Reflection on My Experience as a Nursing Student

The context of the medical situation took place in the hospital during my shift when an elderly patient was wheeled to his post-surgical room having undergone a surgery on his upper left quadrant. I was tasked to do an assessment for the patient after coming from the surgical room and conduct an abdominal assessment on him using the HIAPPACD during the practical examination.  The client happened to have two of his children milling around the post-surgical ward oblivious to the fact that their father had just undergone a long critical surgery to remove a malignant tumor in his abdomen. I took vital signs and admitted the patient to the post-surgical ward (Douglas et al., 2016). 

Feelings

            Initially, when I saw that the patient had regained his vital senses, I was a bit relived as I tend to get anxious handling comatose patients. I was panicked by the fact that the kids did not know the full extent of their father’s condition and were oblivious to the information that he had come through a successful surgery moments ago. I, therefore, hoped to share the information about his surgery with the children so that they could leave him for the moment and give him time for bed rest. I also figured that if I could let tell the children to leave then I would get ample time to conduct my examination using HIAPPACD (Douglas et al., 2016). I followed the procedures as required but later realized that I had forgotten to verify the patient’s credentials before assessing him, hence, I did not check his name tag and the date of birth, two critical things that were missing from my incomplete documentation (Osborne, Douglas, Reid, Jones, & Gardner, 2015). I also forgot to raise his bed to the expected height whilst I was assessing him to avoid straining my back.

Evaluation

            Having to attend to a surgical case was an exploratory and educative experience that made me realize that I needed to learn from my weaknesses and improve my ability to cope with anxiety. I also realized that my communication skills were not excellent as should be expected of me, partly due to the fact that I did not relay proper information to the children as they are still young and cannot cope with the impact of sudden disclosure of patient information (Estes, 2013). I also learnt that I need to be steadier, alert at all times and pay attention to detail so that I do not leave out important information during documentation. The positive side of my interaction with the patient was that I was able to administer HIAPPACD almost perfectly. Surgical patients require utmost care hence due diligence is encouraged. However, this is an area I failed as I did not raise the patient’s bed to the recommended height to avoid straining my back, a scenario that can amount to gross negligence.  

Analysis

            Post-surgical care is a critical component of patient management and should be taken seriously. Surgical patients are therefore very vulnerable to other risk factors such as developing bed sores or falling off their beds (Chou et al., 2016).  Critical assessment is therefore considered very important to the wellness of their client. In compliance with the nursing guidelines, abdominal assessment should be performed during routine admission to monitor the client’s status following trauma or treatment. In order for me to respond better in the future, I will need to inspect, auscultate, percuss and lightly palpate the abdomen to determine any kind of visible abnormalities (Estes, 2013). 

Conclusion

             I have learnt that the management of critical care patients must follow as the stipulations and guidelines of the HIAPPACD procedure. Patients must be informed about the examination procedure to enhance the cooperativeness during the exercise. The reflective process helps one take an introspective look at themselves and identify areas of weaknesses so that they addressed through continued practice. The entire learning process has created a platform for me to identify my strengths and overcome my anxiety in pressure situations.  

Action Plan

            The essence of action plans is to direct the course of change through the timely implementation of the desired inputs to get the right outcomes. The student should endeavor to be very keen and pay attention to detail going forward to ensure that they conduct complete documentation (Estes, 2013). The student should also strive to master the assessment procedures and also learn to deal with stressors that make me anxious when applying the HIAPPACD technique on patients.

References

Chou, R., Gordon, D. B., de Leon-Casasola, O. A., Rosenberg, J. M., Bickler, S., Brennan, T., ...            & Griffith, S. (2016). Management of Postoperative Pain: a clinical practice guideline       from the American pain society, the American Society of Regional Anesthesia and Pain            Medicine, and the American Society of Anesthesiologists’ committee on regional      anesthesia, executive committee, and administrative council. The Journal of Pain, 17(2), 131-157.

Douglas, C., Booker, C., Fox, R., Windsor, C., Osborne, S., & Gardner, G. (2016). Nursing           physical assessment for patient safety in general wards: reaching consensus on core       skills. Journal of clinical nursing, 25(13-14), 1890-1900.

Estes, M. E. Z. (2013). Health assessment and physical examination. Cengage Learning.

Osborne, S., Douglas, C., Reid, C., Jones, L., & Gardner, G. (2015). The primacy of vital signs–     acute care nurses’ and midwives’ use of physical assessment skills: a cross sectional             study. International Journal of Nursing Studies, 52(5), 951-962.