Clinical decision making

Document Type:Essay

Subject Area:Nursing

Document 1

Being a final year nursing student provided me with the opportunity to work in mental health institutions during my placements period. It gave me the exposure and experience regarding the handling of different situations where I got the opportunity to improve on my skills by putting into practice the theoretical learning I had gone through in my previous school years. Nonetheless, it is imperative to note that some of the experiences were new that it caused me to develop an emotional attachment, which I later took as a learning process since I expect to encounter such scenarios aging in my nursing profession. That is, according to Weurlander et al. (2018), through coaching from the doctors at the facility, one can develop measures to avoid emotional attachment and act objectively during such situations.

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The model is represented in the appendices section as appendix 1. At the end of the paper, I will highlight what I have achieved it the learning process during my placement at the mental facility. Description I took my final year placement at Forensic Medium Secure inpatient services located in London as part of the course requirements. At one time in the midmorning hours, the security staff activated the emergency alarm signaling that there was a patient in serious medical condition that required urgent medical attention. They had found him in his room where he appeared to need assistance based on the way he was behaving considering that he was suffering from paranoid schizophrenia. The paramedic assessment JK’s conditions by taking his temperature readings, an indicator he used to declare that the patient was dead.

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As a procedural requirement, the paramedic informed the police about JK’s demise to pave the way for the subsequent process. The staff then informed JK’s next of keen about his passing and then quarantined his body to prevent other patients from accessing it. Senior managers, the medical director, and two police officers arrived to take statements, which the based on in informing the coroner about JK’s death. Senior managers gathered the other patients in the lounge room to inform them about the demise of the colleague together with assuring them about their safety. It I like I was looking for every possible reason to blame on for JK’s death since I felt that he did not deserve it.

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According to Sinclair et al. (2017), becoming compassionate is a normal reaction for any individual and nurses to exhibit it when handling patients under their care. Nonetheless, Sinclair et al. further argues that the compassion should be circumstantial and that nurses should avoid feelings of sympathy during emergency periods taking the case of JK. It was evident that each of them was compassionate towards the other and thus the measures to counsel the other patients and debrief the doctors and other staffs were to mitigate the emotional impact of his death. I felt that the patients since they had developed strong emotional connections amongst each other, they needed counseling to avoid worsening of their condition by facilitating a smooth transition from the loss.

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On the other hand, debriefing of the doctors and staff was a measure to ensure they made objective decisions so that JK’s death could not affect their work. Furthermore, I must comment that the entire scenario was handled with utmost professionalism that ensured effective handling of the situation and smooth return to normalcy after the incident. The way the situation returned to normalcy in the evening of the same day JK died was somehow disappointing considering that the hospital had lost one of its patients. Even though the primary goal of the placement was to gain the necessary experience, I did not imagine how difficult it would be for me to handle when I encountered t for the first time.

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Despite the experience, I must acknowledge the positive contribution the scenario has made in enhancing my practical clinical skills. I learned that a nurse must maintain the duty of care irrespective to the occurrences since the demise of one patient does not signify toping to provide medical care to other patients. Developing compassion towards the patient affirms Sinclair et al. (2017) assertions that emotional attachment to the patient is inevitable. The availability of an effective communication system is a crucial factor in the administration of medical care in any healthcare facility since the illnesses the patients have to require closes observation (Kanerva, Kivinen and Lammintakanen, 2015). As noted from the occurrence during the placement, there were delays in attending to the patient after the security staff sounded the alarm, a factor that could have contributed to the loss of the patient.

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From my perspective, there is a need for communication systems that would permit real-time responses from the emergency staff together with informing the doctors on time instead of waiting until the patient’s condition deteriorates. Upon reflection about the incident, there was a communication lapse among the different categories of physicians, for instance, activating the defibrillator and not using it while waiting for further instruction Conclusions Despite the adverse outcomes of the incidence at the hospital, the experience was informative in that I have gained knowledge of the ways of dealing with the critical situation with the patients. It provided me with an overview of the areas I need to improve on such as limiting emotional attachments towards patients to pave the way for objective thinking.

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Appendix 1 Courtesy of Oxford Brookes University Self-Assessment of Reflection Work Areas for improvement identified from this reflection that I have endeavoured to address: The key areas I need to improve on the aspect of developing emotional connection with the patients. I am positive that doing so will help me in making objective decisions which are important to my nursing career. Aspects I think I have done well? Compassion towards patients Responding to emergencies Things which were difficult and I’m not too happy about and I would particularly like comments on: Lack of direct clinical supervision from the doctors and nurses as they are preoccupied with other roles. Classroom learning involves a lot of theoretical learning which makes it difficult to cope when adjusting to practical learning during placement.

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Therefore, there is need for the introduction of patient simulation exercises. and Lammintakanen, J. Communication elements supporting patient safety in psychiatric inpatient care.  Journal of psychiatric and mental health nursing, 22(5), pp. Kieft, R. A. , Gundogan, B. , Whitehurst, K. and Jafree, D. J. Reflective practice in health care and how to reflect effectively.  Journal of Research in Nursing, 22(1-2), pp. Pohl, S. , Saiani, L. and Battistelli, A. Empathy in the emotional interactions with patients. , Chambers, J. , Anderson, S. and Shields, R. Barriers and facilitators to primary care for people with mental health and/or substance use issues: a qualitative study.  BMC family practice, 16(1), p. , Chochinov, H. M. and Hagen, N. A. Sympathy, empathy, and compassion: A grounded theory study of palliative care patients’ understandings, experiences, and preferences.

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