Clinical Reflection in Icu

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Clinical Reflection in ICU

For the purpose of this essay I will give a descriptive account of what implementation means within the Roper, Logan and Tierney (1986) nursing process. I will describe what implementation involves for the nurse and will be focusing on one aspect of the holistic care given to my patient whilst on placement. I have had the opportunity to see a stroke patient today - she wasnt under the stroke team but her MRI came back with 2 right Cerebellar infacts and CT results showed small ischaemic haemorrages.

Interestingly the patient had an inner ear infection about a month ago and her initial symptoms were suggestive of problems with inner ear - e.g. balance disturbance and dizziness. However she also had a headache and heart palipitations and ended up in hospital after collapsing (although not loosing conciousness).

I reviewed her notes and spent some time reviewing what had been happening for the patient. I had the opportunity to observe the physician completing some sensory tests which was quite exciting. She tested proprioception (asking the patient to close her eyes and describe the movement she was making with her metatarsel joint.

She tested vibration sense - with a metal fork that she banged and held on her joint asking the patient to identify when the vibration was present and when it stopped. I had the opportunity to experience what this sense felt like and the consultant was very helpful and also did a few other sensory tests on me.

He did some sound and hearing tests with the vibration fork asking me to identify what sound of the fork was louder. He also put the end of the fork on my forehead and asking me to tell me what side was louder.

The physician also tested touch - with prick and dull pressure. The consultant tried to explain to me the senses they test for and it brought back some of the learning from teck about the spinal cord and the columns and which sense is associated with each - this interested me...
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