Reflection in Nursing Practice

The incident that I am going to reflect had happed during my nursing studies. I was posted in a busy emergency care (EC). My role was to observe and assist a RN. Ms. X came to EC with severe abdominal pain. After the initial assessment Doctor ordered a list of blood tests. I accompanied RN to observe blood sampling procedure. Ms. X was clearly not cooperating for the procedure and was screaming. I helped to position the patient with the help of family members so that the RN could carry out the procedure. The impact of this incidence was huge in my mind. Initially I felt I was helping RN for the procedure by restraining the patient. However I felt bad at the same time as I thought the reason for the patient’s behavior was needle phobia and as health professionals we never addressed that. We didn’t have consent from the patient for the procedure.

When I evaluate this situation the good thing was we were able collect blood samples in a safe manner. The bad part was we were not helping a patient who is already struggling with some reason instead we forced her in a certain position for blood sampling. I discussed this with my clinical coach and she told me the feeling of something done wrong should be removed from my mind. In EC procedures are done according to clinical condition of the patient. If patient’s condition is critical clinician can make treatment strategy without informed consent. Abdominal pain in young women could have been a surgical emergency like ruptured ectopic pregnancy or inflammation involving peritoneum. Analyzing the whole situation gives me more knowledge about abdominal pain, as well as patient response to this condition. The non-cooperative patient behavior towards the procedure was most likely due to the severe nature of the pain rather than fear of needles.

Moreover I have gained a good understanding of informed consent under different circumstances. Now I can see the different aspects of this situation. Faced with a similar situation again, I will be able to recognize that each behavior of the client has got some relevance for the underlying condition. Understanding it will help me to manage the situation better.