Clinical Placement

Part 1: Reflection on Action

My last rotation placement was in the clinical setting at a secondary hospital in my city. I was placed in a general ward as I was very much enthusiastic about interacting with the clinical team there and was eager to practice my knowledge into skills. I was assigned to four patients to perform my patient-centred care activities include taking and updating patient notes, medication administration under the supervision of an RN. I was able to provide a patient-centred approach as I got to learn more about their pre-existing condition and their daily needs.

During the initial days of my placement, I was confident and motivated that I got a chance to transform my theoretical knowledge into professional practice in a realistic working environment. I was very much enthusiastic to learn and take on anything they assigned to me with their inclusiveness and supportiveness. Gradually, I attained familiarity and confidence during my experience. It was smooth running but with the increase over time, I found that the RN nurse seems to be more frustrated and careless in supervising me.

On one busy day, the staff was short and the RN nurse was doing her second continuous rotation, she assigned me over the four patients along with the medication chart to be followed. According to the patient condition, one patient was more prone to be at risk of a medicine-related problem and which required outcomes to be monitored properly. Later on her busy schedule, she asked me to administer the medication to the patient, and she immediately left without determining the need of supervising me whilst administering the medication this made me feel anxious and worried that how medication administration is a proficient task which only allowed to a licensing body and according to the medication guideline of medication, the nurse should delegate the task with considering the competency level of a health care professional and also considering the supervision all time this made me confuse and later I develop fear because what if I administered the wrong dose, I went to my instructor and explain my scenario.

The major thing that bothered me to reflect over the scenarios are medication safety and patient-centred cared which I felt was missing during the rushing and/or emergency hours. Action 4.10 of NSQHS standard reflect medication review action to minimize the medicine-related problems and is also required to documents the outcomes, it also allows to identify and monitor trends in medicine-related problems in patients. (NSQHS,2019, Action 4.10)

According to NMBA, Registered nurse standard for practice Standard 6: RN nurses are intended to provide safe, appropriate and responsive quality nursing practice. The nurse is advised to delegate actions in an ethical goal-directed way. It allows the nurse to appropriately assigned patients to enrolled nurses according to the scope of criteria and role, also to provide timely direction and supervision to ensure that the delegated task is performed safely and correctly (Nursing and Midwifery Board of Australia [NMBA], 2016, Standard 6)

My goal that will be reflecting my placement experience will be based on achieving expertise to follow a patient-centred approach and abide by medication safety, and effective mentorship. I strongly validate that my practice approach would be according to protocols and guidelines provided, by the time I will go to my first professional experience  I should be proficient and confident to perform the patient-centred approach that I have learned from our placement.

Part 2: Reflection for Action

I have been placed in a secondary hospital care setting in a pediatric ward, the nursing care associated with the pediatric ward required more than usual patient-oriented care and strong inter-professional communication skills. I will be assessing in nursing care plan before and after the operation, also will assist in the physical examination and diagnosis of the patient. I will also act as a care coordinator and intended to provide effective communication with the families and medical staff as well assist in providing direct care for illness and injury.

The main priority of the interprofessional team will be ensuring effective patient safety that reflects high-quality care delivery with optimal safety. Teamwork is very important in the pediatric ward to provide high-quality care especially in stressful conditions, failing communication between providers, patients and families will give rise to medical errors.

I will feel enthusiastic about working with the interprofessional team in the pediatric ward, as I will be giving exposure. I will tend to learn approaches and policies related to child health. The major role in this team will be occupied by the RN nurse as she/he is providing direct patient care in coordination with family and other healthcare professionals. The other team member including GP, physiotherapist and dietician are also the core team members serving to improve the quality care of the patient effectively and efficiently. I will feel comfortable in discussing my patient care with the team because rather than functioning as a skill and integrated team, the entire group of health providers are seems to be focusing on the care of the patient.

I will gain experience in the safe administration of medication by adhering to medication safety standards. I will learn to provide continuous collaborative care to the patient by efficiently working in partnership with patients, carers and families, this will help me to identify, assess and manage patient clinical risk. I will be able to work as a team to deliver comprehensive care by adhering to communicating for safety standards (NSQHS,2019, Action 6.04)

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