Improved Discernment & Decision Making: My Rotations - Essay Sample

Introduction

The level of my critical thinking use of discernment and decision making has improved. Through the rotations, I have been able to interact with different types of patients made assessments of each one of them and determined the type of further care they would need. This has been facilitated most at the triage center where I got to meet the patients first before they saw the doctor, and at this point, I learned to distinguish emergency cases from non-emergency cases.

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I also had a chance to improve the basic nursing skills like taking down patient biodata, checking their blood pressure and pulse rate as well as noting down a brief medical history of the patients.

During the rotation, I also got to assist in performing various medical procedures, most notable one was intubating a non-responsive patient, and the procedure is quite invasive and requires a lot of expertise to be done correctly.

Name three things you might do differently if you encounter a similar situation again.

While assessing the patients at the triage section, I mostly relied on the patient's word on how they were feeling and this would be my basis for the next step to be taken. I would make an improvement on this by paying attention to the nonverbal communication from the patient, I would be keen on their body language to help me in the decision making process. While collecting the patient data I realized I took a lot of time and I would need to improve on my speed to ensure that the other patients are not kept waiting for too long.

I would also need to be keener on the procedures being performed on the patients, such as intravenous line granular insertion and catheter insertion.

The process of nurturing the patient back to health is no easy task. I realized that I needed to improve on my relatability to the patients. Much as there needs to be some friendliness with the patients, firm stands have to be taken when doing what is best for the patient. It is balancing between the two sides that I need to improve on to ensure the patient is back to good health yet still comfortable during their treatment period.

What additional knowledge, information, and skills do you need when encountering this kind of situation or a similar situation in the future?

I would definitely need more training and practice on the use of patient monitoring equipment and the interpretation of data from these, more so, in the intensive care unit where most of the time the patients are plugged into machines.

I would also need to have more practice on drug administration especially when giving injections intravenously.

Maintaining a sterile environment especially when performing invasive procedures also requires a lot of practice to perfect as we have to ensure that the health of the patient is not compromised further when performing the procedure.

A nurse not only has to deal with the patient, but also has encounters with the patient's relatives and friends. I would need to improve my skills in how I interact with the rest of the family, how to update them on the patient's progress and how to help them cope with the patient's current situation. For this, a lot of empathy, assertion, and discernment is required. These are skills that I still need to perfect.

I would also need to improve on my communication skills, both with the patients and with colleagues at the hospital. I realized that good communication led to a smooth running of the system and rendering quality care to the patients at hand, and so I would need to work on my speed and content of the information I need to deliver.

Describe any changes in your values or feelings as a result of this experience.

Throughout the process, my appreciation for the role of the nurse in the patient's recovery process was increased. I learned that the nurse is a vital link between the doctor and the patient. In as much as the doctor is responsible for making a diagnosis, performing certain procedures and prescribing medication, the nurse is also important to the patient as he or she is responsible for nurturing the patient back to health.

I also learned the value of forming both bonds and boundaries with the patients so that I am able to draw the patients out, get to know them and their needs, but without developing emotional attachments. I found that this made my service delivery better and made the whole experience more rewarding.

Identify and explain one key behavior that, through your experience within the clinical intensive, expanded or enhanced your nursing practice.

During my rotation in the Intensive Care Unit, There was a lot of teamwork among all the parties concerned with the care of the patient. Each health care practitioner ad a different role to play, contributing to the greater goal. I, however, realized that each individual's role was clearly defined and that there were set boundaries for each of the practitioners so that there was no overstepping on someone else's role. Important communication was clearly updated on the patient's charts and files so that any other relevant person could easily access it.

Above everything else, the patient's healthcare needs were a priority, every decision that was made in the unit was geared towards improving the condition of the patient. This well-outlined process I found beneficial in improving my interpersonal skills with colleagues, my communication skills both with the family and other practitioners, and I also got to fine-tune my skills on patient analysis and decision making on the procedures required by the patient.

Identify and explain one key behavior that you have identified on which you need to improve during your next clinical intensive.

Conditions in the Intensive Care Unit are not always stable, the patient's vital signs are at times fluctuating indicating a change in the body function and ailment process. I need to improve my skills in evaluating and adapting to these changes as they occur. This process would require that I build up my skills in reading the patient's monitors, the charts provided any of the laboratory reports. Adapting to the change also means that I get the whole team involved, and this means that I have to improve on my communication skills with the other practitioners involved. A proper analysis of the situation and decision making is key, this also I have to fine-tune to ensure that the patient gets the best care possible.