HLT54115 Nursing

Nursing profession often poses certain challenges in course of the professional commitment under specific circumstances. I myself encountered a situation in which intravenous (IV) catheter administration was cumbersome due to difficulty vein in the patient. Hence I would like to share my experience and what I learned pertaining to the issue through heightened awareness and acquisition of prudent knowledge and deeper insight relevant to the matter. I am keen to utilize the Atkins and Murphys (1994) model of reflection in this regard for evaluating my experience (Moon 2013). Once while appointed in the operation theatre prior to a surgery I came across a patient who was extremely obese weighing 250 pounds and her veins were deep seated, almost invisible and appeared like cylinders of fatty tissues. IV administration in her left arm was prohibited following removal of lymph nodes from left arm in course of a breast cancer surgery. Moreover she underwent extensive IV chemotherapy in the past few months that nearly exhausted every feasible vein in the right arm to be located and used. Therefore I was in a dilemma as what to do in order to effectively perform the IV administration so that medications may reach her body and produce the desired effects. The thought of the possible complications that might occur due to inappropriate IV administration especially like that of phlebitis bothered me immensely (Pa?al?o?lu and Kaya 2014). I tried hard to reach onto an effective resolution independently without compromising the health and safety of the patient. I being a registered nurse was in charge of assisting the physicians present at the operation theater and therefore in such demanding and unforeseen scenario I resorted to consulting them for opinions and suggestions. The attending anesthesiologist for this case came forward to help me out and he instructed me to go for the preferential forearm insertion option by means of following both inspection and palpation method (Wallis et al. 2014). As per his directions I tried to feel the cord of the vein in the patient even though I was unable to see it. I tried to maintain calmness and hold patience until I located the best vein for performing the IV administration in her right arm through careful examination. Upon locating the best vein I stimulated the skin over this region by snapping the forefingers at that site that resulted in making the veins prominent. Upon locating the vein I chose a standard IV catheter of suitable gauge. I performed the distal pulling technique to anchor the skin over the vein at the time of inserting the IV catheter with the help of my dominant hand (Dougherty and Lister 2015). Finally I successfully completed the IV administration procedure through valuable guidance and hands on directions received from the anesthesiologist who was also present in the scene. Thus I gained an insight and learnt important lessons and helpful tricks on patient handling in instances of difficult veins for successful IV administration that further widened the horizon of knowledge related to the issue.

References

Dougherty, L. and Lister, S., 2015. The Royal Marsden manual of clinical nursing procedures. John Wiley & Sons.

Moon, J.A., 2013. Reflection in learning and professional development: Theory and practice. Routledge.

Pa?al?o?lu, K.B. and Kaya, H., 2014. Catheter indwell time and phlebitis development during peripheral intravenous catheter administration.

Wallis, M.C., McGrail, M., Webster, J., Marsh, N., Gowardman, J., Playford, E.G. and Rickard, C.M., 2014. Risk factors for peripheral intravenous catheter failure: a multivariate analysis of data from a randomized controlled trial. Infection Control & Hospital Epidemiology, 35(01), pp.63-68.