NRSG355 Clinical Integration

Question:

Module 1 – Critical thinking, clinical decision making  

While you read the article take particular note of how traditional vital signs can be used to assess the critically ill patient as well as the role of the additional three “vital signs”: level of pain, level of consciousness, and urine output.

Module 2 – Collaborative and Therapeutic Practice 

1. What does tribalism refer to?
2. How do tribalism and power inequities impact on information sharing?
3. What are the five key dimensions for a well-functioning health care team?

Case study 2 

Norma Ellis is a 76 year old widow who recently had a fall at the nursing home she has lived in for the past 7 years and fractured her hip. She has subsequently had a hip replacement and has been rehabilitating well and is now due for discharge back to the nursing home. Norma has an extensive medical history including postural hypotension, rheumatoid arthritis and impaired mobility. She mobilised within the nursing home using a walker. Her son is demanding that his mother be kept in the ward as an inpatient as he feels the nursing home staff were negligent and wants his mother to be placed elsewhere but has not arranged this yet. The treating team consists of the doctor, physiotherapist, NUM of the rehabilitation unit, social worker and NUM of the Norma’s wing at the nursing home she was in prior to the fall. You are the designated team leader.
The doctor feels there is no need to have Mrs Ellis on the ward as he feels that her rehabilitation has been maximised, this is an opinion shared by the physiotherapist. Norma wants to go back to the nursing home as she has made many friends there and feels at home there.

Discuss the following questions
1. What are the key issues in this dilemma?
2. How would you deal with Norma’s son? Are his objections warranted?

Module 3 Provision and Coordination of Care 

You are working on the morning shift on the ward, and receive a patient from ED. The ED nurse
provides you with the following handover, using the ISBAR format. Further information about the
ISBAR format can be found on page 7 of this module.
Handover’. Listen to this recording, and then please answer the following:
1. What further questions will you need to ask the nurse?
2. List specifically what further assessments you would complete when the patient arrives onto the ward
3. Upload the above answers to your e-Portfolio on LEO. This forms part of your assessment for this unit.

Module 4 – Professional Practice: Time Management, delegation, scope of practice

Access the following summary of Benner’s stage of clinical competence and consider these along
with the NMBA competencies and decision making tools. Then, consider what your priorities for your
final semester are and consider what skills you need to consolidate that will assist in you making the
transition from student to registered nurse.
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