REFLECTIVE PRACTICE

CLINICAL PRACTICE VI
NRS535

PREPARED BY :
NUR AZIEMAH BINTI MOHD ZAMRI (2017415056)
HAZIQAH BINTI ISMAIL (2017807306)
 Definition

Understaffing is a situation in
which an organization does
not have enough employees to
do its work properly.
 01

DESCRIPTION
Describe the situation, event
or activity in detail
 Description

During our clinical attachment in Coronary Rehabilitation Ward

(CRW), there is 4 patients that we need to care, which one of patient is
in chronic state and need a lot of care, two of the patients needs to
undergo angiogram and percutanious coronary (PCI) and one of them
was Mr. Z himself.

However the staff nurse incharge for every shift in the CRW is only
2 people so it was a lot of work to care all the patients by themselves.
 Description
(cont.)

One of the patient who is in chronic state also need frequent care
from the staff nurse as he need to have three daily dressing in 3 places
(IJC catheter at right neck, bed sore stage IV and wound at left leg).
The patients also need positioning every 2 hour and Ryle’s tube feeding
for every 4 hour.

Meanwhile, Mr. Z has a big body composition and weight so about 5

people need to lift him up the bed to correct his position but because of
the short staff in the ward they sometimes need help from staff nurse in
the other ward.
 02

FEELINGS
Encourage to talk about what
was thought and felt during
the experience
 Feelings

Our feelings during that time was empathy towards the staff nurse
as they look exhausted and have no time for themselves. They also
need to provide many managements for one patient and need to keep
track for other patients management as well.

We also feel impressed because they still manage their patients and
complete all the task. They also having high critical thinking skills as a
critical care nurse especially the team leader.

Other than that, we also feel nervous because it was our first time to
be assigned to critical care unit as patients need meticulous care. Staff
nurse also may not have time to guide students as they also were busy
with the patients.
 03

EVALUATION
Ask whether the experience of
the event in step was good or
bad. Which approach worked
well and in what way? Which
approach did not work as well?
Evaluation
Good
Bad
- Staff nurse able to work under
- Quality of patient’s care pressure environment as they
was affected and cannot can act and think fast about
be optimized because the nursing intervention that can
lack number of staff be given to the patients.
nurse. - Besides, it also taught us to be
- Nurses rushing to more alert with any changes
complete their task before of the patient condition.
their shift ended.
Evaluation (cont.)

Action we take in that

★ Prevent mistakes
situation.
Double check with
staff nurse/ clinical
★ Be assertive
instructor when
Try to ask staff
doing procedures.
nurse task that we
Ask if not sure about
can do.
something.
Willingly involves
in patient care.
 04

ANALYSIS
Phase is about what have
learned from the situation,
event or activity.
 Analysis

There have been a greater media and research attention to patient safety
and the effect of staffing on the occurrence of adverse events and
international media have previously described patients being exposed to
adverse events with severe consequences, of which many are caused by
poor staffing (Glette et al., 2017)

Students can help the staff nurse to care for the patient so that the staff nurse
can have more time to do another task. Students also can help the staff nurse
by ensure that all the equipment or medication are enough and available so
that the staff nurse can do their work more faster and easier.

Staff nurse that was not serious about the patient care can affect the staff
nurse in the next shift (not charting I/O properly, medication error) and cause
delay in their work.
 05

CONCLUSION
Ask whether the experience of
the event was good or bad.
Which approach worked well
and in what way? Which
approach did not work as well?
Conclusion

This situation show the reality that being a staff nurse

is not as easy as it seems. We as a students can use this
opportunity to learn more things and improve ourselves
for our own benefits in the future.

We can improve ourselves by develop time

management skills that useful when doing our tasks.
Skills in critical thinking and adequate knowledge is very
important and useful during critical situation, in which
limited time is obtain to make decision for patient’s
safety.
 06
ACTION
PLAN
Ask yourself whether the
experience of the event in step
1 was good or bad. Which
approach worked well and in
what way? Which approach did
not work as well?
 Action plan

The management can recruit more staff nurse from other department in the
hospital that can help to reduce the workload. However, a few challenges may occur
such as difficulty to adapt to new environment, need supervision is needed to do
tasks and staff training need to be provided to the staff nurse before able to attend
and care for the patient.

Other than that, the salary for the staff nurse can be increase as a motivation and
rewards to do their tasks in high spirit. Staff nurses also need to provide high quality
of care towards the patients so the duration for the patients to stay in the ward can
be shorten.

Staff nurses also need to care for themselves more, physically and mentally in
order to develop effective mental habits and reduce stress of works that have been
accumulated over time.
 References
Glette, M. K., Aase, K., & Wiig, S. (2017). The Relationship between
Understaffing of Nurses and Patient Safety in Hospitals—A Literature Review
with Thematic Analysis. Open Journal of Nursing,
07(12),1387–1429.https://doi.org/10.4236/ojn.2017.712100
THANK
YOU