The aim of this essay is to identify a significant event from the authors clinical practice where there was an issues relating to the management and leadership of the nursing and health care team. Appropriate management and leadership theories will be used to support the issues which would be discussed in this essay. A critical analyses of the event we be carried out. Confidentiality will be maintained. Name
and places used in this essay will be changed to maintain confidentiality in
accordance to the Nursing and Midwifery council (NMC, 2008).
Database search was carried out MEDLINE, CINAHL, BRITISH NURSING INDEX
AND Nursing and Midwifery council were searched for relevant literature. The author
also made several visits to the library for books in order to produce this piece of
During the authors third year of studies, the author had a clinical placement on a medical ward where she observed that nursing staffs did not know the difference between the various types of urinary catheters. The author also noticed that nursing staffs did not observe aseptic technique when emptying catheter bags. When it was time to empty these bags they don’t even put on gloves nor did they wipe the drainage tape before and after emptying the bag as stated by ( Johnson. J, 2002). Warren et al (2008) stated that hand should be decontaminated and a pair of gloves should be worn before manipulating a patients catheter. Nursing staff on the ward just open the catheter bag, empty it and allow the bag to lay on the floor without hanging it on a stand. The National Institute of Clinical Excellence (NICE, 2004) recommend that all indwelling catheter should be connected to a sterile closed urinary drainage system which should be cared for using aseptic technique in order to avoid infection.
There was a patient who had difficulty in passing urine; the patient was in a lot of pain. A bladder scan was carried out which revealed that there was fluid retention in the ladder and the doctor then requested the staff nurse on duty to set up a trolley with all the equipment needed for the patients catheterization. The author was working with this staff nurse A, as the staff nurse was bringing out the Catheter from the shelf in the treatment room, the author then asked the staff nurse what was the difference between the male and female catheter and what inform her choice of the catheter she have chosen? Staff nurse A was unable to explain to the author the rationale behind her choice of catheter and how the use of a wrong catheter might have an effect on the patient. According to Nasako (2010, pp 98) choosing a catheter that is of appropriate length, size and material can help to reduce catheter related problems. The author noticed that there was general lack of knowledge amongst nursing staff on the length of stay of catheters in patients, difference between short and long stay catheters. The author also noticed that on the ward that about 5% of patients on the ward were catheterized. Bhatia et al (2010) states that about 25% of urinary catheterization is unnecessary and that inappropriate catheterization is an indicator for poor quality care. The moment a patient don’t pass urine in 24 hours, they are immediately catheterized. There was this case of a patient becoming sick on the ward due to catheter infection .
According to Woodwood (2003,pp 14) catheterization is the insertion of a tiny flexible tube into the body, usually along the tube through which urine passes out into a bag. According to Nazorko ( 2005, pp 34) urinary tract infection occurs when bacteria enter urine and cause clinical problems. Hospital acquired infection cost the NHS about £ 150 million pounds a year (newman et al, 2004).
The author also noticed that while on clinical placement on the ward , the ward manager was not doing enough in tackling the issue of improper catheter care....
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