Section 5 and 6

Section 5. Drug Safety -AdministrationWhat?During my placement in the ward, I was shadowing my mentor in drug rounds, but before that we have been discussing on the principles that underpin a framework for the safe and secure handling of medicines and can be used to develop working practices, policies and procedures. In handling medication is essential for the safety of the patient, staff and the whole team in the ward. So, my mentor took the medicine trolley and start the medication. I have learned that before giving the medication I have to check for the (5R’s) five rights which are, right name, right medication, right route, right time and dose (NMC.2015) . It is our duty and obligation to protect the patient against the risk associated with the unsafe and management of the medicines, by means of doing the proper technique of administering medicines by recording, handling, using, safe keeping, dispensing, and disposal of medicines used for the purposes of the regulated activity. (Environmental Protection Act. 1990)My mentor and I done all the checking of the five rights and start to administer medication to the patient. However, before handling the medication I ask weather he got allergies at all. Mr. X is allergic to penicillin as he claimed. Since penicillin is not included to the medication, it is safe to give the medication. I stayed with the Mr. X to ensure he takes all his tablets for health and safety. (NMC. 2015)So what?(Starts here)During the drug rounds, I am so cautious and very attentive on what my mentor was showing me, concentrates on the five rights, and very vigilant on what was been done. My mentor introduced me to the patient in the ward as student, I have to put my feet to concentrate on the medication rounds to avoid errors and mistakes although there is no one is perfect, but I have to prove to myself and my patient that I care. Mr. X complains of headache, I asked Mr. X if needs pain reliever, he nodded. I reported it to the nurse looking after him. In 5-10 minutes, the nurse gave Paracetamol 500mg tablets. The code (NMC 2015) states you must communicate clearly using a range of verbal and non-verbal methods. My mentor showed kindness towards the patient. Every patient has the right to refuse treatment at any time and must always give consent (NHS Constitution. 2015). The department of health’s guide to consent for treatment (2009) makes it clear, that it is a legal and ethical principle that you must have a valid consent before giving the patient medication. Public authorities are also required to comply with the rights that are set out in the Human Rights Act (1998). I feel that I have observed good clear communication and the way my mentor spoke and reassured the patient also showed compassion with her care that day. I felt the respect and dignity shown to the patient. As part of the NHS Values (NHS Constitution. 2015), shows that there is a commitment to quality care.Now what?I have learned a lot on my placement during the drug rounds, on how to keep my patient safe by proper handling of medication. I will continue to practice according to the Code (NMC. 2015), the NHS Constitution (2015) and the 6c’s (Cummings and Bennett. 2012). To always do right by the patient, to show commitment and compassion and to continue respecting all and knowing their rights with regards to the treatment and care. This example of good practice will influence me as I progress through as a student and into my professional career. I will take forward just how important patient centred care is. NMC code states that patient’s safety comes first (NMC. 2015). It is important to concentrate when medication is in progress to avoid error and fault. McCabe and Timmins (2013) states that communication to the patient is essential to know what are they allergies and when they need pain relievers. Meanwhile, NHS Constitution(2018) says, commitment to quality of care, respect and dignity are the best values to keep in day to day life.References:Health Education. 2018., NHS Constitution- Values.https://www.hee.nhs.uk>about.our-values.NMC. 2015., Safe Medication Administration.https://www.nmc.org.uk/standards/standards-for-post-registration/standards-for-medicines-management/The Mental Capacity Act. 2015 https://www.nhs.uk/conditions/social-care-and-support-guide/making-decisions-for-someone-else/mental-capacity-act/The Human Rights. 1998. New Legislation. http://www.legislation.gov.uk/Section 6 CommunicationSection 6. Communication Barriers in practiceWhat?I have some adventure in stroke unit, Mrs X was admitted due to stroke, her speech was affected as half body was paralyse and the only communication was through writing due to her condition. Mrs. X was referred to the speech and language therapists as the nurse is concerned about her swallowing. The therapists decided that her inability to swallow effectively was putting her at risk of aspirating when eating or drinking. The ward made a decision to cease her oral intake not unless seen by the SALT team (speech and language therapy). The nurse then sends the task out to the doctor to come and assess as all oral medication were cease. The doctor came and requested a nasogastric feeding tube so that Mrs X nutritional requirements could still be met. It was the duty of the nurse to insert the nasogastric tube to the patient. I went near to the patient and comforted her while the nurse was with the doctor. She smiles as I walk towards her and put her hand in my other hand. I ask her if she is frightened and she nodded. I put my hand around her shoulder to show my comfort to her and whispered to her she will be alright that she is in a good hand. The nurse came over and to call me as we are going to prepare the nasogastric tube, I have observed how she prepares the procedure. The nurse introduces ourselves to her and she nodded in every question. Before putting the tube, I have asked her consent first that we are going to insert the tube. She replied with nodded. Since her right hand is able to hold a pen, she writes in a piece of paper asking whether pain or not. I did reply in a very kind manner and comforted her. Before the procedure happens, I pulled the curtain around Mrs. X bed to respect privacy and dignity(NHS Constitution 2018).The nurse explained to her the procedure, if she feels any discomfort to hold her hand up.So What?Nasogastric tube is inserted via the nose into the stomach, I felt privilege to witness many positive aspects of care in dealing with a patient with a nasogastric tube. The nurse carries out a swallow test this involves in swallowing water. Following a stroke, the swallowing will be unsafe. The nurse showed me the high standards of excellence and professionalism in dealing to patient with nasogastric tube. (NHS Constitution, 2015)The nurse’s ability to carry out the procedure was successful, whilst causing the patient minimal discomfort made Mrs. X feel aware of her competence, another positive nursing attribute. I felt that there was a great building trust between patient and the nurse and made Mrs. X more comfortable. (National Health Service England, 2015). As Mrs. X is not able to speak she shows facial expression whenever she feels discomfort. At first, I felt uneasy as this was my first exposure to it to encounter Nasogastric insertion. However, witnessing the nurse competency made me feel as though I could trust her.The Nursing and Midwifery Council Code (2015) states that nurses must communicate clearly and use variety of verbal and non-verbal communication techniques. Formulating alternative communication methods ensured that Mrs. X needs wishes and preferences were adhered to, this help to ensure autonomy for patient by allowing Mrs. x to express their needs. This stood to me as a student, as it showed that even small actions can have significant effects. Now What?Now that I have been exposed to the procedure once, I feel more confident to be able to have a greater input in the future. For instance, somehow someday if I were to be involved with another nasogastric tube insertion, I will feel that I would be able to identify the correct equipment and be aware of how to carry out each step of the procedure. The local trust policy (2018) state that the correct procedural documentation is completed at every stage of the procedure, staff engaged in the process of inserting, checking and managing the use of nasogastric tubes are expected to be competent to do so and comply with this policy. (Local Trust Policy 2018). This meant that the care nurse provided was person-centred. This is something that I would like to implement more in the future career. In the future, I will make sure that I take time to communicate with patient specially with speaking problem to be able to understand and better communication to meet the proper care that I will provide. This will allow me to get to know them better in order to personalised the care I will provide.The support that the nurse showed during this clinical placement made me more confident and commitment to quality of care, respect and dignity. (NHS Constitution. 2018)References: Cummings, J., Bennett, V 2012. Compassion in Practice.https://www.england.nhs.uk/wp-content/uploads/2012/12/compassion-in-practice.pdfThe Mental Capacity Act. 2015. Making Decision.> https://www.nhs.uk/conditions/social-care-and-support-guide/making-decisions-for-someone-else/mental-capacity-act/The Human Rights. 1998. The human right act. >https://www.egualityhumanrights.com/en/human-rights/-act NHS Constitution. 2018. The Values.Https://www.hee.nhs.uk/about/values//nhs-constitutionvalues-hub-0 The Human Rights Act. 2018., Human Rights Article 8.https://www.libertyhumanrights.org.uk.human-rights

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