Reference no: EM132377836
NRSG355 Clinical Integration: Towards Professional Practice
Module – Critical thinking, clinical decision making and professional development
Clinical decision making - problem solving and prioritising
ACTIVITY 1
Reading:
Please read the article by Coventry and Elliott. While you read the article take particular note of how traditional vital signs can be used to assess the critically ill patient as well as the role of the additional three “vital signs”: level of pain, level of consciousness, and urine output.
Elliott, M. & Coventry, A. (2012). Critical care: the eight vital signs of patient monitoring. British Journal of Nursing, 21(10), 621-625.
ACTIVITY 2
Reading:
Benner et. al., (2009) have dedicated a chapter to the nurse-physician relationship. Follow this link to “Expertise in practice; Caring clinical judgement, and ethics 2nd Ed” by Benner et al, and then click on Chapter 11: The nurse-physician relationship: negotiating clinical knowledge. The chapter is quite long and includes a number of clinical scenarios that are used to illustrate specific aspects of the nurse-physician relationship. There is specific reference to junior nurses in some of the scenarios.
Please take some time to identify the aspects of each scenario that relate to the neophyte RN and their place in this key clinical relationship including the pivotal role of the RN as patient advocate.
ACTIVITY 3
Reading:
Please read Chapter 7: Communication-mastering collaboration, delegation and documentation from Campbell, L., Gilbert, M. & Laustsen, G. (2010) Clinical Coach for Nursing Excellence when you read the chapter you can skip over the general discussion of communication techniques if time is short; however, please focus on the key aspects of the rest of the chapter. In particular, pay close attention to the sections on ISBAR, delegation and documentation.
* Assessment Question One
As part of this module please undertake the following activity and upload your answer into your ePortfolio. Please remember that this forms part of your assessment for this unit.
On returning from your tea break you are met by several staff members who relate the following information to you concerning your patients.
i. Mrs. Chew’s intravenous (IV) infusion has tissued, her IV fluids are running behind and she has missed her 14.00 hrs. IV antibiotic.
ii. Mr. Smith’s visitor hasfainted.
iii. One of the staff toilets has blocked and is overflowing and waste is pouring out rapidly.
iv. Mr. Esposito is scheduled to leave the ward now for his cardiac catheterisation and he has still not received his preoperativemedication.
v. One of the surgical consultants (VMO) is waiting to discuss a medication error that happened last week.
vi. As you are taking this handover, an elderly female post-operative patient collapses to the floor and is unconscious. She has had facialsurgery.
The other RN is busy with NUM role. Staff currently available on the ward to assist you in addressing these issues include: the ward clerk, an Enrolled Nurse who is currently undertaking her IV cannulation certificate but is not yet competent, and an AIN.
ACTIVITY
Using the above scenario:
1: In order of priority, identify which tasks you yourself will undertake and which tasks you will delegate.
2: Document your rationales in detail.