Acute Care: Nurs 453 Adult Health Clinical Case Study
- Purpose of the Assignment:
The purpose of this case study it to integrate knowledge from the humanities and sciences, including nursing research and theory, to plan, provide, and evaluate holistic care provided to a client selected during this clinical rotation.
- Student Approach to Assignment:
For this assignment I chose to focus on a patient I had bonded with and provided the most care to so I knew her case in great detail. I also chose her case because I found her injury and surgery interesting. This assignment taught me a great deal about the decisions physicians make when choosing the type of surgery to perform on a patient, especially because in this patients case there were multiple options for surgeries to perform depending on how sever the physician thought her cervical myelopathy.
- Reason for Inclusion of the Assignment in the Portfolio:
I thought that this assignment was note worthy because it showed a great amount of depth into clinical research and demonstrated how that evidence based practice correlates to taking care of post operative patients. I also thought that this case study demonstrated how I applied clinical knowledge carefully because this patients pain management wasn’t actually centered around her surgery but instead around the arthritis she had in her hip. I also participated in a lot of therapeutic communication as this patient detailed her depression related insomnia to me.
Domain 1, 2, 3: Knowledge for Nursing Practice, Person-Centered Care, Population Health Descriptor
7. Demonstrates clinical reasoning in making clinical or professional judgments. (1.1,1.3, 2.2, 2.3, 2.4,3.4)
-This patient presenting a challenge for me in that she was the first with movement restrictions that were very particular like having to log roll her to protect her spine. I felt like it required a decent amount of clinical judgement to best assist her every time she needed and adjustment or even to go to the bathroom.
Domain 2: Person-Centered Care:
6. Communicate effectively with individuals. (2.2, 2.3, 2.4)
-I spent a lot of time with this patient, she was my only one that day and I was able to get to know her well and communicate a lot about her life and her views and learn things like how she perceived pain and why she wasn’t overly interested in taking opioids. All to provide her better, personalized care.
Domain: 2,3: Person-Centered Care, Population Health Descriptor
8. Applies appropriate knowledge of major health problems to guide nursing practice. (2.2,2.3, 2.4,3.4)
-I learned a lot about spinal surgeries and the post-operative care differences in spinal surgery patients. I will take this knowledge into practice as I’m sure I’ll encounter patients who require similar precautions post operatively as well. Now I have experience and the knowledge from my research for this assignment to guide me in best practices.
9. Implements nursing care practices as appropriate to provide holistic health care to diverse populations across the lifespan. (2.2,2.3,2.4,3.4).
-This patient was a part of the older patient population, and this assignment highlighted some of the ways her care differed because of her age, and how my care differed for someone with comorbidities at that stage in life.
18. Educate individuals and families regarding self-care for health promotion, illness prevention, and illness management. (2.2, 2.3, 2.4, 3.4).
-In caring for this patient, I got to work with occupational and physical therapy and discuss management of this patient’s care at home and how they can best accomplish their activities of daily living. Together we educated them on how to move safely and how their home will need some adjustments.
Domain 2, 3, 5: Person-Centered Care, Population Health Descriptor, Quality and Safety
11. Performs therapeutic interventions that incorporate principles of quality management and proper safety techniques. (2.2,2.3, 2.4,3.4,5.1,5.2)
-In caring for this patient I was able to learn how to properly assist the patient to stand and ambulate with their walker, a technique I’d practiced before but hadn’t applied for a spinal surgery patient in this capacity.
Domain 2, 3, 10: Person-Centered Care, Population Health Descriptor
14. Revises actions plans and goals based on evidence or responses to interventions. (2.2,2.3,2.4,3.4,10.1, 10.2,10.3).
-While caring for this patient and attempting to best manage her symptoms like pain, I found our plan of care had to change when she was more worried about her hip pain than her spinal surgery pain. This was especially a challenge because the way she needed to be positioned post op was influencing her hip pain. Therefore, we had to adjust both our pain management and patient turning schedule and techniques.
Domain 4: Scholarship for the Nursing Discipline
27. Evaluates research that focuses on the efficacy and effectiveness of nursing interventions. (4.2)
-In evaluating my research on the care given to this patient, I actually found there were some ways we weren’t doing our best to position this patiently safely and we could have improved our assistance of this patient to better promote effective healing of their spinal surgery.