Learning Contract for Nursing Professionals in Multidisciplinary Teams for Stroke Patients

Running head: LEARNING CONTRACT
LEARNING CONTRACT
Name of the student:
Name of the university:
Author note:

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LEARNING CONTRACT
Introduction:
A stroke can be defined as the medical emergency where the flow of the blood to the
brain gets cut off. It might happen to any patient at any time. About every year, 9000 people
in the nation of the New Zealand suffer from stroke and require emergency medical treatment
and post stoke rehabilitation treatment (Clarke & Foster, 2015). Providing a faster treatment
to stroke patients help in ensuring less threatening situation of the patient and better patient
outcomes, reducing the chances of fatal consequences. Different nursing professionals have
to work in multi-disciplinary teams of doctors, physicians, and professional therapist like
physiotherapists, occupational therapists, speech therapists and many others (Middleton et al.,
2015). Therefore, as nursing professionals, I need to ensure that all important skills for
treating patients in the emergency conditions as well as effectively working as the member of
the team are present within me. I realised that I have four gaps which I needed to overcome in
order to provide care to patients and work as an effective team members. Therefore, my main
focus of the project would be to strategise ways by which I can overcome the gap and then
evaluate them to see how much I was successful. Therefore the objectives that I would be
hoping to achieve are the administration and management of thrombolysis, close monitoring
patient for any clinical changes as observations and patient care is a primary objective,
exploration of the perception of the nurses’ towards the multidisciplinary teamwork and
understanding the type of the interaction that takes place in the multidisciplinary team
meetings. This assignment will show how I have overcome the gaps and developed
knowledge that would help me to provide effective quality and safe care in future to patients
while working in the multidisciplinary team.

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LEARNING CONTRACT
First objective: administration and management of thrombolysis:
Purpose:
Thrombolysis is the procedure of using proper thrombolytic drugs that would help in
the breaking down as well as dispersing the clot that are causing prevention to the blood for
reaching to the brain who have suffered ischemic stroke attack (Anderson et al., 2017). It is
very important for the nursing professionals to administer the drugs within the first four and
half hours of the stroke symptoms. Very rare cases are there where doctors still think it to be
useful till 6 hours. It is very important for nurses to be quick and skilled in thrombolysis as
more the time passes, the less effective the thrombolysis will be (Zwicker et al., 2017).
Therefore, it is important for the staffs to be very quick from the times of the starting of the
symptoms. When, I was in the time of clinical placement, I saw a man suffered threatening
situation when my preceptor failed to administer the drugs in time due to improve time
management. Therefore, I want to be skilled in this aspect while working in the
multidisciplinary team caring for stroke patients.
Explanation of the objectives:
Thrombolytic therapy is one of the most crucial interventions that need to be
conducted by the emergency team of the nursing professionals immediately after the arrival
of the patient (Schwarz et al., 2018). This therapy has the capability for breaking the clits
formed during stroke in the patient and prevents disruption of the flow of the blood to stop
the chances of brain death (Mehta et al., 2018). Therefore, I needed to develop the skill as
mere basic knowledge is not sufficient to ensure safe administration of the drugs in the
patient. Therefore, I had joined an 8 month training session for becoming specialist stroke
nurse. This had helped me to develop the efficiency and skills required for effective
administration of the drugs through injections and get the standardized stroke specialist

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LEARNING CONTRACT
qualifications. Existing standardised framework for stroke patient protocols as well as
evidence based articles also support nurses in developing the knowledge required for the skill
(Coyne et al., 2016). After completing the training as well as gathering of the standardised
qualifications, I started working under the senior stroke specialist in the emergency team.
Clinical preceptoring and appropriate guidance of the skill management help novice nurses
gain a practical arena for experiencing their capabilities (Dreyer et al., 2016). The preceptor
guided me in every step and I became an expert in the skill management of thrombolysis and
could manage my time effectively as well. The feedback I received from my clinical
preceptor as well as the team members of the multidisciplinary helped me understand how
well I was developing. I took their feedback constructive and never became upset if they
criticised me. Constructive criticism in teamwork is essential for development of skill of
novice nurses (Horton et al., 2016). The different barriers that I had faced were my internal
fear that arose from my lack of confidence. I was not confident about the skill I had for
thrombolysis in stroke as well as lack of necessary skill mix required. My fear also included
of the hemorrhagic side-effects and consent issues. However, as days passed in training, I got
more confident and overcome the challenges. It required me 8 months and now I am quite
confident in the skill and had conducted 28 thrombolytic therapies in last three months.
Second objective: close monitoring of the stroke patients
Purpose:
One of the most important purpose for the development of this skill is that monitoring
during the early stages of the post acute stroke helps the nursing professionals to identify that
whether occurrences of neurological and medical complications had taken place or not
(Olaiya et al., 2017). Several human as well as animal experiments have revealed that various
negative symptoms can occur. Theses might be different disorders like hypotension, hypoxia,