Perioperative Nursing - Essay Example

Learning Plan 2 Introduction This had been placed in the Surgical Ward of the hospital in her second placement. In the Surgical ward, the nurses deliver care to the patients who undergo surgery. As a result, the care delivered involves preoperative and perioperative care. Following the surgery, once the patient is out of the recovery room into the ward, the brunt of postoperative care also is the responsibility of the nurses in the word. This is an important area of work, and since I was new, it was ideal for me to attend a workshop on perioperative nursing (Brazen, 1992). Perioperative Nursing The speciality of perioperative nursing is not limited to immediate pre and postoperative state of the patient. It encompasses the preoperative phase, preanaesthetic checkup, psychological support, explanation of the procedure, nausea and vomiting prophylaxis, preparation of the patient, pain relief, postoperative monitoring, and postoperative care. Thus this should also involve nursing care in the preoperative phase and late postoperative phase (Riley and Peters, 2000). Profile of a Patient A patient who intends to receive surgical care, in most cases surgery is the last resort. Where alternatives are available, these patients usually go through nonoperative measures, until a stage reaches when the surgeon advises surgery. Surgery although very sophisticated in the present era of technological advancement, is a mutilative procedure, and consequently, most patients have apprehension about the procedure. The patients who present are usually patients with general surgical conditions, such as, appendectomy, cholecystectomy, hiatal hernia, inguinal hernia, intestinal diseases, thyroidectomy, so on and so forth. Before the surgery, the surgeons undertake investigations for fitness of anesthesia, and they explain in detail about the procedure. A preanesthetic checkup is done. On the day of surgery, the patients are advised to remain in empty stomach, and they are given certain preoperative medications (Willman and Johnsson, 1994). Nursing Role Research has suggested that nursing can play important roles in both pre and perioperative care. Preoperative apprehension and anxiety have been attributed to be playing important roles in incidence of perioperative nausea and vomiting, which can be very distressing and may even continue into the immediate postoperative phase leading to aggravation of postoperative pain and discomfort (Malen, 1986). Nurses through their empathic communication skill cam assess this situation, and they can explain the situation with greater detail with an attempt to answer all the questions that a patient may have. The nurses can involve the family members in this phase of care to create a familiar and stress-free environment for the patient (Paavilainen et al., 2001). Nurses in the surgical ward can measure the vital signs of the patients, record them, and send them to the operating theater, which can lead to important anesthetic decisions. Preanesthetic medications are administered by the nurses, and they are supposed to dress the patients appropriately for the operating room. An intravenous line and infusion of glucose can compensate for some calorie deprivation during the preoperative nil oral state. They should match the patient with the record and confirm the site and side of the surgery. In the postoperative phase, they must monitor the vital signs, wound dressings, prevent nausea and vomiting, and alleviate pain. They must administer other medications according to the directions. As evident, these activities are at par with the competency standards for nurses. As nurses, they are required to provide evidence-based nursing care to people of all ages supporting the management of their pre, peri, and postoperative conditions, which includes mental support and alleviation of pain. In order to do that, the nurse assesses, plans, implements, and evaluates nursing care in collaboration with anesthesia and surgical team. In the perioperative nursing area, her role is a leadership role which involves coordination of care within and across different care contexts to facilitate optimal health outcomes of the patient (Kleinbeck, 2000). The competency standard 1.2. highlights that the nurse must fulfill duty of care, which is very relevant in perioperative nursing. The perioperative nurse performs appropriate nursing interventions in accordance with recognised standards of practice. She is expected to clarify her nursing roles and responsibilities for different aspects of care with the anesthesia and surgical team. She has immense responsibility to prevent harm on the face of surgery, which is a potentially risky intervention. She must assess the patient repeatedly following comprehensive and accurate assessment (ANMC, 2004). Self-assessment My strength is communication. I could communicate well with the family and the patient explaining what will be done during anesthesia and surgery. This seemed to have alleviated anxiety in the patient. I could administer preoperative medications and measure the vital signs of the patient. I also participated in consent taking and verifying patient credentials before sending the patient to the operating room. However, being new in this area of placement, I found that I lacked considerably in clinical skills which are specifically applicable to perioperative nursing. Therefore, it was evident that I would need to know the clinical presentations of different pre, perioperative, and postoperative patients specific to their clinical conditions. My experience in administering pain relief medications following pain assessment from my previous placement proved to be wrong, and it seemed the intensity of pain and pain management was different in the surgical patients. These learning needs are important since graduate nurses must be able to assess the patient accurately to plan and implement safe management (Happell, 2000). Learning Objective To learn the clinical and management skills in all clinical needs of a perioperative patient in a surgical ward. Related to this speciality, I would apply self-directed nursing skills in acquiring the knowledge, skills, and attitudes necessary to meet the requirements to practice effectively in perioperative nursing speciality. This would conform to graduate nursing qualities, 1, 2, 3, 4, 5, and 6. SMART Analysis I would achieve skills and competencies in perioperative nursing. I have identified certain strategies. It is clear that learning and acquiring new knoeledge would happen, and this objective would lead to desired results. When given responsibility of care, I would be able to take decisions based on assessment of such patients, which would be evidence based and in conformity to the guidelines of the hospital. It would be quite laborious to achieve these goals within the stated timeframe, and I think I would be able to overcome the limitations and constraints through the best use of the resources that I had identified, and therefore, this is a possible objective. I have access to all the resources I have identified. Once into it, I though I would once more revisit by objective so I can redefine my learning needs based on the progress and new knowledge. I am quite certain that this objective is possible to be achieved. There is a stated deadline, and I need to discuss and study evidences based on the perspectives of my area of specialty for graduate nursing. Knowledge and Resources Internet, library, journal search, literature review, academic knowledge, interaction with the multidisciplinary team, and senior nurses would help me to gain this knowledge (Gilder et al., 1999). As mentioned, I attended a 2-day workshop on perioperative nursing. I had a chance to interact with other students and the specialty lecturer via the online discussion specialty group (Gruendemann, 2007). I adhered to appropriate standards of communication and language, and this helped to solve many of my questions regarding nursing practice in perioperative specialty area. Strategies Henceforth, when I will be assigned such patients, I would first plan to learn about their conditions for which they are subjected to surgery. Based on that knowledge, I would collect evidence as to what could be the specific nursing interventions in such patients. I will tally my findings with a clinical scenario and would implement them in practice (Stevens and Pugh, 1999). Wherever I find doubt, I will consult the seniors and other members of the team to learn the rationale of a specific practice. This would be particularly useful in interpreting the vital signs and knowing the medications that I am instructed to administer. In this workshop, the focus was on a range of activities relevant to perioperative nursing, and in my opinion, this workshop was helpful to develop skills of assessment of a patient destined to have surgery. This was my weak area, and this had helped to acquire competencies required as a registered nurse (Stobinski, 2008). Conclusion Perioperative nursing is an important area of nursing specialty. As a future registered nurse, this could be important area of learning to deliver nursing care. Surgery as a speciality is different from other areas of nursing practice since the requirements and needs of these patients are unique, where the nurse needs to be vigilant for any new developing conditions in such patients. Continuous assessment and vigilant monitoring of such patients are important needs, and for that the graduate nurse needs to acquire competencies and nursing skills suitable for care delivery for these patients. Apart from that, good skills in communication and knowledge about anesthesia and surgery are important along with skills in pain management and preventive measures in management of nausea and vomiting. In this module, I had a chance to develop skills through self-directed initiatives, workshops, and online discussion, so I could frame a learning objective for self development. Reference List ANMC (2004) Competency Standard. ANMC. Brazen, L., (1992). Perioperative nursing: a special nursing specialty. Imprint; 39(5): 47-9, 86. Gilder, RE., Koch, F., and McBride, S., (1999). Enhancing perioperative nursing effectiveness through informatics. AORN J, May 1999; 69(5): 978, 981-2, 984-7. Gruendemann, BJ., (2007). Distance learning and perioperative nursing. AORN J; 85(3): 574-86. Happell, B., (2000). Student interest in perioperative nursing practice as a career. AORN J; 71(3): 600-5. Kleinbeck, SV., (2000). Dimensions of perioperative nursing for a national specialty nomenclature. J Adv Nurs; 31(3): 529-35. Malen, AL., (1986). Perioperative nursing diagnoses. What, why, and how. AORN J; 44(5): 829, 832-9. Paavilainen, E., Seppanen, S., and Astedt-Kurki, P., (2001). Family involvement in perioperative nursing of adult patients undergoing emergency surgery. J Clin Nurs; 10(2): 230-7. Riley, R. and Peters, G., (2000). The current scope and future direction of perioperative nursing practice in Victoria, Australia. J Adv Nurs; 32(3): 544-53 Stevens, KR. and Pugh, JA., (1999). Evidence-based practice and perioperative nursing. Semin Perioper Nurs; 8(3): 155-9. Stobinski, JX., (2008). Perioperative nursing competency. AORN J; 88(3): 417-8, 421-36. Willman, A. and Johnsson, GB., (1994). Perioperative nursing education and experience: a Swedish perspective. 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