Journal Entry: Reflecting on Clinical Practice at Queensland Hospital

This journal entry reflects on a nursing student's clinical experience at Queensland Hospital, where the student assisted a patient post-total knee replacement surgery. The entry details a situation where the student, under the supervision of a senior registered nurse, faced challenges in providing adequate patient care due to the senior nurse's unavailability and lack of support. The student analyzes the situation, identifying shortcomings in the application of nursing standards, particularly regarding duty of care and accountability. The entry discusses the student's actions, including attempts to seek assistance, and reflects on the impact of the situation on the patient's well-being. The student references the Nursing and Midwifery Board of Australia (NMBA) standards, highlighting areas where the student's practice aligned with or deviated from these standards, and identifies areas for improvement in future practice, emphasizing the importance of timely care, communication, and accountability in providing effective patient care within the healthcare setting.

Running head: JOURNAL ENTRY
CRITICAL THINKING JOURNAL ENTRY
Name of Student:
Name of University:
Author’s Note:

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Introduction
I was involved in the care of the patient name Mr M at clinical placement, who have
undergone total knee replacement surgery two day before in Queensland hospital. My role was to
assist the patient with his daily living activities as he has become immobile due to knee surgery.
In this clinical experience, I was working under the supervision of senior registered nurse in day
shift. The patient complains of discomfort while lying in bed and was facing problem in eating. I
needed assistance of my senior nurse to provide effective care to the patient in his mobility. I
inquired for her, however she was not available in the floor. I also tried to contact her and asked
for her guidance in assisting Mr M. She responded in negative manner and said that she is
involve in other work and have not time to assist him. She suggested to take help from other
staffs. When I returned to the patient as I was one hour late, patient was in great discomfort and
was unhappy from the service and complained for lack of care. I tired to reposition him with
assistance of other staffs in the floor.
In this clinical scenario at the time of my clinical placement, I have identified lack of
accountability and duty of care among the health care professional in the organization process.
They pay no attention on the need of the patient which has led to distress, and its impact can be
seen in their physical and mental health. Due to such unethical behaviour of RN, I have analysed
that there is the need for quality improvement within the health care organization as it may have
negative consequence in the health of the patient. It can also lead to increase in stay of patient,
late recovery and high health burden. This also have poor impact on the reputation of the health
organization.

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I think that nurses are responsible to provide care to the patient and pay attention to their
need and requirement. In acute care setting, there are mainly critical case and nurses assigned to
involve in care of the patient must deliver their work with sincerity and ethically. As noted in my
clinical experience, the registered nurse was not accountable towards patient and his need, which
truly reflect lack duty of care in her. I think that nurse should be answerable for their action.
They should be present in their shift timing for their responsibility towards patient and at the
time of clinical handover, they must provide all the essential information about the patient. They
must regularly monitor the sign and symptom of the patient and investigate about the need for
positive health outcome. I think in the case scenario, the senior nurse should be present at the
time of her duty and when I contacted, she must not refuse to assist the patient.
According to the nursing and midwifery board of Australia, the standards 1 for enrolled
which states that EN should work as per the law and policies and fulfil the duty of care (Nursing
and Midwifery Board of Australia 2017). I have followed the standard to some extent as I tried to
contact my senior nurse which was my part of duty however her absence and ignorance has led
to discomfort in patient. I also analysed that I should have contacted other health staffs instead of
waiting for RN as for me the most priority thing was to assist the patient with his immobility.
According to the standard number 3 which highlights that EN must accepts the responsibility and
accountability for their action (Nursing and Midwifery Board of Australia 2017). In the absence
of RN, I should have provided care to the patient instead of wasting time in contacting her. I was
responsible to take care of the patient hence I should be accountable for it. It is seen in the
standard number 6 which states to provide timely care for positive health outcome of patient. I
can say I lack in maintaining NMBA standards as I have not provided timely care and does not
involved the patient in decision making. However, I have maintained standard number 7 which

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states to use communication skill to inform the need of care of the patient to other health care
staffs (Nursing and Midwifery Board of Australia 2017). I have actively contacted RN for
conveying the status of the patient. Learning from this standard I can say that I noted my various
shortcomings in clinical placement experience. Therefore, it can be said that I need to improvise
my practice area and learn to maintain NMBA standards for EN.

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Reference
Nursing and Midwifery Board of Australia., 2017. Nursing and Midwifery Board of Australia -
Enrolled nurse standards for practice. [online] Nursingmidwiferyboard.gov.au. Available at:
https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-
standards/enrolled-nurse-standards-for-practice.aspx [Accessed 9 Sep. 2019].