NRSG367 Transition To Professional Nursing

Description:

During the time of placements, I got the opportunity to work in a team and treat a number of patients under a clinical preceptor. During the time of handling, one of the patients who had suffered wounds after a fall, had high blood glucose level, and was admitted in the wound. From the very beginning, I had to work with another fellow member who was very introvert and never disclosed any of her concerns or problems with other members of the team or with the clinical preceptor. It was a very busy shift and we had to handle more than six patients within a very short time. My preceptor tried to guide us how to handle wounds but she had impatient listening skills and therefore, she cut her half way stating that she have understood. This offended the preceptor and she left the ward. I saw her go to the bed and started changing the wound without interacting with the patient. The patient wanted to interact with us but since my colleague had to work fast, she did not engage in the conversation with her. I tried to make her understand that we need to talk with the patient but she hurried away. Secondly, in the hurry, she neither washed her hand nor sterilized the products and she handled the wounds with bare hands and removed the moist dressing, as the wound was deep. She applied the dressing fast and left the ward when I was busy documenting the interventions. Next day, the preceptor complained my mentor that the patient did not like the care provided by us, as my colleague did not communicate with her, did not respect here, and did not take informed consent. Moreover, she did not maintain hand hygiene, which resulted in infection of wound resulting in staphylococcus infection. Although, I tried to make her understand, she was very fidgety and did not care what I said.

Feeling:

I was very upset from the entire situation as I failed to help the other nurse and guide her to provide best quality care that affected the health of the patient. I felt guilty for the increased suffering of the patient as we have the responsibility for developing their health and not for affecting or harming their health. Moreover, the complaint of the patient made me very embarrassed and hurt. This is because I was working with the other nurse and could not help her to prevent the occurrences. I saw her feeling guilty and loss of confidence when such events took place and she thought that she was not right for this profession. However, later, I helped her to regulate herself and she did not allow her emotions to affect my career. I decided that I would try my best to overcome such situation by developing the skills and knowledge in the way by which I can not only provide best quality care to patient but also reach the zenith of success in my profession in effective teamwork.

Evaluation:

The bad part of the incident was that she breached two important standards while providing care for the patient. The first one was “Preventing and Controlling Healthcare Associated Infection”. This standard mainly helps in description of the systems as well as the strategies that help in prevention of the infection and helps in effective management of the infections effectively when they are seen to occur. They also need to limit the development of the antimicrobial resistant with the help of prudent use of different types of microbial (Rahiman et al., 2018). While caring for wounds of the patient, it is extremely important for the professionals to identify the type of wounds, have knowledge about wound dressing procedures, need to realize which forms of wound dressing is require, maintenance of hand hygiene and sterilization of the equipments used. She did not follow the hand hygiene procedures and sterilization of the equipments that might have resulted in entry of germs through the wounds of the patient resulting in negative outcomes. Another standard that was also breached is the “Communicating for Safety”. This standard mainly helps in describing the systems as well as the strategies for effective communication with different stakeholders  (National Safety and Quality Health, 2017). These should include carers, patients, and families, multidisciplinary teams and clinicians, and across the health service organization (Kourkouta& Papathanasiou, 2014). She communicated neither with the patient nor with my preceptor. This resulted in patient dissatisfaction and errors in wound dressing respectively.

Analysis:

Hospital acquired infection is always associated with negative impact. It enhances the suffering of the patient along with resulting in mental and emotional turmoil on the family members. The financial flow gets enhances with creates tension and stress in the patients and family members. They have to stay for longer days in the hospitals making them suffer from anxiety and depression. The professionals can be held guilty for this that might involve the patient in legal obligation (Rahiman, Chitke & Hughes, 2018). The hospitals might also be held accountable for this and this might affect their brand and reputation, they also have to spend extra resources for the patient that could have been prevented (Carico et al., 2018). Hence, her improper practices had the potential to cause all the mentioned outcomes and this made her severely embarrassed and upset. Moreover, she did not communicate with the patient effectively. She did not engage within the communication. Empathy and compassion as well as taking informed consent helps in developing trust and bonding with the patient (Arnold & Boggs, 2015). It also helps in respecting the autonomy and dignity of the patient making him feel empowered and satisfied. However, she did not follow any of the standards. Moreover, she did not communicate with my mentor or team members effectively. Poor listening skills, poor feedback skills and improper team working skills enhance the frequencies of the occurrence of errors in medical treatment and care (Riley, 2015). She did not listen to the suggestions of me and advices of the preceptor. If she had listened to all the advices and guidelines of the preceptor, she would have developed knowledge about the proper ways of doing it and accordingly could have prevented the infection from occurring.

Conclusion:

From the entire analysis above, I realized that it is extremely important for the professionals to develop therapeutic relationship with the patient and I would do that only. Moreover, I would also ensure effective feedback exchange and active listening so that I do not kiss out important information and provide safe and quality care to the patient. Moreover, I would follow the proper procedures and guidelines for effective wound dressing and follow all strategies to prevent infection. This would help in speedy recovery of the patient and ensure patient satisfaction.

Action plan:

My fellow coallague and I would be joining workshop classes for development of communication skills. I would also interact and discuss with my mentor to develop ideas about team working skills. For development of more knowledge on infection prevention, I would follow evidence-based articles and books and join training sessions by nurse mentors as well.

References:

Arnold, E. C., & Boggs, K. U. (2015). Interpersonal Relationships-E-Book: Professional Communication Skills for Nurses. Elsevier Health Sciences.

Carrico, R. M., Garrett, H., Balcom, D., & Glowicz, J. B. (2018). Infection prevention and control core practices: A roadmap for nursing practice. Nursing2018, 48(8), 22-28.

Kourkouta, L., & Papathanasiou, I. V. (2014). Communication in nursing practice. Materia socio-medica, 26(1), 65.

Mody, L., Krein, S. L., Saint, S., Min, L. C., Montoya, A., Lansing, B., … & Rye, R. A. (2015). A targeted infection prevention intervention in nursing home residents with indwelling devices: a randomized clinical trial. JAMA internal medicine, 175(5), 714-723.

National Safety and Quality Health, (2017), e Australian Commission on Safety and Quality in Health Care Service Standards Guide for Hospitals,  https://www.safetyandquality.gov.au/wp-content/uploads/2017/12/National-Safety-and-Quality-Health-Service-Standards-Guide-for-Hospitals.pdf

Rahiman, F., Chikte, U., & Hughes, G. D. (2018). Nursing students’ knowledge, attitude and practices of infection prevention and control guidelines at a tertiary institution in the Western Cape: A cross sectional study. Nurse education today, 69, 20-25.

Riley, J. B. (2015). Communication in nursing. Elsevier Health Sciences