An Analysis of Nursing Practices in Emergency Department, Healthcare

This essay provides a comprehensive analysis of nursing practices within the emergency department, focusing on the care of a 10-year-old patient, Anna, admitted with iliac fossa pain and later diagnosed with appendicitis. The essay examines the pathophysiology of appendicitis and the critical role of nurses in administering medications, including IV fluids, antibiotics, and analgesics. It explores the application of growth and developmental theories, such as Piaget's and Erikson's, to provide age-appropriate care. The importance of family-centered care is emphasized, highlighting the principles of respect, information sharing, patient and family participation, and collaboration. The essay also addresses the psychological effects of hospitalization on the patient and her family. The conclusion reinforces the vital role of nurses in delivering quality care, encompassing medication management, developmental considerations, family involvement, and mitigating the impact of hospitalization. The essay references books and journals to support its findings.

Academic essay

Table of Contents
INTRODUCTION...........................................................................................................................1
MAIN BODY...................................................................................................................................1
CONCLUSION................................................................................................................................4
REFERENCES................................................................................................................................5

INTRODUCTION
The essay will focus analysing nursing practices of health practitioners when working in
emergency department. Practising for emergency department demand dense of urgency and
responsibleness among heath care providers. Also, it will analyse case study in which it will
outline pathophysiology of the 10 year old Anna who has been recorded in emergency
department of local hospital. The essay will help in analysing role of nurse to deliver appreciate
medication services to girl which will be concerned with IV intravenous, triple IV antibiotics,
controlled analgesia. Thus, it will evaluate nursing care according to case with the help of growth
and developmental theories, effects of hospitalisation and family centred care.
MAIN BODY
Anna, who is a 10 year old girl is admitted in emergency department due to iliac fossa
pain which is a surgical problem. The most common disorder related to surgery is acute pain.
With further check-ups in emergency department it has been detected that signs and symptoms of
Anna are related to appendicitis, which is condition appendix get filled with pus and become
inflamed which causes severe pain. The pathophysiology related to Appendicitis is acute
abdominal pain and reddened appendix. Due to increasing pain and redness Anna was taken for
appendectomy which is surgery where appendix has been removed. It is an emergency procedure
and is only conducted at the time of acute Appendicitis. However, infections are common in case
of iliac fossa pain and therefore it is important for the nurse to make proper precaution for giving
medication and for allowing family to meet Anna. Apart from this, appendicitis is a situation
which causes severe complication and pain which can be life threatening for patients. It is the
situation where Anna require urgent surgery because in this condition the where the person starts
feeling sudden pain in lower abdomen on right side (Appendicitis, 2017).
It begins from navel and end up that turning serious in lower abdomen and worsened
when patients starts vomiting. Sense of emergency in care Anna can be abdominal bloating, low
grade fever, acute pain and loss of appetite. After the surgery she has been found gangrenous
perforated appendix with peritonitis which is life threading situation of person suffering from
Appendicitis. This was the situation where Anna was suffering from lack of blood to appendix
which leads to death. Apparently, peritonitis is the situation which reflects ruptured appendix
where tissue lines of abdominal wall turns red. Thus, in accordance, disorders of Peritonitis are
clear and denotes severe abdominal pain, heavy abdominal ache, nausea and poor appetite
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(Peritonitis, 2017). Thus, as per the scenario pathophysiology of surgery reflects critical
condition to Anna which can be life threatening because it has been continuously drowning in
effects of diseases and finally is in ward where she is with nasogastric tube in situ, IV
intravenous, triple IV antibiotics and controlled analgesia. As per the situation the role of nurse
ensure proper care and timely medications. Thus, maintaining hygiene in ward and precaution
while communication and enabling medication is the foremost priority which can helps in
reducing risk and maintaining safety.
The role of nurse in delivering developmental nursing care to Anne
Nurses play crucial role in hospital in order to provide quality care and treatments to
patients. Patient safety is the core value of hospital and nurses play vital role in patient safety.
Nurses are often the generalists in health care, professionals who can work with multiple levels
of staff, provide a broad range of technical care and coordinate the work of other health care
professionals to meet patient goals (Hockenberry, Wilson and Rodgers, 2016). As Anne has
been admitted in hospital for 10 days due to appendicitis, nurses have to take care of Anne
efficiently so that she can recover from the disease effectively.
Growth and Developmental theories
Age and developmental stages are assessed to determine if the client is at the expected
level of growth and development, to plan care that is age and developmentally appropriate and to
modify care as based on the age related characteristics and needs of our clients. These
assessments include the physical, cognitive and psychosocial stages of growth and development.
There are numerous growth and developmental theories and principles that can assists registered
nurse to comprehend the needs of child in health care and provide them effective and precise
type of care so that he or she can recover rapidly. Anne is 10 years old who has been found with
iliac fossa pain and on further assessments she was found with appendicitis. According to
cognitive development theory developed by Jean Piaget, there are four levels of cognitive
development (Moorhead, Johnson, Maas and Swanson, 2014).
As Anne is 10 years old, she stood in third level which is concrete operations. Here, a
child can able to use logic and reasoning and also developed their ability to solve concrete
problems. Nurses have to provide care accordingly to Anne so that her recovery can be done
efficiently. Nurses must engage with Anne and make interactions with her so that she does not
feel isolated. According to Psychosocial Development Theory proposed by Erik Erikson during
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elementary school stage children face the task of industry vs inferiority (Erickson, 2017).
Children often compare themselves with others to see how they measure up. They either develop
a sense of pride or they feel that they don't measure up. To raise the confidence of Anne, nurses
have to consider her situations and make her feel comfortable with other children in the hospital.
They have to create environment which helps in growth and development of Anne.
Family centred care
Family centred care refers to the partnership approach where patients family members
and health care providers collaboratively provide care to patient (Smith, Swallow, and Coyne,
2015). This is considered as most effective process of providing care to the children and prevent
themselves going into isolation and depression. In order to provide care, nurses at hospital has to
prepare a care plan where they can involve the parents of Anne in order to enhance her
motivation. This can affect her health and she can recover efficiently. There are four principles
of family centred care which the nurses have to consider.
The first one is that people are treated with dignity and respect. Anne has been found
with appendicitis, thus it is important for nurses to understand the level of disease and must
respect Anne dignity and respect. Furthermore, they have to respect the family members and
parents decision while providing care (Coyne, Hallström and Söderbäck, 2016). The second
principle is to articulate all the information related with Anne to the parents in the manner that
are affirming and useful. Registered nurses at hospital have the responsibility to communicate
and share unbiased information with parents in order to reduce the complications and conflicts.
To do this, nurses can provide them access to the medical chart which contains information
related with the medication and treatment which will be provided to Anne.
The third principle of family centred care approach is enhancing participation of both
patients and family members in order strengthening the quality of care (Butler, Copnell and
Willetts, 2014). Here nurses must allow parents and family members along with Anne to
participate in the deciding the type of care plan required for treatment. The fourth principle states
that collaboration should be maintained between patient, family members and care providers
during policy and program development and professional education in order to deliver quality
health care (Bryant‐Lukosius, and et.al., 2016).
The effects of hospitalisation on Anne and her family members
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Hospitalisation effects can be disturbing and depressing and it totally depends upon the
type of care which will be provided by the health care organisation (Tourangeau and et.al.,
2016). Anne has to be hospitalised for 10 days in order to recover from appendicitis. The effects
can be terrible as she is only 10 years old. The separation from parents and family members can
cause emotional upset in Anne. She might get upset and depressed due to separation from family
members. She will begin to miss her siblings as she was oldest among five children. It is the duty
and responsibility of the nurses and care providers to keep interacting with her so that her
motivation can be increase. Furthermore, through family centred care approach parents and other
family members can visit the hospital and participate in the care planning in order to enhance her
motivation (O’Leary, and et.al., 2015). Nurses needs to ensure that Anne does not feel isolated or
depressed as this can increase her stress level and she would not be able to recover efficiently.
CONCLUSION
From the study it can be concluded that nurses plays vital role in order to provide quality
and efficient care to health care seekers. Anna, who is a 10 year old girl is admitted in emergency
department due to iliac fossa pain which is a surgical problem. The essay has analysed case study
in which it will outline pathophysiology of the 10 year old Anna who has been recorded in
emergency department of local hospital. The essay also assists in analysing role of nurse to
deliver appreciate medication services to girl which will be concerned with IV intravenous, triple
IV antibiotics, controlled analgesia. Eventually, the role and responsibility of nurses during
growth and development, family centred care and hospitalisation effect on child has been
addressed in this essay.
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REFERENCES
Books and Journals
Bryant‐Lukosius, D., & et.al. (2016). Framework for evaluating the impact of advanced practice
nursing roles. Journal of Nursing Scholarship, 48(2), 201-209.
Butler, A., Copnell, B., & Willetts, G. (2014). Family‐centred care in the paediatric intensive
care unit: an integrative review of the literature. Journal of clinical nursing, 23(15-16),
2086-2100.
Coyne, I., Hallström, I., & Söderbäck, M. (2016). Reframing the focus from a family-centred to a
child-centred care approach for children’s healthcare. Journal of child health care, 20(4),
494-502.
Erickson, M. E. (2017). Modeling and role-modeling. Nursing Theorists and Their Work-E-
Book, 398.
Hockenberry, M. J., Wilson, D., & Rodgers, C. C. (2016). Wong's Essentials of Pediatric
Nursing-E-Book. Elsevier Health Sciences.
Moorhead, S., Johnson, M., Maas, M. L., & Swanson, E. (2014). Nursing Outcomes
Classification (NOC)-E-Book: Measurement of Health Outcomes. Elsevier Health
Sciences.
O’Leary, K. J.,& et.al. (2015). The effect of tablet computers with a mobile patient portal
application on hospitalized patients’ knowledge and activation. Journal of the American
Medical Informatics Association, 23(1), 159-165.
Smith, J., Swallow, V., & Coyne, I. (2015). Involving parents in managing their child's long-term
condition—A concept synthesis of family-centered care and partnership-in-care. Journal of
Pediatric Nursing: Nursing Care of Children and Families, 30(1), 143-159.
Tourangeau, A. E., & et.al.. (2016). Nursing-related determinants of 30-day mortality for
hospitalized patients. Canadian Journal of Nursing Research Archive, 33(4).
Online
Appendicitis. 2017. [Online]. Available through:
<https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/appendicitis>.
Peritonitis. 2017. [Online]. Available through: <http://www.garycrosthwaite.com.au/peritonitis-
inflammations.html>.
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