NURS3002 Advanced Decision
Added on 2021-04-17
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NURS3002 2018Assignment 3 Template Standards for PracticeStudent Name:Student ID: Date: Submission Due DateDate Submitted:Topic Availability:Class no:Standard 1: Thinks critically and analyses nursing practiceDuring my last clinical placement, I encountered one case that I believe was very significant in my studies. I was placed in a medical ward where my role was to take care ofa patient who was undergoing a total hip replacement (THR). My main role was to follow the standards of nursing in conducting complete assessment and administering medicationsto the patient. From the studies, the Standard -1 urges that RN should consult various critical thinking strategies and apply best available evidence to come up with practical decisions. In addition to these standards, we are also required to master the provisions of the legislations and law applicable to practice and the Code of Conducts. In the state of Australia, the professional code of conduct is outlined in the national standards of nursing conducts for the nurses[CITATION NIMBA \l 1033 ]. Besides, one must also comply with the Health Professionals (ACT Nursing and Midwifery Board Standards) Approval 2006 (No1) who oversee the application Code and Standards as well as the nurse practitioners’competency. For instance, the Australian nursing practice must comply with legal provisions from otherlegislations such as the civil laws, criminal laws, common laws and statutes [ CITATIONAtkins2017 \l 1033 ]. For example, nurse who can be guilty of murder or manslaughter if heor she causes the death of a patient intentionally either through administration of wrongdrug or other faults. Other law in nursing include the principles of common law andstatutes. Law provisions in Australian Consumer Laws and the Therapeutic Goods Act1989 (Cwlth) also may apply among others As a registered nurse, I recognized that I have a duty to care to the community andaccountability in the delivery of the highest standard of care. I also recognized my duty topromote the quality of safe. The field of nursing also requires critical thinking skills. There are situations that comeoutside the scope and may require nurses to think critically and employ problem solvingskills [ CITATION Shahbazi2016 \l 1033 ]. Other areas that nurses are also required to advancein is the embracement the rapid development in technology that are changing different
NURS3002 2018Assignment 3 Template Standards for Practiceapproaches to health practices [ CITATION Veer2011 \l 1033 ].During my placement, I learnt how THR has become the most frequent and successful cases in orthopaedic surgeries. I was also able to connect that with the various studies that are providing proof that the procedure is reliable and has a significant socioeconomic effect. From what I leant, THR operations are effective, and they are preferred where patients are experiencing pain with less mobility as a result of severe osteoarthritis of hip joints. According to [ CITATION Ilchmann2014 \l 1033 ], this procedure should only attract a short hospital stay yet delivering a quick recovery. In addition, patient satisfaction and the overall functioning of the hip should be the ultimate goal, and the practitioners should be aiming for a high percentage of patients going back to their lives without any effects of the procedure. The work of [ CITATION Behrend2012 \l 1033 ] terms this as a “forgotten joint replacement.”Again, I got much knowledge to explain the prevalent cases of readmission in THR. There are various reasons for readmission. Some of these included joint dislocation, bone fracture, or any other mechanical complications with signs and symptoms such as swelling,stiffness, pain, etc. [ CITATION mnatzaganian2012length \l 1033 ]. According to [ CITATION mnatzaganian2012length \l 1033 ] readmission is connected to comorbidity and some complications while in hospital. Even though, one of the major complications that come after THR is Venous thromboembolism (VTE). This incident can occur as asymptomatic, symptomatic deep-vein thrombosis (DVT) or the pulmonary thromboembolism (PE). Incidences of DVT and PE are a bit rare though there have been reports of their occurrence in both cases of hip andknee replacement [CITATION Fang2018 \l 1033 ]. While investigating the standard of practice in THR, Relevant information of the case studyWhile handling my patient (Mrs.White), I started conducting a complete and adequate assessment of the patient case to determine the best care plan. Mrs. White had undergone a right THR through spinal anesthesia. This operation was necessitated by osteoarthritis problem on her right hip joint. The psychosocial and physical assessment revealed that Mrs. White was overweight with as she weighted 80 Kg, the height of 166 cms, and BMI of 29.03 kg/m2. Mrs. White took low amounts of alcohol, did not smoke, had hypertension,high levels of cholesterol, old myocardial infarction, and reflux gastritis. She was under HT, high cholesterol, and heart disease medication. Some years back she also had a total
NURS3002 2018Assignment 3 Template Standards for Practiceknee replacement operation and surgeries for hysterectomy and appendectomy. Mrs. White has been using a stick as a walking aid. The recording of such factors are essential for as they are critical to the planning of mobility after the operation and the rest of the postoperative care [ CITATION blythe2016essential \l 1033 ]. The history of Mrs. White’s medical plans shows that she had the prescription of some several medications such as the naproxen (NSAID), fentanyl PCA (narcotics), enoxaparin (VTE prophylaxis), Oxycodone (Opioid), paracetamol (analgesic), and rosuvastatin (for regulating the cholesterol). She also had a symptomatic treatment that was given for the management of gastric reflux. These were metoclopramide, ondansetron, and domperidone. Regarding her social life, she was widowed, and his son Mr. X was helping in the routine care though Mrs. White preferred an independent life. Mrs. White owned a house, and she was sure that she could manage a self-care. In the case of co-morbidities, Mrs. White had issues with overweight, alcoholism, old myocardial infarction, mild malnourishment, reflux disease, and knee replacement. It is paramount to understand these factors as they can also affect her recovery despite having self-care and confidence level positive. These facts were also presented by [CITATION McHugh2013 \l 1033 ] that previous joint involvements and co-morbidities can affect the patient’s outcomes in the cases of hip replacement. Oher factors that can affect the outcomes are a mental disorder, some diseasessuch as diabetes mellitus, aging, anxiety, obesity, and malnutrition among others.Standard 2: Engages in a therapeutic and professional relationship[sAccording to [ CITATION Lasater2016 \l 1033 ], nurses should make sure that they are formingpositive relationships with patient while at the same time keeping professional boundaries. Guided by such nursing principles, I started with developing trust with Mrs. White. I understood that she did not know me, and she did not understand her sickness. Also, I understood that Mrs. White did not know how we as the healthcare professional would approach her problem. By understanding these facts, I understood that I needed to ascertainher attitudes to the problem she had, and the condition of the treatment that she was yet to understand. Therefore, while I was taking the initial assessment, I explore her thoughts andthe attitude she had towards the treatment procedure. I did this by asking her some few questions and being attentive to the responses that that she gave. In this way, my therapeutic relationship with Mrs. White was able to progress from a foundation of the established empathy.
NURS3002 2018Assignment 3 Template Standards for PracticeMy approach for establishing the position of empathy was focusing on three main areas. The first one was my obligation to acquire accurate and relevant information from Mrs. White to inform any risks that might connected to her case. According to [CITATION delaune2016fundamentals \l 1033 ], nurses are required to conduct an accurate physical examination to the patients. Also, a study carried out by [ CITATION Derksen2013 \l 1033 ] on the impacts of empathy during patient consultation showed that there is a an established correlation between health professionals empathy and the patient satisfaction. The study showed that empathy creates positive relationship which lowers the patient’s distress, anxiety and enables the nurse to get correct data during for assessment. As I knew my otherroles involved assessing the patient’s neurovascular dysfunctions and I was supposed to even assess other risks such as peripheral neurovascular dysfunction which the work of[CITATION Yang2014 \l 1033 ] says that they may come after THR, I understood that empathywould play a major role. The second reason why I first focused on empathy was to be able to manage the patient’s confusion associated that would have come with the treatment like possible challenge of accepting the change of circumstances. Thirdly, was helpful in justifying care measures and procedures. As a nurse, I also understood my role in using culturally competent communications skills both which should be verbal and nonverbal. I also understood that these skills should be guided by the identification of the patient’s values, practices, beliefs, perceptions, and her unique health needs. According to [ CITATION Miller2008 \l 1033 ], a nurse efficacy in cultural communication is one way of demonstrating the preservation of the patient’s human rights, dignity and respect. Apart from just being familiar with Mrs. White culture, Ialso comprehended her health care needs by listening to her effectively, being attentive to her body language, and Icarefully used eye contact. Other non-verbal communications that I used were the perceptions of space and time. From what I understood of Mrs. White, she was a woman who wanted to be independent. I therefore tried to maintain the best space that made her comfortable such as helping her reach only the things that are far from her hands. She wanted to handle close objects without help. I also paid attention to other nonverbal communications such as silence, touch, dressing, and provider gender. Another factor that I paid attention to was the patient participation. I needed to recognize
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