PBL Session

One important insight from the PBL session is the need for sensitivity and carefulness in healthcare. Timely actions, patient causative factors, and associated conditions can determine the success of the patient's outcome. The decisions made by the group were based on logical clinical sense. However, it would have been better not to talk with the patient while he was still recovering from surgery. Environmental friendliness, such as colorful pictures on the wall, can also contribute to the patient's psychological healing. It is important to handle matters related to the heart with the highest degree of sensitivity and supervision by a cardiothoracic surgeon.

PBL Session 1
PBL Session
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PBL Session 2
One important insight I have learned from the session is that there is need to be very
sensitive, careful and attentive. Sensitivity in the health practice is essential in overall caring of
the patient regardless of the situation they are in (Zhang et al., 2008). Every time there was a
sensitive issue, concern or condition in Peter’s overall assessment, it was addressed immediately
and amicably. There is sense in which every aspect of peter’s condition including the
surrounding were key determinant in ensuring the overall health outcome of Peter. For example,
there is one instance while in the operating room when Peter was to undergo operation; a time
when Jane asks for some sutures and when they are brought to her they accidently come into
contact by brushing the edge of the irrigation jug with the unsterile packet edge. At this point it is
most significant that in the nursing/ operating room nurses and the general multidisciplinary
team must very careful and sensitive otherwise there could be a lot of trouble awaiting the
individual to be operated on (Deschka et al., 2013). It is important that risks are avoided to the
highest level possible to enhance the safety of whoever will undergo the surgery. Another
notable instance is when Peter complained that he was feeling chest pain, the immediate action
such as assessment is initiated and when it is discovered upon visual inspection that there was a
purulent smell and the dressing in serosanguinous fluid. The next thing to follow was inspecting
the wound and knowing the state and whether there is any necessary action that to be taken. In
all these among other instances I realize that there is a great need for carefulness and
sensitiveness.
One of the factors that will determine the success of Peter’s outcome is timely actions
that are being undertaken. There is quick response among the nurses and the multidisciplinary
team in assessing every bit of condition the patient shows forth. The quick response in assessing
and performing the necessary action on the patient will strongly determine the success of Peter

PBL Session 3
by the time he is discharged. The number two factor is the patient causative factors which may
include peter’s habit of smoking. There is a day according to the case study when Peter did not
request for the cigarette contrary to the other days. His outcome will also be determined by his
smoking habit. Smoking will be detrimental to the success of the outcome as opposed to not
smoking. The final factor that can be a determinant is associated conditions. It is noticeable that
Peter has other conditions like angina which if not managed well may negatively affect the
success of the outcome.
Yes. I believe that every decision made by my group was based on logical clinical
sense. The many concepts, theories and principles of application we made were all directed to
addressing the nursing practices and patient care.
In my view, I have confidence and I believe that everything was designed well
except that it would be better not to talk with the patient while he was still recovering from
surgery and when the wound is not properly healed. I would advise that Peter would have been
allowed to rest and not make him start feeling the sense of helplessness (Catherine et al, 2015);
(Manji et al., 2007). I guess this must have been the reason for feeling some pain in the chest.
Yes. There a group that had suggested that it would be also advisable for an aspect
of environmental friendliness for the patient to be considered. An aspect of beautiful and colorful
pictures all over the wall of the patient room to bring life is essential even as they await to be
discharged. In their thinking they though that it would be a nice idea filling the wall with pictures
in the patient room especially those who have just undergone very sensitive operation (Crain et
al., 2012). Beautiful and life bringing pictures on the wall are therapeutic and they would play a
role in the psychological healing by bringing life in the patient (Zadeh et al., 2018).

PBL Session 4
Yes. There were areas that I thought would have been handled by the surgeon. I
don’t think it was advisable to make the necessary adjustment to the wound without the
supervisor of the surgeon. Matters to do with the heart are very sensitive and they require
sensitivities of the highest degree even as they are handled. Therefore, it posed a lot of concern
to me that a cardiothoracic surgeon should have been in supervision as we tried to look and make
necessary assessment to the wound.

PBL Session 5
References
Catherine Dingley, R.N., Kay Daugherty, R.N. and Mary, K., 2015. Improving Patient Safety
Through Provider Communication Strategy Enhancements.
Craine, D.A., Craine Dean A, 2012. Bed audio entertainment device. U.S. Patent 8,184,846.
Deschka, H., Schreier, R., El-Ayoubi, L., Erler, S., Alken, A. and Wimmer-Greinecker, G., 2013.
Survival, functional capacity, and quality of life after cardiac surgery followed by
long-term intensive care stay. The Thoracic and cardiovascular surgeon, 61(08),
pp.696-700.
Manji, R.A., Arora, R.C., Singal, R.K., Hiebert, B., Moon, M.C., Freed, D.H. and Menkis, A.H.,
2016. Long-term outcome and predictors of noninstitutionalized survival
subsequent to prolonged intensive care unit stay after cardiac surgical
procedures. The Annals of thoracic surgery, 101(1), pp.56-63.
Zadeh, R.S., Eshelman, P., Setla, J., Kennedy, L., Hon, E. and Basara, A., 2018. Environmental
design for end-of-life care: An integrative review on improving the quality of life
and managing symptoms for patients in institutional settings. Journal of pain and
symptom management, 55(3), pp.1018-1034.
Zhang, W.Y., Wu, W.L., Gu, J.J., Sun, Y., Ye, X.F., Qiu, W.J., Su, C.Q., Zhang, S.Q. and Ye,
W.Q., 2015. Risk factors for postoperative delirium in patients after coronary artery
bypass grafting: a prospective cohort study. Journal of critical care, 30(3), pp.606-
612.