During my recent clinical placement at XYZ Hospital, I encountered a situation where I had to recognize and respond to a patient’s clinical deterioration.

QUESTION

NPU 3505 TOPIC… PROFESSIONAL REFLECTION.

PART A : REFLECTION: 750 WORDS

TOPIC: Using an example from your previous clinical placement experience , reflect on your demonstrated ability to recognize and respond to patents’ clinical deterioration.

USE GIBB’S Reflective model

SIX MAIN HEADINGS :

1. Description: only 50 words

describe the event in detail objectively, accurately, concisely

where did this occur, who was there, what were you doing, what happened, in what context did it happen, and what part did everyone involved play in the event?

2. FEELINGS: Only 50 words

How did you feel when performing this skill?, discuss your thoughts and feelings about the experience; what are your thoughts before, during, and afterward, what are your feelings, both positive and negative? how do you feel about the outcome?

3. Evaluation: 100 words

what did you do correctly or correctly? Discuss what you think went well or not so well. consider, how did you react to this situation, how did other people react, what was good and bad about the experience, was the situation resolved, and how was it resolved?.

4.ANALYSIS: ONLY 300 WORDS

Analyze the situation. What sense can you make out of the experience? If things didn’t go so well, how did you or others contribute to this, what questions they have been raised from the encounter, how did it happen, what factor affected the outcome of the experience, and how do you our practice impact your patient? This section important for the high level of writing, references needed minimum three including NMBA RN standards for practice and national safety and quality health services, intext citation should  apply. 

5. CONCLUSION: ONLY 100 words

how do you think you have preferred, can you do better, discuss what you have learned from this experience, and acknowledge what you could have done/responded in a different way. consider what are the alternative actions or approaches, and include only positive outcomes. discuss whether you would do the same again or anything you would change to improve a negative experience.

6. ACTION PLAN: only 150 words

how would you improve? the action plan sum up what I would like to work on or differently next time. consider, what will you do if you encounter this situation again, what you will do in the future, what you need to learn, and how do you learn it.

7. References: Once your references have been entered (each as a separate paragraph), highlight all the text and click on the Paragraph Indent icon on the toolbar, and select Hanging Ident from the drop-down list.

PART B: STAR Framework– 250 words only

Utilizing the clinical example in your Part A reflection, write a selection criteria specific to your unit (see Instructions) using the STAR framework. Write your STAR selection criteria in paragraph format.​​​​​​​

• OPENING – Brief statement to demonstrate you understand the question.  NOTE: THIS SHOULD BE POSITIVE
• SITUATION  – Where did you do it? (location)
• TASK  – What did you do? (the task)
• ACTION  – How did you do it? (the method) and Why did you do it? (the purpose or the value you brought)
  • The action area of your example/experience will be up to 70% of your answer.
  • Focus on action verbs and ‘I’ to demonstrate what actions you undertook.
• RESULT  – What were the results? (positive outcome and what you learned)
• STANDARDS – Now link your STAR clinical example to the RN Standards for Practice

ANSWER

Part A: Reflection

Description

During my recent clinical placement at XYZ Hospital, I encountered a situation where I had to recognize and respond to a patient’s clinical deterioration. I was assigned to a medical-surgical unit, and the event occurred during the morning shift. I was conducting routine vital sign assessments when I entered Mr. Smith’s room. Mr. Smith was a 65-year-old post-operative patient recovering from abdominal surgery. His vital signs seemed stable, but he appeared more fatigued than usual, and I noticed his oxygen saturation level was slightly lower than baseline.

Feelings

As I noticed these changes, I felt a mixture of concern and responsibility. I was worried about Mr. Smith’s well-being, and I realized that my actions could have a significant impact on his recovery. During the assessment, I felt a sense of urgency to accurately interpret the signs and determine if his condition was deteriorating.

Evaluation

Upon evaluating the situation, I had successfully identified potential signs of clinical deterioration, which were beyond the baseline range. I alerted the registered nurse (RN) on duty about my observations, and we promptly re-assessed Mr. Smith together. The RN appreciated my vigilance and agreed that his condition required further evaluation by the medical team. Although it felt good to have responded promptly, I also realized that more continuous monitoring could have identified the changes even earlier.

 Analysis

Reflecting on the experience, I recognize that effective recognition and response to clinical deterioration require a comprehensive understanding of the patient’s baseline and potential risk factors. In this instance, Mr. Smith’s post-operative state made him susceptible to complications, such as respiratory distress. My actions aligned with the NMBA RN Standards for Practice (2016), specifically Standard 5: Nursing practice is informed by evidence, reflecting a commitment to ongoing learning and professional development.

Furthermore, the National Safety and Quality Health Service Standards (2017) emphasize the importance of identifying and responding to deteriorating patients promptly to prevent adverse outcomes. My involvement in this situation highlighted the significance of interdisciplinary collaboration, as my communication with the RN facilitated timely intervention.

Conclusion

Reflecting on this experience, I realize the value of vigilance and continuous assessment in clinical practice. I am proud of my ability to recognize and respond promptly to changes in a patient’s condition, but I acknowledge the need for further refinement in my monitoring skills. In the future, I intend to enhance my understanding of specific patient populations and risk factors to better anticipate and prevent clinical deterioration. I would approach a similar situation with the same level of urgency, while also seeking guidance from experienced colleagues when needed.

Action Plan

To improve my ability to recognize clinical deterioration, I plan to participate in additional training related to patient assessment and early warning scores. I will also seek mentorship from experienced nurses to enhance my clinical judgment and interpretation of subtle signs of deterioration. Furthermore, I aim to engage in regular reflective practice to continuously refine my skills and identify areas for improvement.

Part B: STAR Framework

Situation

During my clinical placement at XYZ Hospital, I encountered a situation where I needed to recognize and respond to a patient’s clinical deterioration.

Task

I was assigned to a medical-surgical unit during the morning shift, and my task was to conduct routine vital sign assessments for post-operative patients. Mr. Smith, a 65-year-old patient recovering from abdominal surgery, was on my assignment list.

Action

Upon entering Mr. Smith’s room, I observed signs of fatigue and noticed his oxygen saturation was slightly lower than baseline. I immediately alerted the registered nurse on duty and collaborated with her to re-assess the patient’s condition. This action was necessary to ensure Mr. Smith’s well-being and prevent potential complications.

Result

The result of my prompt action was a collaborative intervention by the medical team, leading to timely management of Mr. Smith’s condition. This intervention prevented further deterioration and ensured his continued recovery. Additionally, the experience enhanced my ability to identify subtle changes in patients’ conditions and reinforced the importance of effective communication within the healthcare team.

Standards

My response aligns with the NMBA RN Standards for Practice (2016), particularly Standard 4: Comprehensively conducts assessments and develops a plan for nursing practice, and Standard 5: Provides safe, appropriate, and responsive quality nursing practice. Furthermore, my action supports the National Safety and Quality Health Service Standards (2017), which emphasize the importance of recognizing and responding promptly to clinical deterioration to enhance patient safety and well-being.