As this assignment is a critical evaluation of my own practice, elements of it will be written in the first person. Webb (1992) considers writing in the first person acceptable when personal experiences and opinions have played a significant role in shaping the ideas presented.
My current role is that of unscheduled care practitioner (paediatric specialist) within a health centre, which aims to compliment the services of local GP surgeries. I am employed to carry out same day consultation, assessing and managing patients presenting with a vast variety of illnesses and injuries.
The first part of this work will be pertinent with the history taking process within a consultation; the second part will focus on assessment and physical examination. This essay aims to demonstrate comprehensive history taking and a structured approach to the consultation. A thorough assessment and examination of the respiratory system will follow, together with a rationale for examination skills used and a critical analysis of the clinical findings.
On searching the literature, many models of consultation were found. However, one that follows a logical approach, which is applicable to most clinical settings is the Calgary-Cambridge guide developed by Silverman, Kurtz and Draper (2004). As observed by Munson (2007) this model provides an easy-to-use structure that complements the traditional nursing holistic assessment. I choose this guide as it encourages a patient-centred, active partnership between the nurse practitioners and the patient, based on therapeutic communication, whilst it advocates the value of reflective practice to aid personal and professional development (Gibbs,
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