Complex Nursing Care – Assessment Answer

Explain 'Don't Normalise the Abnormal' and Identify A-E Signs of Deterioration and Their Normalization

The phrase “Don’t normalize the abnormal” is a common term used in healthcare. This defines the significance of identifying abnormal signs as well as symptoms. Moreover, these symptoms and signs are different from the expected or the normal. This is referred to as the best practice in the healthcare system. This is because the principle helps in identifying the early signs as well as symptoms of deterioration in the patient's condition and prevents the condition from getting worse (Armenise et al., 2018). The A-E systematic approach can help healthcare providers in providing high-quality treatment. This is because healthcare providers can identify the early signs and take necessary steps to get the patient's health conditions worse. The A-E approach includes assessing the physical health conditions of the patients including airway, circulation disability, breathing, disability, and exposure (Mahmoud & Mohamed, 2017). The evaluation of these conditions can provide necessary information to healthcare providers.

This helps the healthcare providers to identify the potential problem, and its cause and address those conditions before becoming critical. From the case study, it has been observed Matthew Gunter was suffering from different health conditions including hypertension, obesity, and type 2 diabetes. The A-E systematic approach can help in monitoring these signs as well as in the detection of these signs (da Fonseca et al., 2021). It has been observed from the case study that Matthew has problems of difficulty in breathing and shortness of breath. Therefore, the use A-E systematic approach can help in the intervention of these conditions by taking measures at the right time. Similarly, it was observed that the blood pressure of Matthew and heart rate are unstable the A-E approach can help in identifying the issue that he is problem with blood circulation. Further, it was observed that Matthew shows signs of decreased consciousness, confusion, and weakness.

This shows that Matthew is also suffering from neurological dysfunction which could be assessed at the early stage using the A-E approach. Therefore red flag signs observed in the case of Matthew include changes in heart rate, respiratory rate, oxygen saturation, and heart rate. All these symptoms show that the A-E approach can help in monitoring these health conditions, identifying the potential cause, and taking intervening measures (Medicalnewstoday, 2023). However, it is also observed that symptoms including a high respiratory rate can be normalized in conditions. For instance, these conditions can appear normal during exercise or when the patient is anxious. The appearance of abnormal symptoms as normalization can result in delayed recognition of the signs and make challenges in taking the intervening steps at right time. In the case study, it was observed that healthcare providers normalized the red flag signs of Matthew (Gonzalez et al., 2020). The healthcare providers dismissed the signs of shortness of breath and anxiety.

They also assumed that signs of tachycardia were because of baseline tachycardia. However, when the signs of Matthew get worsened healthcare providers reevaluate their assumptions and take intervening measures. They make a rapid-response team for normalizing the red signs of Matthew (Nursesnow, 2023). It was founded that their oxygen saturation level of Matthew was low therefore, the nurse initiate oxygen therapy to normalize the condition. Further, his level of drowsy and unconsciousness was administered by performing a CT scan to find the underlying symptoms (Shirazi & Heidari, 2019). Therefore, both nurses and healthcare providers effectively normalize the red signs of Matthew's abnormal symptoms through the A-E approach.

As Matt’s Night Nurse, Explain Documentation's Importance and Detail Care Steps and Timing for a Clinical Review

Nursing care must include documentation because it gives a complete and accurate account of the state of a patient's care, and progress. In order to deliver safe and effective care, proper documentation makes sure that each member of the medical team receives access to crucial information. In this situation, the needs for nursing care include routine assessments, accurate documentation, plus communication with other healthcare team members. If Matthew had had the right paperwork, his terrible death might have been avoided (Alkouri et al., 2019). A record of the individual's health state, medical interventions, and progress are kept thanks to documentation, which is a crucial component of nursing care. In Matthew's situation, documentation could have been essential in informing the medical staff of his deteriorating health and the requirement for an early intervention.  When a nurse asks for a clinical assessment, it is usually because they have noticed a change in the health of the patient that necessitates additional assessment. Given the problems that developed following Matthew's operation, the registered nurse would have requested a clinical review in his case. In this case, proper nursing care needs would have included consistent vital sign monitoring, accurate documentation of examination findings and nursing interventions, and efficient interaction with other people who were part of the treatment team (Bjerkan et al., 2021). In Matthew's case, documenting was crucial in letting the medical staff knows how serious his illness was. For instance, the medical team might have been aware of the seriousness of the situation and the requirement for prompt response if the nurse had seen that Matthew was unable to breathe as well as coughed up pink foam.

Additionally, keeping track of Matthew's vital signs, such as his blood pressure, oxygen saturation levels, and respiration rate, would have made the medical staff aware of his deteriorating health and the requirement for immediate intervention. In Matthew's instance, clear communication with the other members of the medical team would have been crucial. For instance, the doctor could have quickly examined Matthew and given the right interventions to address his health if the nurse had told him about his worsening condition and asked for a clinical evaluation (De Groot et al., 2022). Regular vital sign monitoring, accurate documenting of assessment results and treatments, and good interaction with other people who are part of the medical staff are all necessary aspects of nursing care for a clinical evaluation. To guarantee that every member of the medical team has access to precise and detailed information regarding the patient's condition as well as their care plan, documentation is crucial. Nursing care for a clinical examination must include regular vital sign evaluation, precise documentation of assessment findings and treatments, and effective communication with other members of the medical staff (Tasew et al., 2019). Documentation is essential to make sure that each member of the healthcare provider's team has access to accurate and comprehensive information on the patient's health and treatment plan. It is crucial to document the reasoning for a nurse's request for a clinical review, any relevant assessment findings, treatment choices, and communications with other members of the healthcare team. This ensures that the patient receives safe and effective care because the entire healthcare team is informed about and involved in the formulation of the patient's treatment plan.

Define 'Critical Thinking' for Nurses and Explain, Using Best Practices, How It Could Have Prevented Matt's Deterioration and Respiratory Arrest

As it entails using reflective, logical, and rational thought to resolve issues and arrive at decisions in healthcare settings, critical thinking is a crucial ability for nurses. It entails having the capacity to assess data, assess evidence, and base judgments upon the best available data (ACN, 2023). Nursing critical thinking may have been essential in saving Matthew's life by avoiding his respiratory arrest and death. There are several ways by which the nurse could have used rational and critical thinking in the case of Matt.  First of all, if the nurse had used critical thinking, nurses would have recognized Matthew's respiratory distress symptoms prior to his passing out. These symptoms include wheezing, coughing, chest pain, and shortness of breath. Nurses may have recognized Matthew's declining health and respiratory problem and intervened quickly to avert his respiratory arrest by keeping an eye out for these symptoms (Willers & Jowsey, 2021). Second, using critical thinking skills in nursing would have allowed healthcare professionals to determine the possible causes of his respiratory difficulty.

An uncommon but possibly fatal illness known as negative pressure pulmonary edema (NPPE) can develop following surgery, especially upper airway surgery. Nurses would have been able to recognize certain indicators of risk for NPPE, such as youth, gender, and obesity, and regularly monitor Matthew's status for indications of this disorder with the help of nursing critical thinking (Nursesnow, 2023). Thirdly, using critical thinking skills in nursing would have allowed clinicians to choose the best courses of action to stop or alleviate Matt's respiratory distress. This might have involved giving him extra oxygen, supporting his breathing, and constantly watching his vital signs. To create a thorough plan of care for Matthew, nurses could have spoken with other medical specialists like respiratory therapists or anesthesiologists (İlaslan et al., 2023). Nursing critical thinking may have made a significant difference in Matthew's situation by averting the respiratory arrest and assuring an improved result for Mathew and his family.

Reflect on 'Speaking Up' as a Nurse and the Australian Processes and Supports for a Deteriorating Patient

I think that Speaking up is a crucial duty that goes along with being a registered nurse. It entails standing up for the patient's interests, despite the fact that there may be difficult circumstances in which to do so. By alerting the medical staff to Matthew's deteriorating condition and the need for immediate assistance, speaking up might have given him the chance to live. Australia has procedures and support mechanisms in place to give nurses the voice they need to voice their concerns about patient care. Registered nurses and other healthcare workers can refer to the recommendations provided by the Australian Health Practitioner Regulation Agency when they have concerns about the behavior or clinical performance of a colleague (Urquhart et al., 2018). Nurses are urged to raise any concerns they have about patient safety with their management, supervisor, or a regulatory organization like AHPRA. I also believe that Nurse who additionally speak up have access to support networks in addition to expressing concerns. For instance, nurses who have voiced concerns about patient safety can get legal and professional support from the Australian Nursing and Midwifery Federation. The ANMF also provides information and instruction on how to address worries regarding care for patients to other people on the healthcare team.

References

ACN. (2023, February 27). Critical thinking. Australian College of Nursing. Retrieved April 19, 2023, from https://www.acn.edu.au/thought-leadership/critical-thinking

Alkouri, O. A., AlKhatib, A. J., & Kawafhah, M. (2019). Importance and implementation of nursing documentation: Review study. European Scientific Journal, ESJ, 12(3), 101. https://doi.org/10.19044/esj.2016.v12n3p101

Armenise, A., Boysen, R. S., Rudloff, E., Neri, L., Spattini, G., & Storti, E. (2018). Veterinary‐focused assessment with sonography for trauma‐airway, breathing, circulation, disability and exposure: A prospective observational study in 64 canine trauma patients. Journal of Small Animal Practice. https://doi.org/10.1111/jsap.12968

Bjerkan, J., Valderaune, V., & Olsen, R. M. (2021). Patient safety through nursing documentation: Barriers identified by healthcare professionals and students. Frontiers in Computer Science, 3, 25–26. https://doi.org/10.3389/fcomp.2021.624555

da Fonseca, M. H., Kovaleski, F., Picinin, C. T., Pedroso, B., & Rubbo, P. (2021, September 10). E-health practices and technologies: A systematic review from 2014 to 2019. MDPI. Retrieved April 19, 2023, from https://doi.org/10.3390%2Fhealthcare9091192

De Groot, K., De Veer, A. J., Munster, A. M., Francke, A. L., & Paans, W. (2022). Nursing documentation and its relationship with perceived nursing workload: A mixed-methods study among community nurses. BMC Nursing, 21(1), 2–8. https://doi.org/10.1186/s12912-022-00811-7

Gonzalez, H. C., Hsiao, E.-L., Dees, D. C., Noviello, S. R., & Gerber, B. L. (2020). Promoting critical thinking through an evidence-based Skills Fair Intervention. Journal of Research in Innovative Teaching & Learning, 15(1), 41–54. https://doi.org/10.1108/jrit-08-2020-0041

İlaslan, E., Adıbelli, D., Teskereci, G., & Üzen Cura, Ş. (2023). Development of Nursing Students' critical thinking and clinical decision-making skills. Teaching and Learning in Nursing, 18(1), 152–159. https://doi.org/10.1016/j.teln.2022.07.004

Mahmoud, A. S., & Mohamed, H. A. (2017). Critical thinking disposition among nurses working in Puplic Hospitals at Port-Said governorate. International Journal of Nursing Sciences, 4(2), 128–134. https://doi.org/10.1016/j.ijnss.2017.02.006

Medicalnewstoday. (2023, April 19). Normal blood oxygen levels: What is safe, and what is low? Medical News Today. Retrieved April 19, 2023, from https://www.medicalnewstoday.com/articles/321044

Nursesnow. (2023, March 16). Examples of critical thinking in nursing and why it's important. NurseJournal. Retrieved April 19, 2023, from https://nursejournal.org/articles/the-value-of-critical-thinking-in-nursing/

Shirazi, F., & Heidari, S. (2019). The relationship between Critical Thinking Skills and learning styles and academic achievement of nursing students. Journal of Nursing Research, 27(4), 34–56. https://doi.org/10.1097/jnr.0000000000000307

 Tasew, H., Mariye, T., & Teklay, G. (2019). Nursing documentation practice and associated factors among nurses in public hospitals, Tigray, Ethiopia. BMC Research Notes, 12(1), 2–6. https://doi.org/10.1186/s13104-019-4661-x

 Urquhart, C., Currell, R., Grant, M. J., & Hardiker, N. R. (2018). Nursing record systems: Effects on nursing practice and healthcare outcomes. Cochrane Database of Systematic Reviews, 22–45. https://doi.org/10.1002/14651858.cd002099.pub3

Willers, S., & Jowsey, T. (2021). How do nurses promote critical thinking in acute care? A scoping literature review. Nurse Education in Practice, 53(9), 103–108. https://doi.org/10.1016/j.nepr.2021.103074

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