NURS 4613 Clinical Decision Making

1. There was one question that did not have a keyed answer. Which one was it? What was the correct answer?

The question that didn’t have a keyed answer was the rinse and air dry question about Abel’s inhaler. After I chose that answer, the nurse went ahead and taught the mom about rinsing and airdrying, but then it said on my report sheet that my answer was incorrect. It says you are supposed to rins and air dry on a clean and dry paper towel.

2. What three questions would you have liked to have asked the nurse who gave you report?

• What does Roman take for his Crohn's?
• Have they done anything for Abel’s asthma besides Fentanyl before he came in?
• What are these patients' allergies?

3. How did you feel in the role of the nurse Laila Stein during this simulation?

It was interesting to be in the role as an ER nurse. I never had an ER clinical rotation so it was interesting to see!

4. What were your thoughts about triaging Roman, Abel, and Charlotte? Did anything surprise you?

It was a very short triage, but that is not too suprising considering this is an Emergency Room setting. It was a very short and consise report.

5. Share what you learned in relation to establishing a therapeutic nurse–client relationship with Roman, Abel, Charlotte, and their families.

She was able to establish a theraputic nurse-client relationship by speaking to Abel in a slow, but informative tone. It helped him to use the inhaler properly and for him to fully understand! There was also a good theraputic nurse-client relationship implemented with Abel’s mother. The nurse addressed Abel’s mother in a good tone and answered all of her questions thoroughly.

6. Share what you learned about interprofessional communication within the healthcare team. Did anything bother you about the interprofessional communication? How should the communication be improved?

The interprofessional communication team was great, besides the emergency room doctor who made a remark. I feel that the doctor could have addressed this with a better tone. There was great interprofessional communication between the girl emergnecy room doctor. She was informative and the nurse and doctor worked as a team.

7. Not everyone works their way through this scenario perfectly. What can you take away from the incorrect decisions/responses you may have made?

I should have chosen vital signs first instead of hypoactive bowel sounds and diffuse pain. The vitals were the most important part of the assesment, but I just skipped to hypoactive bowel sounds and the doctor already knew this.

8. In summary, the learning objectives of this simulation are to:

• Apply knowledge of physical and psychosocial factors when caring for pediatric and adult patients and their family members.
• Identify normal findings, abnormal variations, and potential complications of medical and surgical conditions, such as asthma, fractures, and Crohn’s disease.
• Prioritise care based on clinical assessments and findings.

What were your key learning points related to these learning objectives?

If the patient's blood pressure goes down and heart rate is rising, you should immediately go and assess the patient. It is important to implement good theraputic communication between the team. You need to know what could possibly happen to each patient and always keep those in mind throughout the shift. Priortising who to assess first was key in this scenario as well. If a priority of care was mistaken in this scenario, it changed the entire setting.

9. What will you take away from this simulation to incorporate into your clinical practice?

Priority of care is very important. If you didnt go and assess the patient that needed it most, then the scenario will end up being gerastically different.

10. What questions remain unanswered for you in relation to this emergency simulation scenario?

I feel like the scenario was trying to make a point when Abel asked if he could switch his pulse oximetry to his left hand. Was there a point the scenario was trying to make?

11. How many minutes did it take you to run the simulation? How many minutes did it take you to answer the questions?

It took me 30 minutes to do the simulation and 30 minutes to answer questions.