Critical Reflection In Nursing

The district nursing team were now to be responsible for the wound care of an ulcer on the sole of her right foot on her impending discharge. She had previously attended the practice nurse and a podiatry service based within her local clinic. Due to a change in circumstances, she was now clearly housebound for the near future due to mobility issues. Prior to an arranged visit, the patient had called the nurse to advise her that she was pyrexial and was experiencing a pain in her right foot that was different from her normal neuropathic pain, which was often problematic. She was also finding it difficult to mobilise and was disinclined for diet but was taking oral fluids.

Personally, it is more than wonderful for me to possess such a quantity of concepts and how I recognize the connection between them through two previous classes. I believe this the start point which it is the best way to learn how I utilize these connections fully in nursing science and its scopes. My notes from the class demonstrate that I need to further my study of science and philosophy and this raise many questions in my mind on the nature of knowledge and how we know. The purpose of this paper is to discuss my personal reflection about the topics in the previous class and my own response in a general picture of the nursing science.

Data can be collected on multiple ways, from the point of medical care and patient satisfaction. The scenario points to pressure ulcers and the use of restraints, in both situations I believe that there was a fundamental lack of knowledge by the staff and disconnect by management.

Being ethically and legally responsible for another human being, was recognized as an overwhelming and ‘extremely scary’ experience. Specifically, graduate nurses fear the lack of recognising a deteriorating patient as a result of ‘overlooking something’ important (Goh and Watt 2003). Therefore, this stress and uncertainty in their practice may lead to a number of unfortunate events occurring and put patient’s safety at risk, due to the degree of responsibility and

The case that has been presented in this unit is who is responsible for the injury that the post surgical patient has suffered. In order to justify who is the party at fault, one must look at all aspect as to what lead up to the permanent damage to the patient 's left leg. “Malpractice is negligence by a professional” (Singh, 2006, pp 19). In this case, there has been proven to be negligence, but how many parties should be held responsible is the question. The standard of care can be different in each facility and it is up to the nurses to know what the quality of care should be when dealing with patients (Singh, 2006). In this case, I believe that both the night shift nurse and the day shift nurse should be held accountable for the damage done to this patient.

The careful consideration of professional or personal actions in such a way as to transform present and future experience describe reflection ( Kofoed, 2011). As I reflect over the past ten months, I have enjoyed my journey in the Doctor of Nursing Practice (DNP) program and am looking forward to graduating in approximately ten weeks. The knowledge, skills and competencies I have acquired has enhanced my teaching skills and confidence and helped me to care better for my patients. Although the transformation from a clinical floor nurse to a nurse educator with leadership skills has been problematic, I am acquiring ways to create change in patient care through the reflection in practice, clinical supervision, leadership, education, and evidence-based

Although the patient’s son questioned persistently about why his father’s tracheostomy was being covered, the nurses never seriously addressed the sons’ concern. When announcing the verdicts during the inquest, the council chairwoman professor Lee said it is unacceptable that “the nurses were simply following how the wound had been cared by other colleagues… it is always a nurse’s responsibility to exercise his or her own independent clinical judgement” (Tsang, 2016, para. 10). Hence, if the nurses have slightly questioned why the son was so concerned, the patients’ death could be easily avoided. Unfortunately, due to staff shortages, poor nurse-doctor interaction and heavy workload, it is arduous for nurses to utilize autonomy in such stressful environment (Weiland, 2014). Studies have shown that autonomy over patient care and unit operation can be augmented through continuing education and a climate of inquiry (Weston, 2008). Moreover, there should also be an emphasis on the nurses’ freedom to make decisions upon clinical patient care that is based on the art and science of nursing.

At 12 noon on 12 November 2007, Mrs McKay-Hall’s vital signs were quite abnormal (pulse 140, respiration rate 40) (Hope, 2012). This met the requirements to call the Medical Emergency Team according to hospital policy. The allocated senior nurse, Karen said that she was unaware of Mrs McKay-Hall’s condition because a junior nurse did not inform her. However, she wrote a progress note at 2 pm mentioning that the patient had tachycardia and increased blood pressure. She did not check the patient and did not take further observations. The practice of a nurse is evaluated with regard to the hypothetical reasonably competent nurse (Daly, Speedy, & Jackson, 2014). On the same day at afternoon shift, Nurse Baloyi was called in from another ward for

The notes nurses take play an important part in their role as health care advocates and affect the quality of care the patients receive. Notes are essential because they prove that the necessary care was ensued upon the patient and can be used as a reference for other nurses who will be caring for the patient. Notes can be used to advocate for the decisions the nurse had previously made in the case of false allegations or complains therefore they should be detailed, unambiguous and comprehensible. Nurses should avoid general statements as they tend to be misguiding or misleading and might cause complications that could have a negative effect on the patient’s comfort and health. Even though it might be difficult nurses should aim to write out full medical terms whenever feasible. If nurses are not able to write out the medical terms then they should use terms that are familiar to other nurses and physicians. The notes that were provided are atrocious, faulty and dangerous because they aren’t objective, the data is not supported by descriptions of specific observations or actions taken and lastly there’s an abundance of grammatical errors and spelling mistakes.

Critical thinking is defined as a disciplined, self directed thinking that meets appropriate intellectual standards within a particular mode or domain of thinking (Paul and Elder, 2014). In Nursing, the possession of this important skill helps a nurse to assess a given situation, identify the main problem, determine a perfect solution and implement an effective method of dealing with the problem.

This semester, I have not only grown as a person, but as a student nurse. I was so excited and nervous to start clinical and be able to take care of patients in need. I have become more aware of my actions, words, and care because of having the responsibility of having a resident to take care of.

In late 1990’s towards the early 20’s, the number of malpractice expenses made by nurses increased tremendously at least 500. There are so many reasons the number of malpractice cases against nurses have risen. It’s due to the position of delegation. Nurses are assigning more of their tasks to non-licensed assistive employees. Meaning that they are sending professionals who have not yet had enough or any experience at all. These tasks may be considered as neglect referring to applied standards of care or the practice act of the state. Another factor such as early discharge is what can cause a malpractice suit as well. Meaning the nurses did not properly checking the patient to see, if they have any complications after a procedure and sent them home without making referrals appropriate to patient condition.

When a nurse and patient have different values pertaining to a decision the nurse should self-reflect, ask questions, listen to the patient, provide empathetic responses and education, and collaborate to ensure the best-holistic outcome for the patient. In a scenario that a patient’s decision relies on values that the nurse does not agree with, the nurse needs to self-reflect, first. Self-reflection is healthy for the nurse, the nurse-patient relationship, and to have the ability to approach dilemmas in a non-judgmental manor with an open-mind. Burkhardt & Nathaniel (2014) explain self-reflection as an acknowledgment of personal values to rationalize the power position the nurse holds and prevent bias views to benefit the patient. The nurse does not have to agree with the values that underlay the decision, his or her role is to ensure the patient is competent and informed about the situation, options, and outcomes. Concurrently, the nurse should be sure the situation and decisions are compliant with the ethical principles, including autonomy. If there is any instance that the nurse does not fully understand the reasons or how the patient arrived at the decision, questions should be asked. The questions should be presented in a non-judgmental form and clear that the nurse only wants a better understanding of their values and thought process. Conversation with the patient using effective communication skills to encourage them to make sound decision is appropriate. Effective communication promotes the shift of empowerment onto the patient (Burkhardt & Nathaniel, 2014). Furthermore, this allows for the nurse to assess the patient’s cognitive competence and interpretation of the dilemma while understanding their perception from an empathetic outlook. Be aware the sympathy involves engaging in a negative thought process while empathy is understanding their frustrations or emotions and acting to improve the problem. At this point, the nurse has a broadened perspective of the situation and can provide appropriate and informative education. Finally, the nurse and patient should work collaboratively on the decision to establish effective outcomes for the patient. However, the nurse must be careful not to influence the

On 11/16/17 I met Ms. Black and her brother at the office of Dr. Fernanedez. Ms. Black was transported to the appointment by a transportation service from Kith Haven rehab. She has a brace on her right leg that is not related to the fall. The brace on her right arm was intact. X-ray was taken and they showed good alignment with the plates and a healing fracture. She is able to demonstrate the range of motion to the elbow that is slow. Her wrist is also slow. Her grip strength is weak. She continues to report numbness to the 4th and 5th fingers. Ms. Black was told that the numbness may take up to a year to come back. The surgery location is around that ulna nerve so it may have been damaged and it may never come back fully. The fingers functioning is the goal. She has a prior injury to the 5th finger and that was already stiff so that has not changed. The 5th finger is bending. Orders were obtained for therapy to work on an active range of motion. No resistance training is to start until 12 weeks postoperative. The brace is to be weaned, and she was fitted with an arm sleeve that has to padding over the elbow since it is sensitive to touch.

During this session, I was able to observe Ms. Thomas affect, the tone of her voice and her verbal and nonverbal cues that she was in distress. It appeared that she was in crisis mode, needed to feel supported and needed my help. Ms. Thomas also disclosed to me her secrete she was not sharing with her granddaughter about her medical condition. Looking at it from Ms. Thomas’ perspective, she might be feeling sad, despair, afraid, disappointed and wondering “why me.” My responses were intended to provide empathy and a sense of understanding and support. In addition, I was assessing her emotional stability and level of understanding of the upcoming medical intervention.