NMBA Registered Nurse Standards for TPR Assessment

Discuss about the Reflection Essay On A Video Demonstrating TPR.

A reflection essay on a video demonstrating TPR (temperature, pulse and respiration) assessment. It will be assessing the standard 4 in NMBA registered nurse standards for practice (2016) from the Nursing Competency Assessment Schedule (NCAS) document. The Gibbs reflection model (1988) will be the guide for the self-reflection. It has six stages (Dye, 2011) This involves one, a description of the assessment done on the patient. Two, the feeling, this will describe how I feel and think. Three, evaluation of my skills on the assessment. Evaluation of my competence on the assessment. Four, analysis of the events that occurred above and finding the sense in the situations. Five, a conclusion that will involve me asking myself if there was something else I could have done to make the assessment better. Lastly, this step involves formulating an action plan on how to improve my performance. It also involves formulating a strategy that I will use in future when I encounter challenges. Lastly, there will be a conclusion on the subject, summarizing the essay.

According to NMBA, 2016; NCAS 2016 the standard four; comprehensive conduction of an assessment entails: one, a holistic assessment and culturally appropriate. Two, use of the appropriate techniques so as to collect accurate and relevant information. Three, work in partnership/teamwork. Lastly, one should assess the information important for planning. Comprehensively conducting an assessment (standard four) is as a result of; one, thinking critically and analyzing the nursing practice (standard one). Two, engaging in professional and therapeutic relationships (standard two). Three, maintain the capability for the practice (standard three). In TPR assessment, it involves assessing the client’s temperature, pulse rate and the respiration rate. For this procedure to be termed as, comprehensively conducted, the following standards have to be achieved, one, it should be holistic and cultural appropriate. Two, the appropriate techniques should be applied. Three, the patient care should exhibit partnership/teamwork. Four, the information obtained should be used in planning the patient’s care. The consecutive paragraphs will be a self-reflection using Gibbs reflection model as a guide. The reflection is important as it will assess my skills, attitude and knowledge on the procedure (Tighe & Bradshaw, 2012; Ruth-sahd, Beck & McCall, 2011; McGregory & Cartwright 2013). It is a waste of time if one cannot determine if learning is taking place after a learning activity (Quinn & Hughes 2007).

Self-Reflection on Assessment through Gibbs Reflection Model

The first thing I did after entering the clients room was greeting the patient and introducing myself. I involved the patient in small talks so as to alley his anxiety and also make him more comfortable around me. I explained the procedure to the patient and asked for the consent. I did the procedure as per the guideline. I assessed the temperatures, documented it and reassured the patient that all was well. The assessment of the pulse rate and the respiratory rate, I took them simultaneously. This ensured that the patient was not aware of me assessing his respiratory rate. I also used my middle and index fingers to measure the pulse rate on the radial artery. I answered all my client’s questions and lastly I documented the findings.

As mentioned above this stage is an explanation of my reactions/feelings/thinking. My strengths while conducting the assessment are as follows; one, I was able to create a conduce environment by ensuring the room was well lit and also it had privacy. Two, I was able to create a good rapport with the client by first introducing myself and continuing with small talks. Three, I explained the procedure to the patient and requested for his consent. Four, my techniques were appropriate and accurate. This means I obtained the correct information. On assessing the temperature, I used the thermometer. I assessed the pulse rate and respiratory rate simultaneously (Hinkle & Cheever 2013). This is to avoid alerting the client when I start taking the respiration rate so as to get accurate information. On assessing the pulse rate, I placed my middle and index finger on the radial artery (Hinkle & Cheever 2013). Five, I documented my findings immediately I obtained them (Crowe et al 2008). Six, I updated the client on the findings and on what they meant. Lastly, I thanked my patient for the cooperating. My weakness on the assessment is that I asked the client questions that would have made him think I was not prepared. Before any assessment, the nurse should familiarize him/herself with the procedure, client, client’s condition and the environment (Hinkle & Cheever 2013). On contrarily to this, I asked my patient who he was and when he was admitted. The client could have perceived me as being unprepared.

This stage involves identifying and describing the good and the bad experiences. The good experiences include, one, creating a good rapport with the client (Timmins & McCabe 2015). Two, I successfully conducted the temperature, pulse and respiration assessments. The temperatures using the digital thermometer on the client’s forehead. The pulse on the radial artery using my middle and index fingers. The respiration assessment, unknowingly so as to get accurate results (Hinkle & Cheever 2013). Three, creating a therapeutic communication with the patient as I answered all his questions/concerns. I was also involved the patient in his own care by ensuring that I updated him in my findings and what they meant. Most importantly, before the procedure, I explained what I was going to do and asked for consent. Four, I documented the findings immediately I obtained the results. On the bad experiences, I may have seemed unprepared to the client by asking who he was and asking the duration of hospitalization. I also did not explain the reasons as to why I was doing the assessment.

Strengths and Weaknesses in Assessment

The assessment I performed attained the NMBA, 2016 & NCAS 2016 standards. I achieved the standard four: conducting an assessment effectively as I, one, created a therapeutic relationship with the client. Two, I exhibited professionalism by using the correct techniques while assessing temperature, pulse and respiration. Three, it attained the standards as I involved the patient in his care and also I explained the procedure and asked for consent prior to the procedure. Four, having in mind that patient care is multidisciplinary, I documented the findings so as to facilitate partnership and teamwork (Crowe et al 2008).

This stage describes how I can improve my skills for future practice. This involves enhancing my strengths and improving on my weaknesses. In future if I am to perform this procedure, I will ensure that I create a good rapport with the patient. two, I will create a therapeutic and professional relationship with the client by ensuring that I involve him or her in the procedure. Three, I will ensure that I use the right techniques when doing the procedure. Lastly I will document my finding.

As mentioned earlier I may have made the patient think I was unprepared. In future to avoid such incidences I will ensure that I have a mastery of the patient’s history and disease process. On the explanation of the procedure, in future I will make sure I explain to the patient why I am doing the procedure. I will read more on the procedure so as to enhance my knowledge and skills. Lastly, I will ensure I continue documenting after every procedure to ensure partnership and teamwork.

Conclusion

In conclusion, my procedure was a success and it attained the standards according to NMBA and NCAS 2016 guidelines. This is because I was able to create a therapeutic and professional relationship with the patient. I used the correct techniques when assessing the patents. I also involved the patient in his own care. lastly, I documented my findings immediately after obtaining them. I may have seemed unprepared to the client after asking his duration of hospitalization and for not explaining why I was doing the assessment. These were the only shortcomings I faced.

References

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Dye V., (2011). Gibbs’ reflection cycle; a theory or model of reflection. Academic Services & Retention Team, University of Colombia. 6; 34-98

Hinkle, J.L, Cheever, K.H. (2013). Brunner and Saddarth’s Textbook of Medical and Surgical Nursing, (13th ed) Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.

McGregor, D., Cartwright, L (2013). Developing Reflecting practice: A guide for beginning teachers. Maidenhead: McGraw-Hill Education. 3; 217-234.

McMahon, R., (2012). ‘Therapeutic Nursing: Theory Issues and Practice’, in R. McMahon and A. Pearson (eds) Nursing as Therapy. Cheltenham: Nelson Thornes.

Nursing and Midwifery Board of Australia. (2016). Enrolled Nurse Standards for Practice. Melbourne: Nursing and Midwifery Board of Australia. pp. 6-7

Quinn, M., Hughes, J., (2007). Quinn’s Principles and practice of Nurse Education.  Nursing education. 5,

Ruth-sahd, L., Beck, J., McCall, C., (2010). Transformative learning during a nursing internship program: The reflections of senior nursing students. Nursing education perspectives, 31(2), 78-83.

Tighe, S., Bradshaw, C., (2012). Peer-supported review of teaching: making the grade in midwifery and nursing education. Nurse education today.

Timmins, F., McCabe, C., (2015). How assertive are nurses in the workplace? A preliminary pilot study. Journal of Nursing management. 13, 61-67