Clinical Management Issue - Case Study Example

Name : xxxxxxxxxxx Institution : xxxxxxxxxxx Course : xxxxxxxxxxx Title : Independent and Supplementary Nurse Prescribing Tutor : xxxxxxxxxxx Clinical management issue in relating to Independent and Supplementary Nurse Prescribing Introduction Prescription is no longer the sole field of the doctors and the dentists. Currently, there are numerous nurse prescribers. The nurses who are meet the criteria established by the Nursing and Midwifery Council can seek further training on drug prescriptions. Griffiths 2004, argues that this has presented the nurses with adequate opportunities to prescribe, maintain expertise and confidence, and accordingly protect patient safety. Description of the experience The whole experience involved generating a Clinical Management Plan (CMP) for a patient who was diagnosed by the Independent Prescriber as having COPD, hypertension and high cholesterol in preparation for my practice as a supplementary prescriber. The patient was Mrs. Rosy Rose whose age was 59 years. The patient has exacerbations of COPD and experienced shortness in breathing. I chose this patient because COPD is a prevalent condition within the community where I manage patients with long-term conditions. There was a meeting between the IPGP, Mrs. Rosy Rose and myself. Guidelines were availed on how a CMP should be generated and that it should be precise to a certain patient and to the condition of the patient, easy and it must establish the scope to which prescribing tasks are to be carried out by the supplementary prescriber. Mrs. Rosy Rose participated in decision making she was well acquainted with her condition and was also very cooperative. General reflection It was very encouraging to perform a task I earlier did have the authority or the skills to do since I became accustomed to working alone within a society. I generated a CMG that was specific to the conditions Mrs. Rosy Rose was suffering from. According to Jones & Gautam 2006, a specific CMP is required to every specific condition that a SP manages. The CMP was approved and hence I was able to prescribe for Mrs. Rosy Rose all the medications that were approved within the CMP in my position as supplementary nurse prescriber. This gave me an opportunity to prescribe legally and freely for this patient. It offered me the experience of making a prescription whenever it necessitated, something I had not done before and did have the authority or the required skills to do. Throughout the practice, I discovered that the safety of the patient is very paramount and hence I always consulted with the SP whenever I was unsure of my prescriptions. Eventually, I was able to prescribe effectively within the required prescriptions. I also noticed that this practice was not only beneficial to me in gaining the professional development, but it was also important to the patient since it enabled the patient to access the medications faster and also to the service since it assisted in freeing up professional time (Jones & Gautam 2006). Reflection on Partnerships Anytime I generated any new prescription, I always informed the GP. As a result, there was effective communication is required between GP and me. I held several meetings with the GP and hence we could discuss any issue pertaining my undertakings. I sought clarification from the GP anytime I needed one. This enabled me to form a concrete relationship with the GP and thus we worked as a team effectively. This was very important for me, because I was able to learn so many things from the GP. This was significant to me since it has offered me the right skills to competently interact with the doctors anywhere and take guidelines from them without any complications. In future, I will be able to work with the other medical practitioners efficiently (Jasper 2003). This partnership also helped me gain momentous knowledge in regard to prescription. The GP always examined any medication that I prescribed for Mrs. Rosy. With this, he would make any corrections if required or give me a go ahead when I made the correct prescription. With time, I was able to prescribe properly and efficiently as well any medication that I could within my power to Mrs. Rosy. According to Department of Health 2004, this was very vital in my professional development at acquired proficiency in prescriptions and therefore in future I am likely to make precise and the required prescriptions to my patients. I am able to establish efficient working relationships with the patients, clients and the larger care team since I understand the responsibilities and relationship of everyone who participates in the prescription, supply and administration of medications. In regard to my patient Mrs. Rosy Rose, I gained understanding on what she was already taking and the impacts. Her medications were Simvastatin 40mg o.n, Ramipril 2.5 o.d, and Bendrofluthiazide 2.5mg o.d and her medical history included COPD, hypertension in addition to high cholesterol. The conditions that she was being treated for, included, exacerbation and maintenance of chronic obstructive pulmonary disease. The treatment aimed at accomplishing maximum management of symptoms like cough, breathlessness and wheeze, reduction of the number of exacerbations and also to prevent any unplanned hospital admissions. From Mrs. Rosy Rose, I gained meaningful skills on how to manage patients like her as hence currently I can manage any patient with similar conditions and symptoms successfully. This also would help me deal with patients with different conditions but with similar conditions. I have consequently developed valuable skills required to manage patient with COPD, hypertension and high cholesterol as well (Nursing & Midwifery Council 2007). I am in a position to target, examine and monitor high-risk patients for investigations, conduct health education and promote health education as well in regard to their lifestyle behaviors and facilitate steps towards the patient’s self management for their conditions. For instance, I am in a position to advice the clients who suffer from similar conditions (hypertension and high cholesterol levels) on how to manage them the lifestyle behaviors to avoid in order to treat the condition successfully. Moreover, I can promote health education to the health people on what to avoid to minimize the risk of getting such conditions. I can also make clinical decisions proficiently within the prescribing practice as well as perform a systematic history of the patient consisting of medication history, current medication which also covers the counter alternative and complimentary health medications to diagnose successfully(Nursing & Midwifery Council 2007). From Mrs. Rosy Rose, I also acquired the necessary skills in taking the history of the patient; I can conduct a clinical examination and establish the correct diagnosis. Reflection on Clinical management plan Completing the clinical management plan was very significant in my professional development. For instance, I was able to successfully identify any adverse reactions that Mrs. Rosy had against some medications. This assisted me professionally in that at present I am able to know and recognize the medications that are likely to result into adverse reactions when the patient uses them at the same time. Within the CMP, I identified the medications that as an SP I could prescribe to Mrs. Rosy. This included the inhaled anticholinergics which were meant to relief any symptoms in moderate or severe COPD and oral predinisolone which was supposed to evaluate reversibility and was only used during acute exacerbation among other prescriptions. This developed my professional in that I am in a position to know the medications that I can prescribe for varying patients in the course of my career (Jones & Gautam 2006). Within the CMP, I identified the specific conditions that required referral to the IP. For instance, in the case of Mrs. Rosy, I identified that even if I was in a position to prescribe Ipatropium bromide 20mcgs or salbutamol 100mcgs metered dose inhaler to maintain and reduce bronchospasm, I was supposed to refer the prescription to an IP if breathless rate rose, oxygen saturation reduced below 82 percent and if functionality capability reduced in my patient Mrs. Rosy. As a result, this was important since during my professional work, I will be able to make referrals effectively incase my prescription does not function as required. By Generating the CMP, I got to know the importance of understanding the disease the patient is suffering from, increased my knowledge of relating pathophysiology to symptoms which has hence redeveloped my clinical decision making skills from a wide base to a more précised perspective. Furthermore, the CMP gave me an opportunity of discussing several matters and concerns with the patient Mrs. Rosy Rose and therefore I was able to implement a synchronized treatment to her. The CMP therefore assisted me in providing a personalized holistic care that enabled me to utilize time efficiently during initiation of treatment changes and ensured that treatment, medication as well as resources were easily accessed by the GP and the IP (Jasper 2003). Finally, I can successfully generate a Clinical management plan that is not complicated and can be utilized with ease and also develop a CMP that sets up the scope of the prescribing tasks to be carried out by the supplementary prescriber for any patient with different types of conditions. I am also in a position to create and document a clinical management plan which is within the framework of a prescribing affiliation and meets the legislative requirements (Luker & Wolfson 1999). Bibliography Department of Health, 2004, Building a Safer NHS for Patients, Improving Medication Safety, LSO, London. Griffiths, M., 2004, Independent & Supplementary Prescribing: An Essential Guide, Cambridge University Press, Cambridge. Jasper, M., 2003, Beginning Reflective Practice, Nelson Thornes, Cheltenham. Jones, O, & Gautam N., 2006, The Hands-On Guide To Practical Prescribing, Blackwell Publishing, Oxford. Luker, K & Wolfson D., 1999, Medicines Management for Clinical Nurses, Blackwell Publishing, Oxford Nursing & Midwifery Council, 2007, Standards for Medicines Management NMC, London. Read More