Today I'll be covering four topics in this one post. Enjoy!
Reflection
Reflection is when you think about an aspect of your professional development as a student nurse. It is considered as very important to your learning and experience. It helps nurses to evaluate their own practice and performance. Bengtsson (1998) suggested that nurses need to learn by these experiences and, by doing so, would become more competent and therefore more able to teach others. Callister (1993) sees reflection on clinical events as an expansion of cognitive learning and suggests that the use of professional journals to record events, and reactions to these events, shapes the future of care delivery. This certainly shows that reflection is vital to a students learning and understanding.
Reflection involves meditating about the experiences of a day in practice, analysing and evaluating decisions made, using self-assessment to improve continually, therefore focusing on lessons learned whilst maintaining objectivity.
This can be done through a SWOT analysis. You may have heard of this before... Using SWOT analysis helps us to consider our possible strengths, weaknesses, opportunities and threats.
We can also use Gibbs Reflective Cycle. (See Image)
Potential barriers to reflection
*Stress
*Lack of honesty
*Time
*Insecurity
*Lack of/too much confidence
*Fear
*Bad/lack of feedback
*Stubborn/narrowmindedness
*Arrogance
So, overall, reflection must be done on a regular basis to be beneficial to nurses. And while reflection is fairly commonplace, it's also a good idea to keep checking this against currently theory and acceptable practice.
Record keeping
In nursing, record keeping is very important as it must reflect high standards of clinical care and health care records must keep continuity of care and accurate account of treatment. Records are therefore used as a vehicle for communication between other health care professionals.
What Health Care Records include
*Clinical notes
*Photos (to observe the development of a complaint)
*Letters
*Print outs from monitoring equipment
*Incident reports
*Emails
*X-rays
*Lab reports
Principles of record keeping
*Handwriting must be legible for others to read.
*Must be signed inluding name and job title printed alongside first entry.
*The date and time must be recorded.
*Records must be in chronological order.
*Language must be easily understood (no jargon!!) and must be accurate with clear meaning.
*Records should identify risks and problems and the possible actions that were taken.
*However, the records must never be altered or destroyed.
Confidentiality
This relates closely to the last topic really.
Confidentiality is defined as 'the duty to maintain confidence and thereby respect the privacy of patients health information'.
Regarding confidentiality, the Nursing and Midwifery Council (NMC) states that...
1. You need to be fully aware of the legal requirements and guidance regarding confidentiality, and ensure your practice is in line with national and local policies.
2. You should not discuss the people in your care in places where you might be overheard. Nor should you leave records, either on paper or on computer screens, where they might be seen by unauthoried staff or members of the public.
3. You should not take or keep photographs of any person or their family, that are not clinically relevant.
So, yeah. It's pretty serious stuff.
Drug Calculations
I love this bit. (;
Drug calculations are important in nursing because obviously administering the wrong dosage of medication could potentially kill someone! (Extreme, maybe, but it could happen...)
Here is a little guide for converting metric units of measure...
x1000 x1000
Grams (g) -------> Milligrams (mg) -------> Micrograms (mcg)
Grams (g) <------- Milligrams (mg) <------- Micrograms (mcg)
/1000 /1000
So...
1g = 1000mg
And...
1mg = 1000 mcg
Moving the decimal point
x1000
Move dm 3 places right.
/1000
Move dm 3 places left.
So...
0.04g = 40mg = 40 000mcg
Test yourself on these conversions...
1. 30 g = ____ mg
2. 2 mg = ____ mcg
3. 800 mg = ____ g
4. 50 mcg = ____ mg
5. 20 mg = ____ g
6. 6500 mcg = ____ mg
7. 900 mg = ____ g
8. 0.1 mg = ____ g
9. 0.25 g = ____ mg
10. 125 mg = ____ g
For more information and more test questions check out this website and this book.
Another tip I have is to go into your local drug store (EG. Superdrug, Boots, Tescos, Asda, Wilkies...) and have a little look at the labels of some medication. Imagine the drugs being prescribed to a patient and think up some possible prescriptions in your head. It's all good practise!
Oral Medication Calculations
Kind of the same as before but now we must administer the right amount of drug to meet the specific needs of a patient.
Example:
A patient prescribed 2.5 mg of ramipril orally. Each tablet contains 1.25 mg. How many tablets should be given? Answer = 2.
Another Example:
How many Metronide 200 mg should be given for a prescription of Metronidazole 400 mg orally? Answer = 2.
Further Example:
How many 30 mg tablets of Codeine should be given for a prescription of Codeine 45 mg? Answer = 1.5.
Test yourself on these calculations...
1. A client is ordered 300 milligrams of Thioridazine. 100 milligram tablets are available. How many tablets will you give?
2. A client is ordered 1 milligram of Diazepam. 2 milligram tablets are available. How many tablets will you give?
3. A client is ordered 0.5 milligrams of Digoxin. 250 microgram tablets are available. How many tablets will you give?
4. A client is ordered 30 milligrams of Diltiazem hydrochloride. 60 milligram tablets are available. How many tablets will you give?
5. A client is ordered 62.5 micrograms of Benztropine Mesylate. 0.25 mg tablets are available. How many tablets will you give?
And that's it! I know it was quite a long post again!
Just to let you know I'll be continually updating my blog of the topics I post about, since in Nursing you are constantly learning new things. I'll especially be updating about what I've learnt in reflection and drug calc. In later posts I hope to discuss dosages of meds for injections and intravenous infusion which I think will be very exciting! ;D
I hope you've enjoyed this post! It has taken me a long time to type all this up! ^ ^
Take care.
Emily
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