NRSG355 Clinical Integration: Professional Portfolio & Reflection

This document presents a nursing student's professional portfolio, encompassing various modules related to clinical integration and professional practice. It includes prioritized responses to patient scenarios, demonstrating critical thinking and decision-making skills. The portfolio covers multidisciplinary team communication, addressing issues of equality in healthcare settings, and applying assessment tools like PQRST for pain management. Furthermore, it incorporates a clinical reasoning cycle sheet for a patient with uncontrolled diabetes, detailing cue collection, problem identification, and planned interventions. The portfolio also reflects on delegation strategies and team nursing approaches in a surgical ward, emphasizing the registered nurse's role in ensuring quality patient care and positive health outcomes. Desklib offers a platform to access similar solved assignments and study resources for nursing students.

Running head: PROFESSIONAL PORTFOLIO ASSESSMENT
PROFESSIONAL PORTFOLIO ASSESSMENT
Name of the Student:
Name of the University:
Author note:

1PROFESSIONAL PORTFOLIO ASSESSMENT
Module 1: Assessment Question One
1. My first priority would be the elderly postoperative patient, for which I will initiate an
emergency code blue situation requiring immediate medical help. My second priority
would be the case situation of Mrs. Chew, for which, delegating the task to the NUM
would be appropriate for management. The requiring administration of medications to
Mr. Esposito would be the third priority, for which appointing the newly enrolled nurse
would be appropriate. My fourth priority would require management of the visitor who is
associated with the patient Mrs. Smith by delegating the work to the AIN who can further
delegate the task to additional professionals, would suit best. The fifth priority concerning
my duties would entail the management of the blocked toilet, for which delegation of the
activity to the ward services would be appropriate. The sixth priority would be
management of error during medication.
2. My first priority would be the elderly postoperative patient. The rationale behind this is
the severity of her condition, since she has encountered a state of unconsciousness, for
which immediate treatment is required for treatment. Further, in the situation concerning
prolonged lack of treatment of a fall, there may be a number of fatal negative health
consequences such as injuries to the head and face, as well as possibilities of reduced
mobility and fractures. For this reason, this case is my first priority, resulting in calling
for an emergency medical team through a code blue. My second priority would be the
case highlight of Mrs. Chew. The rationale behind this is her prolonged deprivation of
necessary tissues, infusions and antibiotics. For this task, delegating the NUM would
seem appropriate, since I will be occupied with the elderly postoperative patient and the

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newly enrolled nurses would lack enough competence for this case management due to
their relative occupational inexperience. My third priority would be Mr. Esposito for
whom no emergency has been reported, hence outlining the rationale for this decision.
For this task, delegation to the newly enrolled nurse would seem appropriate, the
rationale being that this activity requires to emergency specification and is within her
new expertise. For my fourth priority, I have selected the case of Mrs. Smith’s visitor, the
rationale being that she is an outsider and it will not be possible for the nurses to manage
her in the critical units. Hence, delegation of this activity to the AIN would be
appropriate, since she call appoint the required emergency ward along with required
doctor for the purpose of management. Finally, the rationale behind the fifth priority, that
is management of the blocked toilet, is due to its non critical and non medical nature.
Hence the ward clerk would be ideal in management of the situation, who would use
required maintenance services. The sixth priority would be the error concerning
medication, with the rationale being the already present delay and requiring merely my
reasoning. There are immediate emergencies at hand, and hence, this task would be done
at last due to its lack of emergency and a week’s delay being already present.
Module 2
Activity 2
1. The act of communication conducted by a team comprising of multidisciplinary
professionals, is dependent upon the severity and rate of emergency outlining the disease.
The additional factor determining the communication activities performed by a
multidisciplinary team, would involve the status of health of the concerned patient.

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Hence, an interplay of this factors leads to the initiation of appropriate communication
between patients, which finally leads to the decision concerning the functioning members
of the concerned multidisciplinary team (Horton, Lane & Shiggins, 2016).
2. The leading members of the concerned multidisciplinary team, would include the
neuropsychologists and additional specialists associated with the him.
3. The care practices performed by the concerned multidisciplinary team, would aim to
provide optimum treatment for the patients which are suffering from neurological
disorders on a long term basis. The major members of this team, would include a general
physician along with a specialist. The function of the specialist, would be to emphasize
the major core details pertaining to the symptoms of the disease as per his specialized
discipline in the medical team. Prior to this, the general physician would be involved
identifying the disease and its key features which would require treatment. Hence, for this
purpose, professionals such as a neurologist and the occupational therapist has been
appointed as the primary members of the multidisciplinary team.
Case Study 5
1. As evident from the above case study, one can identify certain key issues especially
concerning the presence of inequality and prevalence of the freedom for every employee
to participate in the decision making process. Hence, the major issue here is the
dominance exhibited by the medical team, possibly the medical officer and the associated
medical professionals such as the psychiatrist and patient case manager, in undertaking
key decisions, without providing equal opportunity to the additional non medical
members in provision of equal say in the decision making process.

4PROFESSIONAL PORTFOLIO ASSESSMENT
2. As a leader I will be required to adopt several important strategies for the purpose of
ensuring adequate equality and participation in the decision-making process, which is
relative absent in the workforce as evident in the above case study. One of the key
methods to be used is to clearly communicate with the team members, concerning the
importance of fairness and equality in participation of every member of the workforce,
who are participating in the decision-making process. This may involve conductance of
labor meetings and group discussion, where I would actively advocate the same (Adam
Cobb, 2016). Additional strategies would involve educating the employees on the
protocols of Workplace Health and Safety Standards, where prevalence of distress or
bullying amongst any team member, may lead to legal repercussions and compensations
(Powers, 2017). Another strategy which I may adopt is the provision of rewards and
appreciation to the team members, irrespective of the amount of participation exhibited
by every member in decision-making, in an attempt to curb the dominating behavior
exhibited by the medical team. Communicating the importance of non medical
professionals in the team to the medical staff would also be an additional strategy to
reduce the dominance and initiate equity in the workplace (Jacob, 2015).
Module 3
Activity 1
1. A number of additional questions are required to be asked from the nurse, for the purpose
of obtaining information concerning the patient. One of the key data required for
questioning, is the health condition of the required patient, prior to undergoing admission
in the emergency and critical care department (Johnson, Sanchez & Zheng, 2016). Other

5PROFESSIONAL PORTFOLIO ASSESSMENT
questions which are required to be asked, would include the details of the medicine
required by the patient, the method of diagnosis and treatment and most importantly, the
results of the diagnostic procedures so conducted. In addition to these, information
related to the appropriate methods required for assessment would also need questioning,
along with the medical history details of the patient and the expected health outcomes of
the patients, upon commencement of the required treatment procedures (Cowan et al.,
2018).
2. After the patient has arrived in the required ward, the nurse may be entrusted with further
duties to conduct the necessary assessment. Hence, an assessment tool known as PQRST
may be utilized, which helps in obtaining information related to the amount of pain
encountered by the patient (MacSorley et al., 2014). For this, the nurse is required to
assess several factors such as those which related to position of the patient, along with
provocation and pulling (P), factors which are qualitative (Q), features concerning the
region of the pain along with level of radiation and referral (R3), factors which highlight
how severe the pain is (S), and finally, temporal factors which highlight whether the pain
has arrived in the past, how did it progress along with mode and time details of its onset
(T3) (Downing et al., 2015).

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7PROFESSIONAL PORTFOLIO ASSESSMENT
Activity 2: Clinical Reasoning Cycle Sheet

8PROFESSIONAL PORTFOLIO ASSESSMENT
Consider the patient
situation
 What current
information do you
have on this pt?
 What new information
have you gathered?
A 69 year old man who suffering from uncontrolled type
2 diabetes and was admitted upon complaints of fainting,
dizziness along with increased sweating and palpitations.
Upon admission, the vital signs of the patient were:
 BP: 190/82 mmHg
 HR: 90 bpm
 RR: 22 bpm
 SPO2: 100%
 Temp: 40.5 C
New information:
 Fasting blood glucose: 180 mg/dl, indicating diabetes
 Total cholesterol: 165 mg/dl
 LDL Cholesterol: 120 mg/dl, indicating hyperlipidemia
 HDL Cholesterol: 35 mg/dl
 BMI: 32.4 kg/square metres, indicating obesity
Collect
Cues/Information
 What further cues and
information would be
useful? Why?
Further information concerning the dietary and lifestyle
habits followed by the patient would be useful in assessing the
reasons leading to the prevalence of diabetes and
hyperlipidemia. Adherence to faulty dietary habits such as
consumption of overly processed foods high in sugar and fat
leads to occurrences of metabolic diseases such as hypertension,
diabetes and distorted lipid profile (Baetge et al., 2017).
Process Information
 What changes do you
notice in the cues and
information provided?
 Which changes are
significant for this
patient and why?
 What do you think
Obesity and faulty diet are key reasons behind metabolic
disorders. The patient admitted to consuming large amounts of
refined products and sugary pastries. Hence, I believe this is the
reason for his obesity and metabolic symptoms. The patient
should undergo dietary and activity changes because a low fat
and low sugar diet, followed by exercise, will be beneficial in
reducing weight and improvement of metabolic symptoms (
Salas-Salvadó et al., 2015). Healthy weight, improved glucose
tolerance and lipid profile would be the positive outcomes.

9PROFESSIONAL PORTFOLIO ASSESSMENT
Module 4
Upon careful reading and observation of the required case study, we can derive certain
information from the above, mainly the fact that a total of 14 patients have been required to
experience surgical operative methods, amidst the total patient population group comprising a
total of 14 22 patients. Of these, the number of patients who have been granted usage to the
procedures outlining intravenous requirements is 4, along with a total number of 8 patients, who
are under the provision of conventional treatment procedures. Apart from the service which I am
providing, the delegation of a nurse unit manager is also performed by an additional nurse.
Additional members of the team, would include 1 enrolled nurse along with AINs, amounting to
a group of 3. As evident in the case study, there is a need for the adoption of appropriate
theoretical approaches, for the purpose of conducting adequate decision-making, which would
further aim to provide quality treatment and care performance to the patients, further resulting in
the positive health outcomes in the form of betterment in health. For this purpose, adoption of a
team nursing approach would be an ideal solution pertaining to the management of the problem
(Deravin et al., 2017). Hence, based on this, one of the key functions pertaining to the position of
the NUM would emphasize on supervising the treatment and care procedures, which are received
by the patient group of 22 patients. As evident from the case study, the patient who would
require emergency and rapid supervision, are those who are encountered with surgical
procedures. Hence, for the management of such critical care patients, the person who will be
entrusted with greatest responsibility would be the registered nurse. This is because the
registered nurse has garnered enough experience and professional in the management of patients
belonging to critical situations pertaining to the post operative type (Smolowitz et al., 2015).
Thus, in accordance to my duty as a registered nurse, I would promptly delegate 16 nurses for

10PROFESSIONAL PORTFOLIO ASSESSMENT
the management of such patients. In addition, I would also recruit the NUM, since she also
possess enhanced expertise due to being a registered nurse. For the purpose of management of
patients who are under administration of antibiotics through intravenous routes, I believe
delegating the task to the enrolled nurse would be appropriate, since her reduced experience and
expertise is ideal for such non-critical situations (Endacott et al., 2018). For the treatment and
supervision of the group of patients who would require appropriate conventional and traditional
care procedures, I believe delegating the newly enrolled nurses would be highly appropriate.
Further, I believe that delegating the same task to the AINs would be ideal for the situation, since
they will be able to help the newly enrolled nurses in the process and would require further
assistance (Alexander, 2015). The duties of a registered nurse, lie beyond the mere alleviation of
somatic symptoms in the patient and require additional responsibilities such as delegation,
leadership, supervision and patient diagnosis (Young & Siegel, 2016). Hence, such delegation
activities by the registered nurse, is an ideal way to ensure quality treatment and care for the
fellow patients (Kim & Gu, 2015).

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References
Adam Cobb, J. (2016). How firms shape income inequality: Stakeholder power, executive
decision making, and the structuring of employment relationships. Academy of
Management Review, 41(2), 324-348.
Alexander, G. L. (2015). Nurse assistant communication strategies about pressure ulcers in
nursing homes. Western journal of nursing research, 37(7), 984-1004.
Baetge, C., Earnest, C. P., Lockard, B., Coletta, A. M., Galvan, E., Rasmussen, C., ... & Oliver,
J. (2017). Efficacy of a randomized trial examining commercial weight loss programs and
exercise on metabolic syndrome in overweight and obese women. Applied Physiology,
Nutrition, and Metabolism, 42(2), 216-227.
Cowan, D., Brunero, S., Luo, X., Bilton, D., & Lamont, S. (2018). Developing a guideline for
structured content and process in mental health nursing handover. International journal
of mental health nursing, 27(1), 429-439.
Deravin, L., Francis, K., Nielsen, S., & Anderson, J. (2017). Nursing stress and satisfaction
outcomes resulting from implementing a team nursing model of care in a rural
setting. Journal of Hospital Administration, 6(1), 60.
Downing, J., Jassal, S. S., Mathews, L., Brits, H., & Friedrichsdorf, S. J. (2015). Pediatric pain
management in palliative care. Pain management, 5(1), 23-35.

12PROFESSIONAL PORTFOLIO ASSESSMENT
Endacott, R., O'connor, M., Williams, A., Wood, P., McKenna, L., Griffiths, D., ... & Cross, W.
(2018). Roles and functions of enrolled nurses in Australia: Perspectives of enrolled
nurses and registered nurses. Journal of clinical nursing, 27(5-6), e913-e920.
Hasan, S. T., Zingg, J. M., Kwan, P., Noble, T., Smith, D., & Meydani, M. (2014). Curcumin
modulation of high fat diet-induced atherosclerosis and steatohepatosis in LDL receptor
deficient mice. Atherosclerosis, 232(1), 40-51.
Horton, S., Lane, K., & Shiggins, C. (2016). Supporting communication for people with aphasia
in stroke rehabilitation: transfer of training in a multidisciplinary stroke
team. Aphasiology, 30(5), 629-656.
Jacob, D. (2015). Every vote counts: equality, autonomy, and the moral value of democratic
decision-making. Res Publica, 21(1), 61-75.
Johnson, M., Sanchez, P., & Zheng, C. (2016). The impact of an integrated nursing handover
system on nurses' satisfaction and work practices. Journal of clinical nursing, 25(1-2),
257-268.
Kim, E. J., & Gu, M. O. (2015). Recognition for nursing competency importance, nursing
competency level, and their influencing factors of nurses in the long-term care
hospitals. Journal of the Korea Academia-Industrial Cooperation Society, 16(3), 1989-
2001.
MacSorley, R., White, J., Conerly, V. H., Walker, J. T., Lofton, S., Ragland, G., ... & Robertson,
A. (2014). Pain assessment and management strategies for elderly patients. Home
Healthcare Now, 32(5), 272-285.

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Salas-Salvadó, J., Guasch-Ferré, M., Lee, C. H., Estruch, R., Clish, C. B., & Ros, E. (2015).
Protective Effects of the Mediterranean Diet on Type 2 Diabetes and Metabolic
Syndrome–3. The Journal of nutrition, 146(4), 920S-927S.
Smolowitz, J., Speakman, E., Wojnar, D., Whelan, E. M., Ulrich, S., Hayes, C., & Wood, L.
(2015). Role of the registered nurse in primary health care: meeting health care needs in
the 21st century. Nursing Outlook, 63(2), 130-136.
Young, H. M., & Siegel, E. O. (2016). The right person at the right time: Ensuring person-
centered care. Generations, 40(1), 47-55.