Introduction
Simulation session was shown to have better prepared the nursing students in developing communication skills and providing safe care for deteriorating patients (Liaw, Zhou, Lau, Siau, & Chan, 2014). The aim of this paper is to explore areas that will influence nurses’ clinical practice based on reflection of the simulation session. The topic of the simulation session is multidisciplinary teams and the deteriorating patient. The session includes four activities: poison grids game, Lego recreation, ball games, and two clinical case scenarios. Based on reflection of the games, communication is identified as the core factor which affects the achievement of the group activities. Furthermore, facilitation of effective communication
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In the case scenario 1, the nurse from post-anesthesia care unit (PACU) transferred a patient who undergone post-operative hip replacement. The PACU nurse didn’t give a proper handover to the ward nurse, as she only did a quick introduction about the patient without checking the orders and charts with ward nurse at patient’s bedside, she then rushed back. Later on, the patient was deteriorating with declined level of consciousness, dropped oxygen saturation. After the primary and head to toe assessment, the nurses identified that patient experienced Morphine overdose, as the order in the medication chart was different compared to the actual rate showed on the patient-controlled analgesia machine. The patient’s deterioration could have been avoided if the PACU nurse could give a structured and detailed handover to the ward nurse at the bedside. The ward nurse could also hold back the PACU nurse and require to check the orders and drug charts at patient’s beside with …show more content…
In the case scenario 2, the patient’s oxygen saturation dropped to 88% on room air, respiratory rate increased to 30 per minute. The nurse then tried to apply the oxygen mask to the patient. The patient’s daughter was worried about the patient, and kept asking the nurse about the rationale for each intervention. Reflect on the scenario, the nurse did not acknowledge patient’s daughter’s distress, did not provide clear explanations and reassurance to her. This is the reason why the daughter seemed to be anxious and kept asking questions. The nurse should initiate communication with both the patient and her daughter from the beginning, inform the daughter about patient’s condition timely, and articulate rationale for each intervention. Study conducted byMitchell and Chaboyer (2010) highlighted that the challenges issues for nurses during crisis time not only include the multifaceted patient care issue but also the complexity that the patient’s family can add to the
As a post-anesthesia care unit (PACU) Registered Nurse (RN), I care for patients of all races, ages, gender and ethnic backgrounds. However, a majority of the people I care for are of advanced age. Therefore, one must be aware of changes in the body related to aging. The purpose of this discussion is to present a case that addresses the considerations and issues of the perioperative care of an elderly patient.
4). Examples of how nurses can integrate this competency include; using current practice guidelines and researching into hospital’s policies (Jurado, 2015). According to Sherwood & Zomorodi (2014) nurses should use current evidence based standards when providing care to patients. Nurse B violated one of the rights of medication administration. South Florida State Hospital does not use ID wristbands; instead they use a picture of the patient in the medication cup. Nurse B did not ask the patient to confirm his name in order to verify this information with the picture in the computer. By omitting this step in the process of medication administration, nurse B put the patient at risk of a medication error, which could have caused a negative patient
...estions if not 100% sure of something or use a double checking system. When a nurse is administrating medication, they should use the ten rights of medication administration (right patient, right drug, right route, right time, right dose, right documentation, right action, right form, right response, and right to refuse). Nurses should always keep good hand hygiene and always wear appropriate clothing to prevent from the spread of disease. Good communication with patients and healthcare team members is also key to success. Keeping on the eye on the patient within an appropriate time is important. If the patient ever seems to be looking different than their usual self vitals should be taken immediately. Encouraging patients to ask questions if they are unaware of something can prevent errors as well. Nurses should make sure the patient is on the same page as they are.
The nursing discipline embodies a whole range of skills and abilities that are aimed at maximizing one’s wellness by minimizing harm. As one of the most trusted professions, we literally are some’s last hope and last chance to thrive in life; however, in some cases we may be the last person they see on earth. Many individuals dream of slipping away in a peaceful death, but many others leave this world abruptly at unexpected times. I feel that is a crucial part to pay attention to individuals during their most critical and even for some their last moments and that is why I have peaked an interest in the critical care field. It is hard to care for someone who many others have given up on and how critical care nurses go above and beyond the call
Cultivating teamwork is vital in the fast-moving pace of the Emergency Department. One of the most important ways to cultivate this process is through developing a plan of communication with the team. According to L.J. Hood, communication is “…the dynamic interaction between two or more persons in which ideas, goals, beliefs and values, feelings, and feelings about feelings are exchanged. Even very brief communication exchanges may change all involved parties” (Hood, 2014, P.81). In many scenarios some nurses and staff members are unwilling to be those team players that are needed in a busy nursing unit, and many times nurses and staff will not communicate professionally at all. In these situations, some nurses and staff will require coaching sessions on how to communicate, and in worst case scenarios some nurses and staff, who are unwilling to communicate professionally, will be asked to leave the team
Every day there is a constant trust adhered to many different people in the profession of Nursing—the decision of what will help patients in terms of medicine, and the confidence to make these decisions. One false act or one slight misdiagnoses of medication to a patient could be the prime factor in whether the patient lives or dies. Nurses in hospitals across the country are spread thin, and thus makes the probability of mistakes higher. If a medicinal dose is off by even one decimal a patient could die, so the only real answer is for nurses to not be afraid to ask for assistance, always follow procedure and voice opinion is they feel something is wrong.
The second causative factor is task factors (Ogrinc, G. & Huber, S., 2010). The hospital had a conscious sedation policy in which Mr. B should have been on continuous blood pressure, electrocardiogram (ECG) and pulse oximeter monitoring throughout the procedure and until he met discharge criteria. However, this policy was not followed in Mr. B’s case. All practitioners administrating conscious sedation must pass training modules. Nurse J had completed the training modules but the LPN was the nurse checking on Mr. B. The LPN did not notify Nurse J of low oxygen
The patient was transferred into my care via the Emergency Assessment Unit for Surgical Patients (EAUS). I was given handover by the charge nurse who has already pre-a...
Q.3 Nurses as part of regulated health care practitioners are responsible and accountable to abide by the standards, codes and guidelines of nursing practice (NMBA, 2016). The nurse in the case study has breached the standard 1.4 of the Registered Nurse Standards for Practice. According to standard 1.4, the registered nurse should comply with "legislation, regulation, policies, guidelines and other standards or requirements relevant to the context of practice” when making decisions because this will be the foundation of the nurse in delivering high quality services (NMBA, 2016). The nurse in the scenario did not follow the hospital policy concerning “Between the Flags” or “red zone” and a doctor should be notified of this condition. Furthermore, the nurse failed to effectively respond to a deteriorating patient.
Due to this mistake the hospital, nurses and some of the staff had to be sued for negligence and the patient could have lost their life. It is important for nurses to ask if they believe something is a mistake. If they believe the medication was given but not recorded due to the dosing schedule the 2nd nurse could have asked the patient or called the pharmacy to double check. It is also important to record information on the right chart or under the right account. All pertinent information should be recorded and
For this section of presentations, I learned about health professional jobs that focused on behavior health. This section’s class presentations focused on community needs, substance use disorders, and nursing simulation learning program. Each presentation was educational and interesting to learn about. I enjoyed learning about the simulation learning center and how the student nurses learn and engage in nursing school.
With technology moving so quickly within the medical and nursing fields, it is vital to embrace new and innovative ways to learn how to care for a patient. A nurse or nursing student is faced with the ever growing challenge of keeping up with new technologies. A fairly new way to gain education and build upon skills is with the use of simulated based learning. With the use of a simulated nursing environment, a student will be able to increase their level of understanding of new skills and technologies; this great resource has three major forms of real-life reproduction, can be used in many different areas of nursing, provides a means to evaluate a student’s understanding and demonstration of a skill, and eliminates the potential for harming a patient. With all education, the ultimate goal of mastering a specific trade or skill is the desired end result.
Simulation learning is becoming more fascinating as the advancement of technology practiced across all domains of education, this is the same is true in nursing education. Simulation experience provides opportunity for students to practice patient care prior to the actual clinical setting. It allows students to reflect on their own skill by critically thinking and analyzing the action. Simulation learning promotes active learning process and helps students to evaluate and investigate the alternative teaching methods. It also opens a news ways for educators and researchers to practice and improve nursing education as the nursing field advanced.
After reviewing the situation and analyzing, this situation will and has affected my practice as a student nurse integrating into my professional self. Considering my analysis of the key issue, I have realized stress management and a lack of clinical knowledge, affecting judgment and clinical decision-making. My assumptions in the beginning of this situation when I first experience the patient in distress were to immediately call rapid response because they had called earlier on the day. With the knowledge I have gained, it’s important to stay calm in situations to be able to think clearly, analyze the situation appropriately to focus on the patient’s needs. I learned that stress is caused by how an individual perceives it. I perceived this situation as stressful because of my lack of experience and self-efficacy. My preceptor responded to the situation in a calm manner because she was mentally prepared and had a plan of actions if he became symptomatic. I learned that if I better prepare myself in review possible situations that occur and have interventions ready, it would decrease the stress and shock. Through experience, I have gained more confidence since my second
I am now more comfortable playing roles such as the initiator and recorder. Furthermore, I now know the scope of practice of professionals like occupational therapist, physical therapists and social workers. Attending the Help Save Stan simulation also had a positive impact on my learning. In the ‘Simena’ simulation, I saw a resident who was experiencing difficulty in communicating with a patient, due to his belief that the patient was drunk and dependent on pain medication. From this scenario, I was able to identify the need for professionals to listen to patients without making assumptions because patients are the expert of their own symptoms and have all the key data (Warren, 2015). Again, in the ‘Say what’ simulation, I was able to identify how communication affects patient safety. In this scenario, I received a change of shift report with some vital details missing. Since safe clinical handover is a requirement for safe patient care, the use of structured communication tools, such as SBAR (situation, background, assessment and recommendation) will provide a framework for providing key information (Guadine & Lamb,