Reflect on my 3rd placement in Royal Brisbane and Women’s Hospital located in Herston, Brisbane.
I do reflect on my 3rd placement in Royal Brisbane and Women’s Hospital located in Herston, Brisbane. It was a one-month placement and I was allocated two weeks in post-anesthesia care unit and rest two weeks in operation theatre. I have utilized Gibbs’ (1988) Reflective Framework as a guideline of my reflection. This reflection focuses on what I learnt in the theatre including planning, proper documentation, checklists, and interprofessional collaboration.
During one of the surgeries that I participated in, we lost track of two surgical sponges. The incident was stressful since we were supposed to be recording and keeping track of everything. The surgery went for whole day and when we were doing using the 3rd surgical sponge when were realized that we could not account for the two used surgical sponges. We searched for it for a while and at last we found it on a bin in which the surgeon threw it mistakenly since it was supposed to be thrown into another bin.
During my one-month placement period I felt that I failed in properly check what the surgeon was doing keenly and inform him that he had placed used surgical sponges in a wrong bin. Besides, I failed to properly position the biological waste bin strategically to where the surgeon could have easily reached. I feel that proper documentation, use of checklists, and effective interprofessional collaboration could have help prevented occurrence of similar incidence in the future.
Planning, proper documentation, use of checklists, and interprofessional collaboration contributes to delivery of safe and high-quality care. Planning in this case imply proper positioning of every item for easy reach of the surgeon. Documentation and use of checklist could have facilitated tracking whereabouts of unused and used equipment and materials. Standard 2 of the Registered Nurses Standards for Practice by The Nursing and Midwifery Board of Australia (NMBA) (2016) requires nurses to engage in professional and therapeutic relationships. I should have noted the incident and engage the surgeon to help him to place the used surgical sponges in the correct bin. According to Gibbs (1988) it is important to learn from the past so as to avoid occurrence of similar incidences in the future; thus, other nurse students can learn from my experience. Similarly, Code 10 of the Professional Conduct of Nurses, requires nurses to practice nursing in a reflective and ethical manner (NMBA, 2008). Besides, Standard 7 requires a Registered Nurse to evaluate outcomes; therefore, I do evaluate my learning experience and skills set acquired during my placement period (NMBA, 2016). In addition, my learning experience to pay keen attention to details is in accordance with the Code 1 of Professional Conduct of Nurses that requires a nurse to practice in a safe and competent manner (NMBA, 2008).
I do attribute occurrence of the incidence to failure of other members of the multidisciplinary team (I included) to play their role to help the surgeon. The surgeon was focused on the surgical process; thus, it is understandable why he placed the two used sponges in the wrong bin. According to Buljac-Samardic, Doekhie, and Wijngaarden (2020), teamwork is fundamental for provision of safe and high-quality care. Conversely, lack of teamwork is considered as the primary point of vulnerability for safety and quality of care (Buljac-Samardic et al., 2020). On the other hand, practices that I observed such as proper planning, documentation, and use of checklists are some of the measures used to improve the outcomes of invasive procedures (Hou et al., 2021).
My placement period was short but successful since I learnt of important practices and procedures that I can use henceforth to improve safety and quality of care. It includes promotion of interprofessional teamwork culture where team members can learn from each other. Besides, I have appreciated the importance of paying attention to details in areas such as planning, proper documentation and use of checklists.
Reflective practice in nursing using reflective models such as Gibbs (1988) reflective model can help novice clinicians to learn from others with the aim of prevention of similar incidences in the future. Some of the positive strategies that can help promote culture of safety include paying keen attention to details in areas such as planning for patient-centered care, proper documentation, and use of checklists. Besides, teamwork culture should be developed and embraced in any setting of healthcare provision so as to improve patient outcomes.
Buljac-Samardic, M., Doekhie, K. D., & Wijngaarden, J. D. H. (2020). Interventions to prove team effectiveness within health care: a systematic review of the past decade. Human Resources for Health, 18, Article number: 2. https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-019-0411-3
Gibbs, G. (1988). Learning by doing: A guide to teaching and learning methods. Further Education Unit.
Hou, Y., Di, X., Concepcion, C., Shen, X., & Shun, Y. (2021). Establishment and implementation of surgical safety check project for invasive procedures outside the operating room. International Journal of Nursing Sciences. https://www.sciencedirect.com/science/article/pii/S2352013221000247
The Nursing and Midwifery Board of Australia. (Aug 2008). Code of professional conduct for nurses in Australia. Author.
The Nursing and Midwifery Board of Australia. (June 1, 2016). Registered nurses standards for practice. Author.