Professional Behavior and Evidence-Based Practice - Essay Example

? Professional Behavior & Evidence-Based Practice Question Arnold (2006, pg.502) presents that promoting professional behaviour is currently the main concern across the continuum of medical education. As such, one of the critical components of such an initiative involves carrying out assessment in professional manner. This is considered critical because it is through this assessment that a medical professional can ascertain the historical details of a patient, crucial for determining subsequent way of treatment and progress of the a patient. Arnold (2006, pg. 502) further elaborates that proper assessment of a patient, therefore, requires an examination of the state of the art. The American Board of Internal Medicine (ABIM) stipulates that honour, integrity and accountability and duty should be the pillar of a professional assessment. The South Australia Ambulance Service failed to observe these rules of professionalism. This is evident in the manner they approached Mr. Markantonakis, first by questioning the patient personally despite the pain that he was going through. Similarly, despite being told by the patient’s wife about the patient’s past medical problems, the officers further demonstrate their lack of professionalism and ethics by seeming to refuse to acknowledge the wife’s account of the patient’s prior problems Further, they also fail to perform extensive physical assessment of the patient as required in the practice so to have an account of how to further contain the situation. As a matter of fact, the officers also overrule carrying out simple basic initial assessment procedures such as blood pressure measurement, opting to assess the patient by mere physical assessment procedure such as colour, as explained by the Eleni Markantonakis. The officers demonstrate poor professionalism by prejudging Mr. Markantonakis’s movements of pain, deeming as exaggeration, which they further aggravate by refusing to take the patient to his medical facility of choice citing congestion at the facility. Arnold (2006, pg. 503) asserts that professionalism entails respect for others, including patients, as the essence of humanity. Question 2 - From the coroner’s report, being a patient over sixty years of age, the first diagnosis would have been to consider diseases or infections where age sixty is a serious risk factor. A number of diseases that cause abdominal and back pains are usually associated with ageing, especially in men. - The observation of the major medical symptoms apart from the pain, such as skin colour and condition, nausea and vomiting and the heart rate. These may point to a number of diseases such as jaundice, as well as abdominal aortic aneurysm - Examination of the patient’s abdomen by palpation to examine whether there are any lamps, stiff or rigid abdomen, and pulsations in the abdominal region. This would pave way - For abdominal or back pain without any major symptoms, further tests can include carrying out an Angiogram. Following confirmation of a lamp, the size of the lamp can be determined using a CT scan of the abdominal area. This can be confirmed by an ultrasound crucial for determination of the exact location of the lamp, the nature of the lamp whether inflammation or blood clots. - Ultrasound is quite crucial, especially when abdominal aortic aneurysm among other conditions is suspected because it aids in measuring the size and other important aspects of the condition to help determine the risk for rapture. - The above diagnoses can provide a confirmation of the patient’s condition as abdominal aortic aneurysm. Additionally, depending on the size of the lamp, that is, the possibility of rapture, immediate open abdominal aortic aneurysm repair surgery would be recommended. - The repair can include the replacement of the abnormal vessel with an artificial Dacron graft or performing an endovascular stent grafting (Bhimji 2012). Question 3 As explained by Mrs. Markantonakis, Ms Bell’s interaction with both the patient and the patient’s family can be deemed as unprofessional and based on misconceptions and prejudgment. Ms Bell considers the patient and the patient’s family’s ideas as uninformed evident in the manner she overrules their suggestions and submission of the patient’s medical history. According to Franton (2008, pg. 77), that effective communication with patients and family entails preparing one for the optimal exchange, which entails listening to the patient before responding and making any conclusion. Subsequently, an effective communication strategy also entails creating an environment that enhances a true exchange and connection by introducing oneself making eye contact with patient and family and reassuring the patient through touch, as well as recognizing the family members and engaging them to the assure them of their important role in the care of the patient. Question 4 Curie (2002, pg. 24) presents that handover of a patient normally influences the delivery of care for the following shift of caregivers. As such, she presents that a successful handover should be guided by the nursing and medical documentation. This should include basic patient’s diagnosis such as the vital signs, diagnostic tests and restrictions as well as the patient’s previous medical history such as the drugs used by the patient. Such issues are critical towards ensuring fluidity on treatment. Curie (2002, pg. 25) affirms that a purely verbal handover without note taking tends to useful, especially in an emergency where time is factor. The information should be confidential, uninterrupted, brief, and accurate without any prejudgment. Question 5 Based on Ms Moore’s evidence, Ms Bell initial diagnosis of Mr. Markantonakis was that he was suffering from exacerbation of a chronic back injury that caused the pain in the back. However, based on the patient’s expression of the pain, Ms Bell thought that the patient was exaggerating the making her overrule any chance of a cardiac problem as the cause of the pain. In addition, citing the patients insistence of immediate pain reliever, Ms Bells advised to give the patient the pain killers that he was using before they left. Following the second call, Ms Bell offered to take the patient to the hospital rather than administering a pain relieving treatment citing the ambulance service policy. According to Disorbio, Bruns and Barolat (2006, pg.1) the goals of treatment of such chronic pain should be to reduce the pain and increase the patient’s ability to function. However, this initial treatment depends on the kind of pain that one has and the severity of the pain. Similarly, the cause of the pain, such as an injury, an illness or an unknown cause, will also determine the treatment and management of the plan. They assert that emergency departments should realize pain is a true emergency situation and should be treated as such. References Abelson, J. A., Mitchell, N., & Cooper, S. (2007). Patient handover: time for a change? Accident Emergency Nursing, 15(6), 141-147. Arnold, L. (2006). Assessing Professional Behavior: Yesterday, Today, and Tommorow. Academic Medicine, 502-514. Bhimji, S. (2012). Abdominal aortic aneurysm. Retrieved April 1, 2013, from MedlinePlus: http://www.nlm.nih.gov/medlineplus/ency/article/000162.htm Committee on Patient Safety and Quality Improvement . (2007). Communication Strategies for Patient Handoffs. American College of Obstetricians and Gynecologists, 408-411. Curie, J. (2002). Improving the efficiency of Patient Handover. Emergency Nurse, 10(8), 24-28. Disorbio, M., Bruns, D., & Barolat, G. (2006). Assessment and Treatment of Chronic Pain; A phycian's Guide to a biopsychosocial approach. Practical PAIN MANAGEMENT,, 1-10. Frampton, S. (2008). Communicating Effectively With Patients And Families. Planetree, 77-91. Hong, K. (2010). Imaging of Abdominal Aortic Aneurysm: the present and the future. Current Vascular Pharmacology, 8(6), 808-819. Read More