Being a Professional Nurse - Clinical Incidence and Lessons Learnt

Running head: BEING A PROFESSIONAL NURSE 1
Being a Professional Nurse
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BEING A PROFESSIONAL NURSE 2
Being a Professional Nurse
The clinical incidence
On day one the 81 years old patient visited GP clinic complaining of breathing challenge.
The diagnosis revealed of fine creps at the base of both lungs with slightly elevated jugular
venous pressure. The patient received oral Lasix and was to report back after two days for
review. The following day the patient visited a local hospital complaining of the similar problem.
On 9th January 2013, the patient became dizzy, had atrial fibrillation, not eating or drinking,
with pain in the abdomen. She became depressed, anxious, required mobilisation, the respiratory
rate doubled, became “woozy”, skin cold and clammy. Blood sugar level was 16.1mmol/L. She
received Digoxin and Valium drugs.
On 11th January 2013, she could not void, was pale and grey with nausea. White cell
count was at 17.5. Urinary tract infection was observed. On 11th January 2013, the blood
pressure and heart rate were below normal. An Introduction Situation Background Assessment
Recommendation (ISBAR) form was completed in the presence of a respondent. The patient’s
family was contacted. The patient was critically unwell. An emergency on-call doctor was called
to treat the patient. The condition was critical that a referral was done. The patient died due to
septicaemia.
Activities to be completed by the nurse in the immediate situation
It was concluded that the patient died of septicaemia. Septicaemia is a risk disease
affecting mainly the aged, individuals who have diabetes and suffering from urinary tract
infections and challenges of breathing (Hsu, Yu and Guo, 2015). Upon arrival in the health
facility, the nurse should have identified from the patient a person who can assist the patient

BEING A PROFESSIONAL NURSE 3
through the treatment process and have the person come to the health facility. Once treatment
was offered, the nurse was to present the clinical report to the patient’s assistance. With the
patient complaining of challenges of breathing, an Electrocardiogram would have been
conducted to establish whether the condition arose from atrial fibrillation or it was another
disorder in the heart rhythm. A chest X-ray would also reveal the conditions of the patient’s
lungs.
Upon diagnosis, the patient was found out to be suffering from atrial fibrillation. The
nurse should have given the patient medications and other interventions that would aid in altering
the electrical system of the heart. When it was noted that the patient could neither eat nor drink,
the nurse should have administered food and liquids intravenously. The patient will also need
assistance in breathing. Vincent (2017) concludes that the supply of oxygen and intravenous
fluids will ensure that the blood pressure of the organs does not fall further. The nurse should
have helped the patient mobilise as well as massaging the patient’s back with warm water to
alleviate the back pain. The nurse will need to give antibiotics and fluids. The antibiotics will
counter the effects of microorganisms (Banks, 2016).
The nurse will need to communicate swiftly to the Clinical Nurse Manager who will, in
turn, call the doctor who will carry out a test to identify the infection affecting the patient before
it escalates further. The doctor should come and find documentation of the patient’s treatment
history which should have been prepared by the Registered Nurse. The RN will make the
documentation following an alarm raised by the Enrolled Nurse. The oral Lasix, Digoxin and
Valium will need to be withdrawn if need be (Marik, 2018). Mclver, Mukerjee, Tokis and Taylor
(2018) observes that if a specific source of the infection has been identified, then it will need to