Posted: April 5th, 2022

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Appendix 5: Assessment of a Work Expertise Placement Reflection (PEPAE)

Registered nurses are instructed to judge their work to enhance care in a healthcare system that’s at all times altering (Nicol & Dosser, 2016). On this paper, I’ll use Driscoll’s mannequin of reflection to suppose critically about one thing that occurred throughout my final scientific placement (Driscoll, 2007). This paper will give a quick abstract of the occasion, an Assessment of what occurred, and a suggestion for one more manner to enhance the care given.
What’s it? The PEPAE in short

This PEPAE reflection is a couple of girl in her mid-20s who was moved to the ward for ache administration, monitoring of her meals and fluid consumption, and administration of her stools. She had an acute flare-up of Chron’s illness, and when she went to the emergency room, she had extreme ache within the decrease proper quadrant of her stomach, diarrhea, and bleeding. Throughout the Assessment, she was in ache on a scale of 6 out of 10, which led to a precedence nursing prognosis of acute ache. As an intervention, the affected person was taught about non-drug strategies (Ackley & Ladwig, 2016). Additionally, the affected person did not drink sufficient or eat sufficient and was shedding weight. From these, an unbalanced food plan was discovered to be the second nursing prognosis. Then she was given high-calorie meals and dietary dietary supplements to take by mouth (Ackley & Ladwig, 2016). She additionally had a low variety of pink blood cells and haemoglobin. She was additionally very stressed about work.
Then what? Ideas concerning the Essay

When first-year nursing college students go on scientific placements, they typically do not know sufficient or have sufficient abilities to provide patient-centered care (Ewertsson et al., 2017). This essay was written in my first yr, after I did not have a variety of scientific expertise. As such, I used to be not in a position to do a complete Assessment on the affected person and didn’t recognise the attainable results of her situation on her psychosocial wellbeing. Individuals with Chron’s illness could really feel very annoyed as a result of they can not management once they go to the toilet (LeMone et al., 2014a). This

might need gotten in the best way of the affected person’s private, social, and work life, and it could have given her or him a foul physique picture (Ackley & Ladwig, 2016; LeMone et al., 2014a). I used to be too centered on getting the head-to-toe analysis finished that I forgot to consider how she felt. I am now extra positive that I can embrace this in my future assessments and make adjustments primarily based on that.
I additionally instructed the affected person that earlier than she may go dwelling, I needed her weight to be within the regular vary. In Chron’s illness, abdomen ulcers make it onerous for the physique to soak up vitamins (Craft & Gordon, 2017; LeMone et al., 2014a). Because the affected person’s situation bought worse, I now suppose it’s unlikely that she is going to acquire weight in a brief period of time. I’d as an alternative work together with her dietician and counsel an enteral food plan like Guarantee to exchange the vitamins she has misplaced (Ackley & Ladwig, 2016; LeMone et al., 2014a).
Alternatively, one good factor I did within the PEPAE was ensure that I and my sufferers have been secure by solely doing issues that have been inside my scope. Although non-drug strategies like deep respiratory and leisure are evidence-based ache administration interventions (Ackley & Ladwig, 2016), I’d now give sufficient ache medicines to complement these non-drug strategies (Ackley & Ladwig, 2016; Szigethy, 2018). (Non-pharmaceutical therapies needs to be used along with pharmaceutical therapies.)
What’s subsequent? The brand new plan

As I already stated, the primary factor I did for the affected person’s acute ache was to show them non-drug methods to take care of ache, like deep respiratory and enjoyable. Although these are evidence-based therapies, I’d now give opioid painkillers after a PQRST ache Assessment as a brand new manner to Help the affected person take care of ache higher (Ackley & Ladwig, 2016; Crisp et al., 2020). There may be proof that opioids can be utilized to deal with belly ache attributable to Crohn’s illness. That is in keeping with the rules for giving painkillers for average ache (MIMS, 2021; NMBA, 2020). The affected person’s physician gave them professional re nata oxycodone, which works finest after an hour (Australian Medicines Handbook, 2021). The affected person’s ache must be taken care of immediately as a result of it retains them from sleeping and getting by their every day duties. It additionally causes stress and nervousness, which lowers their high quality of life (Szigethy, 2018).
It’s attainable, although, that opioids (multimodal analgesia can be extra correct and efficient) may cause unwanted side effects within the intestine, like paralytic ileus, which makes the signs of Chron’s illness worse (Australian Medicines Handbook, 2021; Norton et al., 2017). Before everything, non-drug interventions Help and Help analgesia each in ache reduction and ache management, lowering the necessity for oxycodone (Szigethy, 2018; Zeilinska et al., 2019). So, giving analgesics and different methods to take care of ache that do not contain medication makes ache administration simpler. Oxycodone provides the affected person instant reduction, and deep respiratory and leisure Help scale back the danger of unwanted side effects from utilizing it for a very long time (Regueiro et al., 2017; Shallik, 2018).
Conclusion

After occupied with my final PEPAE, I used to be ready to consider making some adjustments to how I take care of my sufferers.

This crucial reflection helped me work out why I did not discover the affected person’s psychological and social well being. I’d now take into consideration doing an intensive analysis as a part of my apply. Additionally, along with the non-drug strategies I discussed in my earlier PEPAE, I’d now add the administration of opioid analgesia (THIS WOULD BE MORE OF A PRIORITY, AND NON-DRUG PAIN MANAGEMENT WOULD SUPPLEMENT THIS) to Help her handle her ache higher.

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