Workplace Reflections
[Name of the Writer]
[Name of the Institution]
HLTENN005
Health information
Clinical presentation
Possible Nursing Intervention
A person is facing complex conditions such as memory loss and difficulty in paying focus and attention.
Cognitive dementia tests are a reliable way of indicating dementia. Mini-Mental State Examination helps to evaluate the diagnostic performance of these tests in order to detect the possibility of dementia.
Community Mental health nurses need to provide support to people who are suffering from dementia. These nurses can advise the carers on how to improve the quality of life for the patient. These nurses can also advise carers to use certain medications such as rivastigmine (Exelon) that can boost the memory and judgment level.
A person is suffering from anxiety disorders which includes extreme fear and panic attacks.
Physical examination often looks for signs that are contributing to an anxiety disorder. Blood tests also help to determine the symptoms of anxiety disorders. Using DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) also help to determine a diagnosis.
Nurses need to recognize the awareness of the patient’s anxiety. Nurse’s interventions also include the use of touch and verbalization to encourage clarification of needs and concerns. It is also effective if nurses interact with the patient in a peaceful manner.
A person is suffering from the bipolar affective disorder. He is experiencing episodes of elation and depression.
Physical examination and psychiatric assessment provide a better understanding of the thoughts, feeling, and behavior patterns of an individual. The criteria of DSM-5 also helps to effectively compare the symptoms of patients with standards of bipolar disorder.
Nurses need to provide structured solitary activities to the patient in order to provide focus and security. In order to prevent the risk of serious dehydration, it is the responsibility of a nurse to provide frequent high-calorie fluids. Patients also need to redirect violent behavior by focusing on the patient's physical exercise as it helps in reducing tension.
HLTENN006
Criteria
Please document examples of what you have observed, practised, performed or discussed related to each criterion
Participate in client education activity on wound management strategies
Before addressing any wound, it is required to perform an overall assessment of patient which includes history, examination, investigation, diagnosis, and implementation. It is essential to understand the medical and surgical history of the patient. It is effective to examine the patient before addressing the wound. Before addressing a wound, it is useful to take blood tests and perform x-rays to investigate the wound. After identifying the type, volume and consistency of wound, along with the types of tissues (necrotic, infective, poor quality granulation, and macerated), one can address the wound.
Perform Wound Management
21 years old male was burned during a bonfire get-together with friends. He was pushing logs into the blaze when he burned his hands. It is notable to mention that the friends of patient applied running water on him for some time in order to treat the burn. The patient had superficial burns on his right at the time of ER admission. It is worthy to mention that the patient also had partial thickness burn on his left palm. Pads and gauze bandages are effective to wrap the hands of patients. After that, there is a need to perform ACTICOAT dressing. As the wounds are extensive in this case, so ACTICOAT dressing must be applied. Apply the dry ACTICOAT dressing to the wound and it should be covered with an absorbent secondary dressing. It is useful to apply ACTICOAT dressing as it reduces the swelling in less than 2 to 3 days.
48 years old male with a history of should wound. It is notable to mention that the wound remained untreated for several months. The shoulder of the patient developed an ulcerating mass. Radiation treatment is effective to handle this wound. After applying radiation treatment, the wound needs to be dressed in hydrogen peroxide and saline gauze. In order to remove the tissues near the brachial plexus, there is a need to perform a resection. Regional flap rotation is also effective after performing a resection to reduce the symptoms.
The patient is a 58 years old male who has been diagnosed with type II diabetes. His left foot developed severe ulceration. He is suffering from severe red blotches and edema and erythema. In addition to the round of IV antibiotics, there is a need for debridement before placing a wound VAC. In order to reduce edema, it is compulsory that a straightforward suture line needs to be treated with a dressing to provide waterproofing covering. This type of dressing needs to be placed for five to seven days in order to reduce the symptoms of severe red blotches.
Wound Swab
In order to perform wound swab, one must need to review the health care provider’s order. First of all, clean the wound by gathering supplies and clean the specimen. After that, one must need to redress the wound. It is notable to mention that one must put on clean gloves to ensure hygiene. Assess the wound and its nearby area to check the condition of tissues. Thoroughly rinse the wound with sterile saline solution and then swab the wound from margin to margin. After that, place the swab in the culture medium and redress the wound accordingly.
HLTENN007
Criteria
Please document examples of what you have observed, practised, performed or discussed related to each criterion
Locate the Poisons and Therapeutic Goods Act and summarise the implication of this act
The Poisons and Therapeutic Goods Act 1996 highlights the regulations promulgated formedicines, poisons and drugs. The legislation aims at protecting the welfare and health of the members of the NSW community. For instance, it imposes stringent limitations on the use of several potent drugs, poisons and medicines by restricting the distribution or administration to viably authorized and qualified persons. The absence of substances from the schedules never implies that they are devoid of legal restrictions on supply, possessions, use, packaging or labelling.
Locate and become familiar with the documentation for medication administration including medication registers
The administration of medicines by authorized persons should be conducted in a systematic manner to assure the following elements:
Right patent
Checking the name on the patient and the order
Using two identifiers
Asking the patient to identify himself
Using technology when available
Right documentation
After dispensing the ordered medication, document administration
Charting the route, time and pertinent essential information
Right Dose
Checking the appropriateness of the dose by using a drug reference
Calculating the dose and taking the assistance of a professional to calculate it if necessary
Locate the specific areas for storage of medications
Storage facilities ought to have the capacity for both handling and storing. In large facilities, it is imperative to utilize cold rooms rather than several freezers or refrigerators. Primarily, these facilities should have a negative temperature. However, the presence of secure storage is also essential. A locked cupboard or cabinet can be sufficient for facilities while other facilities may need a cage or vault. The light inside the storeroom should absorb natural light (sunlight) to avoid the utilization of either incandescent or fluorescent bulb lighting. The ultraviolet rays emitted by fluorescence lightning cast an adverse impact on some products.
Observe and practice methods for handling medications
The social and healthcare staff can manage staff on behalf of others using their services. However, providers ought to promote and sustain the efficient usage of medicines while handling them. It encompasses a wide range of issues as manifested in handling, prescribing and administering medicines. The failure to comply with the measures is likely to pose potential threats to the people who are prone.
Observe checking of S8 medication
Critical attention needs to be paid to the discarding mechanism of Schedule 8 as buprenorphine and fentanyl transdermal patches which have been removed from the skin of the patient. Discarded patches, as the best practice, should be folded in half to keep the medication trapped within the adhesive area and further disposing of in the sharps container. For liquid S8 medication, excessive amount than the prescribed volume can be present in the bottle. The volume has to be adjusted in the register of Ward’s DD.
Observe client assessment and administration of medication
The administration medication support will refer to assisting the client with self-medication which can comprise several reminders to the client to administer and take the medication. If needed, helping the client by opening the medication container and pertinent assistance other than medication administration. The client possesses the responsibilities and obligations for medication administration.
Monitor clients for effect of medication administered
The plausible and effective supervision of medical administration is essential to cast a positive impact on the overall health of clients during treatment. The route, dose, methods, dispensation and necessary checks shape the impact of medical administration on the client. If steps are taken profoundly, productive implications are yielded otherwise adversities may harm the health of the clients.
Discuss and observe the RN's administration of certain forms of a topical medication.
For the listed administration of the listed topical medication, hygiene is the foremost aspect to be considered. The sensitive parts should be injected with drops or sprayed in an empty place where conversation with others can be avoided. The name and label on the medication must be double checked. Tissue needs to be offered to the patient and in case of dealing with the skin, clean and non-sterile gloves should be worn.
Note the various forms of intravenous access devices used in the clinical area and determine why that device was used for the particular client
Peripheral Intravenous is a commonly used device for the administration of intravenous medications and fluids. These are placed in the peripheral veins through an intravenous catheter. Another device used commonly in the clinical setting is the Central Venous Access Device (CVAD). Intended for both long term and short term use, it can offer access to the venous system via inferior vena cava (IVC) or the superior vena (SVC).
HLTENN0011
Health information
Clinical presentation
Possible Nursing Intervention
Asthma is a prominent chronic disease of the airways which transport air from and to the lugs. Systematic and critical clinical management can assist a person suffering from asthma to live an active and healthy life. It is an incurable illness which manifests in narrowing inside the lung, inflammation and restricting the air supply. In severe cases, the airways get tightened to such an extent that the airways are further restricted causing the overproduction of mucus.
Chest pain or tightness
Shortness of breath
Coughing and wheezing making it difficult to sleep
A wheezing or whistling sound while exhaling
The need for utilizing the quick-relief inhaler persistently
Cold or flu further aggravating the wheezing or coughing attacks
Asthma induced by exercise (worse in dry and cold air)
Occupational asthma (dust, chemicals and gases)
Asthma induced by allergy (mould spores, pollen)
A step by step intervention plan is essential to address the adversities and complications to prevent the asthma attacks. First, the history of the patient should be assessed to check for the allergic reactions before prescribing medication. The severity of signs as pulse oximetry and breath sounds should be monitored. Besides, pharmacologic therapy is crucial to administer the responses of patients to medication. A common intervention is administering the fluids when patients are dehydrated.
HLTENN005
Criteria
Please document examples of what you have observed, practised, performed or discussed related to each criterion
Observation of Continuous Cardiac Monitoring
Continuous monitoring is established as the one important form to ensure the proper clinical approach in case of the cardiac domain. Telemetry is recognised as the specific observation instrument that permits continuous observation and assessment of different cardiac perspectives such as the features of ECG, RR, etc. This form of consideration is particularly applied to the client concerning to the concern of cardiac aspects. Regular monitoring is one prominent aspect of consideration when it comes to the idea of comprehensive clinical guidelines for the nursing staff.
Observation and Performance of 12 lead ECG
The approach of comparing the particular classification can be used to attain better forms of diagnostic knowledge. This form of diagnostic knowledge come up with the consideration of standard 12 lead ECG created in the specific form of the clinical setting. the phenomenon of standard 12 lead ECG applied for the specific client by adopting the approach of 120-lead data or the feature of the body surface. Classification of the group helps to determine the overall signal leads. Construction of potential maps can be helpful to determine the suitability of all relevant measurements. Consideration of different values eventually helps to determine the original measurements concerning the medical state of the client.
Neurovascular Observations
Establishment of the idea of neurovascular observations is adopted for the client to attain a better approach in the form of circulation observations. Performing circulation assessment in case of the client helps to determine the cardiac positioning. The basic functions of this form of consideration are to properly evaluate the paradigms of sensory and motor function and the domain of peripheral circulation. The overall phenomenon of neurovascular observation comprised of the important practical implications in the forms of pulses, capillary refill, skin colour, temperature, sensation, and the overall perspective of motor function.
Pain Management Options
It is important for the nursing staff to have an adequate understanding of the different options concerning the broad idea of pain management. The particular prospect is closely linked with the domain of health care facility. Pain killers are one critical perspective relevant to the broad idea of available pain management options. The perspective of specific pain management options includes the aspects of tablets, injections, continuous drip that contain pain medicine. Patient-controlled analgesia (PCA) is another prominent option relevant to the concern of pain management in a healthcare setting.
Care with a Nasogastric Tube Insitu: Tube Position Confirmation, Aspiration
Nasogastric Tube Insitu requires some specific form of considerations concerning the main idea of a feeding tube. It is important for the nursing staff to critically examine the comfort level of the patient to attain a better form of aspirate in the form of Nasogastric tube management.
Performing Intermittent &/or Enteral Feeding Pump Administration of NG Feeds
There are different practical ways that can be considered to successfully adopt the approach of enteral tube feeds. The bolus is a significant option to attain the better form of the administration of the approach of enteral tube feeds. The domain of intermittent infusion is established as an effective aspect to ensure the moderate form of feed availability for the client.
Gastrostomy Tube Feeding
The approach of Gastrostomy tube (GT) is characterised as the short feeding tube that is directly linked with the domain of the stomach. This form of connection is observed through the perspective of surgical incision which is recognised as a stoma. Performing the domain of GT eventually helps to provide liquid food and water to the patient through the option of a feeding tube.
Client’s Care with Cast &/or Traction
Adoption of the perspective of client care with the forms of cast or traction is one prominent form of the overall healthcare form for the care of the client. The approach of cast care is defined as the suitable form of external immobilizing device that is developed in the form of proper delineations of the client’s body. The approach of the cast is used to develop the approach of immobilization with the objective of reduced fracture or the consideration of any form of irregularity in the body.
Participation in the Care of a Person with a Stoma
It is important for the nursing staff to have a clear understanding of the option of care of a person in the form of the stoma. Proper nursing participation is mandatory to consider the domain of stoma patients in the form of self-care. The approach of the stoma is used referred to the surgically created option. It is established as the artificial openings that are used to connect a part of the gastrointestinal tract to the surface of the skin of the patient.
Participation in the Care of a Client with a Tracheostomy
Tracheostomy care is characterised as the one important form to ensure proper health and safety consideration for the client. Active participation in this domain is established as the adoption of required changes within every 8 hours and according to the specific need of time. The procedure of tracheostomy involves the consideration of deep breathing and coughing exercises for the client in every 2 to 4 hours.
Indwelling Urinary Catheter
The approach of an indwelling urinary catheter is another option considering the overall perspective of patient care for the client. The perspective of indwelling is established as the consideration of the inner domain of the body. The feature of catheter drains urine from the bladder relevant to the outside of the body.
Ministry of Health Circulars
The platform of NMBA is established as the authority who regulates the healthcare practices of nurses in the country. This particular regulatory institution settles comprehensive guidelines for the practice of nurses particularly appeared in the form of healthcare circulars.
Referral Options & Resources
It is a need for a proper understanding of specific referral options and resources to ensure the proper execution of the domain of complex needs specifically linked with the community. The approach of referral options comprised of different forms of healthcare services to ensure timely and exact healthcare paradigms.
HLTENN012
Criteria
Please document examples of what you have observed, practised, performed or discussed related to each criterion
Complete a pain assessment on a client and list the effects pain may have on a client with a chronic health problem
There are various methods of pain assessment in heart patients with chronic diseases. The one I found to be most effective is the ‘PQRST' method of analysis. The first step is to determine the position of pain, and this can be done simply by asking the patient where they are feeling pain. The second step is to ask the patient to describe the quality of pain – whether it is stabbing in nature or crushing? The next step is to ask the patient if the pain is radiating towards other parts of the body. The fourth step is to determine the severity of pain and any accompanying symptoms such as nausea or vomiting. Finally, the time duration of pain must be discovered and whether the pain is intermittent or continuous.
HLTENN013
Criteria
Please document examples of what you have observed, practised, performed or discussed related to each criterion
Observe the use of validation therapy, music therapy, and reminiscence
The use of validation therapy reduces the number of medicines taken by patients, a testament to its success. Moreover, the number of times patients fall down also reduces.
I have found that music helps calm the patient and sometimes puts them to sleep. Music is very helpful in reducing stress in older patients.
Reminiscence helps foster positive attitude in older adults as stress is reduced. Also, I have observed that agitation gets minimized. In certain cases, patients began to wander less which can be a difficult situation to handle.
Identify in hospital resources and community services available for medical conditions
There are multiple cancer resources in and out of the hospital including support groups and counselling. Specialized personal is available that deal with patients according to the problems they are facing. Equipment is also available for specific purposes that serve the need of individuals with health issues.
Investigate the physical, emotional and mental signs of stress in the older person
Changes in eating habits, mood swings, increased irritability, general sadness or depression, body aches or pains, changes in sleeping patterns and refusing to socialize.
Participate in a family conference
Family meetings are important as they help decide the future courses of action in accord with the next of kin of patient. Important decisions are made with consultation and guidance from relevant doctors.
Participate in an aged care funding instrument assessment
The ACFI assessment has three broad categories that are ‘activities of daily living’, Complex Health Care and behaviour. The appraiser checked for physical well-being, wandering about in the hospital as well as verbal behaviour. The appraiser also inquired about depression. All of these criteria, along with more, were used to identify which patients deserve the most funding.
Discuss the behaviour modification of the behavior of concern
Behaviour modification requires a few steps including risk assessment, behaviour assessment and finally management strategies. Risk assessment allows us to determine whether there is any immediate concern to the health and safety of the individual as well as those around the individual. Behaviour assessment then integrates the condition of a patient with the symptoms displayed and tries to assess the exact behavioural problems. Finally, the strategies for management are discussed and the appropriate psychosocial therapy is applied to modify behaviour displayed in situations such as dementia and depression.
Discuss the primary health care services for the older person
One of the most important health services for the older person is the integration of prevention with illness management. Another service is that of education about things unknown to the older person. Perhaps most importantly, continuity in care is the most important concern for the older person as they need to be taken care of the most.
Discuss counselling and support for the older person
Counselling for the older person is crucial as they require planning for health care and resolving other conflicts. Families may also attend the sessions as the planning is crucial for the older person because their relationships depend on their mental health along with their overall general well-being.
CHCPRP003
Goal
Current Level of Knowledge
Timeframe
Potential Support Network-Training
Work Methods to Improve Performance
Ways of Measurement
Enhance the involvement of necessary intervention
Nursing staff have an understanding of the overall form of healthcare practices
3- 6 months
Increasing experience level to achieve the objective of personalized healthcare
Adoption of the aligned and developed practical domains
Analysis of the overall approach of patient care
Expansion of the knowledge about required instruments
Currently, working at the first level of healthcare perspective
9-12 months
Training is necessary to enhance the understanding level of practical implications
Integration of important data with a suitable form of practice execution
Workload reliability is one approach of consideration
Increase the empowerment of nursing staff
Nursing department has the perspective to follow specific guidelines
9-12 months
Development of support networking is integral
Consideration of the initial workload and health care perspectives are integral to ensure improved domain of action
Adoption of a method to ensure the involvement and effort of nursing staff.
CHCDIV002
Criteria
Please document examples of what you have observed, practised, performed or discussed related to each criterion
Investigate and evaluate services available to assist Aboriginal and Torres Strait Islander clients in the Health care facility
Healthcare access for Aboriginals and Torres Strait Islander persons is not the same as that for people of other ethnicities. The disparity has been reduced somewhat but a large gap still remains. Aboriginals and Torres Strait Islander people still have lesser access to dental facilities in the healthcare facility and ear health is also ignored to a certain extent. However, other services such as digital health services are more accessible to Aboriginals and Torres Strait Islanders in the healthcare facility now than any other time in the country’s history.
Immunization services to children as well as adults of the Aboriginals and Torres Strait Islander are also available. To a certain extent, there are programs for healthy eating and environmental injury hazards. The access to sexual health and sex education has also improved for the Aboriginals and Torres Strait Islander persons. Moreover, injury and accident prevention facility and services are also available for them. Perhaps, most importantly, the Healthy Lifestyle program is available and accessible for most people belonging to the Aboriginals and Torres Strait Islander.
Comment and reflect on cross-cultural awareness you observed with other cultures in work practices
Cross-cultural awareness has improved in the healthcare facility and beyond as people start to become more aware of the fact that each culture has its own traditions and specific activities as well as mannerism that is unique. Understanding this makes the job of healthcare professionals becomes easier as people start to respect different cultures. Since everyone in Australia is legally allowed to have basic healthcare access, denying someone this access or creating hurdles is unbecoming of a true healthcare professional. A facility is a good place for people of different cultures to come and access healthcare services without fear of being discriminated against. Isolated incidents may take place but the overall outlook of the environment remains positive. When hospitals and people working there started to respect cultural sensitivities, there has been a marked increase in cooperation from people of different cultures as well. This has led to better access and availability of health services in the facility in my observation.
END NOTES
Mehmood, Nasir, Alex Hariz, Robert Fitridge, and Nicolas H. Voelcker. "Applications of modern sensors and wireless technology in effective wound management." Journal of Biomedical Materials Research Part B: Applied Biomaterials102, no. 4 (2014): 885-895.
Phillips, Jane Louise, and David C. Currow. "Cancer as a chronic disease." Collegian 17, no. 2 (2010): 47-50.
Riedlinger, Dorothee I., Paul A. Jennings, Dale W. Edgar, John G. Harvey, Ms Heather J. Cleland, Fiona M. Wood, and Peter A. Cameron. "Scald burns in children aged 14 and younger in Australia and New Zealand—an analysis based on the Burn Registry of Australia and New Zealand (BRANZ)." Burns 41, no. 3 (2015): 462-468.
