Impactful Nursing Practices

Introduction:

Effective and systematic nursing management is important for providing compassionate and holistic care to patients in terms of determining their health condition and managing their disease or health issues. This study is going to discuss the nursing management process across the care setting of the patient in the given case study. In this section, the study will discuss how nurses can carry out the ABCDE assessment of the patients in the case study by following all the core principles of nursing. Then the study will demonstrate how effective communication would be maintained in the care setting of the patient and how the diagnostic tests are performed systematically to assess the current health condition of the patient. Then this study will discuss how the emergency and elective surgery will pose psychological and physical impact on the patient mentioned in the given case study throughout his journey from the GP surgery unit to the emergency unit. Finally, the study will draw a relevant conclusion in which the summary of the entire discussion will be presented.

Nursing management across the care setting:

For conducting effective as well as systematic nursing management throughout the care setting, nurses must follow all the core principles that are associated with providing safe and compassionate care to patient (Jensen, 2018). In the given case study, Archie, the 29 years old man, needs effective nursing management framework throughout his care setting. Immediate after his emergency admission to the GP surgery unit, nurse practitioners have carried out the ABCDE assessment in which they implement all the core nursing principles to enhance the level of accuracy and valid result after assessment.

ABCDE assessment:

Here nurse practitioner needs to prioritise patient safety while assessing the health of Archie [NHS, 2018]. Under NMC (2015), a nurse needs to follow the codes 'prioritising safety’ while conducting health assessment of patient [NMC, 2015]. Here the nurse practitioner has followed this NMC code and ask some open-ended questions to Archie. Under NMC (2015), nurses need to treat each patient as an individual and respect his or her interest, dignity and value [NMC, 2015]. In the case study, the nurse practitioner needs to check whether Archie can answer the question without facing any issues. As Archie suffers from breakthrough pain, it is expected that he will speak little which shows that he faces severe health issues.

Airways:

Under NMC (2015), nurses are responsible for the care and support they will provide to the patient throughout the care setting [NMC, 2015]. Here in the assessment of the airway, nurse practitioners need to check whether Archie has partially occluded, fully blocked or patent airways. Through this assessment nurse practitioner found that Archie had the normal or patent airways with no airway obstruction.

Breathing:

Here the nurse practitioner has used the Look-Listen-Feel process to check the airways. Under NMC (2015), nurses should work under their level of competence to ensure patient’s safety throughout the care setting [NMC, 2015].

Here the nurse practitioners looked for any sign of respiratory obstruction chest tightness, chest pain, central cyanosis and wheezing (Jarvis, 2018).

The nurse practitioner also listened to whether Archie has any sound of wheezing, gurgling or rattling (Bartlett et al. 2016)

The nurse practitioners also felt that whether there is any airflow obstruction through the nose or mouth of Archie.

From thigh assessment, it is found that Archie has no sign of breathing or respiratory issues with no chest pain and any sound of rattling or stridor. Throughout this assessment nurse practitioner has ensured that each stage of the assessment is done through using a high level of expertise and skill in terms of assuring a high level of safety to the patient [NMC, 2015]

Circulation:

Through carrying out the circulatory assessment systematically, nurse practitioners found out that, Archie has low BP (100/60 mmHg) with a normal pulse rate. Under NMC (2015), while carrying the blood test for assessing the circulatory system of patients, nursing practitioners need to ensure they have up-to-date knowledge and skill in doing so [NMC, 2015]. Here nurse practitioner of Archie needs to assure that the circulatory assessment is done systemically and efficiently without having any chances of any errors in the result which can interfere with overall health assessment of Archie.

Disability:

This assessment has shown that the pain score for Archie is 8/10, which is marked as the severe pain, thereby showing that Archie is under critical health condition that needs immediate clinical support. Here Nurse practitioners need to follow the NMC (2015) code "promoting profession" in terms of maintaining their professional accountability and conducts to ensure that the health assessment is done for Archie is relevant to his health condition which assists the health professionals to develop an effective care plan for him.

Exposure:

While checking whether Archie shows sweat, rashes or abdominal pain, nurse practitioners must ensure that that patients’ autonomy, as well as dignity, is respected throughout the assessment and care process. Here nurse practitioners need to show friendly and supportive approach towards Archie instead of showing arrogance or irritation. The assessment results show that there Archie is sweating and having painful abdomen.

Effective communication and diagnostic test:

As mentioned by Park and Ryu (2016) effective communication is highly important in nursing practitioners that assist the nursing practitioners to develop systematic collaboration with other members of a multi-professional team to provide the high quality and compassionate care to patients. Here in case of Archie. The nurse practitioner needs to maintain transparent information delivery system within the multidisciplinary team, that will allow the nurse to provide all the up-to-date information regarding the heath assessment of Archie to the team members such as to the senior nurses, doctors, psychologist and therapist. Under NMC (2015), the nursing practitioner needs to ensure that they will form friendly and understandable communication with the patient and their family members [NMC, 2015]. Here nurse practitioner needs to use friendly and support communication with Archie to not only collect et important health-related information but also provide him with proper psychological and emotional support. Under NMC (2015), the nurse practitioners also must ensure that polite, friendly and soft conversation techniques are used while communicating with Archies to reduce his anxiety, depression and fear [NMC, 2015]. In the case study, the nurse practitioner needs to ensure that he or she has good skills and knowledge on using professional language while discussing the heath condition of Archie with health professionals and other nurses.

Diagnostic test:

Following tests have been carried out in case of Archie:

• ABCDE assessment test of Archie is done, which has shown that there are no signs of respiratory illness or breathing difficulties in Archie except he has severe abdominal pain.
• Full blood count (FBC) of Archie has been done
• Checking of Archie’s pulse rate (120 bpm) and oxygen saturation level (93%).
• Checking his body temperature: 37.6C
• Testing his venous blood gas level
• ECG
• Computer tomography (CT) scan of his abdomen

Psychological and physical impact on emergency and elective surgery of patients:

There are potential impacts on elective and emergency surgery on patient’ psychological and physical wellbeing. In the case of Archie, the surgical complication can lead to long-term disabilities or chronic health issues which develop severe psychological distress and dilemmas in him. Here in the case study, nurse practitioner needs to have good knowledge and skill in managing the safety of Archie in the pre-surgical condition in throughout his journey from GP surgery unit to the emergency unit, such as providing him proper medicine, perform all his diagnostic test safely and checking whether there is further deterioration of Archie’s health before surgery. In the context Heidari et al. (2019) mentioned that, as compared to the A to E assessment in the GP practice, patient with critical health needs is provided with more appropriate and effective clinical support through conducting the health assessment in the emergency ward. Evidences suggest that emergency ward is the more relevant place than GP practice to make effective health assessment of critical patients like Archie, in which the patients can get the immediate support from specialised doctors and nurses. This is why Archie had been transferred from the GP surgery to the emergency ward for providing the specialised treatment and well-organised health assessment framework. As mentioned by Park and Ryu (2016), as compared to GP practices, the emergency ward is more specialised and well-constructed which provides the easier and faster medical support to the emergency patients through carrying the effective A to E assessment of patient. Here Archie was suffering from the vomiting, nausea and abdominal pain, which needed immediate treatment by the gastroenterologists, through carrying out the entire ABCDE assessment. As compared to emergency ward, the GP practice ward has limited medical equipment and less modern clinical technologies that are important for conducting the faster health assessment and follow the relevant care plan to make the faster management of patient’s health condition (Bartlett et al. 2016). In this context it can be stated that Archie was transferred to the emergency ward as he needed the immediate A to E assessment and the effective clinical support to manage his pain and improve his overall health condition. As stated by Alamri and Almazan (2018), nursing and health professionals need to have a high level of expertise and knowledge in managing the pre- surgical and post-surgical condition of patients to ensure patients safety. The weird and unsupportive approach of nursing professional before and after surgery can enhance the tension, stress and anxiety in patients, therefore, nurse practitioners need to use optimistic and supportive words for Archie before his surgery to make him relax and remove his anxiety and fear.

Conclusion:

From the above-mentioned discussion, it can be concluded that, for maintaining an effective nursing management framework, it is important for the nurse to follow and implement the core nursing principles into practices. In terms of providing compassionate and holistic care to patients, nurses need to ensure that they have strong skills and knowledge in managing patients’ health needs and their health condition. Additionally, effective communication is crucial for maintaining effective management of patient’s symptoms and meeting their health needs.

Reference list:

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Bartlett, M.L., Taylor, H. and Nelson, J.D., 2016. Comparison of mental health characteristics and stress between baccalaureate nursing students and non-nursing students. Journal of Nursing Education, 55(2), pp.87-90.

Heidari, M., Borujeni, M.B., Borujeni, M.G. and Rezaei, P., 2019. Assessment the relation between lifestyle with mental health and educational achievement in nursing students. Bangladesh Journal of Medical Science, 18(4), pp.722-728.

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