Abstract physical condition of a newborn), and was placed

 

Abstract

I chose to write my essay on the work load
of nurses because it is something that seems to be over looked. From a young
age, I have been drawn to everything related to medicine and taking care of
others.  From the bottom of my heart, I
believe that nurses deserve the same recognition as doctors because at the end
of the day, they are a team. I recall a time when my sister, a registered nurse
midwife of 15 years, saved a patient and her baby’s life and the doctor was the
one recognized.  A patient was brought in
at 12:30 am at 3cm, and only moved 1cm since admission with a grade 3 meconium
(the first feces of a new born), receiving 5l oxygen via face mask as the baby
was in destress and needed additional oxygen. Upon reviewing the patient’s
notes, she spoke to her gynecologist 2nd, explaining to her that she was
preparing the patient for an emergency caesarean. Doctor Gomez said, “wait to
see if she makes any progress because I am not interested in doing a caesarean
section today.”  After speaking to the
doctor, she examined the patient to find small clots at the introitus (vagina).
My sister then bypassed the doctor’s decision, and took the patient into the
operating theatre for a caesarean section as she was noted to have placenta
abruption (when the placenta is detached from the mother). As for the infant,
he came out with Apgar score (a physical condition of a newborn), and was
placed in the nursery for close observation. 
If my sister had waited longer the infant would have died, but Doctor
Gomez got recognition for saving their lives. This particular incident my
sister experienced, drove me to highlight a day in the life of a registered
nurse, with hopes to enlighten my audience that nurses work just as hard as
doctors.

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A Day in the Life of a Registered Nurse

A doctor may find the medical cause of a
patient, but it is the nurse who helps the individual to overcome them (Picoult,
2003). To say registered nurses are busy is a bit of an understatement. They
spend long hours daily dedicating time and effort into their work. The
determination is clear within the role of a nurse which includes leadership, assessment
and treatment, for each of their patients. Nurses are doers who work physically
harder than doctors. They are not as well paid or respected as they deserve. As
well, they have less autonomy and less credibility than they might. Finally, they
are wonderful patient advocates.

Nursing leadership assures that every
individual does their part to get a job done. The individual that is in charge
for the entire nursing team is called the head of nursing, and that individual must
allocate each staff member to a task, they need to ensure that every patient
has received adequate care and debrief every individual on the team. According
to the American Nurses Association (ANA) Code of Ethics for Nurses with
Interpretive Statement, the nurse is responsible and accountable for individual
nursing practice and determines the appropriate delegation of tasks consistent
with the nurse’s obligation to provide optimum patient care (Kelly-Heidenthal
and Marthaler, 2005).

When the staff arrive to work, the
individual that is in charge has to assign each nurse to five-six patients and a
clipboard (medical chart containing information such as: medical history, vital
signs, diagnoses, treatment plans, laboratory and test results). Then, the
nurse has to go into every patient room during morning assessments, set up
patients for breakfast, chart (medical chart), give medications, and assist patients
with following out doctor’s orders. Lastly, at the end of the shift the nurse
and the nurse in charge must debrief the nurse on the oncoming shift. During
the handover, the nurse has to give details of every patient assigned. The
handover of each patient is generally made up of three sections: Past:
historical information. The patient’s diagnosis, any information the team needs
to know about the patient treatment plan. Present: current presentation. How
the patient has been during that time of the shift and any changes to their
treatment plan. Future: what is still to be done. For lots of reasons tasks
that need to be completed at a certain time may be handed over to the next
shift, simply because the team did not have time to complete the task (Daniels,
2004). Nursing leadership is vital not only to the long-term credibility of the
nursing practice, but to achieving good patient and client care and effective
nursing leadership is very important in all nursing role.

Clearly, nurse-patient encounter is the
first encounter between a nurse and patient while assessing that patient. Nurse
assessments focus upon the patient response to health problems, perceived
health needs, health practices and values. The goal of assessment is the
collection and analysis of data that are used in formatting nursing diagnoses,
identifying outcomes and planning care, and developing nursing interventions.
Incomplete or inadequate assessment may result in inaccurate conclusions and
incorrect nursing interventions. When entering a healthcare facility nurses are
the first person individuals will encounter asking them series of questions
while checking their vital signs, it may not seem like a lot of work to some,
but nurses do assessment from the moment an individual walk through the door
and at the beginning of every shift. There are three types of assessments carried
out by nurses, comprehensive, focused and an ongoing assessment.  Firstly, the nurse must perform a
comprehensive assessment which is completed upon admission to a healthcare
agency. This assessment includes assessing the physical, emotional and mental
aspects of all body system as well as the environment and social issues
affecting the patient. Next, a focused assessment, this assessment collects
data about a problem that has already been identified. This assessment has a
narrower scope and a shorter time frame than the initial assessment, the nurse determines
whether the status of the problem has change (improved, worsened, or resolved).
Finally, an ongoing assessment which is a systematic follow-up when problems
are identified during a comprehensive or focused assessment. This assessment
includes the nurse doing systematic monitoring and observing related specific
problems, it also allows nurses to broaden the database or confirm the validity
of the data obtained during the initial assessment (Daneils, 2004).

 “The
most important practical lesson that can be given to nurses is to teach them
what to observe- how to observe-what symptoms indicate improvement- what the
reverse- which are of importance-which are of none-which are the evidence of
neglect- and of what kind of neglect. All this is what ought to make part, and
an essential part, of the training of every nurse” (Nightingale, 1860/1969,
p.105).

 

Nurses provide care based on patient needs,
working along with doctors to formulate a care plan. The nurse provides
psychological support to clients with terminal illness. In addition, through
the assessment process nurses individualized priority-setting, priorities will
be influenced by the acuity of the patient’s condition and the acuity of all
patients assigned to a nurse. Priority ranking of patients are characterized
into three levels: First level is where they treat patients with immediate
survival, safety and high demand. Second level highlight concerns such as
mental status change, acute pain, acute urinary elimination, untreated medical
problems requiring immediate attention (diabetic needing insulin), abnormal
pathology lab results, risk of infection and safety or security. Third level is
where those that do not fit into the above categories. When there are no
life-threatening problems, nurses used both professional judgement and the
patient to set priorities and determine planning. “Prioritization is defined as
deciding which needs or problems require immediate action and which ones could
be delayed until a later time because they are not urgent”. (LaCharity,
Kumagai, and Bartz, 2006, p.4)

Critical thinking skills is the core of
being a good nurse, in addition, they use these skills to provide effective
care while coping with the expansion in roles associated with the complexities
of current health-care systems. Nurses use critical thinking skills to prevent
medication error. In fact, they think in a systematic and logic manner with openness
to questions and reflect on reasoning to ensure safe nursing practice and
quality care. Every day, nurses make decisions through critical thinking.
Critical thinking is identified as an essential nursing competency by the
National League for Nurses (1997). Critical thinkers are people who know how to
think. They possess intellectual autonomy, in fact they refuse to accept
conclusions without evaluating the facts and reasons for themselves. Critical
thinking is process that allows nurses to see the big picture instead of
focusing only on details. Furthermore, nurses must administer numerous drugs
daily in a safe and efficient manner. They administer drugs according to the
nursing standards of practice and agency policy. Before administering any
medication, the nurse must compare the medications listed on the Medication
Administration Record (MAR), other recording forms, or computer orders with the
healthcare practitioner’s order. When administering medication, the nurse must
check the label when removing the drug container from the drawer, check the
drug when removing it from the container and before returning it to the
patient’s medication drawer. The nurse should give only medication that they
prepared and checked, because they are the responsible party should an error
occur.

As a result, long hours and dedicated time
spent by nurses are their daily work routine. Everyone has a common goal, but
the nurses are not being recognized for their hard work. They deserve the same
recognition as doctors because nurses are the center of healthcare. Society
think so little of nurses, but at the same time doctors rely on them so much.
Doctors will see a patient anywhere from five to thirty minutes a day depending
on how sick they are, and the rest of the work are left to the nurses. They are
the ones making sure patients get their pills, check their vital signs to
ensure they do not drop, make sure patients do not fall and break something. If
a patient vomits, doctors will run out of the room while a nurse rushes in. They
change patients wound dressings and start their IV line. They will clean
disgusting things off patients even if they are drunk, delirious or mean and
through all of this they try to be friendly and positive. To say registered nurses
are busy is a bit of an understanding. The determination is clear within the role
of a nurse which includes leadership, assessment and treatment, for each of their
patients.

 

 

 

 

 

 

 

 

 

 

 

 

 

References

 
Daniels,
R. (2004). Nursing fundamentals: caring
& clinical decision making. New York, NY: Thomson
Delmar Learning.
Delaune, S. C.
& Ladner, P.K. (2002). Fundamentals
of nursing: Standards & practice (2nd ed.).
             Albany, NY: Thomson Delmar
Learning.
Kelly-Heidenthal,
P., & Marthaler, M.T. (2005) Delegation
of nursing care. Clifton Park, NY:
              Thomson Delmar Learning.
LaCharity, L.A.,
Kumagai, C.K., & Bartz, B. (2006) Prioritization,
delegation, and assignment:
              Practice
exercise for medical-surgical nursing. St. Louis,
MO: Mosby Elsevier
National League
of Nursing. (1997). Interpretive
guidelines for standards and criteria 1997:
             
Baccalaureate & higher degree. New
York: National League for Nursing Accrediting
              Commission.
Nightingale, F.
(1860/1969). Notes on nursing: What it
is and what it is not. New York: Dover.
Picocult, J.
(2003). My sister’s keeper. Simon &
Schuster.

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