Drug administration varieties a major area of the scientific nurse's role. Drugs are prescribed by the doctor and dispensed by the pharmacist but responsibility for right supervision rests with the rn (O'Shea 1999). So as a student nurse this became our obligation and something that we practiced and become competent in carry out as explained in body 1, we were also faced with the troubles of administering medication. Each rn is in charge of his/her practice. This practice includes planning, checking out and administering medications, updating understanding of medications, monitoring the potency of treatment, reporting unfavorable medication reactions and coaching patients about the drugs that they receive (NMC 2008). Accountability also applies to students, if at any point I felt I wasn't qualified enough to dispensing a certain medication it would be in my responsibility to speak up and allow recorded nurses know, so that I possibly could shadow them and also have the chance to learn and then in future be able to practice and administer.
The reflective model I've chosen to use is Gibbs model (Gibbs 1988). Gibbs style of reflection incorporates the next: description, feelings, evaluation, and realization. (Gibbs 1988). The model will be applied to the essay to aid critical thought, relating theory to practice where the model allows. Discussion will include the knowledge underpinning practice and the data base for the clinical skill, that I've learnt and encouraging this with current books.
The first level of Gibbs (1988) model of reflection takes a description of incidents. I used to be asked to manage a medicine to an individual. I had witnessed this scientific skill on a number of occasions and experienced previously given medication under guidance. At this juncture I was being seen by two qualified nurses, one of which was my mentor. The drug had been dispensed and was prepared to be administered and the patient consented to truly have a university student administer the medication. My mentor was speaking me through the procedure step-by-step, and educated me they have battled with this patient and her conformity with medication before so I should keep an out and ensure that she swallows her medication and this she not keeping it her mouth.
The Medication that this patient is on is Clozapine. Clozapine is mentioned for patients with treatment resistant schizophrenia, or those who find themselves unable to reap the benefits of other antipsychotic treatments, as they cannot tolerate the side effects. The decision to work with clozapine is not used lightly due to potentially life intimidating side effect of neutropaenia, which requires regular blood vessels tests to ensure its safe use. In addition, there is the chance of developing paralytic ileus plus some cardiac abnormalities. (WLMT).
In addition compared to that statement if a patient on clozapine white blood cells count falls below accepted lower limit are categorized as "Red alerts" medication must be withdrawn, and another prescriber in the foreseeable future wishing to restart medication are aware of the patients haemotological record. Adverse drug reactions are the main limiting factor on using anti-psychotics, because of this prescribers should keep dosages to a minimum required for efficiency starting at a minimal dose with steady upward titration. An awareness of side effects is important to principal care practitioners because they may have most contact with the patients, patients with long-term monitoring falls of their remit. Clozapine can be an atypical antipsychotic, and atypical anti-psychotics are believed of choice both accurately and for maintenance in schizophrenia. Clozapine contains a unique position among the atypical because of its ability to boost negative as well as positive symptoms (delusions, hallucinations). (Morris, D).
During the process of administering anti-psychotics I learned that using anti-psychotics is just a component of any holistic method of the patient with psychotic health problems and that care and attention should also include mental health treatments and communal care. The individual at such does not have any issue with the drug it self but with the personnel, as she is in an exceedingly psychotic state she is very paranoid and non compliant with medication this is tightly monitored by staff and as explained in physique 1 I have to prompt her to ensure that medication is complied with. Service users have requested strategies from services providers to control the risk of using psychiatric medication to see their choice about which psychiatric medication to work with. (DOH 1999). However proof suggests that, there exists choice, but generally by specialist experience. (Hamann et al. 2005). In non conformity of medication I had to encourage the individual to make their choice to consider the medications and this it was in their good care plan and apart of their treatment. A nurse who has built a good marriage with an individual by informing and empowering them will maintain a strong position to truly have a non judgmental dialogue with them about the importance of adherence. (Mc Lellan. A 2009).
I am now heading to enter the second stage of Gibbs (1988) style of reflection, which really is a conversation about my thoughts and emotions. I was aware of being under the supervision of two licensed nurses and this made me feel very nervous and timid and I had to ensure i was doing everything correctly and this I made no mistakes. Once my mentor questioned my practice, relating to if I realized the side effects of the drug I used to be about to administer, I became even more aware of feeling nervous and under pressure. The patient was present and I did not want the patient to feel that I did so not really know what I had been doing. THEREFORE I was required to ensure before administering which i was offering the medication to the right patient and at the correct dosage that it was at the right time and way. Many of these had to be done to ensure which i am competent in my own ability to administer medication under the supervision of a registered nurse. This also gave me the chance to carry out this in order to do this so I could get it signed off by my mentor in my essentials skills cluster.
The nurse patient relationship is by many considered the central of nursing; this is done to build a good marriage and rapport with patients. (Framer. J. Kramer. S, 2001). WHILE I was first orientated to the ward, I took it upon myself to read the patients notes so which i had little insight to the patients and their disorder and index offences if any. Following this I went and introduced myself to the patients because it's vital that the patients are aware of who I am and my status if I am to provide nursing look after them. (Berlo 1960) places great focus on dyadic communication, therefore stressing the role of the relationship between the source and the recipient as an important variable in the communication process. To provide patients with adequate care it is important that there surely is effective communication, that the patients is aware of everything, and that the nurse provides care and attention and compassion in the delivery of good care. There is information that our capability to use terminology actually influences the thoughts themselves, the words we can control, and just how that we put them together affects:
what we think
how we think
whether we live thinking
So as a student nurse I got made aware that words can have an impact on good care provided and the way in which these words are shipped can have an even greater impact. As explained in physique 1, once i was admitting an individual on to the ward I put to make certain that I was interacting effectively, making sure that I was providing information with techniques that were easy to understand refraining from uses of jargon, and this I was displaying compassion to the patient as this may be a period of high stress for them, reassuring them they are in great hands and offering them tea were among the things I did to exercise my attention and compassion skill. so my main aim was to make the care of people your first concern, dealing with them as individuals and respecting their dignity, and working with others to safeguard and promote medical and wellness of those in my care, their own families and professions, and the wider community. (NMC 2008). However I attempted to use different types of communication to mention information from my patients', for example as explained in amount 1, after i experienced my 1-1 personal time with my patient I'd use (Bein and Miller 1992) the utilization of open and concluded questions and energetic listening, so that I could understand everything I was being told so that whenever I came around to me providing detailed and exact written report founded they would reflect everything that was being. Studies also show that during social communication only 7% of the communication is verbally communicated by what used. From the 93% non-verbal communication: As a result I learnt to pick up non verbal indicators "Even if someone decides to state nothing they remain conversing" (effective communication skills). Which skills I can adopt to engage with patients and also to help with my development in nursing.
Evaluation is the 3rd level of Gibbs (1988 ), here I'll the explain the importance of administering medication and how this coupled with attention, compassion and communication forms the bases of the holistic method of service, and with the data I got from supporting books formed the foundation of my learning and practice. Burnard (2002) suggests that a learner is a passive recipient of received knowledge, and that learning through activity engages all of our senses.