Description
During the second year of my placement, I was asked to assist a sixty year old gentleman who had undergone surgery in the surgical ward. Under the supervision of my mentor, I was asked to remove the wound dressing of the patient so that it would be easy for the doctor to assess his wound. Using a non-touch procedure, I removed the wound dressing and cleaned the wound as directed by my mentor. As my mentor was asked to attend another patient, so she requested me to stay with the patient until the doctor come to see him. The doctor was busy examining another patient’s wound. I noticed that the doctor came straight to the sixty year old gentleman and started examining his wound without using alcohol gel or hand washing. I noticed that the long sleeves of the doctor’s shirt might be contaminated that would have cause infection. By the time, I would gather some courage to tell something, it was already late and the doctor has started examining the patient’s wound.
Feelings
I was highly alarmed by the incident as I did not expect that the doctor would examine the gentleman without using alcohol or washing his hands. I felt intimidated as I thought that being a doctor, he was more experienced than me and I did not want him to get embarrassed. Moreover, I did not want the gentleman to get concerned by my confrontation. I was scared about the gentleman’s wound as it might get infected due to contamination from the previous wound that the doctor was examining before attending him. Later, I conveyed the whole incident to my mentor and she decided to talk to the doctor about it. The doctor was asked whether he had washed his hands before examining the gentleman by my mentor. He was shocked and said that as he was busy, he had forgotten about washing hands or spraying alcohol. He discussed the importance of infection prevention and maintenance of clean, hygienic clinical environment with the doctor. He assured my mentor that he would wash his hands before examining any patient after this incident.
Evaluation
The incident was challenging as well as regretting for me. I regretted that I should have acted before the doctor examined the gentleman. However, the doctor responded positively towards the feedback and that pleased me. I observed that the doctor has now changed after the incident took place and was careful regarding hygiene. I learnt that good hand hygiene and using of personal protective equipment (PPE) helps to achieve and maintain a clean clinical environment (Howatson-Jones 2016). The infection can be prevented or controlled by practicing good hygiene practices. It also reduces the prevalence of healthcare associated infection and in the management of infection borne accidents (Zone and Guide 2017). This incident also taught me that it is important to act assertively with the colleagues in order to achieve a hygienic environment for the patient’s well being.
Analysis
The Royal College of Nursing states that good hand hygiene is the most crucial factor that reduces the cross-infection and in the prevention of infection (Berry 2014). It also points out that it is important for the healthcare professionals to decontaminate their hands before examining any patient. It is also important to maintain a hygienic, clinical environment in order to minimize the risk for infection due to cross-contamination. The infections are possibly transmitted by the staffs’ uniform and precautions are required to reduce the cross-contamination. Under the Code of Professional Conduct of Nursing and Midwifery Council, nurses have a duty to identify and minimize the infection risk in patients (LeMone et al. 2015). As the gentleman was under my mentor’s supervision, this applies in my own practice also. There is requirement of good communication among the healthcare professionals in a team along with patients and family members. The maintenance of universal precautions for standard infection control is the way to safe practice that intends to protect the staffs and patients from the micro-organisms that cause infection (Baillie 2014). The maintenance of hand hygiene, use of personal protective equipments along with alcohol hand rubs are the most convenient and effective way to support clean clinical environment. The safe handling of disposables and sharps, clinical waste allows the nurses and healthcare professionals to prevent and control the spread of infection.
Conclusion
I concluded that had I acted sooner, I would have been able to ensure that the doctor had washed his hands before examining the gentleman. I also concluded that this inaction had put the gentleman’s life at risk for infection. The discussion with my mentor was successful in developing the practice of good hand hygiene in the doctor who examined the gentleman. This incident also taught me that I need to develop the confidence in me that would help me to challenge the practice of my colleagues by putting the well being of my patients at the forefront. I also realized that I need to be empathetic and supportive towards my colleagues as they are under pressure that might interfere with their profession. However, their practice should not affect the clients’ well being and put them at risk. Nurses have a moral obligation to protect their patients by providing them a sustainable and protective environment (Parahoo 2014). Use of decontamination equipments with spillage management of blood and body fluids, use of PPE, management of indwelling devices helps to give better patient care and health outcomes (Butcher et al. 2013).
Action Plan
In the future, if I encounter this kind of situation, I will ensure that the patients’ well being is maintained. I will develop good communication and assertive skills with my colleagues and other healthcare professionals. I will try to develop confidence and voice my opinion in situations where the patient’s well being is at stake. I will enhance my knowledge about the principles of infection prevention and control that will help to minimize the infection risk and bring about better health outcomes in the patients. Moreover, I will try to develop good communication skills with my colleagues and clients that would help to allay the fears related to outbreak of infection risk and precautions that help to prevent transmission of infection (Rudd 2013).
References
Baillie, L., 2014. Developing practical nursing skills. CRC Press.
Berry, L., 2014. NICE standard tackles high rate of patient infection under NHS care: Handwashing and appropriate antibiotic prescribing among quality measures to improve safety, writes Lisa Berry. Cancer Nursing Practice, 13(4), pp.9-9.
Butcher, H.K., Bulechek, G.M., Dochterman, J.M.M. and Wagner, C., 2013. Nursing interventions classification (NIC). Elsevier Health Sciences.
Howatson-Jones, L., 2016. Reflective practice in nursing. Learning Matters.
LeMone, P., Burke, K., Dwyer, T., Levett-Jones, T., Moxham, L. and Reid-Searl, K., 2015. Medical-surgical nursing. Pearson Higher Education AU.
Parahoo, K., 2014. Nursing research: principles, process and issues. Palgrave Macmillan.
Rudd, P., 2013. Starting out-Even a first-year student can make a positive difference to patient care: Student experiences in the real world of nursing. Nursing Standard, 27(21), pp.26-26.
Zone, C.P.D. and Guide, S., 2017. Infection prevention and control in primary care. Sign, 3531(934).
