Guided Reflection of a video “Receiving a patient to the ward from PACU”
Order Instructions:
C. Guided Reflection of a video “Receiving a patient to the ward from PACU”
Video link: http://webconf.acu.edu.au/assess3
Due Date: Week 8 (5pm on 8th May 2015).
This assessment is Pass/Fail. Students must submit by uploading your reflection to your Professional Portfolio to pass this unit. See “how to upload” ‘How to copy an ePortfolio” in Mahara (LEO). See marking rubic in Unit Outline.
Length and/or format: 1,000 words (+/- 10%)
Assessment Task:
Identify and discuss the assessments and nursing interventions when caring for a patient who has just returned from the Post Anaesthetic Care Unit (PACU) with a PCA and an abdominal wound.
After watching the video, reflect on the nursing care given to the patient in the video. When writing the guided reflection, consider the following questions:
1. Identify the assessments performed. Were these assessments adequately prioritised?
2. How effective was the communication between the two nurses? Did it promote teamwork?
3. How effective was the communication between the nurses and the patient?
4. Identify the post -op orders. Were all of these discussed?
5. Based on literature, are there any recommendations to improve for future practice?
SAMPLE ANSWER
Guided Reflection of the video “Receiving a patient to the ward from PACU”
Introduction
Nurses have a duty to ensure that patients receive quality care to enhance their recovery. Patients have to understand assessment procedures and interventions as they provide care to patients that have come from post anesthesia care unit (PACU) with abdominal pain and PCA. This paper is a reflection on the role and behaviors of nurses that receive patient in the ward from PACU behave. It as well deliberates on various aspects relating to communication and post op orders among others.
In this video, nurses in charge of the patient performed various assessments to ensure that the patient was in a stable condition. On arrival in the PACU the nurse re-evaluated the patient and provided a verbal report to the nurse in charge. The nurses recorded the vital signs and blood oxygenation saturation every after a duration of time. They also assessed the blood pressure, pulse rate and respiratory rate of the patient. They as well measured the patient temperature. The nurses as well monitored on various aspects such as pain, central venous pressure and intracranial pressure. The nurse as well checked whether the patient was breathing normally. The nurses checked the blood pressure of the patient using a blood pressure cuff to ensure the she was in a stable condition. They also placed a warm blanket around the body of the patient to enhance warmth. They also checked and assessed the condition of the bandages on the areas of the body that had injuries such as the legs and the abdominal to ensure that they were in better condition. They also ensured that the patient controlled analgesia (PCA) used for pain control was functioning well. The patient uses the PCA to self-dose pain-relieving medication by pushing a bottom. The PCA is computerized to provide small pain dosage. The assessments conducted on the patients were prioritized to ensure that the patient recover well.
These assessments were adequately prioritized because the nurse in charge complied with the requirements on how patients from PACU should be treated. The nurses had assembled and correctly completed documentation to provide insights on the progress of the patient. There were a lengthy discussions and directives between the two nurses. The other nurse from PACU on the status of the patient briefed the receiving nurse and kept on directing and assisting the ward nurses on the procedures. The handover was therefore done well hence contributing to proper assessments by the receiving nurse.
Communication is one of the most important aspects when providing care to patients. Through communication, people get to understand one another and help to create a conducive environment to work as a team. The communication between the nurses was effective as they worked together as a team. They were audible in their conversation and allowed each one to speak before one could interrupt. This therefore enhanced their level of communication. They also listened keenly to one another and followed directives as given. They also maintained good eye contact and used gestures sparingly to bolster their communication something that made them to move on the save level. Communication promoted teamwork since they understood their role in providing care to the patients and this minimized conflicts but instead helped them to provide quality services to the patient (Reynolds, 2010). The receiving nurse in the conversation asked various orders about the patient receiving care. One of them is how the patient is feeling, what medication should be given, the period to give meals, and how to carryout assessment of the chest and the bandaged leg.
Communication between a nurse and patient is also very important in promoting understanding and delivery of care. In this video, the communication between the nurses and the patient was effective. The nurses already had established a conducive environment that made the patient feel at home. The tone of voice, facial persons and body gestures of the nurses helped to create siren environment for negotiation (Milby, Bohmer, Gerbershagen, Joppich & Wappler, 2014). Even though communication between the nurses and the patient was sparingly, it was successful. The patient responded to the queries the nurses asked which helped to gain an in depth understanding about how she was feeling. She also was able to receive advice that the nurses gave to her as she laid on her bed.
This interaction between the nurses themselves and the nurses and the patients is supported by Virginia Henderson Needs theory. The theory has three major assumptions that pertain to nursing; nurses have a duty to provide care to patient until the patient is able to care for themselves (Risjord, 2014). Nurses should always be willing to serve; should therefore devote to their patients every time and nurses should have a certain level of education such as bachelor’s degree in science and art to serve as a nurse (Im, &Ju Chang, 2012). The nurses in the movies showed their devotion and dedication in providing their support to ensure that a patient recovers. Their assessments and interventions is a clear indication of their readiness to help patients to recover. Furthermore, the nurses through their interactions and intervention, it is evident that they have requisite skills and experience to offer the services they provided.
There are a number of post-operative orders that manifest in the video as the nurse provided care to the patient. The patient had vital signs that indicated that she had been through PACU. She was lying on the bed and had bandages covered on the areas with wounds such as the chest and the leg. She also had PCA to control her pain. The nurses as well had a file containing laboratory investigations about the patient condition and status. The nurses discussed about these issues and how they should be controlled and checked. The nurses as well provided advice on the period the patient was supposed to wait before being given a meal.
Based on the available literature, one recommendation that require improvement for future practice is ensuring that the patient is under continuous surveillance and care. Nurses should provide all sorts of care including psychological care to enhance recovery of the patient (Phillips, Street, Kent & Cadeddu, 2014). The focus should not be on the physical care as sometimes patients are mentally affected and are therefore affected when they are discharged. This will go greater miles in ensuring quick recovery of the patient. It is also important to uphold to ethical standards at all time when rendering health care to patients. Nurses should be respectful and be honest.
References
Im, E., & Ju Chang, S. (2012). Current Trends in Nursing Theories. Journal of Nursing Scholarship, 44(2),156-164.
Milby, A., Bohmer, A., Gerbershagen, M., Joppich, R., &Wappler, F. (2014).Quality of post– operative patient handover in the post–anaesthesia care unit: a prospective analysis. Acta Anaesthesiologica Scandinavica, 58(2), 192-197.
Phillips, N., Street, M., Kent, B., & Cadeddu, M. (2014).Determining criteria to assess patient readiness for discharge from post-anaesthetic care: an international Delphi study. Journal of Clinical Nursing, 23(23/24), 3345-3355.
Reynolds, J. (2010). The nurse-patient relationship in the post-anaesthetic care unit. Nursing Standard, 24(15), 40-46.
Risjord, M. (2014). Nursing and human freedom. Nursing Philosophy, 15( 1), 35-45.
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