Developing Practice in adult Nursing

Introduction

Reflection is an essential component in nursing practise. The nurses who will be working as nursing professional will employ reflection to apply their experiences in their future applications in order to provide culturally acceptable, ethical, and legal care to their patients. It consists of six steps: description, emotions, evaluation, analysis, conclusion, and action plan. This assessment focuses on the manner in which nurses should apply regulatory and ethical standards.

It also incorporates the Gibbs reflection cycle reflection and findings. Reflection, in my opinion, is a technique by which healthcare professionals can learn and improve their practices based on their interactions with patients. Reflection can help you learn before, during, and often after an event or experience. Clinical care, clinical leadership, clinical management, studies, management, and consulting duties, administrative or policy creation are all part of the job.

Additionally, the code is applicable to any setting where a nurse may do these activities, whether in-person, in print, via the Internet, or electronically. Nurses should be aware of the obligations stipulated by national law in order to comply with regulations in their practice (Ferrero et al., 2018).

Description

I am a 2nd year nursing student and I had to work with a registered nurse (RN) throughout my placement at the ormskirk hospital. I was given a list of gynaecology procedures. My first patient agreed with the help of another postoperative pain management in gynaecology has to be significantly improved. This is mirrored in the fact that pain scores in gynaecology departments in ormskirk hospital are greater than in all other surgical departments.

Gynaecological surgeries have also been linked to severe pain. Open uterine surgeries, in particular, are linked with considerable pain, which is comparable to pain levels after spondylodesis. Complex surgeries in the female breast, as well as ostensibly modest laparoscopic interventions such adenectomies, are associated with severe discomfort following the procedure. In fact, pain levels in the aforementioned situations exceed those recorded after large upper abdominal surgeries. NMC guidelines defines a student's developmental needs.

The values—often referred to as the "6Cs of nursing"—were: care, compassion, competence, communication, courage, and commitment. Each of the six principles, which were supported by six areas of action, had equal weight and was centred on the idea that nurses should place patients at the "heart of everything" they perform.

Feelings

Prior to the incident, I was feeling confident and eager to learn everything there was to know about life support. Endometriosis is a painful condition in which tissue similar to the endometrium which normally covers the lining of the uterus, grows outside of the uterus. Endometriosis is most commonly associated with the ovaries, the tubes of the fallopian tubes, and vaginal tissue. Endometrial-like tissue can be found outside of pelvic organs on occasion. Based on the circumstances of this study, I concluded that the patient's consent is the most crucial factor in nursing practise as a student nurse.

The standards of registered nurses made it plain to me that student nurses must adhere to legal and ethical criteria. I learned from nursing legal guidelines that it was not acceptable to enter the operating room without the patient's consent. Furthermore, we discovered that endometriosis affects gene expression in the insula, amygdala, and hippocampus.

These brain regions are important in pain, anxiety, and sadness (Koninckx et al., 2021). Endometriosis is now thought to be caused by: During periods, blood from menstruation with cells from the endometrium flows back through the tubes known as the fallopian tubes and into the pelvic cavity, while blood flows out of the body through the cervix and vagina.

Pelvic discomfort, which is typically accompanied by menstruation, is the most prevalent symptom of endometriosis. Although many women have cramps during their menstrual periods, endometriosis patients frequently describe substantially severe menstrual pain than usual. Pain can sometimes get worse over time. According to the Nursing and Midwifery Council (NMC), nurses are required to practise effectively, which includes utilising all available information and giving the best care possible to all patients.

Endometriosis is characterised by the following feelings

• Period discomfort (dysmenorrhea) - Vaginal pain and cramps can occur several days before and after a menstrual period. Lower back and abdominal pain are also possible.
• Pain during or after sex - Endometriosis usually causes pain during or after sex.
• Urinary or intestinal pain- These symptoms are likely happening during a period of menstruation.
• Excessive bruising- You may experience heavy menstrual cycles as well as bleed during periods on occasion.
• Infertility- Endometriosis is occasionally discovered in women undergoing infertility treatment.
• Other symptoms and indications- Patients might experience tiredness, diarrhoea, bloating, constipation, or nausea during their menstrual cycle (Lebovic et al., 2021).

Explaining this story to others may lead them to believe that it was just a manikin and not a real person, and I had no need to be worried and anxious, but it was my first time that made me comprehend I might someday be responsible for saving someone's life.

Evaluation

Endometriosis is the presence of endometrial tissue outside of the uterine cavity, which affects up to 10% of reproductive-aged women. It is more common in women who have pelvic pain or infertility ([correction] 70–90% and 21–40%, respectively) (Schrager et al., 2013). Some endometriosis patients are asymptomatic, while others experience symptoms such as excruciating pelvic pain, dysmenorrhea, dyspareunia, and diminished fertility. Endometriosis is primarily diagnosed clinically in general care.

Nonsteroidal anti-inflammatory medications, combination estrogen/progestin contraceptives, or progestin-only contraceptives are frequent first-line treatments for primary dysmenorrhea.

Nonsteroidal anti-inflammatory medications, combination estrogen/progestin methods of contraception, or synthetic progesterone-only contraceptives are frequent first-line treatments for primary dysmenorrhea.

There is some evidence suggesting these agents are beneficial with few side effects. If the signs and symptoms persist or the patient has no ability to become pregnant, a gynaecologist should be consulted. Before pursuing subsequent therapy, laparoscopy is frequently used to confirm the diagnosis. Gonadotropin-releasing hormone analogues, danazol, and surgical excision of ectopic endometrial tissue are further treatments. These measures may be more effective than early treatments in controlling symptoms, but they can have serious side effects and limit the duration of therapy. 

In nursing, emotional intelligence is described as the ability to recognise one's own feelings as well as those of others, to keep an eye on oneself, and to manage emotions in both personal and interpersonal situations. In addition, we discuss self-awareness.

In nursing emotional intelligence is on the ground of interpersonal skills and decision-making practices. The effective delivery of healthcare depends on interpersonal ties. Since interpersonal relationships are at the core of nursing practise, advanced practise registered nurses (APRNs) are well-equipped to guarantee the provision of safe, high-quality care. Interpersonal dynamics can be improved, according to research. An important component of interpersonal relationships is emotional intelligence (EI), which is the capacity to recognise, comprehend, regulate, and use emotions in oneself and others.

Nurses may interact effectively with a diverse patient group and change their behaviour as necessary by having a strong sense of self-awareness. Better evaluating one's capacity to offer care and evaluating patient needs are both abilities of the self-aware nurse. In situations that are changing, pivot as necessary.

Nurses may interact effectively with a diverse patient group and change their behaviour as necessary by having a strong sense of self-awareness. Better evaluating one's capacity to offer care and evaluating patient needs are both abilities of the self-aware nurse. In situations that are changing, pivot as necessary.

Analysis

While trying to make sense of everything, a couple of thoughts came to mind that could explain why I was feeling that way. As nursing students, we receive classroom instruction as well as practical practise. The analysis of endometriosis is a prevalent female ailment that causes chronic discomfort and infertility and is linked to an increased risk of ovarian cancer. We examined the transcriptomes of more than 370,000 individual cells from endometriomas (n = 8), endometriosis (n = 28), eutopic endometrium (n = 10), unaffected ovary (n = 4), and endometriosis-free peritoneum (n = 4), creating a cellular atlas of endometrial-type epithelial cells, stromal cells, and micro environmental cell populations across tissue sites.

Endometrial-type epithelium and stroma cellular and molecular markers vary across tissue types, implying a role for cellular remodelling and transcriptional reprogramming in the disease. Endometrioma epithelium, stroma, and proximal mesothelial cells revealed deregulation of pro-inflammatory pathways and over expression of complement proteins. Somatic ARID1A mutations in epithelial cells were linked to increased levels of pro-antigenic and pro-lymphangiogenic factors.

Action plan

The practise of nursing must include reflection. In order to give their patients care that is culturally appropriate, ethical, and legal, nurses that will be working as nursing professionals will use reflection to apply their experiences in future applications. Definition, emotions, evaluation, analysis, the end, and action plan are the six steps that make up this process. By creating an action plan for the following time, I aim to be more proactive in the way I address issues in the future.

As my first duty is to prioritise the patient, this includes being aware of the environment and resisting the urge to become overwhelmed by the crowd. Therefore, having good communication with the patient is crucial. Obtaining their consent and giving them all the necessary information may help to defuse the situation. As a duty in my nursing practices in the endometriosis issues, "nursing care" is used to refer to the nursing procedures, care standards, and behaviour of nurses when providing patient care. During the nursing process, I have offered a framework for the delivery of patient-centred care, including evaluation, diagnosis, preparation, execution, and assessment (Griffiths et al., 2020).

According to the Nursing and Midwifery Board of Australia (2017), the standard of care is used to assess a nurse's competence or aptitude within the parameters of their practice. Even nurses can face endometriosis-related health problems, therefore we should support one another and promote self-care, especially for those who are dealing with this condition personally. In any context, the nursing profession has the chance to improve the care given to patients with endometriosis. Menstruation, fertility, and pain are three of the most challenging conversations to have, and these subjects require more in-depth investigation.

Conclusion

In order to sum up my entire experience, I would say that I learned a lot from the circumstances and will bear them in mind moving forward. Since we need to be intellectually capable and in good health in order to give the patient the greatest care, I think it is important for me to be self-aware and attempt to take care of my own wellbeing. Reaching out to community members who can help you or speaking to your friends, family, or an expert can help you do this. Moving on to the professional front, I feel that I may benefit from more practises with the skills that would boost my confidence.

References

Ferrero, S., Evangelisti, G., & Barra, F. (2018). Current and emerging treatment options for endometriosis. Expert opinion on pharmacotherapy, 19(10), 1109-1125.

Griffiths, P., Saville, C., Ball, J., Jones, J., Pattison, N., Monks, T., & Safer Nursing Care Study Group. (2020). Nursing workload, nurse staffing methodologies and tools: A systematic scoping review and discussion. International Journal of Nursing Studies, 103, 103487.

Koninckx, P. R., Ussia, A., Adamyan, L., Wattiez, A., & Donnez, J. (2012). Deep endometriosis: definition, diagnosis, and treatment. Fertility and sterility, 98(3), 564-571.

Lebovic, D. I., Mueller, M. D., & Taylor, R. N. (2021). Immunobiology of endometriosis. Fertility and sterility, 75(1), 1-10. 

Olive, D. L., & Pritts, E. A. (2001). Treatment of endometriosis. New England Journal of Medicine, 345(4), 266-275. 

Rocha, A. L. L., Reis, F. M., & Petraglia, F. (2012). New trends for the medical treatment of endometriosis. Expert opinion on investigational drugs, 21(7), 905-919. (Rocha et al., 2012)

Schrager, S., Falleroni, J., & Edgoose, J. (2013). Evaluation and treatment of endometriosis. American family physician, 87(2), 107-113. 

Valle, R. F., & Sciarra, J. J. (2003). Endometriosis: treatment strategies. Annals of the New York Academy of Sciences, 997(1), 229-239.