduled lab time/day, tutor full name]
and oxygen saturation (SpO2) of 89% on room air. His degree of pain is 8 on the pain
scale.
Recommendations
The wounds should be immediately covered because changes in temperature and air
movement can worsen the pain a patient is experiencing (Yoshino et al., 2016, p. 993).
It is also important to periodically elevate the burned extremities which are Lewis’ feet
in this case. The elevation is very important as it helps in preventing the formation of
oedema (Butcher and Swales, 2012, p. 50). After some time, the positions should be
changed to lower the risks of contractures of the joints. This periodic elevation also
helps in reducing discomfort. Elevation also helps in systemic circulation thus reducing
the risks of oedema (Rawlins, 2011, p. 524). Morphine is also administered to manage
pain. Intravenous method of drug administration is recommended to maximise the
effects of the drug. Intravenous fluid resuscitation is also important to manage his
hypotension and replace the volume of lost fluids (Warden, 2012, p. 118, Guilabert et
al., 2016, p. 287). Administration of medication during the IV is important to prevent the
destruction of tissues. Administration of Mafenide acetate which is an antibiotic is
important to prevent infections due to the burns. It is important to note that the
destruction of tissues due to burns affects the defence mechanism of the skin and
increases the risks of developing tetanus (Stander and Wallis, 2011). Therefore, it is
necessary to administer tetanus toxoid to prevent tetanus. The skin should also be
kept free from pressure to promote circulation and prevent graft failure and necrosis
(Nurseslabs, 2019). Irregular pulses should also be investigated and blood pressure
measured on the unburnt extremities.
Part 2
I reported every morning to the hospital with a designated patient to help me in
developing my behavioural skills. Additionally, I carried a point card around the
hospital to collect the feedback of the patients admitted in the hospital. At the end of
the day, I would return to my designated patient to review all the feedbacks received
from the patients regarding the level of care. I could then give the point card to my
seniors for them to review and assess my progress. This was made possible by the
CICO tool that was a priority of the hospital. It is important to note that CICO can only
be implemented successfully if it is made a hospital priority (Lacquiere et al., 2015. P.
533). In this situation, my designated patient was Mr Lewis. He had experienced
second-degree burns and needed constant care to get back to his previous healthy
state. I managed to look after him and dress his wounds until he was transferred to
Royal Brisbane and Women's Hospital for surgical review. I collected his feedback
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[Surname, first name, student number; scheduled lab time/day, tutor full name]
every day and he was most impressed with the quality of care I offered him. As a
nurse, it is important to form a positive patient-nurse relationship to gain the trust of
your patient. Once they trust you, the provision of care becomes easier and they can
also confide in you (Rørtveit et al., 2015). I always included him in the decision-making
process to ensure that he always consented to the type of care I proposed. Consent is
very important in a healthcare setting. In fact, before any medical procedure or
administration of any medication, a nurse must seek a patient’s informed consent
(Katz et al., 2016). Otherwise, a nurse risks breaking the standards and ethics of the
nursing practice. I believe that this kind of patient-nurse relationships helps in
improving health outcomes and ensuring quality ad safe care.
I believe that my previous experience will help me in my future practice in the
healthcare sector. I aim to always improve and ensure that my patients feel free and
confident to confide in me. There were some challenges that I faced and that I
recorded in the point card after Lewis gave me his feedback. One of the challenges
was fear of the sick. I was initially very empathetic with Mr Lewis to the point that I was
afraid to care for him because I always thought that everything I did could hurt him and
he was already in extreme pain. I believe that empathy is a good thing in nursing
because it enables one to share the feelings and emotions of the patient. However,
one must not be afraid to provide quality care to the patient no matter the
circumstances. I, therefore, plan to show more confidence when providing care
because I believe that if I can be confident with myself then my patient will also be
confident with me.
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[Surname, first name, student number; scheduled lab time/day, tutor full name]
Reference
Butcher, M. and Swales, B., 2012. Assessment and management of patients with
burns. Nursing Standard (through 2013), 27(2), p.50.
Guilabert, P., Usúa, G., Martín, N., Abarca, L., Barret, J.P. and Colomina, M.J., 2016.
Fluid resuscitation management in patients with burns: update. BJA: British Journal of
Anaesthesia, 117(3), pp.284-296.
Katz, A.L., Webb, S.A. and Committee on Bioethics, 2016. Informed consent in
decision-making in pediatric practice. Pediatrics, 138(2), p.e20161485.
Lacquiere, D.A., Hodzovic, I., Woollard, A., Varvinskiy, A., Chishti, K. and Hughes, R.,
2016. DAS 2015 guidelines for management of CICO. BJA: British Journal of
Anaesthesia, 117(4), pp.532-533.
Nurseslabs. (2019). 11 Burn Injury Nursing Care Plans. [online] Available at:
https://nurseslabs.com/11-burn-injury-nursing-care-plans/7/ [Accessed 21 Sep. 2019].
Rawlins, J.M., 2011. Management of burns. Surgery (Oxford), 29(10), pp.523-528.
Rørtveit, K., Hansen, B.S., Leiknes, I., Joa, I., Testad, I. and Severinsson, E., 2015.
Patients' experiences of trust in the patient-nurse relationship-a systematic review of
qualitative studies.
Stander, M. and Wallis, L.A., 2011. The emergency management and treatment of
severe burns. Emergency medicine international, 2011.
Warden, G.D., 2012. Fluid resuscitation and early management. Herdon DN. Total
Burn Care. 4th ed. St. Louis, MO: Saunders Elsevier, pp.115-124.
Yoshino, Y., Ohtsuka, M., Kawaguchi, M., Sakai, K., Hashimoto, A., Hayashi, M.,
Madokoro, N., Asano, Y., Abe, M., Ishii, T. and Isei, T., 2016. The wound/burn
guidelines–6: Guidelines for the management of burns. The Journal of
dermatology, 43(9), pp.989-1010.
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