Description
I attended a Clinical Skills session, which was focused on peak flow meters, inhalers and spirometry. The aims of this session were to practise explaining to a patient how to use a peak flow meter, to interpret the peak flow results, to undertake and interpret the results of a spirometry, to practise explaining to a patient how to use an inhaler and to understand the use of an Aerosol Inhalation Monitor in optimising a patient’s treatment. I was given the opportunity to learn about the different types of inhalers used by patients, and assess the effectiveness of my inhaler technique using a Vitalograph Aerosol Inhalation Monitor (A-M Systems) and using an inspiratory flow meter (Robinson & Scullion, 2009).
Feelings
When using the
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This assumption was based on the fact that I have been using a metered-dose inhaler for approximately 10 years. Also, I was under the misconception that a strong expiration is required when using a metered-dose inhaler. My theory is that I was adhering to a ‘lay perspective’ (Nettleton, 2006), and in this case, a common misconception that feeling the sensation of the medication depositing on the back of my throat is an indication that inhaler has worked effectively. I believe that completing the clinical skills session shifted my view from the lay perspective to the ‘professional perspective’, as I have come to the realisation that a metered-dose inhaler has an inbuilt propeller and so a low-strength inspiration would be the most effective technique to ensure the medication enters the lungs. However, a dry-powder inhaler does not have an inbuilt propeller and so a strong inspiration would be required to ensure that the medication enters the lung. I initially did not know the dry-powder inhaler existed, so I think from a lay perspective, there is a possibility for the two types of inhalers and their required inspiration techniques to be confused with one another. The realisation that I may have been using the incorrect inhaler technique for several years is a strong memory that I will hold. I think this can be a positive outcome, as I now understand from a patient’s point of view, the importance of explaining the
Duerden, M. & Price, D. (2001). Training issues in the use of inhalers. Practical Disease
HENDERSON, Y (1998) A practical approach to breathing control in primary care. Nursing Standard (JULY) 22 (44) p41
In the clinical setting there are clinical and non-clinical advanced roles. A clinical advanced nursing role is one that involves direct patient care. An example of this is a nurse practitioner who provides treatment to patients and medical testing. A non-clinical advanced nursing role is one that does not provide direct care to the patients. Examples of this include nurse educators and nurse administrators who do not provide direct treatment to the patients. Both the clinical and non-clinical advanced roles have core competencies specific to their specialties.
Discuss at least four different methods that can be used to diagnose asthma and the results you would expect to see in Mr. TG’s case.
Hess Dean R., M. N. (2012). Respiratory Care: Principles and Practice 12th Edition. Sudbury, MA: Jones and Bartlett Learning.
For me competency 2 is the ability for us as social workers recognizing the characteristics and factors that help shape an individual’s identity and help define what an individual believes in and what they stand for. These characteristics and factors include things such as gender, ethnicity, culture, religion, age, etc. Its these characteristics and factors that affect an individual’s human experience and it’s what makes each of us incredibly unique. As social workers, we must have both respect and appreciation for diversity. Finally, competency 2 also means that we’re able to see how diversity and difference also brings oppression, marginalization, and as well privilege and power. We must be able to understand the different forms and mechanisms of discrimination and oppression and how
I have a lot to reflect on from my clinical practice this week: working with my client’s primary care giver, my client’s complex health experience and through acknowledgement of the areas of practice of where I am wanting to improve confidence in my skills as a nursing student as well as recognizing and acknowledging areas I have strength in. These two clinical days gave me experience that enabled me to step forward in understanding of collaboration with other health care providers, new ways of finding information, working with a more acute client and recognition of feelings that develop in situations where I am strengthen my skills, and where I am needing work on my confidence in my skills and abilities to communicate with different care
My clinical week was emotional and physically draining this week. I enjoyed being the lead on Thursday because it gave me the opportunity to stop and observe. The nurses and the CNAs were very stressed out, and I clearly saw the effect on the patients. For instance, one of the CNAs asked me to help her with an occupied bed change. I was excited. However, she kept passing a bunch of comments of how hard nursing is and how she did not want to be old. I did not acknowledge any of her comments. Perhaps she thought she could express herself (as a result of her stress) in front the patient since the patient was non verbal and could not understand. I felt very bad. I was very uncomfortable and sad. For me, it doesn’t matter whether the patient
Ascertaining the adequacy of gaseous exchange is the major purpose of the respiratory assessment. The components of respiratory assessment comprises of rate, rhythm, quality of breathing, degree of effort, cough, skin colour, deformities and mental status (Moore, 2007). RR is a primary indicator among other components that assists health professionals to record the baseline findings of current ventilatory functions and to identify physiological respiratory deterioration. For instance, increased RR (tachypnoea) and tidal volume indicate the body’s attempt to correct hypoxaemia and hypercapnia (Cretikos, Bellomo, Hillman, Chen, Finfer, & Flabouris, 2008). The inclusive use of a respiratory assessment on a patient could lead to numerous potential benefits. Firstly, initial findings of respiratory assessment reveals baseline data of patient’s respiratory functions. Secondly, if the patient is on respiratory medication such as salbutamol and ipratropium bromide, the respiratory assessment enables nurses to measure the effectiveness of medications and patient’s compliance towards those medications (Cretikos, Bellomo, Hillman, Chen, Finfer, & Flabouris, 2008). Thirdly, it facilitates early identification of respiratory complications and it has the potential to reduce the risk of significant clinical
My reflection report will be on how to teach a clinical skill, which could be done either by the simulation training “workshops” or in hospital settings. Any reflection report is basically an evaluation of a person’s records of certain findings about certain topic or experience
I believe placing student nurses in the clinical setting is vital in becoming competent nurses. Every experience the student experiences during their placement has an educative nature therefore, it is important for the students to take some time to reflect on these experiences. A specific situation that stood out to me from my clinical experience was that; I didn’t realize I had ignored the patient’s pain until I was later asked by the nurse if the patient was in any pain.
Nursing Diagnosis I for Patient R.M. is ineffective airway clearance related to retained secretions. This is evidenced by a weak unproductive cough and by both objective and subjective data. Objective data includes diagnosis of pneumonia, functional decline, and dyspnea. Subjective data include the patient’s complaints of feeling short of breath, even with assistance with basic ADLs. This is a crucial nursing diagnosis as pneumonia is a serious condition that is the eighth leading cause of death in the United States and the number one cause of death from infectious diseases (Lemon, & Burke, 2011). It is vital to keep the airway clear of the mucus that may be produced from the inflammatory response of pneumonia. This care plan is increasingly important because of R.M.'s state of functional decline; he is unable to perform ADL and to elicit a strong cough by himself due to his slouched posture. Respiratory infections and in this case, pneumonia, will further impair the airway (Lemon, & Burke, 2011). Because of the combination of pneumonia and R.M's other diagnoses of lifelong asthma, it is imperative that the nursing care plan of ineffective airway clearance be carried out. The first goal of this care plan was to have the patient breathe deeply and cough to remove secretions. It is important that the nurse help the patient deep breathe in an upright position; this is the best position for chest expansion, which promotes expansion and ventilation of all lung fields (Sparks and Taylor, 2011). It is also important the nurse teach the patient an easily performed cough technique and help mobilize the patient with ADL's. This helps the patient learn to cough and clear their airways without fatigue (Sparks a...
This week’s clinical experience has been unlike any other. I went onto the unit knowing that I needed to be more independent and found myself to be both scared and intimidated. However, having the patients I did made my first mother baby clinical an exciting experience. I was able to create connections between what I saw on the unit and the theory we learned in lectures. In addition, I was able to see tricks other nurses on the unit have when providing care, and where others went wrong. Being aware of this enabled me to see the areas of mother baby nursing I understood and areas I need to further research to become a better nurse.
This reflective essay will discuss three skills that I have leant and developed during my placement. The three skills that I will be discussing in this essay are bed-bath, observing a corpse being prepared for mortuary and putting canulla and taking it out. These skills will be discussed in this essay using (Gibb’s, 1988) model. I have chosen to use Gibb’s model because I find this model easier to use and understand to guide me through my reflection process. Moreover, this model will be useful in breaking the new skills that I have developed into a way that I can understand. This model will also enable me to turn my experiences into knowledge that I can refer to in the future when facing same or similar situations. Gibbs model seems to be straightforward compared to the other model which is why I have also chosen it. To abide by the code of conduct of Nursing and Midwifery Council (NMC) names of the real patients in this essay have been changed to respect the confidentiality.
Clinical Reflection: Therapeutic Use of Self One of the complexities of mental health is the disease’s unpredictability, not only of its progression but also its manifestation. Patient’s mood and behaviors can change in any given moment, so I try to put in to use all theories learned to anticipate and adapt. Each individual patient react differently to the various therapeutic approach. Consequently, their altered mental state makes it difficult for me to apply a generalized perspective towards their care. These patients, however, all have genuine needs to be met.