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Discuss About The Perception Of Safety In The Intensive Care Unit.

Critical Thinking in Analyzing Nursing Practice

The two AHPRA Registered Nurse Standard of Practice selected are Standard 1 and Standard 6 that Registered Nurses think critically and analyses nursing practice and provides safe, appropriate and responsive quality nursing practice (Birks, Davis, Smithson & Cant, 2016). There is more to being a nurse than just possessing good clinical skills. Being able to think critically helps Registered Nurses reach patient’s needs within their setting of unreliability considering options ensuing in greater health care standard, think meditatively not just receiving pronouncements and executing errands with no remarkable discernment along with assessment. Critical thinking insinuates that one possesses proficiency base from which to intellectualize together with the capability to scrutinize and assess proof. Registered Nurses should evolve the personality and comparative expertise that help them realize and comprehend the needs and concerns of their patients (Bucknall et al., 2016). This needs an accurate interpretation of patient’s information which is relevant to the particular patient and situation.


Registered Nurses think about the world and the content of nursing including theories, concepts, and ideas in nursing. To think critically, Registered Nurses need to be clear, fair, precise, accurate, logical and complete (Naber & Wyatt, 2014). For nurses to think about the care of patients, they have to get rid of illogical and irrelevant thinking. Critical thinking process involves spotting an issue, ascertaining the prime resolution along with selecting the best effectual technique. For instance, when a Registered Nurse inevitably experiences a situation in which there are several treatments or solutions and are tasked with determining the best potential result for the patient. In this case, they must swiftly and assuredly evaluate the situation and generate a prime decision in every distinctive situation. Therefore, to make the best choice in these situations, it requires critical thinking skills (Johansen & O'brien, 2016).

Critical thinking in analyzing nursing practice is a vital process for the safe, efficient and skillful nursing practice. Registered Nurses with critical thinking skills can monitor complex patient situations, prioritize workflows or tasks as new information emerges, remain calm, focused and functional under intense pressure and time constraints. Moreover, they can pick up on subtle changes in patient’s vitals, quickly change trajectory to address the most crucial requirements of a patient and evaluate lab results together with other incoming medical information. The standard is also essential because Registered Nurses can identify, document and accurately communicate relevant information to colleagues, physicians as well as other health care providers to deliver continuity of care (Clynch & Kellett, 2015). Also, they can maintain open and frequent communication with family members, patient, and coworkers.

My Undergraduate Nursing Clinical Experience

I encountered a complicated situation in a ward where my patient was admitted and had a right leg amputated above the knee. The patient was on a Dilaudid PCA but was still complaining of awful pain. He maxed it out every time saying that the pain was becoming so horrible and even when the doctor came and complaint the same he gave him oral opioids and wrote an order that I should give him oral and PCA dosing to reduce the pain.

Feelings:

I was moved by the patient’s struggles of pain by putting myself in his shoes when he continually requested more medications, and I asked him to describe the pain. The description was of a nerve pain that was burning profoundly and tingling, and I thought of the pain being similar to that of my patients with diabetics with neuropathy and remembered that they were taking gabapentin for pain every day. I then went to PA for the surgeon and asked them what they thought of trying gabapentin for his pain after describing my patient's type of pain, and they recommended my idea. They wrote an order for the medication and when the patient took it his pain significantly reduced and I felt relieved that he was no longer in pains.

Evaluation:

This encounter was positive since the pain subsided after taking gabapentin and I would prefer identifying the problem first in my next practice before administering any painkiller so that the condition does not become worse than before.

The experience is integrated with the standard since I was able to think critically and provide a solution that was successful which was not possible in my earlier practices. I was confident after the experience that I could offer assistance to patients after being aware of their problems.

I learnt that not any painkiller that could abate pain but the type of pain should be identified at first to take the correct precautions so that patients do not suffer too much. I identified some strength of empathy and compassion in me that I could feel my patient’s pain and not hesitate to relieve them.

My priorities for my future practice would be interprofessional collaboration which would help doctors and nurses to work together in delivering the highest quality care and also foster respect along with trust among them (Redmond, 2017).

Registered Nurses provide safe, appropriate and responsive quality nursing practice to their clients (Wassenaar, van den Boogaard, van der Hooft, Pickkers & Schoonhoven, 2015). In that case, they coordinate, distribute and utilize resources which are within their reach to appropriately and responsibly advance their nursing practice with the help of technology. This practice has been made possible by the advanced technology in which patients are monitored through wireless chips and sensors integrated into the blankets, mattress pads and into the beds to check and report back on the movement and blood pressure of the patient. Moreover, they acknowledge, intervene and say near misses or unfortunate incidences that can put the safety of their patient at peril (Archer et al., 2017). The role of Registered Nurses comprises of showing conduct that professionally upholds the public trust together with practicing reasonable judgment and seeking the correct assistance.

Analysis

This standard has been essential since it provides a general safe along with quality nursing practice so that the agreed target is met together with the result that is responsive to the nursing requirements of a person. Furthermore, it shows sensitivity, awareness, and responsiveness to diversity comprising of environmental, cultural and impact of the family’s community. It also assists families to identify the needs of a client considering their growth and development, health and wellness. In that case, they enable families to give responsive and sensitive parenting, developing parenting capacity and developing protective factors along with building resilience. Registered Nurses develop and deliver health care messages along with enhancing parenting groups to advance social networks, social support, and health literacy via the health literacy evaluations of family members (Wiener, Weaver, Bell & Sansom-Daly, 2015).

The standard has been vital in the sense that it involves multidisciplinary teams and community associates to build the social capital of the community together with sustaining and developing the health of the family. Registered Nurses explore and challenge the attitude and conduct of some of the client's family members that are not conducive to the health of the patient together with those that can be harmful. They contribute to safe and high-quality healthcare by monitoring the patient's health status, providing education and support to both the client and the family together with supervising other nursing teams (Carlsson, Carlsson, Prenkert & Svantesson, 2016). The public understands the role of nurses being an emotionally and physically demanding although they view the work as providing care as ordered and delivering emotional and physical comfort to patients and their families. All healthcare organizations monitor what their clients encounter so that they can be able to evaluate and improve the quality of care they deliver (Wang, Kung & Byrd, 2018).

One day we had an extra patient because there were few nurses and I happened to have a patient who was dying who had just come from the emergency ward and another patient had difficulties in breathing. I was trying to spend time with the one who was dying and also for the one with breathing problems together with their families. Suddenly, the patient with breathing problems started to be choky, anxious and I had to go and set the suction up and keep reassuring her. After doing some rounds I decided to go back to the dying patient when he requested for painkillers. I went to check with the medication nurse and in the medication room I found that the pharmacy had not completed the unit stocking and the medication nurse had to get the most needed medication in the pharmacy. I started preparing the pain medication and due to the many questions by the floating registered nurses it took time to get back to the patient where I found his family disappointed and requested to speak with the head nurse.

Importance of Standard 6

Feelings:

For not making my patients along with their families happy I felt that I had failed them and they would no longer have trust in me. Personally, I thought maybe I was not competence enough to deliver to patients the safe and quality care they deserve.

Evaluation:

 I had difficulties in satisfying my patients since I did not have enough time to spend with them and I would make sure that all medications are available anytime a patient is in need of them to avoid the same mistake in near future.

Analysis:

 My contribution to this encounter was negative and I was not confident in it because it was not helping a lot for I had to leave a patient in need to attend to another patient. I should have assessed my patients on arrival and identify the immediate action to be taken without delay.             

Conclusion:

I learnt that planning was vital in my practice to know what needs to be accomplished first to avoid the complications in my next practice. I was able to identify personal weakness of long-term planning in multitasking.

From my encounter, I would prioritize delivery of care in my future practice to improve in my practice.

References

Archer, S., Hull, L., Soukup, T., Mayer, E., Athanasiou, T., Sevdalis, N., & Darzi, A. (2017). Development of a theoretical framework of factors affecting patient safety incident reporting: a theoretical review of the literature. BMJ Open, 7(12), e017155.

Birks, M., Davis, J., Smithson, J., & Cant, R. (2016). Registered nurse scope of practice in Australia: an integrative review of the literature. Contemporary Nurse, 52(5), 522-543.

Bucknall, T. K., Forbes, H., Phillips, N. M., Hewitt, N. A., Cooper, S., Bogossian, F., & First2Act Investigators. (2016). An analysis of nursing students’ decision?making in teams during simulations of acute patient deterioration. Journal of advanced nursing, 72(10), 2482-2494.

Carlsson, E., Carlsson, A. A., Prenkert, M., & Svantesson, M. (2016). Ways of understanding being a healthcare professional in the role of a family member of a patient admitted to hospital. A phenomenographic study. International journal of nursing studies, 53, 50-60.

Clynch, N., & Kellett, J. (2015). Medical documentation: Part of the solution, or part of the problem? A narrative review of the literature on the time spent on and value of medical documentation. International journal of medical informatics, 84(4), 221-228.

Johansen, M. L., & O'brien, J. L. (2016, January). Decision making in nursing practice: a concept analysis. In Nursing Forum (Vol. 51, No. 1, pp. 40-48).

Naber, J., & Wyatt, T. H. (2014). The effect of reflective writing interventions on the critical thinking skills and dispositions of baccalaureate nursing students. Nurse Education Today, 34(1), 67-72.

Redmond, B. (2017). Reflection in action: Developing reflective practice in health and social services. Routledge.

Wang, Y., Kung, L., & Byrd, T. A. (2018). Big data analytics: Understanding its capabilities and potential benefits for healthcare organizations. Technological Forecasting and Social Change, 126, 3-13.

Wassenaar, A., van den Boogaard, M., van der Hooft, T., Pickkers, P., & Schoonhoven, L. (2015). ‘Providing good and comfortable care by building a bond of trust’: nurses views regarding their role in patients' perception of safety in the Intensive Care Unit. Journal of clinical nursing, 24(21-22), 3233-3244.

Wiener, L., Weaver, M. S., Bell, C. J., & Sansom-Daly, U. M. (2015). Threading the cloak: palliative care education for care providers of adolescents and young adults with cancer. Clinical oncology in adolescents and young adults, 5, 1.

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