Fundamentals of Nursing and Midwifery 2e

Unit III Thoughtful practice and the process of care

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BOX 18-3 Organising student clinical responsibilities

To organise clinical responsibilities, check: 1. The person’s notes and history

2. The name by which the person wishes to be addressed 3. The person’s chief complaint and reason for admission 4. The person’s current health status • Note any physical or emotional changes indicating the need to modify the plan of care. 5. Routine assistance the person needs to meet basic human needs 6. Priorities for care: • Priorities identified by the person as most important. The student might state: ‘I’ll be your nurse or midwife until 3 p.m., and I’m interested in learning what you would most like to accomplish today.’ • Identified health problems, goals for the person and related nursing/midwifery interventions • Medical orders that need to be implemented • Interdependent or collaborative nursing/midwifery responsibilities 7. Special ‘events’ of the day that may require special observation of the person, teaching, preparation or aftercare: • Diagnostic tests • Consultations with specialists • New therapies (physiotherapy, medications, surgery, radiotherapy, etc.) 8. Special teaching, counselling or advocacy needs 9. Special needs of the family

vital signs and nutritional status assessed. Discuss with each other the truth or falsity of the claim, ‘Who the nurse is, is as important as, and sometimes more impor- tant than, what the nurse does’. 2. Receive the same clinical assignment as another student, and independently outline your care priorities, specifying what you plan to accomplish during each of your clinical hours. Talk with the other student about the differences in what you both hope to accomplish and how you would do this. Try to imagine what these dif- ferences would mean to the person. 3. You are the only registered nurse (RN) on a 50-bed wing in a long-term care facility. You have one enrolled nurse (EN) working with you and two assistants in nursing (AINs). Each of the 50 residents requires assis- tance with activities of daily living, all take at least some medications and most require monitoring for multiple chronic (and sometimes acute) illnesses. When the nursing home is short-staffed, you are sometimes the only RN covering two 50-bed units. How will you decide which interventions to delegate? 4. Describe how you would probably respond, and how you would like to respond (if these are different), to hearing another nurse in the shift report that one of the people you are assigned to was a real ‘PIB’ (pain in the butt) all day and ‘just impossible’ to care for. Reflect on the importance of the language we use to report on a person to one another.

Developing knowledge skills

In this chapter you have been learning about implementing care as part of the process of person-centred care. Once you have had the opportunity to practise and carry out imple- menting care you will be more confident to practise these identified skills and procedures. What have you learnt? • Basic knowledge of how to implement person-centred care • Ability to collect the appropriate data to implement appropriate care • Knowledge of what constitutes accurate and appropriate data for the implementation of person-centred care • Ability to understand and interpret the meaning of the collated data • How to recognise actual and potential barriers to collecting accurate and appropriate data for the implementation of care.

To enhance your learning and facilitate further understanding of this chapter, refer to thePoint and LNPS online resources.

Developing critical thinking skills

1. Team up with another student and take turns role-playing a nurse visiting a homebound older man who needs his