QUESTION
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adventitious sounds
i need to write a reflection paper about my day at clinicals. i wrote a little something about my day. I need you to elaborate and add more for me.
This is the instruction and also enclosed and example
Section 1 – Critical Incident
Write up a critical incident from your clinical experience. A critical incident is a situation in which you are involved that requires you to make a decision about what kind of action to take to benefit the patient. It could be a conversation, an event, or an activity you observe. Be concise, but include details to “paint a picture” of the incident so your faculty will see the situation as you did. Remember this must be a specific incident, not a recording of your clinical activities.Section 2 – Respond
What did you think/feel when you recognized there was a critical situation/event? Describe in detail your feelings and thoughts.Section 3 – Analyze
List all the actions you considered taking and why you thought about that particular action. Then state which action you chose as the best action (critical decision you made) and why it was the best action to take. Describe what might have happened if you had chosen one of the other actions. Describe here what, if anything, you would change about what was done and why. If you would not change anything, explain why.Section 4 – Implications for the Future
How will this incident influence you in your own clinical practice next week/next year/the rest of your life? Are there any changes in your perceptions of yourself/others?
Messages
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| Subject | Nursing | Pages | 3 | Style | APA |
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Answer
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Journal 1: Adventitious Sounds
Critical Incident
It was on the second day of placement as a student nurse; I was assigned direct care to a male patient who had been admitted with Covid-19, but the condition had been resolved. He also suffered CVA, DM, had right AKA, and was a feeder but refused to eat. He was receiving TPNAT 70ML/HR continuous, PICC to RUA, CDI no inflammation or infiltration noted. While providing direct care (bathing, mouthcare, skincare), I could hear adventitious breathing sounds emanating from the patient. I knew there was a serious problem that needed to be urgently addressed but was not sure on what to do next, being a new student nurse. With or without adequate experience, I knew I was obliged to act immediately.
Respond
My little experience notwithstanding, I knew an assessment of the respiratory system was necessary. However, the thought of possibly being answerable for whatever action I took at that instant made me afraid. A part of me wanted me to relax, assuming that the nurse in-charge and the doctor were perhaps aware of the issue and as such had some action lined up or had already addressed it so there was no need to worry or do anything. Still, I thought ignoring the issue would later make me answerable for omission, yet it was my responsibility to monitor the patient and continuously assess him while viewing such assessment alongside his clinical history.
Analyze
Ignoring the adventitious breathing sounds and making assumptions such as that the doctor and nurse were probably aware of everything concerning the patient’s state would have me later blamed for omission. While I was a new nurse student, doing nothing about this critical incident would not only be unprofessional but also insensitive, reckless, and uncaring. I had to do something. After all, doing nothing would only increase the patient’s chances of getting from bad to worse, or from a stable condition to an unstable one. I decided performing an auscultation was better than doing nothing as it would help know what was probably wrong in the respiratory system. I auscultated both lungs and my assessment suggested crackles; the nurse arrived shortly afterwards, and I briefed her on the situation, suggesting to her that the patient could need a breathing tx. She conducted her own assessment and later, together with the doctor, confirmed that indeed the patient had crackles in the posterior lung at the base. The doctor attributed this to the patient being immobile in bed for too long. They both commended me for acting excellently despite my limited experience in the clinical practice setting.
Implications for the Future
This critical incident will continue to influence me even as I look forward to entering clinical practice in the future in the sense that I learnt the significance of critical thinking in such situations. Indeed, it is through critical thinking that I was able to analyze various possible action routes before finally settling on auscultation. It also helped boost my confidence as an aspiring practice nurse given the manner the nurse and the doctor commended me. It taught me the significance of communication amongst healthcare professional where the sharing of information especially on the patient helps inform action geared towards improving patient outcomes. Indeed, the communication among the nurse, the doctor, and myself as well as the united effort for patient’s sake reflected the kind of communication, cooperation, and collaboration required among healthcare professionals as they seek to deliver patient-centered care. This critical incident helped elucidate some of nursing’s core tenets.
References