Patient Reflection

One patient, James, has just come back from the operating room and was still feeling the effects of the anesthesia. He was still drowsy when the PACU nurse was getting his vitals and he always had his arms wrapped around his chest. Although his vitals were stable and he showed no signs of pain, the nurse was bothered by his laconic

This essay will demonstrate my reflective abilities within an episode of care in which I have been involved with during my practice placement. It will discuss several issues binding nursing practice with issues of ethics and the model of reflection which provided me with a good structure and which I found most appropriate, is Gibbs model (Gibbs 1988). This particular model incorporates - description, feelings, evaluation, analysis, conclusion and the action plan.

assess Mr. B’s respiratory states while Nurse J. and Dr. T finished the sedation and reduction

Reflection is a process of exploring and examining ourselves, our perspectives, attributes, experiences and actions / interactions. It helps us gain insight and see how to move forward (Nursing Times 2018). I believe reflection is particularly important when it comes to Nursing, as medicine is constantly changing/ improving and us ourselves medical professionals must adapt with the changes in medicine. I find that reflection is extremely useful in doing this as we can look over procedures or experiences that we have had, how that made us feel, whether we would change anything, then in the future we can see the changes that may have been made, whether this has changed our feelings and opinions on medical practice.

On august 13, 2016 I was assigned to follow one of the ICU Nurse. It was a very calm day. She had two patient one was more critical than the other. Both patients were on the ventilator because they had to be intubated the night before. The lady is obese and had gastric bypass surgery two years ago and suffering from severe sleep apnea, but the patient is non-compliance to the CPAP treatment. That was her second time being intubated. She was admitted for seizure monitoring because she was constantly having seizures the day before while she was at home. Due to the fact that she did not want to wear her CPAP machine while in the hospital, after pain medication was administered she was found unresponsive, that was the reason for her intubation the night before. Patient was on intermittent suctioning, she has sinus tachycardia . I had the opportunity to observe some of her daily care. The patient was on fentanyl but when the Dr. try to wean her out of the ventilator she stop breathing, therefore, the DR. discontinue the fentanyl temporarily in other to retest her later.

Patient “DD” is a 56-year-old woman who was admitted to a nearby hospital for respiratory failure. With the only previous medical history being chronic bronchitis, she was diagnosed upon admission with COPD, anemia, hypoxia, moderate anxiety, and dyspnea.

The objective of this reflection is to explore and reflect upon a situation from a clinical placement on an orthopedic unit. The incident showed that I did not provide safe, timely and competent care for my patient when the oxygen saturation was low. Furthermore, this reflection will include a description of the incident, and I will conclude with explaining what I have learned from the experience and how it will change my future actions.

The patient was a five year old male, fit and well in himself, with no allergies other than a mild Asthma. This would classify the patient ASA 2 according to the American Society of Anaesthesiologists (ASA).This means that the patient has a mild systemic disease that does not limit activity and is well controlled with the use of inhalers, (Simpson PJ and Popat M 2002). He was listed for an Adenotonsillectomy under general anaesthesia and was brought to the anaesthetic room with his mother accompanied by a member of the Ward Staff. The Operating Department Practitioner (ODP) and I introduced ourselves and I explained that I was a Student ODP and if there were no objections, that I would be assisting with the care and preparation of the patient for theatre. This is in keeping with HCPC 2012 (pg 9-10).

There was a strong pungent of disinfectants and rubbing alcohol as she was rushed into the lobby. Crying out her last breath to express her agonizing pain as she lied down on the cold gurney. The nurses in a light blue uniform quickly arrived as several doctors in long white gowns rushed to the scene. Her mother was by her side, holding her hands as tight as she could, as the nurses pushed the agitating gurney towards the automatic doors. Soon her visions blurred and as the world turned into a tint of pink and red. As her vision slowly darkened, she solely relied on the touch of her mother’s warm hand and her soothing voice. Notwithstanding the tight grip of her mother’s hands, they was soon torn apart. Fear took over her body as she cried even louder. The sudden yet rhythmic beep was the last memory she could recall. It was March 5th.

During my first day at clinical placements, I was quite nervous. I performed slowly due to my anxiety and required assistance, from a health care aide, to fully complete morning care for the resident. After receiving my report to perform a bed bath for the resident, I began searching for the equipment required. I felt pressured locating supplies in an unfamiliar environment, especially under time constraints. After a time consuming process, of gathering supplies, a health care aide came in the room. She was displeased with how long I was taking mentioning that I needed to hurry, to allow the resident to be ready for breakfast at 8:00 A.M. She instructed me to watch, while she sped up the process. I apologized for taking long, explained how

Skin integrity is an important concept that’s nurses assess on their patients. A key skill in nursing practice is to frequently assess the skin for possible breakdown or decreased skin integrity. Skin assessments should be conducted thoroughly once a shift and frequently reassessed for any signs of change. Skin discrepancies may be the first sign of an underlying issue. Early detection of any breakdown can help to implement interventions sooner. Unfortunately, unless there is a major skin discrepancy, skin issues can easily get overlooked, specifically in documentation and report. The focus of this paper is to research new skin integrity assessments to improve documentation effect and accuracy, resulting in decreased prevalence of skin breakdown in hospitalized patients. Topics discussed include reviewing current practices and new skin assessment techniques that decrease the prevalence of skin breakdown and pressure ulcers.

The topic we focused in the class was about Inpatient Rehabilitation and Post Acute Care in the United States. The presentation was given by Susan Hartman and currently, she is working at HealthSouth Nittany Valley Rehabilitation Hospital, position of Chief Executive Officer . The lecture began with the topic of the continuum of care. I had experienced difficulty with this thought because I trusted that everybody should have to know all about acute care because it’s very vital to know in the HPA field. I didn't know whether I could regard it a privilege. I felt that access to health acute care status was significant, particularly because I also, from a place where health care is hard to find, as well as difficult to pay for services. During the lecture, I came to comprehend that without health acute care, few of us could legitimately appreciate the other fundamental rights. This presentation applies to me, when I was working at health clinic volunteer service in Bhutanese American Organization of Philadelphia.

My reflective clinical practice experience was based on my eight weeks placement in an acute mental health ward in a hospital. I was not sure of what to expect because I have never worked or placed in an acute ward and this was my second placement. Before starting my placement, I visited the ward and was inducted around the ward. This gave me a bit of confidence and reassurance about working in an acute ward.

Today I had a great day at the clinic. For the morning section, I had Omar Lora as my patient. Last time when he came, I collected all my assessment data. Today I updated his medical history, dental history, vitals, and EIOE, then I completed filling out the gingival assessment, the treatment plan, and the SAOP. Finally, I was ready to have my assessment data checked. It went really well, and I learned ways to helped me be more efficient with my time management, for example, I did not know how to have my radiographs up in the other monitor while I was doing my assessments. It was a little time consuming having to open and minimized the window every time I needed to look at the radiographs. Also, I discovered that having a piece of paper out and taking

The Royal College of Nursing defines reflection as the process of thinking deeply with the purpose of understanding (RCN 2013). Reflection is a way people recollect, think and evaluate their knowledge which is a vital part of learning. (Boud et al cited in Royal College of Nursing). Reflection allows us to be conscious of any form of discrimination. It enables learning from mistakes and prevents future occurrence (RCN 2013). In addition, Jasper et al (2013) looks at reflection as a way professionals learn through various experiences in their role. They also went further to say, for development to happen in our roles as professionals, there is the need for continuous process of building our knowledge.