Nursing Assignment: Patient Care in Surgical Department, Module 1-4

This nursing assignment comprehensively addresses several key aspects of patient care within a surgical department. The assignment begins by prioritizing nursing issues, detailing the delegation of tasks to various healthcare staff, and providing rationales for each decision, focusing on patient safety and recovery. It then explores the concept of a multidisciplinary team, defining its composition and the roles of different healthcare professionals, such as general practitioners, registered nurses, physiotherapists, and psychologists, highlighting the importance of nurses in communication and patient assessment. The assignment further analyzes case studies, including a focus on a patient with a fracture and aggressive behavior. Module 3 focuses on patient assessment, including gathering patient history, performing physical assessments like blood pressure and pulse oximetry, and the need for diagnostic tests like sputum tests and CT scans. Finally, the assignment addresses time management within a surgical ward, outlining staff allocation and responsibilities, emphasizing the importance of efficient care delivery and adherence to nursing standards. This assignment provides a detailed overview of practical nursing scenarios and best practices.

Running head: NURSING ASSIGNMENT
NURSING ASSIGNMENT
Name of the student:
Name of the university
Author note

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Module 1:
Issue Priority Action and rationale
An older female patient, who
recently had a facial surgery,
has collapsed.
This task will be 1st the
priority list and I will
delegate the task to the
enrolled nurse assisted by
AIN.
As the patient recently had
a facial surgery, sudden
collapse might hamper to
recovery of the patient and
the patient also might get
physical injury. Therefore
the enrolled nurse with the
help of the AIN, will place
the patient on the bed by
facing upwards.
The intravenous infusion of
the Mrs. chew has tissue and
also has also missed her
antibiotic
This task will be 2nd on the
priority list and will be
handled by me.
Tissue in the intravenous
infusion can hinder the
blood flow to the body
(Kumar et al., 2018).
Hence, I will check the
intravenous infusion of the
patient and will remove the
tissue and will administer
the missed antibiotics by
assessing the vitals of the
patients. As according to

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the only ne registered
nurse can administer
medication to the patient, I
will handle the patient by
myself.
The visitor arrived to visit
Mr. smith has fainted.
This task will be 3rd on the
priority list and I will
delegate the task to the AIN.
The AIN will move the
visitor to appropriate place
and lay him/her facing
upwards and will provide
the first aid to regain the
consciousness of the
patients (Solbiati, Sheldon
& Seifer, 2016).
Mr. Espito is about to leave
the ward for his cardiac
catheterization, but has not
taken his preoperative
medication yet.
This task will be 4th on the
priority list and will be
handled by me.
Rendering to the
Australian comission on
Safety and Quality in
Healthcare (2019), only the
registered nurse can
administer medication to
the patient. If the
medication before the
cardiac catheterization will
be delayed, it might

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hamper the procedure.
Surgical consultant is
waiting to converse
regarding the medication
error.
This task will be 5th on the
priority list and I will be
handling this task.
As per the Australian
commission on Safety and
Quality in Healthcare
(2019), any decision
related the medication or
the medication error will
be handled by the nurse to
avoid similar mistake in
future.
The staff washroom has been
blocked and the waste is
coming out and overflowing.
This task will be 6th on the
priority list and I will
delegate the task to the ward
clerk.
According to World Health
Organization (2017), It is
important to maintain
hygiene at the healthcare
sector to avid the
occurrence of any other
illness or injury and hence
will be allocated to the
ward clerk for cleaning. As
the other tasks recorded
above are more important
than this one and requires
immediate, this one is 6th in

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the priority list.
Module 2:
Multidisciplinary team is defined as the group of several healthcare workers which can
provide specific health care facilities to patients in order to enhance their health. Rendering to
Mndaust.asn.au. (2019), the multi-disciplinary team involves different specialist such as,
Community aged care workers, dieticians, physiotherapist, palliative care team, respiratory
specialist, respiratory specialist, MND Association Advisor, neurologist, neurologist, speech
pathologist, aged care worker, occupational therapist, orthotist, palliative care team, registered
nurse, and support coordinators. Involvement of the health care specialist in the care of the
patients is entirely dependent upon the mental, physical and social health kg of the patient. For
example, if the patient is suffering from respiratory illness or nervous System disorders, then
respiratory specialist or neurologist is included in the team respectively. The healthcare members
who are most commonly involved in the multidisciplinary team are the general practitioner,
registered nurse and social worker. Apart from that, involvement of other team members is
dependent on patient’s illness. In the case of older individuals, physiotherapist, aged care worker
are usually involved in the team.
The healthcare team is led by the general practitioner. General practitioner is the one who
refers the patient to different health care specialist based on patient's condition.
By reviewing the study of Morley and Cashell (2017), it can be stated that the most
imperative member of the healthcare care group is the nurse. Nurse communicates with the other
healthcare staff regarding the pateint’s condition on regular interval and updates them

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accordingly. Nurses involves in a professional relationship with the patient and gathers
information regarding the physiological and emotional needs of patient and convey it to the
different specialist as rendering to the Nursing and Midwifery Board of Australia, the registered
nurse should engage in a therapeutic relationship with patient.
By critically reviewing the case study of Robert, it is observed that the primary issue in
the situation is his fracture and his aggressive behavior. As observed from the case study that the
patient engages in an aggressive behavior with the health care staff which can hinder his
treatment, it can also be considered as the key issue of the case study.
By observing the case study of the Robert it can be stated that for the proper treatment of
the patient, multidisciplinary team is required. The healthcare specialist which should be
involved in his treatment includes general practitioner, registered nurse, physiotherapist,
psychologist and orthotist.
As the patient had a fracture to the tibia, orthotist is involved in the team. To control the
emotional outburst or aggressive behavior, psychologist or counselor is involved (Barry, 2016).
General practitioner will assess the normal physical health condition of patient to enhance the
health outcomes of the patient. Registered nurse will communicate with the patient and the other
team members to update them about patient's condition and will assist the patient in recovering
from his illness by supporting the patient physically and mentally (Murphy, Curtis &
McCloughen, 2016). Nurse is the one who will provide 24 hour care to the patients.
Module 3:
By observing the case study Joe, it is evident that the patient is suffering from the chief
complaints of chest cough and frothy sputum. In the handover, received by the nurse, the current

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medical conditions, vital signs assessment details are mentioned. However, in the Handover past
medical history is not mentioned. Hence I will further ask nurse to provide me with the previous
clinical history of the patient, which is required to provide effective care to the patient and also
reduces the chance of any further medication error.
As the patient is a 92 year old woman, chances of other chronic illness or moving
disability is also high, hence I will ask the nurse about the same. From the case study, it is
observed that the patient has recently lost 3 kgs weight which can hamper her physics health.
Therefore the nurse might have formulated a diet care plan to prevent further weight loss of the
patient. Therefore, I will ask the nurse about the diet plan of the patient. Apart from this, I will
also ask the nurse about allergies if the patient have any. It is vital for me to gain knowledge
about the allergies of the patient in order to avoid any further medication error or clinical error.
By observing the case study, it is observed that the patient requires sputum test to ensure
if the patient is suffering from pneumonia or not. As the patient is suspected to be suffering from
pneumonia, sputum test is must. In the sputum test, the sputum of the patient is collected and
observed. The color and the texture of the sputum are generally observed (Kakiuchi et al., 2018).
If the collected sputum is observed to be yellowish in color the patient is stated to be suffering
from pneumonia.
According to Maatouket al., (2018), in the case of older adults the chance of hypertension
is high and most frequently observed. Therefore, I will perform a blood pressure assessment of
the patient to ensure if the patient is having the complaints of hypertension or not. If the observes
blood pressure is observed to be low or high than 120/80, which is the optimal blood pressure,
the patient is stated to be suffering from low blood pressure and high blood pressure respectively.

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Apart from this, pulse oximetry test of the patient will also be performed by me. As in the
case of pneumonia the supply of oxygen in the lungs get limited, this reduces the amount of
oxygen in the blood. Therefore by the aid of the pulse oximetry test, the volume of oxygen in
blood of the patient is evaluated and it is observed to be low than the optimal range, the patient is
stated to be suffering from pneumonia (Plana et al., 2018). As Joe is an elderly patient, CT scan
is also conducted to get the more detailed image of the lungs of the patient. At last the pleural
fluid cultural is also done to determine the type and severity of the infection in the patient
(Stankey et al., 2018).
Module 4:
Time management in the healthcare sector is essential as it helps the nurse and the other
health care staff to provide appropriate and real time care to the patient. According to the case
study, when I arrived at the surgical department, I noticed that there is only one other registered
nurse, two enrolled nurse and along with that there are three AIN are there in the ward. The ward
consist of total 22 patients among which 14 have went for the surgery, which means we have to
take care of the remaining 8 patients. Four out of the 8 patients, might require antibiotics at any
time and have the intravenous access and hence they required more attention. Therefore to
manage the entire patient appropriately, it is important that the health care staffs are allocated
with different roles and responsibilities (NSW, 2010).
Apart from me there is one other registered nurse in the ward. As understood from the
case study that the registered nurse is already playing the role of NUM as the NUM is not present
in the ward. Therefore, I will allocate the nurse to take care of the two Patients who is having the
intravenous access and might require antibiotics. The registered nurse has been allocated to these

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patients because as per the Australian comission on Safety and Quality in Healthcare (2019),
only the registered nurse can provide medication to the patient in the absence of the general
practitioner. As the patient is on the intravenous access, alone registered nurse would not be able
to handle the patient; hence, the nurse would be assisted with AIN. Another two patients have
intravenous access that will be handled by me and assisted by one AIN. Apart from this, both the
enrolled nurse will be allocating to take care of the other 4 patient in the surgical ward assisted
by AIN.
The scope of repetition of the registered nurse is to deliver safe and suitable care to the
patient by engaging in a therapeutic relationship with the patient. The registered nurse will assess
the physical condition of the patient who has the intravenous access and provides medication
whenever required. As according to Nursing and Midwifery Board of Australia (2019),
medication can only be provided by the registered nurse, the patient who might require
antibiotics is allocated to the registered nurse (Nursing and Midwifery Board of Australia, 2016).
The opportunity of the training of the enrolled nurse in the healthcare setting is to
monitor the patient and report if anything observed (Nursing and Midwifery Board of Australia,
2016). As in this case, the other 4 patient does not require antibiotics or any other medications at
any time; they are allocated to the enrolled nurse. According to National Council of State Boards
(2014), the enrolled nurse should also engage in a therapeutic relationship with patient and
gathers information about the physiological and psychological needs and concerns of the patient,
therefore the nurse would engage herself in a professional association with the patient and
monitor accordingly and will advocate the patients about their physical condition (Schwartz,
2002).

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Another staff member present in the ward is the AIN. The scope of practice of the AIN is
to help the patient in conducting their daily activities and repositioning if require. Therefore, the
AIN are assigned to work with the enrolled nurse and the registered nurse to help in the proper
management of the patient.

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Reference:
Australian comission on Safety and Quality in Healthcare. (2019). Retrieved 26 September 2019,
from
https://www.safetyandquality.gov.au/sites/default/files/migrated/SAQ123_NursesUserGu
ide_V6.pdf
Barry, T. G. L. M. (2016). Male Adolescent Aggressive Behavior. Proposing Empirical
Research: A Guide to the Fundamentals, 137.
Kakiuchi, S., Suzuki, M., Dhoubhadel, B. G., Furumoto, A., Ito, H., Matsuki, K., ... & Morimoto,
K. (2018). Accuracy of high-throughput Nanofluidic PCR-based pneumococcal
serotyping and quantification assays using sputum samples for diagnosing vaccine
serotype pneumococcal pneumonia: analyses by composite diagnostic standards and
Bayesian latent class models. Journal of clinical microbiology, 56(5), e01874-17.
Kumar, S., Kane, P., Bhowmick, S. B., Ganorkar, K., Mistry, N. B., & Varu, R. K. (2018). U.S.
Patent Application No. 15/550,638.
Maatouk, I., Herzog, W., Böhlen, F., Quinzler, R., Löwe, B., Saum, K. U., ... & Wild, B. (2016).
Association of hypertension with depression and generalized anxiety symptoms in a large
population-based sample of older adults. Journal of hypertension, 34(9), 1711-1720.
Mndaust.asn.au. (2019). Members of a multidisciplinary care team. Retrieved 26 September
2019, from
https://www.mndaust.asn.au/Get-informed/Information-resources/Living_better_for_long
er/WEB-MND-Australia-Fact-Sheet-EB3-Multidisciplinary.aspx

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Morley, L., & Cashell, A. (2017). Collaboration in health care. Journal of medical imaging and
radiation sciences, 48(2), 207-216.
Murphy, M., Curtis, K., & McCloughen, A. (2016). What is the impact of multidisciplinary team
simulation training on team performance and efficiency of patient care? An integrative
review. Australasian emergency nursing journal, 19(1), 44-53.
National Council of State Boards (2014) A nurse’s guide to professional boundaries
https://www.ncsbn.org/ProfessionalBoundaries_Complete.pdf
NSW (2010).Assistants in Nursing working in the acute care environment. Retrieved from:
https://www.health.nsw.gov.au/workforce/Publications/ain-acute-care.pdf
Nursing and Midwifery Board of Australia (2013). Professional boundaries for
nurseshttps://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/
professional-standards.aspx
Nursing and Midwifery Board of Australia (2016).ENROLLED NURSE STANDARDS FOR
PRACTICE.Retrieved from: https://www.nursingmidwiferyboard.gov.au/Codes-
Guidelines-Statements/FAQ/Enrolled-nurse-standards-for-practice.aspx
Nursing and Midwifery Board of Australia (2016).Registered nurse standards for practice.
Retrieved from: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-
Statements/Professional-standards/registered-nurse-standards-for-practice.aspx
Plana, M. N., Zamora, J., Suresh, G., Fernandez‐Pineda, L., Thangaratinam, S., & Ewer, A. K.
(2018). Pulse oximetry screening for critical congenital heart defects. Cochrane Database
of Systematic Reviews, (3).