This care summary will look at the management of nursing practice given to one of my patients on my management placement looking at managing the transfer of care. I shall use the reflection model by Gibbs (1988) (see appendix i) to critically reflect on this situation. There are many models of reflection available which can be seen as potential frameworks to structure the reflective activity. I have chosen this reflective cycle because I find it straightforward to use and it helps encourage a clear description of the incident, analysis of feelings, and evaluation of the experience. I have used it in previous essays so am familiar with the contents of it. Many authors use the Gibbs cycle (1988) of reflection Gustafsson and Fagerberg (2004), Slater (2003) and Campbell (2004). I have used pseudonyms throughout, to protect confidentiality in accordance with clause five of the Nursing and Midwifery Code of Professional Conduct (NMC 2002a). This essay will conclude that managing a transfer of care, was successful.
Description of event
The situation in which I shall be discussing will be transferring patients from one ward to another ward of the hospital. For this placement I am situated in the Accident and emergency department (A&E) in which there is a high turnover of patients. The reason why I decided to look at managing the transfer of patients is because it is an area of management which is commonly practised, it needs to be well planned and if not well planned can result in delay of delivery of care and can potentially put the patient at risk of inappropriate treatment. As a registered nurse under the Code of Professional Conduct we have a duty of care to ensure patients ensure safe proficient care (NMC 2002a p3). I want to research this area in more detail to be able to provide effective care for my patients. The word management and leadership are often used interchangeably, this is based on that they use similar skills (Bowman 1997 p22 and Greenwood 1997 p22). Effective leadership is critical in any organisation and the key to effective leadership is having the staff focused and working towards achieving the desired goals (Walton 1997 p13 and Greenwood 1997 p22).
I was left to manage my own few patients of which one of my patients needed to be transferred to another ward in the hospital. This patient had come in with chest pain. Although the chest pain had subsided the patient needed to be admitted for observation. My patient’s condition was stable and an ECG had been done. As part of a government initiative the NHS plan has a target for A&E patients to be discharged, admitted or transferred within four hours of arrival (DOH 2003). Therfore this management skill of transferring patients is commonly practised.
Once the doctor had decided the patient could be transferred to a medical ward I had to inform the bed manager of this decision giving her a brief handover of what was wrong with the patient so that she could find an appropriate bed in the hospital. Communication is an important aspect of all nursing care which is done through verbal and non-verbal communication and by written documentation (Chandler 1999 p39and Currie 2002 p24). The bed manager notified me of the ward where the patient was to be transferred to. I then called the ward to make sure that they were expecting this patient. I also gave a brief verbal handover this was to make sure that they were aware of the patient they were going to be expecting and so that they could make sure that they had a side room as the patient had MRSA and oxygen available. This would also avoid any confusion when coming up to the ward. There has been a lot of research on handovers which have looked at the contents Hesse (1983) Liukkonen (1993) and McMahon (1990), duration Matthews (1986), Sherlock (1995) Thurgood (1995) more recently into taped handovers Miller (1998) Mosher and Bontomasi (1996). This literature all conclude that handovers influences the delivery...
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