NPP3201 Nursing Practice 4

Introduction:

The event I will reflect on was during my placement in G61 General surgical ward At Sir Charles Gairden Hospital (SCGH).  I was working with my buddy nurse caring for patients with a range of the pre and post-surgical conditions. At the beginning of the shift, my facilitator provided me with a chance to administer an intravenous antibiotic to the patient who had undergone abdominal surgery.  Demonstrating timely and accurately information, documentation, and evidence was one of my scopes of practice. The facilitator advised me to go through Sir Charles Gairdner nursing practice guideline before I could start an assessment so as to know how to manage my time correctly and appropriately to permit for an effective assessment. I read the guideline for intravenous injection and then collected all the necessary equipment.   Also, providing care to the patient with the medical complication was one my scope of practice. Finally, since the intravenous antibiotic injection cannot be administered by the student alone, I did it under the watch of my facilitator, and thus, formed part of the scope of practice. I was well aware I cannot administer medication without nurse present or like I cannot check S4 and S medication without the other nurse which is out my scope of practice

Feeling: I was very conscious about my hand hygiene, aseptic technique and time management. Additionally, I felt partially nervous being under constant supervision by my facilitator, but he was supportive and willing to correct me where necessary throughout the assessment period (NMBA standard 2.8).

Evaluation: Before the assessment, I had reviewed the SCGH practice guideline on the safety administration of an intravenous antibiotic injection to make sure that I had the knowledge to where I should concentrate on my assessment (NMBA standard 4.2). During the process, it was important to communicate with the client to gain permission, put her on ease and clarify the query raised during the assessment (NMBA standard 2.1).  According to Kourkouta & Papathanasiou (2014), some medical staff may find it hard to be empathetic on a busy ward, but communication is important to solve any raising concerns. Having been given the opportunity to administer the antibiotic intravenously and manage patient care abdominal surgery with a particular time frame was challenging to provide universal care (NMBA standard 4.1).  The experience of administering the intravenous injection taught me how to manage time effectively and be compassionate to the patient while prioritizing care with accordance to the patient condition and needs, which is also part of my scope of practice.

Analysis: My communication with the patient was comfortable, and I explained the procedures to the patient that she would feel little of pressure and pain when I administer the intravenous injection on her left arm (Leask et al., 2012). The process made her to be aware and cool about all process. Then, she expressed gratitude to me later for my professionalism and my great focus on detail.  I provided the cloth to cover her abdominal area which made me offer the privacy of the patient and also to preserve the dignity and minimise embarrassment of exposing her body (Tadd, 2017). I feel my preparation and conduct of assessment went quite well and in future, I plan to practice the needed skills.

Conclusion: The skill of administering antibiotic through the intravenous route went well without any hitches such as swelling of her vein or a puncture hole in the skin around the IV, as they can harm the skin or tissue or cause a blood clot. At first, I was nervous because I feared I might miss a crucial step while doing the intravenous but my confidence was restored when I explained the guideline to the facilitator and patient. A student cannot be allocated to give nor carry a set of medication key but may handle medication keys in the course of taking medication from a bedside locker, imprest cupboard or medication trolley for administration to the individuals under the direct supervision of RN/RM.  According to the guideline, the student cannot at any time, carry or hand the schedule eight (s8) medication keys, sometimes referred to as the DD or the red keys, which proves it to be out my scope of practice.

Action plan: In future, I will check and follow the SCGH nursing guideline policies before I commence my assessment.  I will follow the hospital’s aseptic techniques and the process of hand hygiene. In future, if I encounter such same scenario, I will review the progress of notes which might have changed and sought further advice from the interdisciplinary and clinical facilitator. Finally, documentation is crucial in nursing progress and there I will ensure continuity in my patient care and optimal care, which is also my scope of practice.  The student is encouraged and permitted to observe the administration of drugs. Also, the student should refer to the organisation policies regarding the medication administration.

References

Kourkouta, L., & Papathanasiou, I. V. (2014). Communication in nursing practice. Materia socio-medica, 26(1), 65. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3990376/

Leask, J., Kinnersley, P., Jackson, C., Cheater, F., Bedford, H., & Rowles, G. (2012). Communicating with parents about vaccination: a framework for health professionals. BMC pediatrics, 12(1), 154.  Retrieved from https://doi.org/10.1186/1471-2431-12-154

Nursing and Midwifery Board of Australia (NMBA). (2016). Registered nurse standards for practice. Retrieved from https://www.nursingmidwiferyboard.gov.au/Codes-GuidelinesStatements/Professional-standards/registered-nurse-standards-for-practice.aspx

Tadd, W. (2017). Dignity and older Europeans. In Ethics, Law and Society (pp. 73-91). Routledge. Retrieved from https://www.taylorfrancis.com/books/e/9781351567732/chapters/10.4324%2F9781315094311-7