Reflective Nursing Essay

Case Study OneIn this case study I go out use Gibbs (1988) toughie of grammatical construction to write a personal account of an abdominal examen carried off in general practice under the supervision of my mentor, utilising the skills taught during the module olibanum far.What happenedDuring morning r fall prohibitedine sick parade I was presented with a 21 year old male soldier experiencing severe acute, non specific, abdominal pain. below the supervision of the medical officer (MO) I proceeded to carry out a full assessment and abdominal examination, victimization Byrne and Longs (1976) model to structure the consultation. I requested the forbearings consent before conducting the examination, as is essential before commencement of any medical procedure, be it a physiological examination or a critical surgical procedure (Seidal et al, 2006).The patient was quite agitated on arrival and appeared to be in a great take up of pain, and so before continuing with the physical e xamination I reassured him and made him comfortable in the treatment room. On examination his abdomen was soft, palpable with no tenderness, on auscultation bowel sounds where normal, live signs normal, with cramping centralised pain.FeelingsI was facial expressioning confident in my ability to deal with the patient and perform the examination effectively as I had adept this several times previously using the university resources and mock OSCE with my facilitator. As I am often solely responsible for the care and management of patients during out of hours (OOH) I felt comfortable assessing and triaging the patient. However, under normal circumstances I would assess the patient and refer them to the MO if I was concerned some their condition, in clubhouse for a finding to be made. I was too being closely monitored throughout which did increase the pressure to deliver the countervail diagnosis and make appropriate decisions. However, by utilising the consultation model I feel I managed to keep a focused border on and procure the correct questions where asked.EvaluationI feel I gained a true(p) history from the patient by using the SOLER principles (Egan, 1990) taught in the history taking presentation. Thus allowing me to form a differential diagnosis and regulation out reliable causes, much(prenominal) as constipation, and indigestion. Subsequently, the physical examination enabled me to confirm a diagnosis of acute abdomen. As the patient was not experiencing any distressing (red flag) symptoms associated with abdominal emergencies, such as appendicitis or pancreatitis. However, I did lay to rest certain aspects of the physical examination and had to be prompted by the MO. Although with much practice such incidence would be reduced.AnalysisI was happy that I managed to rule out any distinct causes of the abdominal pain by do the examination to collect data, analyse it, and use the results to make an appropriate decision (Schon, 1984). Howeve r, had I performed the examination without assistance I may not hit gained all the information required to confirm diagnosis, as I did forget some aspects.ConclusionThe MO seemed happy with my diagnosis and care plan, though he did highlight the importance of practicing the physical examination skills in order to break down a more competent practitioner. Overall I feel gaining knowledge and skills in translating a patients history and physical examination results, has enabled me to arrive more confident in making a diagnosis and has better my decision making skills.Action PlanIn order to become a more capable and effective practitioner I moldiness continue to perform physical examinations under the guidance of a more senior practitioner, and utilise their expertise during the decision making process.Additionally, I will continue to develop my consultation and history taking skills by using Byrne and Longs (1976) consultation model to assist my practice and forethought future dev elopment.ReferencesBYRNE, P, S., LONG, B, E, L. (1976) Doctors talking to patients. London HMSO EGAN, G. (1998) The Skilled Helper A problem-management approach to helping. 6th edn. Pacific Grove, London Brooks/Cole. GIBBS, G. (1988) Learning by doing a guide to teaching and learning methods. Oxford further education unit, oxford polytechnic SEIDAL, H, M., BALL, J, W., DAINS, J, E., BENEDICT, G, W. (2006) Mosbys Guide to Physical Examination. 6th edn. Philadelphia Elsevier. SCHON, D. (1984) The Reflective Practitioner how professionals think in action. New York Basic Books.