Management of Post-Surgical Patient in Acute Care Settings

Title
Student’s name
Student’s id

Description
I was taking care of Antonio Cabrini who underwent a bowel resection following a
perforated bowel three days ago. He has a large surgical wound that consists of an active and
a non-active drain tube. I was about to follow several medical plans including the drain
removal and other relevant tasks. Initially I had to identify the patient with correct id and then
I had to develop therapeutic interaction with the patient. I positioned the patient properly,
ensuring the safety and comfort issue. After performing 5 moments of hand hygiene, I set up
the dressing tray to clean, dispose and apply proper dressing to the wound and then remove
the drain tube after cleaning it with an appropriate solution. Simultaneously, I was
documenting all the information in detail. However, the cleaning of the wound was difficult
as the patient was afraid of pain and lacking faith upon the nursing management.
Feelings
Initially, I was feeling nervous and I had lack of experience of working in acute care
settings. The patient was also unable to develop trust on my work as I was new to him. He
was afraid of pain and reluctant to allow me for dressing. His attitude towards me was quite
discouraging and I was losing confidence from my own work as well. Later on, I believed on
myself and assessed the vital signs of the patient before setting up the dressing tray. While
cleaning the wound, the patient at the beginning was not cooperating with me. Then I decided
to develop a therapeutic interaction in order to establish trust between he and me. It worked
effectively and the patient cooperated with me in performing my task. However, while
removing the drain tube, I was really nervous and my hands were almost shivering but, my
theoretical knowledge helped me to recover my confidence level and I successfully removed
the drain tube without affecting the wound of the patient. I feel providing care to any post-
operative patient is really difficult as it has risk of harming the patient further. I also feel that

each and every step of assessing the wound, dressing and removing the drain tube is crucial
as well.
Evaluation
It was my first handling of a post-surgical patient in acute care settings and thus I had
so much to learn and gain from the experience. Having asked several questions and establish
a good therapeutic relationship between nurse and patient, I was involved in performing the
task of dressing and removing the drain tube. I asked some senior nurses and came to know
that patient with bowel surgeries are quite difficult to take care of. Some studies also indicate
that patients might react differently due to pain and fear after surgery. Also, some researchers
mentioned that sometimes, route of administration should be changed if patient still
complains about acute pain (Harrison et al., 2019). Also, hand hygiene plays an important
role while handling any wound and I was aware of this (Musu et al., 2017). My main
weakness was nervousness but, my strength was my theoretical knowledge that helped in to
be confident.
Analysis
Despite the fact that Antonio had a surgery three days back he was in very good spirit.
However, he was not so confident at the beginning regarding my performance, but the
development of a therapeutic relationship helped to close all the gaps. According to
literatures, therapeutic relationship is a key component to strong outcomes (Stargell, 2017).
Over the years, so many research studies have been conducted in this regard, and all of those
revealed that therapeutic relationship itself is essential for a better care experience (Zilcha-
Mano, 2017). Also, I had to perform 5 moments of hand hygiene before handling his wound.
Result of different studies disclosed the fact that infection is more likely to affect the patients
in acute care settings if hand hygiene is properly not maintained. Improvement of hand