The Role Of The Nurse In Chosen Clinical Setting And With Particular Client Population
Knowing the Nursing Profession
Nurses on E2 perform a variety of tasks that are specific to their patients as well as to the floor. Each nurse is responsible for advocating for, on average, four or five patients assigned to them for that shift. This includes advocating on behalf of the patient to the family, other nurses, doctors, physiotherapists and other members of the healthcare team. Secondly, nurses take on a role of leadership. This is demonstrated by the position of charge nurse. However, other nurses also must demonstrate leadership during meetings or discussions held between the nurses. During our first week on the floor, I watched my buddy nurse show great leadership and safety while passing on all relevant information to his colleagues before leaving for his breaks. In doing so, the nurse who was caring for his patients was well informed and could provide adequate care. Safety was also demonstrated by nurses keeping all the hallways, paths for ambulation, and patient rooms clear of obstacles. Furthermore, when getting a patient out of bed, I overheard many nurses maintain constant communication with the patient; asking them if they were okay to continue. The value I saw implemented the most on this floor was that of respect and professionalism. When performing a bed bath, my buddy nurse highlighted the importance of making sure curtains around the bed were completely drawn, ensuring optimal privacy.
Professionalism was also demonstrated through appearance, how nurses passed on information to other nurses regarding clients, and overall demeanour. It was fascinating to see these principles of nursing that we had discussed in level one, in action.
Knowing the Self
What relevant knowledge and actions do I have from my education (i.e., nursing & health sciences courses), and previous life and nursing experiences? What are my strengths, limitations, assumptions? What are my learning goals for this week?
As a second-year student, there is a wide range of knowledge that I can draw from my previous education. Courses offered in high school, such as biology and chemistry, built the foundation for classes that I took in first year. In my opinion, this accumulation of knowledge is a huge strength when it comes to clinical placement, as it can be drawn upon when explaining things to patients. Another strength I noticed last week, was my comfort in talking to patients. I believe this developed as a result of standardized patients in the simulation lab and my KO2 placement at the Ronald McDonald Family Room. A big assumption I made upon coming into E2 for the first time was the idea that patients were unstable. Although it may seem juvenile, I think many television shows and movies developed this concept that every floor is like an emergency room. However, upon spending a day or two on the real hospital floor, I now realise that although, many patients are ill, there is not that same aura of crisis on the floor. This previous assumption is the foundation for my limitation: the fear of making a mistake. As I am now dealing with living individuals and not mannequins in a lab, there is an added pressure to perform. However, in reality many errors can be changed into opportunities for improvement and learning, and this is a mindset I hope to cultivate. As a result, my learning goal for this week is to be more “hands on”. This includes continuing the activities of care I performed last week, such as, bed baths and helping patients up in bed. However, I would also like to perform vitals and try to be as involved as possible.
Knowing the Case or Patient Population
What does the diagnosis mean? What is the underlying pathophysiology? How do patients with this problem/issue typically present (signs, symptoms, emotional responses, difficulties, diagnostic test results)? What are the most common risk factors? What types of treatments (including medications) are used and why? What are the treatment priorities and why? What is the typical / usual clinical course? What is the population at risk for? What do I expect to find? What is the nursing role in caring for patients with this diagnosis? What types of assessment, communication, and nursing actions will I likely need to provide safe and effective care for my patient?
The diagnosis is a Left Hip Fracture. This is defined as a break located in the upper end of the femur. The hip joint is a ball-and- socket joint, composed of the acetabulum which is part of the pelvis and the femoral head. These two surfaces articulate, separated by articular cartilage. This cartilage as well as lubricating synovial fluid, allows the bones to move freely and without friction. Unlike hip replacements, which can be elective, most hip fracture patients are admitted due to a fall or a blow to the hip. Individuals of all ages and genders are susceptible to this injury. This being said, patients over sixty-five are at a higher risk for falls, bone weakness and issues with gait, making them common candidates.
Individuals with fractured hips often experience discomfort with movement, pain or aching along the outer thigh, a shortened injured leg and rotation of the lower extremities. Upon admittance, there are a variety of tests run to diagnose hip fracture patients. These include but are not limited to: X-rays to determine the type of fracture, physical examinations and obtaining a medical history. Using this information, a plan of care can be developed, and either surgical or non-surgical treatment performed. Non-surgical treatment involves bed rest and less invasive methods of care which are suggested for unstable or ill patients who may not withstand surgery. Patients who are well enough for surgical intervention will receive the surgery suited to the type of fracture they endured. There are three main types of fractures: Intracapsular, Intertrochanteric and Subtrochanteric.
Nurses play a vital role in post-operative care. Their roles include monitoring wound care, helping with diet, following the physiotherapist’s guidelines for activity, maintaining hip precautions if in effect and preventing falls. The nurse also plays a large role in client education, explaining fall prevention strategies, and helping individuals get back to their daily lives after discharge.
