Nursing Reflective Essay.

Nursing Reflective Essay

Introduction
I am working in a 100-bed private hospital and my recent duty to provide care in a 12-
bed Critical Care Unit (CCU). A large portion of our CCU patients are post-surgical patients
with complications. In addition to this, we also provide care to patients with severe pneumonia,
different form of shocks, strokes and acute decompensated heart failure, among others. In these
cases the patient necessitate a close hemodynamic screening and in some cases mechanical
invasive or non-invasive ventilation.
Care provided to the patients who have required invasive ventilation; I obtained
considerable amount of knowledge and skills during this semester. My nurse unit manager is my
in-practice support person. She corrected me, point out my mistakes to make my performance
better.
I have been working in CCU and Cardiac Cath Lab for many years. Plus, I have
completed a post-graduate diploma in heart catheterization (nursing), which is helping me in
providing better patient care. Providing care to patients who are on hemodynamic support is my
active practice area. Besides, research has a significant role; it helps me to be friendly with recent
advancement in patient care.
During this semester, I have investigated renal support indications, health assessment, a
plan of treatment, and recovery frameworks for the hypotensive patient and various measures of
considering patients requiring renal help. Recently I have attended a haemodialysis practical
study day where I was incited the most ideal approach to manage a start, keep up and complete
hemodialysis sessions similarly as unequivocal machines research tips. Bringing about getting
such learning, I am induced that I can supervise patients with hemodynamic and renal
complexities.

# Reflective Journal One
Patient problem/description:
My first journal entry is regarding a 65 years old Caucasian male patient admitted to the
emergency division with shortness of breath. Signs had begun around 2 days earlier and had
constantly intensified with no related, infuriating, or extenuating factors noted.
Issue/what happened:
At the start of my shift a patient admitted to the hospital had reported difficulty in
breathing. The patient was critically ill and rapidly decompensating with multisystem organ
failure. The fundamental treatments of the patient spun around the respiratory failure with altered
mental status.
Ideas for learning/what I have learnt:
I found that not every case of shortness of breath is COPD or congestive heart failure
(CHF). A past stacked up with hypothyroidism should raise the vulnerability of myxedema coma
in a patient with any cognitive changes (Hawatmeh et al., 2018). A certified hypothyroidism
emergency prompts critical multiorgan faliure (Wankanit et al., 2018). Myxedema is the
wonderful imitator sickness that affects all organ structures. It can easily be confused with
congestive heart failure, COPD exacerbation, pneumonia, renal injury or faliure, or neurological
insult (Heksch and Henry, 2018 and Assar and Baffoe-Bonnie, 2019).
Action plan/where I can develop further:
As I was new to this case and the care of the patient, I need a further insight to this
treatment to feel confident with management of patients when issues rise.

What would I do differently?
I will keep on closer watch as these patients should be checked in a concentrated thought
condition with relentless telemetry (Lamos, Woodworth and Munir, 2015).
References:
Assar, S. and Baffoe-Bonnie, A. (2019). A 45-Year-Old Man Presenting With Sudden Onset of
Shortness of Breath. Clinical Infectious Diseases, 68(9), pp.1603-1605.
Hawatmeh, A., Thawabi, M., Abuarqoub, A. and Shamoon, F. (2018). Amiodarone induced
myxedema coma: Two case reports and literature review. Heart & Lung, 47(4), pp.429-431.
Heksch, R. and Henry, R. (2018). Myxedema Coma due to Hashimoto Thyroiditis: A Rare but
Real Presentation of Failure to Thrive in Infancy. Hormone Research in Paediatrics, 90(5),
pp.332-336.
Lamos, E., Woodworth, G. and Munir, K. (2015). Carotid artery aneurysm resulting in
myxedema coma. Interdisciplinary Neurosurgery, 2(2), pp.120-122.
Wankanit S, Mahachoklertwattana P, Anantasit N, Katanyuwong P, Poomthavorn P.
Myxoedema coma in a 2-year-old girl with untreated congenital hypothyroidism: Case report and
literature review. J Paediatr Child Health. 2019 Jun;55(6):707-710. [PubMed]