GUIDELINES FOR REFLECTION ASSIGNMENT

The assignment should be 2 pages long (approximately 500 words) excluding the cover page and
the references page.
1. Introduction (50 words)
A brief, concise explanation/description of the particular clinical situation/experience, such as, a
patient physiological problem (e.g. a particular diagnosis, a new treatment experience
(chemotherapy/radiation therapy), a situation involving patients’ family, or ethical dilemma
regarding the treatment/ patient care).
I was pursuing my duty in the day shift and in an emergency my senior assigned me with the task
to attend the patient who was admitted in the rehab department of our hospital. His condition was
very critical and I was asked to provide him the primary aid in the intensive care unit.
This patient was suffering through the complaint of acute withdrawal syndromes from alcohol, liver
cirrhosis, swollen abdomen, and ascites. Since his condition was very critical, I checked the fluid
balance, level of fluid, weight etc. on an urgent basis. The level of peripheral edema and the usual
rhythm of respiration were checked. The level of sodium and fluid was checked and limited to resist
the accumulation of fluid and hence maintain the apt level of dilutional hyponatremia(Keogh 2014,
p. 11). The level of albumin and serum in blood were also checked for bringing down any
abnormalities. From my knowledge and the results from the tests undertaken I came to a
conclusion that the patient is going through serious stage of liver cirrhosis and liver disease from
alcohol, which was also confirmed by the complaints while attending him in the hospital. This made
me conscious and I started to take actions and procedures which should be taken against a patient
suffering from liver cirrhosis. I had conducted the entire test and all the actions by referring to my
senior and had monitored every variation in the readings and condition of the patient.
2. Feelings (100 words)
Describe own emotions, feelings, beliefs and thoughts prior, during and after the particular clinical
situation/experience. Provide knowledge/thoughts that have had helped in the response to the
particular clinical situation/experience.
While attending the patient I was very confident and was able to handle the situation and the
patient very well. I was able to stabilize the critical condition of the patient and had taken care of
him during my entire shift. When the situation came in which I was not sure what to do and was
sceptical about the next step I asked my senior for guidance. While attending the patient I was very
confident and studious in handling the patient and conducting the required tests. . If any
abnormality or any uncertainty happened in the condition and the test results of the patient, without
any delay I have informed it to the mentor (Mikkelsen et al. 2015, p. 3632). Conducting this patient
in the intensive care unit had made me more aware and knowledgeable about how to attend a
person who is in a very critical stage. Before attending the patient I was very sceptical and unsure
of my practical abilities as I had never a patient in such a critical condition of liver cirrhosis. After
pursuing this experience I had acquired great knowledge of the interventions to be conducted in
the practices of nursing. I was very cautious and attentive while I was attending the patient. I am
now very confident in handling and attending the patients summering from acute liver disease from
the consumption of alcohol.
3. Evaluation (100 words)
Identify what went well and what went wrong in the particular clinical situation/experience. How did
the experience end? Was there any resolution? Describe what you thought about the situation
(e.g. its potential causes)? Describe the response/the assistance obtained from the clinical
instructor/the responsible nurse?
The progressive part of the event was that the event helped me in acquiring a lot of confidence.
The patient was allocated to me by the senior and I had to take my decisions on my own since, the
senior was not always available to help me. This required me to apply every theory and knowledge
I have studied in the nursing class regarding liver diseases and alcohol withdrawal symptom to
control the situation (Vardy et al. 2013, p. 261). I had to go through the medical history of the
patient and had to apply some critical reasoning and decision making ability in that situation. In
order to control the aldosterone effect along with restricting the ascites and edema, diurectics like
frusemide and spironolactone were used. Since the patient was going through acute liver disease
potassium was continuously lost through urine. Thus the external supply of potassium was
provided to the patient. To improve the cardiac condition of the patient Arterial vasodilators were
injected in the body of patient. Since the patient had recovered from the situation there was no
such any regressive aspect in this experience. The patient was allotted to me for only one day,
which has limited my opportunity to study more about the medical practices. By this event I was
able to gather much information about nursing interventions and has provided me a better stage to
learn about the urgency in nursing. The situation was all under control and thus the event was a
very pleasant experience for me.
4. Analysis (100 words)
 Describe why the particular clinical situation/experience went wrong? What did you think
lead to the negative consequences? What could have been done to avoid these negative
consequences?
 Describe why the particular clinical situation/experience went well? What did you think lead
to the positive consequences? How these positive consequences could have been further
improved?

By attending the patient in the intensive care unit of the rehab unit I have inferred that the main
activities in nursing, depends on the clinical judgement and the decision making capacity of the
attender. The process of nursing majorly relies on the delivery of quality patient care and arriving at
better decisions suddenly which will give the attender a great knowledge and confidence to carry
further urgent cases. The practices and the interventions of nursing majorly depends on how the
reaches are conducted, the way of collecting the evidence and analysing it, and arriving at a
conclusion by going through a thorough critical analysis by keeping in mind the diverse and
different patient population and their individual medical history. In the process of attending the
patient I had recorded all the interventions carried out in the nursing procedure very accurately. I
had made the detailed notes for finding , interventions made and the observations in the event.
The interventions carried by me to the patient of primary character, because the patient was just
admitted into our department. The interventions noted by were of great importance as the
continuing treatment of the patient was to be done by referring to the notes prepared by me. The
notes and the interventions drafted by me were well appreciated by the senior as they were very
accurate and consisted of in depth analysis of the patient’s condition.
5. Conclusion (50 words)
 What did you learn about yourself positive or negative?
 What did you learn about your current knowledge/level of practice (strengths and
weaknesses)?
 Did the experience achieve any of your learning goals/ meet any of your required
competencies?

My senior had played a great role in guiding me through th critical situations. I followed each and
every guidelines provided by him and it had really helped me in handling the patient. Since this
patient was suffering through acute liver disease, he was losing very much nutrients from urine and
other media. Thus he was asked to take a very balanced diet and to follow a very healthy routine of
food intake. It was recommended for the patient that the intake of alcohol should be stopped on an
urgent basis(Jaurigue and Cappell 2014, p. 2154). The family of the patient should be made aware
of the seriousness of the situation and should be asked to provide the patient with mental and
social support to help him recover and join rehab centre. This situation has elevated my knowledge
of liver cirrhosis and I was able to witness the acute withdrawal symptom of alcohol. I wanted to
give the patient nursing intervention throughout his medical course as I wanted o gather more
knowledge on his condition. I was not able to do this as on my next shift I was allocated with
another patient. I was able to achieve my learning goal of studying the nursing interventions. It was
a great opportunity for me to apply my theoretical knowledge and by virtue of which attain some
practical knowledge.
6. Action Plan (100 words)
Describe ways by which your nursing care skills could be expanded after this particular clinical
situation/experience? What additional knowledge and skills do you need to be better prepared to
face this particular clinical situation/experience in the future? Include the priorities areas to be
improved, specific steps needed to be taken in order to achieve these improvements. Describe any
changes in your values/ feelings as a result of this particular clinical situation/experience?
I have observed by the analysis of the event that the mutual co-operation and synchronized team
work plays a vital role in the process of nursing interventions. I have determined to focus on a
patient till his medical course is completed since I was not able to give nursing intervention
throughout the patient’s medical course. In my perception that will enhance my knowledge on
nursing interventions and give a great boost to my confidence. It was a very pleasant condition
since the patient was able to recover from the critical condition but I need to handle same cases
again in order to make me well verse in handling the critical situations. My priority would be in
handling critical patients without any interference from the senior.
7. References
The student should provide references list and in-text citation which may include recent studies,
policies documents or data from reliable academic sources.