NCS2202 Culture And Health

This is an amalgamation of the experience I have obtained from the last five weeks of clinical placement in the ECU practicum of the Sir Charles Gairdner Hospital (SCGH) in the general surgical Ward where I have been placed. I would be taking the assistance of the Gibbs reflective cycle for this essay (Smith & Roberts, 2015). I have had a revelling experience in the ECU and have learned a range of activities such as varivac drain management including insertion and removal, administration of IV medication in both preoperative and postoperative setting including PAOB, IVOB, PO, subcut and also eye drops, doing wound dressing of surgical wounds, drawing blood through a PICC line, and finally participating in a clinical incident involving a MET call. In each of the weeks I have learned new practice skills which has enhanced and enriched my professional competence as a future nurse.

However, I believe the most important and impactful experience for me had been my encounter with the MET call. Elaborating further on the experience, the patient had gone through a tachycardia episode with 135 heart rate and febrile 38. I had been assigned the opportunity to carry out post-operative observations on the guidance of my preceptor after the patient was sent to post-operative recovery unit after her appendectomy surgery. I noticed the patient starting to shiver and I immediately checked her vitals and informed my preceptor and my shift coordinator. A MET call was arranged for her on an urgent basis and immediately necessary interventions were given to stabilize her (Levett-Jones, Reid-Searl & Bourgeois, 2018).

Feelings:

I would like to mention that after completing my placement in the G-61, I have mixed feelings regarding the array of experiences I have had. First of all, each of the weeks I had the opportunity to learn completely different and new professional aspects which enriched my professional competence (Levett-Jones, Pitt, Courtney-Pratt, Harbrow & Rossiter, 2015). I had very little idea regarding drawing blood from patients through PICC line, drain management and wound dressing. In each case, even though I had felt initial nervousness, as the task progressed I gained my confidence and completed my tasks accordingly with the guidance of my supervisors and buddy nurse. However, emphasizing on the clinical incident, it had been my first encounter with a patient going through any emergency. As a result I was shocked and scared to see the patient suddenly deteriorate. Although, I was anxious I still had faith in the MET team and senior nurses. Soon the patient recovered and was stable which made me ecstatic.

Evaluation:

There have been many positive instances in this experience, first and foremost, I would like to mention that the supervisors and mentors I had the opportunity to work with had been very helpful and I learned a wealth of knowledge from them. Another positive aspect had been that I could learn the skills of drawing blood, administering intravenous medication, and managing varivac drains. Especially, regarding the MET call incident, I had the opportunity to learn how the medical emergency team functions in an emergency situation. It helped me learn skills of decision making in critical situations (Tollefson & Hillman, 2016). One negative aspect will be that due to my limited knowledge and extreme nervousness, I was not able to contribute and help with the MET call as much as I would have liked to.

Analysis:

Placement experience is a crucial step in the journey of student nurse as it provides practical hands-on knowledge and expertise regarding the care experience to be carried out in the practice in future (Levett-Jones, Reid-Searl & Bourgeois, 2018). In my case, I had the golden opportunity to not just learn key skills of post- and pre- operative patient management such as drawing blood, managing drains and catheters and administering IV medication, but also arrange and encounter a MET call situation. I had the chance to learn how the MET nurses and ward nurses followed the practice guidelines of NMBA and Australia National Competency Standards for registered nurses effectively (Nursingmidwiferyboard.gov.au, 2018). In a clinical emergency, each doctor and nurse had a singular role with overlapping responsibilities. All the health care members need to co-operate and collaborate to achieve the care outcome for the patient and prioritize patient safety (Cec.health.nsw.gov.au, 2018). I contributed very little by just getting the IV fluids and communicating with the daughter of the patient, yet the learning experience had been remarkable for me.

 On a concluding note, my ECU practicum placement experience in the general surgical ward G-61 had been excellently helpful. I had gained expertise in a range of professional skills which I had only theoretical idea about before. I understood the importance of communication, co-operation and practice guidelines in clinical emergencies in the MET call incident and it can be hoped that I will be able to employ these skills and knowledge in my future practice effectively.

Action plan:

I understood that confusion, nervousness and lack of confidence in clinical emergencies are my most notable flaws. I will be reaching out to my supervisor to build on these soft skills and based on her suggestions, I will be enrolling in online courses and professional workshops to improve my skills. Along with that, I believe I need to expand my knowledge professional guidelines and standards of practice to provide effective and safe care even in emergencies. Hence I will be attending course and seminars I would be improving my knowledge so that my understanding of my roles and responsibilities are clear (Levett-Jones, Reid-Searl & Bourgeois, 2018).

References:

Cec.health.nsw.gov.au (2018). Clinical Excellence Commission – index. [Online]. Retrieved from https://www.cec.health.nsw.gov.au/programs/between-the-flags/standard-calling-criteria [Accessed on 31st Oct]

Levett-Jones, T., Pitt, V., Courtney-Pratt, H., Harbrow, G., & Rossiter, R. (2015). What are the primary concerns of nursing students as they prepare for and contemplate their first clinical placement experience?. Nurse Education in Practice, 15(4), 304-309. doi: 10.1016/j.nepr.2015.03.012

Levett-Jones, T., Reid-Searl, K., & Bourgeois, S. (2018). The clinical placement: An essential guide for nursing students. Elsevier Health Sciences. Retrieved from https://books.google.co.in/books?hl=en&lr=&id=vw9aDwAAQBAJ&oi=fnd&pg=PT6&dq=importance+of+clinical+placement&ots=sEX3-0pNze&sig=nIHSZZruuhuuAnk8K1QEb_Dxdek#v=onepage&q=importance%20of%20clinical%20placement&f=false 

Nursingmidwiferyboard.gov.au (2018). Registered nurse standards for practice. [Online]  Retrieved from https://www.nursingmidwiferyboard.gov.au/Codes-GuidelinesStatements/Professional-standards/registered-nurse-standards-for-practice.aspx [Accessed on 31st Oct]

Smith, J., & Roberts, R. (2015). Reflective practice. Vital Signs for Nurses: An Introduction to Clinical Observations, 222-230. doi: 10.1002/9781119139119.ch14

Tollefson, J., & Hillman, E. (2016). Clinical psychomotor skills : Assessment tools for nurses(Revised sixth ed.). South Melbourne, Victoria, Australia: Cengage Learning Australia. Retrieved from https://books.google.co.in/books?hl=en&lr=&id=VRpSDwAAQBAJ&oi=fnd&pg=PR1&dq=Tollefson,+J.,+%26+Hillman,+E.+(2016).+Clinical+psychomotor+skills+:+Assessment+tools+for+nurses(Revised+sixth+ed.).+South+Melbourne,+Victoria,+Australia:+Cengage+Learning+Australia&ots=ht0umtW_kF&sig=CzjQnkmspw190oHTG46bd6VQl2s#v=onepage&q&f=false