NRSG140 Integrating Nursing - Action Plan

The purpose of this assessment is to help prepare professional documentation for employment and other purposes and to build on reflective writing skills. 

The Registered Nurse Standards "thinks critically and analyse nursing practice" (Standard One) 
Assessment Task 2 requires you to develop a beginning professional portfolio using Mahara which will include the following: 

Part A : Certificate of completion National Standard Medication Chart (NSMC) Curose

(https:filearn.nps.org.auimodipageiview.php?id=4278) 

Part B: Reflection using Gibb's Reflection Cycle: 

Select one of the new skills accomplished during one of your practical classes in NRSG140.

Using Gibb's Cycle of Reflection as a structural framework, 

Answer

Integrating Nursing 

Description

Reflection is the act of narrating or thinking of what happened during a particular scenario that needs nursing intervention (Tolomeo, 2013). In this assignment, I will reflect on the skills of respiratory assessment that I learnt in the lab practical .I will use the Gibbs Model of reflection since it is a very convenient mode of reflection and it is also systematic. There was a case in which I came across a patient who was called Amanda. The patient was 53 years old. I established her past medical history that included appendectomy. I then went ahead to estimate the vitals and they were as follows: The body temperature was 37.9 Degree Celsius, the pulse rate was 94 and the Respiratory rate was 22.The blood pressure was 110/64 and the oxygen saturation was 93%.When I was obtaining the pulse rate, I was using one finger but the tutor interrupted and told me that I should use three fingers instead. There are other assessments that I conducted to the patient and they include auscultation, inspection, palpation of the chest and percussion. I made sure that I adhere to the nursing protocol or rather the clinical reasoning cycle during the respiratory assessment. During auscultation, I compared the left to the right, lateral and concluded by the anterior. I then conducted the nutritional assessment by determining the weight of the patient and her Body Mass Index by obtaining her weight and dividing by the square of her height in meters .I also made sure that I review her breathing sounds and patterns. From the assessment, it was clear that she was suffering from pneumonia and the established goal was to ensure that the symptoms of pneumonia subside. 

Feelings

At the beginning of the assessment, I was very anxious and curious. This is because this was not sure if the whole process would be successful. I was not sure if the objectives would be achieved. I was also not that confident enough since I have not done respiratory assessment before. With time however, I got confident and could perform the assessment very well. At the end of the process, I was very happy since the objectives had been achieved.

Evaluation

Everything in this scenario was positive. This is because I made sure that I adhere to the nursing protocol of respiratory assessment. I made sure that I collect all the vital signs accurately. The only negative aspect in the case was using one finger to obtain the pulse rate. However, the tutor intervened and made corrections on the spot. All the other colleagues that we were working with contributed positively during the assessment and this is the reason why the objectives were achieved. Am really looking forward to another case of respiratory assessment since I have amassed important skills that would really assist me in the future.

Analysis

There are different NMBA nursing standards in Australia that govern the operation of nurses. Standard 1 dictates that it is the role of the nurse to critically think and analyze any nursing problem before assessment (McGrath, Pyke, & Taenzer, 2016). In this scenario, I made sure that I analyze the important vitals that should be obtained from the patient. NMBA Standard 4 on the other hand states that it is the role of the nurse to conduct a comprehensive assessment (Douglas, Windsor, & Lewis, 2015). I therefore made sure that I adhere to the clinical reasoning cycle throughout the assessment. This is the reason why the vitals obtained were accurate. I have therefore managed to learn that it is essential to adhere to all the nursing protocol if nurses are to get accurate results. This is very important since a comprehensive assessment is the basis of nursing intervention (Birks, James, Chung, Cant, & Davis, 2014). I have learnt that evaluation is very important after the assessment as it provides feedback on whether the objectives were achieved or not (Spitzer, 2016). This is an area that I will focus on in the future.

Conclusion

In this case, there are things that I feel I should have done in a different way. This includes the nutritional assessment. The nutritional assessment should be the initial assessment yet I did it at the end of the session. Despite the deviation to the normal protocol, the objectives of the assessment were achieved. However, I have learnt that it is important to adhere to the established nursing protocol.

Action Plan

The skills of respiratory assessment that I have obtained in the practice will be of great importance in future. There are things that I need to improve on in future. I will think critically and analyze the patient situation even before I begin the assessment (Considine & Currey, 2014). This will assist in gauging on what particular aspects I should focus on during the assessment. I will also ensure that I evaluate the outcomes through reassessing of the vital sign survey more so the oxygen saturation levels.

References

Birks, M., James, A., Chung, C., Cant, R., & Davis, J. (2014). The teaching of physical assessment skills in pre-registration nursing programmes in Australia: Issues for nursing education. Collegian, 21(3), 245-253. doi:10.1016/j.colegn.2013.05.001

Considine, J., & Currey, J. (2014). Ensuring a proactive, evidence-based, patient safety approach to patient assessment. Journal of Clinical Nursing, 24(1-2), 300-307. doi:10.1111/jocn.12641

Douglas, C., Windsor, C., & Lewis, P. (2015). Too much knowledge for a nurse? Use of physical assessment by final-semester nursing students. Nursing & Health Sciences, 17(4), 492-499. doi:10.1111/nhs.12223

McGrath, S. P., Pyke, J., & Taenzer, A. H. (2016). Assessment of continuous acoustic respiratory rate monitoring as an addition to a pulse oximetry-based patient surveillance system. Journal of Clinical Monitoring and Computing, 31(3), 561-569. doi:10.1007/s10877-016-9884-y

Spitzer, A. R. (2016). Data Collection and Assessment of Respiratory Outcomes. Manual of Neonatal Respiratory Care, 769-775. doi:10.1007/978-3-319-39839-6_97

Tolomeo, C. (2013). Pediatric Respiratory Health History and Physical Assessment. Nursing Care in Pediatric Respiratory Disease, 38-50. doi:10.1002/9781118785805.ch2