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Case Scenario

Identify a situation when you had to be assertive in clinical practice and critically reflective upon this experience. You have to apply a reflective model to aid the critical reflection, we recommend Rolfe et al (2001), but whichever one you choose, remember that it is a framework  nly.
 

A massive road accident had take place in Lakewood Boulevard between two buses which is very near to our nursing home. As a result our Nursing Home campus was fully jammed by the ambulances and there was a pathetic scene where so many injured people were present. I immediately went to the changing room and soon appeared for my duty.

As the number of beds of emergency unit of our nursing home is not sufficient to admit all the patients who had heavily injured in the road accident. It soon became very much difficult to combat this situation as the patients were crying and the relatives of the injured patients become uncontrollable as they want to see their relatives ok. So here I just want to discuss the importance of being assertive in nature to combat this horrible situation.

The situation is not under our control and it became bad to worse as the injured people were coming continuously by ambulance and there were so many number of patient’s relatives there to check there loved ones are ok or not(Rolfe et al. 2001).

So what is my role in this situation is that, I went to the patient’s relatives who were present there and try to talk to them and try to make their calm as they are very much shouting and were aggressive in nature (Berman & Snyder, 2012).  I tried to convince them to gather in a place where we hang the admitted patient’s name and also about their present condition (Dinh, et al 2012). I had also told them that the nursing home authority will immediately supply more beds to admit more patients who were badly injured in the accident.

On the other hand my duty was to inform the nursing home authority about the actual scenario of the incident and the present condition of the nursing home. So that they could attempt any prompt action. I had told the authority about the emergency and they had soon take the action to supply more beds as per requirements.

When I told the relatives and the health workers about the news, they felt somewhat relaxed. But the nursing home authority was not able to fulfil patient’s requirement on time i.e. it takes a lot of time for supplying the emergency beds. So I, as a responsible nursing student suggested our head to suggest the authority to at least call the neighbour nursing home to send their emergency stuffs and doctors, to get rid of this emergency condition (Rolfe et al. 2001).

Framework Model

So I felt very much pressure for this condition and I could see the health workers became very much angry on them as they were continuously shouting and became very much restless. Even I also felt anger on them. But for me the most important thing was then, the patients, who were severely injured by the accident. As a nurse my first duty is towards my patients, and as I have been taught that I have always to be assertive in my working area (Dugan, 2012) I had not to be passive or aggressive in this freaking condition as this is my duty.

Actually I have been taught that I have to be decisive in this type of emergencies.

Here’s what I had meant to be assertive –

I gave my opinion for the situation to the health workers working there and to the relatives present there.

I ask for what they want or need.

I also listened others opinion too.

If I don’t want their decisions I disagree it respectfully.

I offered my ideas to the working team.

I said no without feeling guilty to them.

Management actually was not able to give their best as they did not have the emergency supply and it also took a lot of time.

The authority on the basis of my suggestion called the neighbour nursing home for their emergency stuffs and doctors and all kind of medicines. And they had appeared to our nursing home as soon as possible and helped us to overcome this freaking condition.

 So tasks were distributed on individual basis (Perry, Potter & Elkin, 2012).

I with some other nurse started to first aid the patients who were mildly injured.

Persons who did not show any pulses, CPR (Cardio Pulmonary Resuscitation) and EAR (External Air Resuscitation) had been done on them (Failner, 2011).

Persons who can’t breathe making them to breathe by clearing their airway (Gooding & Furlong, 2002).

The other health workers help the severely injured patients to be admitted to the OT (Helmstadter & Godden, 2011).

In the OT, there were also some nurses to help the doctors (Karch, 2010).

At last but not the least some health workers were able to make the patient’s name list along with their present condition. And soon there was a list of patients who were admitted to the nursing home. Thank God the relatives of patients became calm as soon as they have found their patients name in the list and under the good condition.

So What?

Healthy and mutual satisfaction of needs in any relationship (that can be between doctors and patients) can only occur between assertive peoples. Assertiveness is an excellent skill for both managing relationships with others and managing relationship with yourself. So here I come, if I had not keep assertiveness at that moment when every relative of patients become restless and uncontrollable and behaving very rude then everything would be unmanageable and going to mess all the thing. But being calm, positive, assertive, confident, decisive, and determined I and my partners, means my co-workers ( everybody including other staff nurse, ward boy, doctors, student nurses and the stuffs of neighbouring nursing home) we came to our success and beat all the difficulties and problems arouses then.

Ultimately our group of health worker achieved a successful result. Actually no patients were dead as all health workers cooperate with each other and made it fruitful.

A special mention about to be assertive in nature, as it helps us to understand about the actual need of the condition and how to overcome it. If we did not calm us down then this went to be very worse condition to handle.

The nursing home authority apologized to the relatives and made sure them that would never happen as they would soon acquire more emergency beds in their nursing home. As a nurse I felt happy as no patients were dead. And as a human being I have learnt that to be assertive everyone should understand that everyone has a basic requirements and rights and everybody should respect that. Responding passively or aggressively can actually ignore such requirements. More particularly when behaving aggressively the rights are actually abused. On the other hand when it comes to the culture and different human it may vary, as it vary from person to person and culture to culture. Being assertive does not mean that I will get everything in life, which I want to get but assertive people allows other people to wish what they want in life. As in this case I tried to help the patient’s relatives as well as fulfil my duty as a nurse, and make patients felt relief.

But for future perspective and for improvement in future we need special trained health workers with assertive nature to combat this type of situation (Dinh et al, 2012). For a general nursing student it is really very tough to manage all this pressure. But being an assertive natured and trained nurse who has knowledge about this type of situation and how to overcome it and also for assertive nature can actually manage the situation. What I’ve learnt from this situation is that I’ve to be assertive in any freaking condition. Which can actually help me to overcome the situation. If I or the other health workers could not be assertive then we actually could not overcame the situation. But working together and having faith on each other and being assertive in nature we actually won this horrible condition.

Now What?

I had learned from this incident about the time management in this horrible condition when not only patients but also their relatives become your concern. And actually learned a very good lesson in life, that even in real life we face this type of situation where we lose our temper under some freaking condition which actually make us unhappy, angry, out of control, and even we can’t get the solution of our problem (Powers and Knapp, 2012). Being not assertive in nature, people can undergo depression and as we all know that depression can actually make us lose our confidence and self worth (Lindsay, 2002). People not being assertive can actually become very irritable on people around them. So this incident had taught me that if we can be assertive in nature we can actually combat any typical situation in our life.

Reference List

Bergs, J., & Gillet, J. (2012). Comment on aœ Under-triage as a Significant Factor Affecting Transfer Time between the Emergency Department and the Intensive Care Unitâ€Ã‚. Journal Of Emergency Nursing, 38(4), 320-321. doi:10.1016/j.jen.2011.09.022

Berman, A., & Snyder, S. (2012). Skills in clinical nursing. Upper Saddle River, N.J.: Pearson.

Dinh, M., Walker, A., Parameswaran, A., & Enright, N. (2012). Evaluating the quality of care delivered by an emergency department fast track unit with both nurse practitioners and doctors. Australasian Emergency Nursing Journal, 15(4), 188-194. doi:10.1016/j.aenj.2012.09.001

Dugan, D. (2012). Nursing assisting : a foundation in caregiving. Albuquerque, NM: Hartman Pub. Inc.

Failner, B. (2011). Nursing 2011 and Beyond. Orthopaedic Nursing, 30(1), 1-2. doi:10.1097/nor.0b013e31820b9e37

Gooding, M., & Furlong, W. (2002). Artists, land, nature. New York: Harry N. Abrams.

Helmstadter, C., & Godden, J. (2011). Nursing before Nightingale, 1815-1899. Farnham, Surrey, England: Ashgate Pub.

Karch, A. (2010). 2011 Lippincott's nursing drug guide. Philadelphia, Pa.: Lippincott Williams & Wilkins.

Lindsay, C. (2002). Being assertive. BMJ, 324(7331), 27S-27. doi:10.1136/bmj.324.7331.27s

Mason, T., & Mason-Whitehead, E. (2003). Thinking nursing. Maidenhead: Open University Press.

Mathesius, U., Keijzers, G., Natera, S. H., Weinman, J. J., Djordjevic, M. A., & Rolfe, B. G. (2001). Establishment of a root proteome reference map for the model legume Medicago truncatula using the expressed sequence tag database for peptide mass fingerprinting. Proteomics, 1(11), 1424-1440

Perry, A., Potter, P., & Elkin, M. (2012). Nursing interventions & clinical skills. St. Louis, Mo.: Mosby.

Powers, B., & Knapp, T. (2011). Dictionary of nursing theory and research. New York: Springer Pub. Co.

Sorrentino, S., & Remmert, L. (2012). Mosby's textbook for nursing assistants. St. Louis, Mo.: Elsevier/Mosby.

Vincent, J. (2012). Annual update in intensive care and emergency medicine 2012. Berlin: Springer.

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