NRSG355 Clinical Integration: Towards Professional Practice


Critical Thinking, Clinical Decision Making and Professional Development

Please complete this module by completing the following activity. Then upload your answer to your electronic portfolio.

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You will be met by several staff members upon your return from your tea break. They will provide the following information concerning your patients.

Mrs Chew’s intravenous infusion (IV) has failed. Her IV fluids are now running behind. She has also missed her 14.00 hrs IV antibiotic.

Mr Smith’s visitor has collapsed.

One of the toilets for staff has become blocked. It is overflowing rapidly and there is a lot of waste.

Mr Esposito is expected to leave the ward soon for his cardiac catheterization. However, he has not received his preoperative medications.

One of the VMO’s surgical consultants is currently waiting to discuss a medication mishap that occurred last week.

While you are handing the over, an elderly woman post-operatively falls to her knees and is unconscious.

She has undergone facial reconstruction.

NUM role. The other RN is currently busy.

There are three staff members currently on the ward who can assist you in addressing these problems: the ward Clerk, an Enrolled Nursing nurse, who is currently completing her IV Cannulation Certificate but is not yet competent, as well an AIN.

Answer to Question: NRSG355 Clinical Integration: Towards Professional Practice

As a nurse, the first priority should always be the well-being and comfort of the sick.

Three of the patients in this scenario require immediate attention.

Mrs. Chew, one patient, has yet to receive her prescribed 14.00 hour antibiotics. Also, her IV fluids have been delayed (Campbell Gilbert Laustsen 2010, 2010).

Mr Esposito has another patient who will be undergoing cardiac catheterization. However, he has yet to get his preoperative medication.

Post-operatively, an elderly patient fell to the ground after becoming unconscious.

There are other tasks such as the obstruction of the toilet and the meeting with the surgical consultant to address a problem such medication error.

In this situation, there are 2 RNs (Registered nurses) working in the unit.

One of the RNs is working, and she is responsible for being the NUM on that shift.

One RN is on her own and can take control of many aspects of the unit.

The other members of this unit include the ward clerk and an Enrolled Nursing nurse (who is currently in training for the IV Cannulation Certificate). One AIN (Assistant Nurse in Nursing) are also included.

The RN is responsible for some of these responsibilities. However, he or she can delegate some tasks (Aitken Chaboyer Elliot 2102).

As Mrs Chew needs IV antibiotics, the RN should initially take her case.

The EN should be appointed to take care of Mrs Chew’s fluid intake.

After attending to her, the EN can also take care of Mr. Smith’s visitor. The EN should check with the doctor if the visitor has a medical condition.

The RN should appoint AIN as the patient’s post-operative care.

The RN should visit Mr. Esposito, the pre-operative patient who requires his pre-surgery medication.

After giving the medication and naming the ER, you can get Mr. Esposito ready for surgery.

The RN should inform the ward clerk about the overflowing toilet and ask him to contact a plumber.

The RN should attend the meeting of the physician regarding the problem. This was held last week (Benner Tanner Chelsa).

Since the EN does NOT have the IV cannulation certificates, the RN must give Mrs Chew her medication by herself. Last week, there was a medication problem and the RN does want to prevent it from happening again. (Elliott & Coventry 2012.

The RN appointed AIN to take care of the post-operative patients and told the AIN that she would make an appointment to see the doctor.

Since Mr. Esposito is scheduled for surgery, the RN should give Mr. Esposito the post-operative medicine and assign the task to attend to the ER.

An EN is qualified to provide care for an unconscious person and should accompany the visitor.

The plumbing problem in staff toilets should be taken care of by the ward Clerk.

The meeting must be attended to by the RN.References:Aitken, L., Chaboyer, W., Elliot, D. (2102).

Scope of Critical care Practice.

In ACCCN’s Critical Care Nursing (2nd Ed. Sydney: Elsevier.Benner, P., Tanner, C., Chelsa, C. (2009).

Expertise, Caring, Clinical Judgement, and Etiquette 2nd Ed. Springer, NY.Campbell, L., Gilbert, M., Laustsen, G. (2010).

Clinical coach to nursing excellence. Retrieved from, A., Wallis, A.

(2011) Effective communication. Principles of nursing practice E. Nursing Standard 32 (32), 35–37. Retrieved from &AN=2011015656&site=ehost-liveChaboyer, W., Hewson-Conroy. (2012).

Safety and quality.

In ACCCN Critical Care Nursing II, 2nd Ed. Elsevier, Sydney.Elliott, M. & Coventry, A. (2012).

Critical care: The eight vital indicators of patient monitoring.

British Journal of Nursing 21, 621-625. Retrieved from &AN=2011651321&site=ehost-live