Lily was a 65 year old lady with stage 5 CKD, she had recently begun hemodialysis treatment three times a week as an inpatient and had been responding well to treatment. During dialysis treatment on the morning of the first day, Lily’s observations showed that she was: tachycardic, hypotensive, tachypnoeaic, had an oxygen saturation level of 88% and was becoming confused and drowsy. It became apparent that Lily had become hypovolaemic. The hypovolaemic shock seen in this patient was of a particular critical nature due to the fact that her dialysis treatment had moved her rapidly through the first two stages of shock with her compensatory mechanisms failing very quickly (Tait, 2012). It was also much harder to identify the early signs of …show more content…
Lily had only recently began dialysis treatment, and her unwillingness to proceed with treatment would have resulted in her care becoming palliative, something the healthcare professional did not think was suitable at this point in her illness trajectory. Tait (2012) points out that a critically ill patient experiences not only physiological trauma, but also psychological trauma. This psychological trauma that can be experienced after critical care has been addressed by the National Outreach Forum (2003) who suggested that services should be developed to address the implications of critical illness. Samuelson (2011) suggests that any negative emotions associated with critical care can be counterbalanced with memories that reinforce safety, control and trust. This is a useful point to consider in Lily case, who fortunately had the time to talk through her worries concerning continual dialysis treatment with the staff on the ward, who were able to convince her she was in the safest possible hands and that continuing her dialysis treatment would be the best option.
The psychosocial impact of this event and its repercussions surrounding Lily unwillingness to continue her dialysis treatment is a key aspect to consider when looking at involving Lily in the decision making process. The DOH document “No decision about me, without me” (2012)
Although most people think they can get away with picking an easy topic for their senior projects it turns out to be a little more complex than that. Growing up my ideas and passions would always seem to be changing but when I finally became set in my ways at least in knowing what I would like to pursue the Nursing Program was up to par. I chose to do mine on Nursing in the ED (emergency department) because this is a field I would love to go into so I can be of service to those in need of any medical care, to always have a stable job to rely on, and further more to be able to excel in the field of medicine. I would love to be one of the people on call to respond to the needs of another individual in their time of need. Anyone could only
The following essay is a reflective account on an event that I, a student nurse encountered whilst on my first clinical placement in my first year of study. The event took place in a nursing home. All names have been changed to protect the confidentiality of the patient (NMC, 2008).
In October 2005 the Quality and Safety Education for Nursing program was established. This program is funded by the Robert Wood Johnson Foundation. QSEN was developed specifically for future nurses to understand and be aware of key challenges such as the knowledge, skills, and attitudes that are essential to constantly advance the quality and safety of the way healthcare systems work. The goal for QSEN is to reshape the identity of nursing so it includes the recommendations by the Institute of Medicine so there is a commitment to the quality and safety proficiency (Dycus, 2009).
In this essay we are going to explore the connection between professional nursing practice and professional caring. I will outline the terms of professional nursing practice and what makes nursing a profession? I will describe the term of professional caring and the connection to the nursing practice and discuss the dilemma of care and cure. And also determine the importance of both in professional nursing practice.
The aim of this assignment is to critically discuss the nursing assessment individualised care and nursing interventions of the acutely ill patient. The patient discussed developed severe sepsis due to a urinary tract infection and her condition deteriorated during the recovery process in the nurse’s care. Lovick (2009) defines sepsis ‘as a known or suspected infection accompanied by evidence of two or more of the SIRS criteria’. SIRS is outlined as a ‘systemic inflammatory response’ consisting of two or more of the following symptoms ‘temperature >38 degrees Celsius or 90 beats per minute, respiratory rates greater than 20 breaths per minute and white blood count higher than 12,000 cells per microliter or lower than 4000 cells per
This essay will discuss a clinical skill in which I have become competent in practicing as a student nurse.
There are many interventions that can assist an ME sufferer in improving their occupational imbalance and regaining a sense of identity.
This piece of work will be based on the pre-assessment process that patients go through on arrival to an endoscopy unit in which I was placed in during my second year studying Adult diploma Nursing. I will explore one patient’s holistic needs, identifying the priorities of care that the patient requires; I will then highlight a particular priority and give a rational behind this. During an admission I completed under the supervision of my mentor I was pre-assessing a 37 year old lady who had arrived to the unit for an upper gastrointestinal endoscopy. During the pre-assessment it was important that a holistic assessment is performed as every patient is an individual with unique care needs as the patient outline in this piece of work has
1 Understand the requirements of legislation and agreed ways of working to protect the rights of individuals at the end of life.
I think the feedbacks that I have received were really useful and will certainly help me with my future personal and professional development. I feel that the given feedback has pointed out my weakness and that point that I need to work on for the future. It has motivated me to join in group deciosituon and to express my ideas. I feel much confidence when talking to others especially in group discussions. I understand that nursing is a profession that requires you to be more confidence with communication as you have to work with lots of different people from all sorts of different backgrounds and therefore, practicing these skills will become handy for the future.
This essay sets out to discuss the importance of comprehensive and accurate assessment on a registered nurses’ ability to make excellent clinical decisions. It will examine what factors can change a nurses’ capability to be aware of, and act on abnormal assessment findings. As well as assessment being part of the nursing process that is used in every day nursing, it is also a critical part of patient safety (Higgins, 2008). Assessment findings are used to determine what needs to be done for the patient next. Early warning scoring systems currently exist to aid in the early detection of patient deterioration (Goldhill, 2005). The rationale for the use of these systems is that early recognition of deterioration in the vital signs of a
The national league for nurses defines critical thinking in the nursing process as “a discipline specific, reflective reasoning process that guides a nurse in generating, implementing, and evaluating approaches for dealing with client care and professional concerns” (Kozier, 2008). This definition is imperative to help a nursing student learn how to think in terms of nursing care. Nursing students must achieve a comprehensive understanding of critical thinking in order to understand the nursing process. The purpose for this paper is for nursing students to learn how to use the nursing process, how to properly document their findings and assessments, and correctly implement APA formatting in a formal paper.
3.) Define each letter in SOAP and discuss where you would look to find the chief complaint. Why would you find it there? S in the SOAP note stands for “subjective”. This is when the patient comes into the office and will tell you how they are feeling and how long these symptoms are lasting. The O in the SOAP note stands for “objective”. This is the actual recordings of temperature, blood pressure, pulse are recorded. The “A” in a SOAP note stands for assessment. This is where the physician will give his diagnosis of the patient. The “P” in the SOAP note stands for plan. This is where the physician will give their plan of treatment of the patient, such as
“Advanced nursing practice is the deliberative diagnosis and treatment of a full range of human responses to actual or potential health problems.” (Calkin, 1984). Advanced nurse practitioners attempt to maximize the use of knowledge and skills and improve the delivery of nursing and health care services. The field of advanced nursing practice differs from basic practice as the former requires clinical specialization at the master’s level. At this level, nurses become expert practitioners whose work includes direct and indirect patient care. Direct patient care involves caring for patients and their families; this is the focus of my section on nurse clinicians. Indirect patient care includes work as an educator, researcher, and a
Nurses provide excellent patient care, teach patients about health conditions, and give advice and support to patients and their families. Nurses have a variety of duties. They must monitor and record patient symptoms, take vital signs, watch patients diet and physical activity, supervise less skilled nurses, and order and interpret tests to access the condition of the patient. Nursing can be a wonderful, caring, and thoughtful job. However, to other nurses: nursing can be a difficult, tiring, and stressful job. Any job can be tough but nursing is emotionally and physically draining on a person. Nursing can be such a burdensome and demanding job sometimes because of the long hours, the exam to become a nurse, and dealing with other people.