Partnership With The Patient - Essay Example

First Shift A patient who is 20 years of age was transferred from theatre to the ward I was on placement. I was asked to look after the patient withthe supervision of my mentor. He had a removal of omaya reservoir, mini craniotomy for debulking of germ cell tumour. During the hand-over I was told that morphine was given before coming down from recovery. On getting to the bay the patient was transferred to, the General Coma Scale (GCS) was taken which was 14/15. Half an hour later it dropped drastically to 8/15. I immediately reported the changes to my mentor who then asked me to do a continuous 15 minutes observation while he called the attention of the consultant that had operated on the patient. Upon the arrival of the consultant, a CT scan was carried out and came out alright. The respiratory team was as well called to assess the patient. Second Shift When the hand-over was done the following day, I was again allocated the patient for continuity of care. The patient’s condition remained the same. The patient’s family was then involved to speak to patient in mother tongue to see if it was going to help in bringing back patient. The respiratory team did a follow up and the GCS improved through the involvement of family and healthcare teams. In the process of working with patient, I was able to develop my understanding of respiration and the procedures of a patient being in coma. A patient who is 20 years of age was transferred from the scene to the ward where I was on placement. After the patient was transferred, I checked the general coma and found it to have dropped drastically after an hour, so I immediately reported the changes to my mentor. I was keen on the patient having been told he was given morphine before coming down from recovery. Following the instructions from my mentor, I did a continuous 15 minute observation. The following day, I was again allocated to the patient for continuity of care. The patient’s family was directed to speak to the patient in his mother tongue to see if it was going to help in bringing back the patient. The GCS improved through the involvement of family and healthcare teams. In the process of working with the patient, I was able to develop my understanding of respiration and the procedures of a patient being in coma. At about 17:00, the patient came out of coma, the GCS went back to 14/15 and the neurological observation was fine. Even though the patient was not speaking, I was pleased at the result from the shift worked. I pled politely with the parents to see the patient at the set time despite their growing anger on wanting to see the patient whenever they wish. I told the relatives of the patient softly and in a low tone that everything would be alright. The patient was not happy being isolated and wanted to spend most of the time with relatives. I clean my hands every time I attend to a patient and use the sterilisers to make sure the patient is not infected. This includes thorough cleaning and removing of blood spillages and any other body fluids to ensure the maximum safety of patients. Without cleaning spillages, infections will spread to the patient (Department of Health 2003). I ensured that every time I cleaned and stored at appropriate place the care equipment so as to also reduce the spread of infections. Equipment is very useful and important. If it not cleaned and kept well, it can put the life of patient at risk (Burnard & Gill 2008). I utilised personal equipment also for protection to prevent infections. To further prevent infections, I ensure that I dispose of any waste during my daily routine of providing healthcare support. Used linen always spreads infections in most cases and to prevent that, I was extra cautious when removing it and disposing (Naidoo & Wills 2005). I also ensured that the clean linen is safe. I stored it at its positions and used it as per the instructions. I used it in accordance with the infection and prevention standards and also in conformity with the national occupational standards (Naidoo & Wills 2005). On attending my client, I always checked my competence and tried harder to be innovative for the purpose of quality assurance to the patient (Maggie 2004). All my undertakings were based on evidence, not leaving anything to chance. I also promote self-management in order to maximize care by maximizing on relationship and partnership (Sue 2010). I also ensured the safety of the patient by reporting to the supervisor after every observation. This sharing of information in an effective manner and precisely in a variety of situations ensured that the patient was safe (Bach & Grant 2009). I gained a lot of knowledge and skills through observation every time the consultant came to attend to the patient (Neil G 2011). My care was also boosted by my ability to work within protocols and standard operating procedures, and by writing down everything accurately and subsequently in the course of my duty (Department of Health 2005). Whenever there was a crisis, I made sure that I used initiative and followed organizational procedures. Before making any judgement, I first consult widely or in most cases read a number of documents because the judgements I make often have far reaching consequences (Department of Health 2005). I kept my client very satisfied by respecting their dignity and beliefs and ensuring that I involved him in decision making. On my duty, I undertake the assessment of emotional, physical, psychological, social, cultural and spiritual needs of the patient (Hutchfield 2010). This was evident because every time I found patient praying, I did not interrupt him, especially when in a stable condition. Every time I examined the patient, I compared the results with what was on record, e.g. weight, and in case of emergency reported to the consultant. Through this exercise I improve and learn how to use electronic facilities and manual devices. I also act within the legal framework to ensure that I safeguard the interest of the patient, such as the right to privacy, and also put myself within legal requirements (Nursing & Midwifery Council 2002). At some point, the health of the patient worsened drastically, so I responded quickly because it was an emergency, and within time reported to the consultant (Clarke 2001). When relatives came to see the patient, I did not rush to get them in. I first sought the consent from the consultant who then ordered me to let them in to interact with the patient, after which the condition of the patient seemed to improve. By doing so I demonstrated respect for other people’s freedom and choices because had I just sent them away without consultation, I could have interfered with their right to see his relatives (Department of Health 2001). Whenever I communicated with the patient, I listened carefully and keenly and often took time to respond because every time you respond quickly, you might end up tongue slipping, which might hurt a patient in one way or another (Nursing &Midwifery Council 2008). I always like listening more than speaking and that strategy help me a lot. Often during interactions with the patient, I was able to distinguish information that was relevant to care and that which was not relevant (Marilyn 2008). Working in partnership with the family helped me a lot because the family provides emotional support to the patient. The family members also communicated effectively with the patient in their local language and I was able to obtain later useful information from the relatives (Mason & Whitehead 2003). In order to minimise risks, I constantly and frequently shared information with the consultant (Baughan, & Smith 2008). The consultant was always more experienced and often interpreted the information I got effectively and in the right way, hence helping save the life of the patient. I made sure that I was very conversant with my responsibilities, and I accepted them and made sure that I took appropriate action. In partnership with the patient and his relatives, I put an appropriate plan to ensure everything was delivered, documented and kept well to demonstrate effective risk management, infection prevention and control (Pam & Margaret 2009). I politely told the relatives about the risks of infection and went a step further to educate them on the need to prevent infections and how to control. After close monitoring and assessment of the patient, I discussed the progress with the consultant and he was able to review my progress and told me on the areas I had to improve. I made sure that I asked anything that was not clear for clarification (Howatson-Jones, Standing & Roberts 2012). After the discharge of the patient, I was better off than I was before. I believe I can now attend and take care of the patient on my own. I am confident that I can do it on my own brilliantly, having worked under a brilliant and cautious consultant. Bibliography Bach, S & Grant, A 2009, Communication and interpersonal skills for nurses, Learning Matters, Exeter. Baughan, J & Smith, A 2008, Caring in nursing practice, Harlow England, Pearson Education, Harlow. Burnard, P & Gill, P 2008, Culture, communication and nursing, Pearson Education, Harlow. Clarke, A 2001, The sociology of healthcare, Prentice Hall, Harlow. Department of Health 2001, Guidance on informed consent, DoH, London. Department of Health 2003, Discharge from hospital, pathway, process and practice, DoH, London. Department of Health 2005, NSF for long term conditions, DoH, London. Department of Health 2005, The expert patient, DoH, London. Hutchfield, K 2010, Information skills for nursing students: transforming nursing practice series, SAGE, Harvard. Howatson-Jones, L, Standing, M & Roberts, S, 2012, Patient assessment and care planning in nursing: transforming nursing practice, SAGE, Harvard. Maggie, N 2004, Essential nursing skills, Elsevier Health Sciences, Richmond. Marilyn, E 2008, The informed practice nurse: Wiley series in nursing, John Wiley & Sons, New York. Neil, G 2011, Mentoring and supervision in healthcare, Harvard, SAGE. Sue, H 2010, Nursing study and placement learning skills: prepare for practice, Oxford University Press, London. Pam, M & Margaret, G 2009, Nursing research: an introduction, Harvard, SAGE. Mason, T & Whitehead, E 2003, Thinking nursing, McGraw Hill Education, Maidenhead. Nursing &Midwifery Council 2008, Code of professional conduct: standards for conduct, performance and ethics, NMC, London. Nursing & Midwifery Council 2002, Guidelines for record and record keeping, NMC, London. Naidoo, J & Wills, J 2005, Public health and health promotion: developing practice, Oxford, Baillierre Tindall. Read More