An analysis of a critical incident related to the care of a patient of a higher dependency who is critically ill.

An analysis of a critical incident related to the care of a patient of a higher dependency who is critically ill.

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This paper is reflection essay, exploring an aspect of care for a
critical ill patient. Baillie (2005), described a reflection as a
practice that provides evidence of skills development and increased
clinical competence in nurses. The patient involves is a 60 years old
female, who presented with shortness of breath and chest pain. The
diagnosed was infective Exacerbation Asthma. The reflective diary was
impossible to write, as the patient was under our care for a week
before she was discharged. Finally, the role of the nurse and my
experience of involvement will be addressed. Due to confidentiality
purposes, the patient will be referred to as “Mrs A“, (Nursing and
Midwifery Council, 2008) (NMC).
Communication plays an essential part in all care delivered; according
to Sulley and Dallas (2005), nurses have a role in ensuring that
effective communication skills are utilised. Communication is a two
way process, is the only means a patient can get information about
their illness William (2000). It can speed up recovery; reduce the
number of complications stress, pain relief, and fear. Furthermore,
requires engagement, empathy, an ability to listen and respond and it
also requires time however, there is evidence that it’s not always
done well in the health service (Arnold & Boggs, 2004).
According to NMC (2008) nurses have a professional responsibility and
accountability where administering prescribed medication and must have
a sound knowledge in the medication administered and its side effects.
In addition to that Hendrick (2000) states that nurse have a duty of
beneficence to their patients and this was done by identifying the
needs of the patient and discussing her care with the doctor. Mrs A
was prescribed Salbutamol 5mg nebulizers and Atrovent 500mcg,
2. Benzylpenicillin 1.2g, Clarithromycin 500mg, and Hydrocortisone 100mg
infusions was also given as prescribed by the doctor. Mrs A was also
instructed to use peak expiratory flow which measures the lung volumes
and airflow. Explanation of the medication and how to get It, was
explained to Mrs A in order to ensure she understood the need for
taking the medication and side effects, of which resulted in better
recover .
According Hogun and Award (1992) supports this way of care provision
as failure to discuss drug regimes with patients is one of the reason
why patients refuse to comply with medication, which further causes
relapses of their sickness. According to Shaw (2006), nurses should be
aware that a patient, as in Mrs A’s case, the higher the risk due to a
decline in drug metabolism and elimination. It was therefore
importance to start on low doses and gradually increase the dose if
need be and nurses should be aware of the side effects such as nausea
and drowsiness of drugs, (Herr 2002).
Furthermore, according to the NMC(2004) nurses must always update
their skills and knowledge on current practice, in order to make the
right decision and to be aware of any harmful effect the medication
may have on the patient. Furthermore, if Mrs A was not using her
medication properly it could impact on her exacerbation; therefore,
re-educated and ensured the proper use of her asthma medication (Herr
2002). This would cause patient been readmission to hospital.
In conclusion, this reflection explored the an aspect of care for a
critical ill patient. The role of the nurse with regards to
communication and medication has 3
been mentioned. The Importance of reflection on practice enabled an
improvement to professionalism and patient care. In regards with my
experience with Mrs A, Looking back I feel confidence in my abilities
to conduct an effective assessment; when faced with similar situation
in future and I have learned that having knowledge and experience in
caring for a critical ill patient is a key to therapeutic.

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