Nursing Practice: Reflection on Respiratory Assessment Skills

This assignment presents a student's reflective analysis of a respiratory assessment conducted in a lab practical setting, using the Gibbs Model. The reflection details the assessment process, including vital signs, auscultation, and adherence to the clinical reasoning cycle. The student discusses their feelings of anxiety and eventual confidence, evaluating both positive and negative aspects of the experience, such as the initial use of an incorrect technique for obtaining a pulse rate. The analysis connects the practice to NMBA nursing standards, emphasizing the importance of critical thinking and comprehensive assessment. The assignment concludes with a plan for future improvement, focusing on critical analysis and evaluation of outcomes. The student reflects on a case involving a 53-year-old patient named Amanda, who was suspected to have pneumonia, highlighting the importance of adhering to established nursing protocols and the value of nutritional assessment.

RUNNING HEAD: INTEGRATING PRACTICE 1
Integrating nursing practice
Name:
Institution:
Tutor:
Date:

INTEGRATING PRACTICE 2
Integrating nursing practice
DESCRIPTION
Reflection is the act of narrating or thinking of what happened during a particular
scenario that needs nursing intervention (Tolomeo, 2013). In this assignment, I will reflect on the
skills of respiratory assessment that I learnt in the lab practical .I will use the Gibbs Model of
reflection since it is a very convenient mode of reflection and it is also systematic. There was a
case in which I came across a patient who was called Amanda. The patient was 53 years old. I
established her past medical history that included appendectomy. I then went ahead to estimate
the vitals and they were as follows: The body temperature was 37.9 Degree Celsius, the pulse
rate was 94 and the Respiratory rate was 22.The blood pressure was 110/64 and the oxygen
saturation was 93%.When I was obtaining the pulse rate, I was using one finger but the tutor
interrupted and told me that I should use three fingers instead. There are other assessments that I
conducted to the patient and they include auscultation, inspection, palpation of the chest and
percussion. I made sure that I adhere to the nursing protocol or rather the clinical reasoning cycle
during the respiratory assessment. During auscultation, I compared the left to the right, lateral
and concluded by the anterior. I then conducted the nutritional assessment by determining the
weight of the patient and her Body Mass Index by obtaining her weight and dividing by the
square of her height in meters .I also made sure that I review her breathing sounds and patterns.
From the assessment, it was clear that she was suffering from pneumonia and the established
goal was to ensure that the symptoms of pneumonia subside.

INTEGRATING PRACTICE 3
FEELINGS
At the beginning of the assessment, I was very anxious and curious. This is because this
was not sure if the whole process would be successful. I was not sure if the objectives would be
achieved. I was also not that confident enough since I have not done respiratory assessment
before. With time however, I got confident and could perform the assessment very well. At the
end of the process, I was very happy since the objectives had been achieved.
EVALUATION
Everything in this scenario was positive. This is because I made sure that I adhere to the
nursing protocol of respiratory assessment. I made sure that I collect all the vital signs
accurately. The only negative aspect in the case was using one finger to obtain the pulse rate.
However, the tutor intervened and made corrections on the spot. All the other colleagues that we
were working with contributed positively during the assessment and this is the reason why the
objectives were achieved. Am really looking forward to another case of respiratory assessment
since I have amassed important skills that would really assist me in the future.
ANALYSIS
There are different NMBA nursing standards in Australia that govern the operation of
nurses. Standard 1 dictates that it is the role of the nurse to critically think and analyze any
nursing problem before assessment (McGrath, Pyke, & Taenzer, 2016). In this scenario, I made
sure that I analyze the important vitals that should be obtained from the patient. NMBA Standard
4 on the other hand states that it is the role of the nurse to conduct a comprehensive assessment
(Douglas, Windsor, & Lewis, 2015). I therefore made sure that I adhere to the clinical reasoning
cycle throughout the assessment. This is the reason why the vitals obtained were accurate. I have

INTEGRATING PRACTICE 4
therefore managed to learn that it is essential to adhere to all the nursing protocol if nurses are to
get accurate results. This is very important since a comprehensive assessment is the basis of
nursing intervention (Birks, James, Chung, Cant, & Davis, 2014). I have learnt that evaluation is
very important after the assessment as it provides feedback on whether the objectives were
achieved or not (Spitzer, 2016). This is an area that I will focus on in the future.
CONCLUSION
In this case, there are things that I feel I should have done in a different way. This
includes the nutritional assessment. The nutritional assessment should be the initial assessment
yet I did it at the end of the session. Despite the deviation to the normal protocol, the objectives
of the assessment were achieved. However, I have learnt that it is important to adhere to the
established nursing protocol.
ACTION PLAN
The skills of respiratory assessment that I have obtained in the practice will be of great
importance in future. There are things that I need to improve on in future. I will think critically
and analyze the patient situation even before I begin the assessment (Considine & Currey, 2014).
This will assist in gauging on what particular aspects I should focus on during the assessment. I
will also ensure that I evaluate the outcomes through reassessing of the vital sign survey more so
the oxygen saturation levels.

INTEGRATING PRACTICE 5
References
Birks, M., James, A., Chung, C., Cant, R., & Davis, J. (2014). The teaching of physical
assessment skills in pre-registration nursing programmes in Australia: Issues for
nursing education. Collegian, 21(3), 245-253. doi:10.1016/j.colegn.2013.05.001
Considine, J., & Currey, J. (2014). Ensuring a proactive, evidence-based, patient safety
approach to patient assessment. Journal of Clinical Nursing, 24(1-2), 300-307.
doi:10.1111/jocn.12641
Douglas, C., Windsor, C., & Lewis, P. (2015). Too much knowledge for a nurse? Use of
physical assessment by final-semester nursing students. Nursing & Health Sciences,
17(4), 492-499. doi:10.1111/nhs.12223
McGrath, S. P., Pyke, J., & Taenzer, A. H. (2016). Assessment of continuous acoustic
respiratory rate monitoring as an addition to a pulse oximetry-based patient
surveillance system. Journal of Clinical Monitoring and Computing, 31(3), 561-569.
doi:10.1007/s10877-016-9884-y
Spitzer, A. R. (2016). Data Collection and Assessment of Respiratory Outcomes. Manual of
Neonatal Respiratory Care, 769-775. doi:10.1007/978-3-319-39839-6_97
Tolomeo, C. (2013). Pediatric Respiratory Health History and Physical Assessment. Nursing
Care in Pediatric Respiratory Disease, 38-50. doi:10.1002/9781118785805.ch2