They work with people suffering from various types of illnesses in diversity of roles and actions demanding expert skills and professional knowledge. The situations are many a times complex requiring an understanding of the complexity of the situation. Every nurse-patient encounter is unique and there are no fixed solutions to many nursing problems. Due to these demands and requirements, some professional standards and skills are expected from the nurses. Competence for nurses is important for the kind of profession it is and the expectations that the profession arouses. Nursing profession involves complex combinations of performance, knowledge, attitudes and skills (David 2005). In this essay, nursing care of a patient with pancreatitis will be discussed to enhance reflective thinking and appraise nursing competence during case management.
The case discussion is about a 58 year old patient by name James (name changed to maintain privacy). James was brought to the emergency room on a Friday evening after a weekend party with severe abdominal pain. He was accompanied by his wife and friend. In the past, James had few episodes of abdominal pain and he responded well to antigastritis treatments. However, since the intensity of pain was more and he also had severe vomiting, his wife forced him to see a doctor in the emergency room. In the emergency room, James appeared dehydrated and was in distress. On enquiry, it was found that he did not pass much urine in the past 6 hours and had vomited several number of times. He had severe abdominal pain in the centre of the abdomen which radiated towards his back. He did not have loos stools and was passing flatus normal. The emergency doctor suspected acute pancreatitis. He performed serum amylase levels and they were 3000IU/l. CT scan which was done immediately confirmed the same. The patient was then transferred to surgical intensive care unit for further management. I was put incharge of