Nursing Episode of Care: Mr. X in Emergency Department

Running head: NURSING
Nursing
Name of the Student
Name of the University
Author Note

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Outline of the episode of care
During my professional placement in the emergency unit, I got a chance to get
involved in numerous events of care. But for the purpose of writing this assignment, I would
like to focus on a patient named Mr. X who was admitted to the emergency department (ED)
following loss of conscious or black out during the morning when he was about to leave the
bed to go to the bathroom. He was 79 years old and used to live in nursing home. Upon
admission in the ED, he was complaining about chest pain along with dizziness and nausea.
His extremely high blood pressure (170bpm) has led to his hospital admission through the
South Australia Ambulance Service (SAAS). Patient has a past medical history of hyper-
tension, angina, type 2 diabetes mellitus (T2DM) ischemic stroke, depression and dysphagia.
Upon admission in the ED, he was diagnosed with supraventrivular trachycardia. Upon his
admission to the ED, his vital signs were measured and doctors reported that he was suffering
from spraventricular tachycardia. The medication management use for Mr. X include
administration of adenosine ( for spraventricular tachycardia management) with rapid bolus
and metoprolol (blood pressure management) and aspirin for control of pain. Glasgow coma
scale (GCS) and ECG was used to ascertain the condition of the patients’ and the level of
patients’ progress. Decrease of the troponin level at the normal range was followed by
patients’ released with discharge report.
Standard 1
According to the standard 1 for the Nursing and Midwifery Board of Australia
(NMBA), it is the duty of a nursing professional to think critically and analyse the required
nursing practices in relation to the care plan of the patient or clinical priority identified to
the patient. According to NMBA, a registered nurse (RN) must employ a variety of critical
thinking strategies while relating with the best available evidences for the effective decision

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making process. This helps in procuring safe and quality nursing practice with person-centred
care plan. The NMBA recommends critically accessing, analysing and monitoring the
patients in order to understand the clinical priority. The identification of the clinical priority
helps to improve the overall quality of care. The first sub-class (1.1) of standard one is safe
practice. Thus in order to abide by the safe practice guidelines, I first performed the hand
hygiene before giving treatment to the patient. This practice coincides with the standard 3 of
the National Safety and Quality Health Service Standards (2012), Preventing and Controlling
Healthcare Associated Infections. Proper use of the hand hygiene by the nursing professional
helps to control chances of hospital acquired infection and thus helping to procure safe
nursing care (Luangasanatip et al., 2017). Seventh sub-class (1.7) highlights that it is the duty
of the nursing professional to maintain accurate, comprehensive and timely documentation in
order to aid proper planning and the decision makes process (NMBA, 2016). Thus, before the
installation of the defibrillator for treating Mr. X for his sudden cardiac arrest, I performed
the ECG and recorded a detailed documentation of the his vital signs. Novosad (2016) stated
that proper documentation of the vital signs of the patients like the respiratory rate, blood
pressure, oxygen saturation, flow of oxygen, pain score, pulse rate and body temperature is
important to order to access the cardio-vascular health of the patients. This proper
documentation of the vital signs of the patients helps to improve the overall quality of care
and increase the provision for the person-centred care plan. 1.4 sub-class states that nurses
must abide by the prevailing healthcare policies thus when I was asked to administered 300
mg aspirin by the physician, I followed eight rights of medication as per the South Australia
health legislation (SA health). Since I was a student at that time, I went through the policy
thoroughly and then implemented it accordingly by taking help from my mentor nurse.

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NURSING
Standard 2
As per the standard 2 of NMBA professional code of conduct (2017), a nurse must
engage in a therapeutic relationship and professional relationship with the student. When I
first meet the patient, I introduced myself politely to the patient. As per the sub-class 2.2, it is
the duty of the nursing professional to communicate effectively with the patients by
maintaining patients’ dignity and keeping respect to the cultural and spiritual values of the
patients. Thus before initiation of the medication of aspirin for the pain management, I
enquired Mr. X about any previous reported cases of allergy. MacLean et al. (2017) are of the
opinion that the use of the effective communication skills by a nursing professionals helps in
the initiation of quality interaction and thereby helping in the development of the therapeutic
relationships. This effective communication with Mr. X in a polite tone helped me to
understand his status of allergy. This in turn helped me to increase the participation of
patients in the therapy. As per the Australian Government Department of Health, Therapeutic
Goods Administration, (2019) in the prime component of the medicine is written over the
label of the medicine. Thus before the administration of the medication, it is the duty of the
healthcare professional to enquire about the allergy sate of the concerned patient and tally the
same with the label of the medicine that is required to be administered. Giving patients’
knowledge importance is a reflection that I am recognizing my patients as experts and
valuing their experience in life and this is what being told by the sub-class, 2.3. Sub-class 2.6
states that as per the professional standards, it the duty of the nurses to make proper use of the
delegation, supervision, co-ordination followed by proper consultation and standard referrals
in their professional relationships in order to improve the outcome of care. As I was trainee
then, I was not authorized for referrals however, I ensured effective co-ordination my
working under supervision of my mentor and taking her opinion in order to handle the