Reflective Essay On Pressure Sore Nursing Essay

Reflective strain On Pressure Sore Nursing EssayMy aim of this seek is to reflect on my instruction awaycome ram peeled trouble and management. Pressure unbalanceds also known as decubitus ulcers. Benbow (2006) defines it as areas of localized tissue paper damage as a result of excess squash, shearing or friction forces. To reflect on my learning process, I am overtaking to apply Gibbs brooding model, which is a renowned model in meditative go for. This model requires passing through six decimal points to complete one reflective cycle. These six stages are description, feelings, analysis, evaluation, conclusion and action plan and I am tone ending to explore in these six strides how I achieved my learning outcome.In the introductory stage of Gibbs reflective model (1988) I allow describe the event which inspired me to get competent in obligate sore management. My smearment area was a nurse home circumstance where al more or less all service users are old age m ess who are prostrate to get wedge sores so I had seen many an opposite(prenominal) bosom ulcers. However, one musical compositionicular service user whose stuff accidental injury I go away never forget. I will address her as Mrs. N to maintain her confidentiality (NMC 2008). She is an 86 yr old, pitiable from dementia and doubly incontinence. She had a big, black and hard wound on her right hip. The flake off was intact but it was extremely discolored. accord to EPUAP (European Pressure Ulcer consultative Panel) guidelines, it was grade 4 pressure wound as there were copious thickness skin loss and it was covered by necrotic tissues. It was acquiring foul smell and the wound started to debride from the sides in a few days.The atomic number 16 stage of Gibbs reflective cycle requires me to reflect on my feeling for the event. It was my first day in that unit and I went with a nurse in Mrs. Ns room where she was going to do her pressure wound get dressed. I had no ide a around her wounds grade. I started to assist the nurse and as she clear the dressing I was shocked. I did read the description and seen pictures for grade 4 pressure wound (EPUAP guide to pressure ulcer grading) but never seen it in my past practice so it was absolutely shocking for me. I felt very disgusted. I tried to put myself in her place and when the nurse was touching her wound I was feeling like its natural event to me but the most tragic thing for Mrs. N was that she was not able to express her pain as a result of her dementia. The study conducted by Bale s., C. Dealey et al (2007) had found shocking revelations about the effect of pressure ulcers, amount of pain and its effect on a patients life. I was thought what could be the reason behind it. Is it our negligence or something else for what patient was suffering?Third stage of Gibbs reflective model rents reflecting telescope evaluates the event. According to NICE guidelines, a patient who is at risk of developin g a pressure ulcer should be treasureed within 6 hours of admission (NICE 2003). man in Mrs. Ns case she has been in the nursing home for a coherent time so her opinion should learn been current as she was prone to develop it. The other thing I evaluate was that nurse rest very busy during her shifts so she relies on support staff regarding the patients curb so there are chances that nurses missed to assess Mrs. N for pressure sore on regular interval. According to Mockridge and Antony (1999), the nurse must allow basic knowledge of pressure ulcer prevention, healing and treatment to head off the occurrence and discomfort. There are many risk assessment tools to assess patient for pressure ulcer development which I have been beaten(prenominal) during my learning process. These scales known as Norton scale, Waterlow scale and Branden scale (Norton et al. 1985, Branden and Bergstrom 1987, Waterlow 1991 and 1998). It could have been realizable to prevent Mrs. N from getting that worse ulcer by carrying out assessment based on one of these scales.Analysis is the fourth stage of Gibbs reflective model (1988). My knowledge about the pressure sore upkeep and management was very limited. According to the code (NMC 2008) you must take part in appropriate learning and practice activities that maintain and develop your competence and performance. I decide to get competent in pressure sore take and management as I am going to be a qualified nurse I should have the knowledge and attainment to practice safe (NMC2008). I analyzed from this event that first step to become competent in this readiness is to learn a decorous risk assessment skill using one of the risk assessment tools because prevention is always better than cure. To justify this, during my learning process I carried out some assessment on service users who were vulnerable. I utilise Waterlow scale (Waterlow, 1998). This assessment helped me to classify ulcer. The classification of wound helps to determine the most effective treatment (Daugherty and Lister, 2008). The next aim should be to minimize the pressure on pressure area. To apply this in my placement area I followed NICE guidelines which suggested that there must be a position changing schedule (NICE 2003). Thus, I participate with my team and we prepared position play charts for the service users who were at risk of developing a pressure ulcer.The other factors involve in preventive managements are pressure relief devices i.e., cushions and mattresses, pressure area skin carry on specially in incontinence patients and ongoing assessments. The next step after the assessment is planning. It is very crucial back up which leads the patient towards fitness. I prepared and the update care plan by following NICE (2003) guidelines and my placement area policy and procedures. I debateed it with my mentor, my colleagues and other support staff to get suggestion and to improve quality of care (NMC 2008). Apart from al l above factors, the important management step in grade 3-4 ulcers are dressing. I also analyzed that I need to perform ulcer dressing on Mrs. Ns ulcer to get office and to know my abilities. Before starting dressing I discussed with the nurse about dressing materials used for Mrs. N and prepared trolley using antiseptic technique. My mentor observed me carry out dressing and I followed the stairs as done by tissue viability nurse. I also practice for dressing on grade-2 and grade- 3 pressure sores under supervision which gave me self-assurance. The nursing care is not complete without an evaluation. It helps nurses to critically evaluate the patients condition whether it is stable, has deteriorated or improved. During evaluation process I found that our care plans were making crucial effects on patient care and helped us to promote their health.In the fifth stage of Gibbs reflective cycle I am going to draw a conclusion following my learning process. I have become competent in t he care and management of pressure ulcer. It had provided me skill to practice confidently. If nurses caring of Mrs. N had used their skills and knowledge, then they could have prevented pressure ulcer. There must be busy taping environment where for the nurse it is not possible to give detailed attention on both service user but according to the code (NMC 2008), the nurse should work with others to protect and promote the health and well-being of those in her care. I sure as shooting learn the importance of close observation in health care practice.The final stage of the reflective cycle (Gibbs, 1988) is an action plan which facilitates the reflector to plan for the future. It needs you to prepare a plan of actions to take if the home arises again and also plan for improvement in future practice. I planned that I will perform pressure ulcer dressing whenever there will be a patient requiring pressure sore dressing to get expertise, to increase my confidence and knowledge . I wi ll read more research articles in this area to dig up more and to deliver the silk hat care based on the best available evidence (NMC 2008). I am also planning to discuss this topic with fellow peers.