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  • Essay / Clinical Issues Reflection Journal

    Table of ContentsIntroductionInadequate nurse-patient ratioMisunderstanding of a patient's symptomsA problematic telephone counselingConclusionReferencesIntroductionNursing is a multifaceted field of work in which nurses face many difficult problems at the during their clinical experience. Reflective practice is one of the main tools available to an experienced nurse that can be used as a powerful weapon against these multiple clinical problems. Reflective practice helps a nurse learn from their experiences through careful assessment and analysis of incidents so that they can better handle a new, similar situation. This writing addresses 3 clinical issues using Gibb's model of reflective writing: inadequate staffing, misunderstanding of patient symptoms, and problems associated with telephone counseling, supported by appropriate journal articles. Say no to plagiarism. Get a tailor-made essay on “Why Violent Video Games Should Not Be Banned”? Get the original essayInadequate Nurse-Patient Ratio Staff shortage is one of the major problems facing many hospitals in India, especially government hospitals. Being an experienced nurse in India, I have faced the issues related to this many times. The following is one such problem. About five years ago, when I was newly appointed as a nurse in a public hospital, I was forced to care for 40 patients alone due to staff shortage. I thought that if I fail to complete my routine work faster, I will not be able to receive new admissions. Immediately after handing him over, I began checking vitals starting with bed #1. I was in a hurry to finish my work because there was no one else to help me. When I approached the last patient on the ward, I noticed that he looked irritable and confused. Additionally, he was sweating profusely. When I asked him about his feelings, he told me he had been experiencing uncomfortable feelings for a few hours. As it was not an easy task to remember the history of all 40 patients, it took me 5 minutes to check his file. He was a diabetic patient who received his first dose of insulin that day. When I checked his blood sugar, it was too low. Immediate action was taken to reverse the hypoglycemia. During this incident, I felt multiple feelings in my mind. I felt guilty for not finding the time to speak with my patients to understand their concerns. At the same time, I was confident that I could manage this patient without causing additional complications. Hypoglycemia was easy to manage compared to other problems that can occur in older adults. Maybe he fell out of bed. The risk of fall-related injuries is higher in older adults due to hypoglycemia. As I evaluated my actions during the incident, 2 questions came to mind. If I had missed his symptoms, what could have happened? What could have pushed me to do it? The answer is lack of care due to a lack of nurse-patient ratio. Missed care is an indicator of an inadequate nurse-to-patient ratio. It wasn't a good idea to take on too many patients at once. The majority of nursing errors are due to increased workload on nurses beyond their capabilities. An interruption during work can accelerate this phenomenon. Medication errors and decreased patient satisfaction are some of the common effects oflack of staff. An inadequate nurse-to-patient ratio can put a patient's life at risk. By analyzing all the events, I was a good observer and could discover the signs of hypoglycemia. At the same time, it was my responsibility to keep an eye on this patient who was receiving his first dose of insulin. I could have given priority to elderly patients. I learned many things from this incident, including the importance of observing the after-effects of insulin and the need to prioritize. In light of this incident, I have developed some action plans for the future as a reflective practice. First, don't take on too many responsibilities at once. But this is not possible in all circumstances. Second, one must always establish priorities before beginning to care for a patient. Third, to find time to interact with patients, I used vital signs to check the time. Finally, offering a helping hand to my colleagues during busy shifts. These steps were very helpful to me when I faced similar situations.Misunderstanding of a patient's symptomsAbout 9 years ago, during my internship program in India, I was posted in the ward. observation and I took care of 3 patients. The 3 patients arrived almost at the same time. One complained of general weakness and sore throat, the second of shortness of breath and the third of vomiting. When I checked the first patient's vital signs, everything was normal. There was an order for IV fluids with a multivitamin. He said his throat pain was getting worse. Panadol was administered for pain and IV fluids were started. Compared to the other patients, I felt that the second patient was in need. There was a lot to be done for this patient. After completing all his treatment orders, I approached the third patient. At this point, the first patient complained of throat pain again and said it extended to his neck. Thinking Panadol had been given to him for the pain, I told him it would get better and approached the third patient. After completing all the work, I approached the first patient. As he was very irritable, I called the doctor on duty. He ordered an ECG. Thinking what is the role of ECG in this patient, I took his ECG. The report was quite shocking to me as it indicated signs of myocardial infarction. I immediately transferred this patient to intensive care. At that time I was thinking about throat pain which turned into an MI. Later, I learned that pharyngeal pain is one of the rare symptoms of AWMI, which is difficult to diagnose. I felt sorry for not giving importance to his complaint. Additionally, I was confident that I could quickly transfer this patient to the ICU without losing any golden hours. In assessing my actions during the incident, it was my failure to misunderstand the throat pain as a symptom of viral infection. I didn't recognize the signs of MI even after he said his pain radiated up to his neck. If I had not informed the doctor about his condition in time, it could have turned into medical negligence. “A nurse's accuracy in assessing, monitoring and providing a timely report to a physician can often mean the difference between life and death.” By analyzing this incident, I learned that it is always important to pay attention to a patient's complaint. I also learned that sore throats could be a symptom of MI. as part of learning from this experience, I will ensure that all patient complaints are addressed meaningfully, even if minor, so