NURS2007 - Integration of theory with practice- Case world Scenario Critical reflection-Nursing Assessment Answer

December 05, 2018
Author : Andy Johnson

Solution Code: 1AJBH

Question: Integration of theory with practice- Case world Scenario Critical reflection

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Nursing Case Study Assignment

Assignment Task

Critical reflection is an extension of “critical thinking” and requires students to think about their practice and to examine their thinking by asking probing questions. Critical reflection moves beyond examining past situations and moves forward to apply theoretical knowledge to the future. In this assignment students must ;

  • choose one of the case world scenarios used in this topic to develop a written piece of work that demonstrates their capacity to critically analyse a patient situation.
  • consider the following theoretical perspectives : pathophysiology, relevant pharmacology, anatomy and physiology best practice, inter-professional roles in patient centred care, lifespan and psychosocial issues and choose four (4) perspectives, from the chosen case world scenario  for extended discussion within your assignment.
  • demonstrate the capacity to think critically and relate theoretical concepts to clinical practice.
  • use the following headings in the structure of their paper:

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Solution:

A Critical Reflection of a Critical Patient Scenario

Introduction

According to Meier & Nauck (2014, p. 132), many nurses have had several hard situations with patients with hard diseases. Sometimes, a nurse might be under internship and meets a patient with a strange disease for the first time, and she doesn’t know what to do. Others might have worked for some time but find it hard when they meet a patient with a strange disease they have never encountered, and the doctor leaves them the responsibility to take care of the patient. This situation needs critical thinking and reflection. For instance, this paper has used the case scenario of Nadia who a nurse in a critical thinking situation and Adam Knight, a patient who needs medical attention. Therefore, this paper is going to provide four perspectives in this scenario to show how critical reflection can be applied in a critical situation. The four perspectives are anatomy, patho-physiology, lifespan, and psychosocial issues and inter-professional roles in patient cantered care.

Theoretical Foundation

One day Nadia was on her pediatric rotation during her first week of internship at the hospital when the doctor left her written instructions to take care of Yasmine. Nadia had confused the doctors handwriting when she thought the patient had cerebral palsy when in the real sense Adam Knight had cystic fibrosis as she thought the doctor had written CP instead of CF. So, she was confused by the enzyme supplements the doctor had written. The doctor was tough on her, and he assumed that Nadia had understood the situation clearly since she has class work knowledge. So, she had to apply the knowledge in that situation to ensure that the patient had regained her consciousness and receive the best nursing services for around 30 minutes. So, Nadia passed through a hard time as the situation required a critical reflection so as to make the right decision. The doctor was tough and did not entertain questions requesting him what to do.

Nadia had to be self-driven, self-controlled, self-directed and use self-corrective thinking to be able to use the list of supplements that the doctor had written to identify the disease. However, what saved Nadia was the fact that she liked doing something she understands or understands what she is doing. In nursing, Rondón et al. (2012, p. 1471) says that accountability is a very important aspect, and therefore, Nadia has to use the information from the list of supplements to determine the disease first. Thereafter, she researched for the signs and symptoms of the disease and tried to match with Adam Knight’s current condition. There are certain aspects that every nurse needs to have to manage such hard conditions. They include intuitition, intellectual integrity, flexibility, conceptual perspective and more importantly, confidence. Understanding and application of all these things through integration could help Nadia identify and determine the right thing to do. Therefore, the four perspectives: anatomy, patho-physiology, lifespan and psychosocial issues and inter-professional roles in patient cantered care will be explained to know how critical reflection is applied.

Objective and Subjective Data

Subjective data can be described as that data or information obtained from the patient himself. The patient may tell the nurse about how he/she is feeling so that the doctor can determine the symptoms and match them with the available diseases. Subjective information is based on believing or relying on the patient’s point of view so as to make a decision. Dombrowski & Karounos (2013, p. 335) says that the patient’s point of view is the best information especially when the patient is normal and conscious. Objective data, on the other hand, can be described as that information or data obtained from diagnosis of the patient. Debette (2014, p. 20) observed that laboratory tests and measurements are applied here and expert examination is done to the patient to determine what disease the patient is suffering from. When the patient is unconscious or does not know exactly how she is feeling, objective data is very essential.

However, even after subjective data, the nurse needs to go ahead and provide objective data to the patient. In this case, Adam Knight was unconscious, and subjective data was not availed. So, the doctor had already performed objective analysis and collected the date he had presented to Nadia. The main issue here was the confusion that Nadia had taken where she thought the doctor had written CP when in the real sense it was CF. Therefore; Nadia had to concentrate much on the symptoms. The following perspectives would have helped the situation much when well understood;

Patho-Physiology Perspective

Patho-physiology can be explained as those functional changes which appear during a certain disease. It is composed of two words: pathology and physiology. Pathology is a discipline in medicine that provides an explanation or descriptions about a disease. Physiology, on the other hand, is a discipline that provides explanation about the mechanisms and processes that happen in a patient. Therefore, we can say that patho-physiology provides a detailed description of how a disease develops in a patient’s body and all the processes that are involved. According to Waugh & Grant (2014, p. 78), all the doctors and nurses needs to be keen in their analysis of the subjective data while at the same being accurate and sure about the objective data they gate.

From this perspective, it comes out that this scenario requires a critical reflection to manage the situation. The nurse has to do a lot to save the patient. The idea that Nadia had first thinking that it was cerebral palsy was wrong. Therefore, if she had continued with that idea, she could have done the wrong treatment and could have even caused the death of the patient as she could refute the supplements given by the doctor and provide her own. Andreassi (2013, p. 482) says that patho-physiological perspective provides that she had to diagnose the patient keenly again s as to get the right objective data that could help her manage the situation. Therefore, she was supposed to research on cystic fibrosis after knowing what it was then identify the processes that happen and the changes that happen to a patient’s body. This discipline shows that theoretical knowledge is the best solution in such a situation as it would provide clear guidance to the nurse.

Anatomy and Physiology Best Practice Perspective

Anatomy can be described as a discipline which deals with the study of animal body parts. Therefore, any nurse needs to have a class theoretical knowledge all the essential parts of the body. Physiology as explained above about the mechanisms and processes that happen in the body of the patient counts a lot to critical situations requiring critical reflection. Under this perspective as McArdle, Katch, & Katch (2010, p. 53) explained that human body is the source of evidence for the nurse to acquire data before performing the treatment. Therefore, Nadia had to have enough skills gotten from the experience from other patients even if they were not suffering from the same disease as the one at hand. Understanding the human body and the processes that take place helps to solve the condition easily.  Mistakes are a very big burden in nursing and treatment. A nurse needs to understand what to do and the procedure to go about it to be able to handle the situation. The nurse needs to know all parts of the body and how to go about handling each part even the delicate ones and how to treat the disease.

Handling a patient under this perspective requires that the nurse be able to do the right thing, at the right place with the right supplements thus curing the right disease. The functions of various parts and organs of the body need to be understood by every nurse. Cystic fibrosis is not a common disease, therefore, not familiar to many nurses including Nadia. For the first time encounter, Bennett et al. (2011, p. 573) puts it that mistakes always happen but the nurse needs to be very careful not to worsen the condition. Since the discipline of anatomy requires that every nurse has a rough and general idea about the body parts and their functions, physiology requires her also to understand the processes that happen. Any changes in these processes need to be understood and curbed effectively. Therefore, this perspective helps as the nurse needs to rely on the general understanding as the best evidence to base on when handling the condition.

Inter-Professional Roles in Patient Centered Care Perspective

According to Currie & White (2012, p. 1337), inter-professional roles of providing service to patients play a bigger role in the healthcare sector and bails out many nurses without a clear idea in such situations. It involves teamwork and collaborative effort by professional healthcare officers. Through good relations and teamwork among nurses, Nadia easily consulted a fellow nurse who was also on a pediatric rotation that night for some assistance. The nurse also looked at the supplements on the list written by the doctor then concluded that it was cystic fibrosis and not cerebral palsy. This gave some confidence to Nadia to continue with her work she had been left to do by her doctor. The doctor did not tell her anything, and he kept on saying that it’s Nadia to know what to do since she was the nurse on the shift. Therefore, the fact that her fellow nurse was a professional nurse, and with more experience than Nadia helped her much in that condition.

This perspective shows that best practices and efficient service to customers is always provided by inter-professional collaboration. Rushmer (2005, p. 82) says that teamwork enables those nurses who do not have an idea to a certain condition that one of their patients is suffering from to seek the right help from their fellow nurses who have an idea about that condition. It means that at times being perfect with the knowledge about the disease theoretically alone cannot help solve all the problems. At times, it requires more than that, and majorly the assistance from those with enough experience. It enables to curb some tensions that emerge in health sector especially when a critical situation needs to be handled with effective care and efficiency.

Lifespan and Psychosocial Issues

The lifespan of a person is very useful and is one that every nurse needs to have in mind. No nurse is allowed to do work without knowing what he/she is doing as it might lead to the termination of the life of the patient. This goes against the healthcare principles such as beneficence and non-maleficence. Therefore, Bennett, et al. (2011, p. 575) observes that the nurse also needs to quickly identify the situation of a patient then at the same time determine the seriousness of the condition. If a condition is worse and the patient is left with limited time unless saved, the nurse needs to know what to do at that point to save the life. Therefore, lifespan is a very important discipline in the health care sector.

According to Andreassi (2013, p. 83), psychosocial issues, on the other hand, deals with the psychological matters of a person or a patient conflicting with his societal needs. In most cases, a crisis starts occurring at the beginning stages of development. Therefore, the nurse of the physician needs to understand the patient’s psychosocial needs by finding information from the medical reports of the patient and the extra information provided by the patient at the reception. This would help the nurse in providing a better solution to the critical situation. This perspective provides that the nurse be able to read the personal information about the patient to understand his/her psychosocial issues. In this scenario, it was necessary as Nadia went through Adam Knight’s files to get more information about her conditions and determining her social life.

Conclusion

In summary, this paper has provided an explanation about handling a critical situation using a critical reflection approach. Nadia is a nurse that experienced a critical situation with Adam Knight who was suffering from cystic fibrosis and not cerebral palsy as she had confused in the first time. Therefore, four perspectives in the health care sector have been applied to provide a critical reflection. They include patho-physiology that provides important information on class work, anatomy that bases on evidence, inter-professional roles that base on teamwork, and lastly psychosocial issues.

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