Clinical Practicum Reflection Essay

Clinical Practicum Reflection Essay During my first day of clinical practicum in MMW AQH, the register nurse made a medication error and did not report it, she instead she tried to cover it. I would like to reflect on the incident and what I have learned from that situation as a nurse. Elaborate This incident happened during- my first clinical day in MMW AQH around 1pm while administering drugs by a register nurse, I was observing her practice in drug administration. She started to prepare the drugs on advance she asked me to collect the drug charts from patient bedside and nursing station .While she was distributing drugs for patient she was attending their needs and answering doctors order by the time goes she become distracted and lost her concentration this situation made me confused and not knowing which patient is next. The nurse had many task to do at the same time. She continued in drug administration but this time with improper way of patient identification, when we reach to the room where incident happen patient requested to take his drugs later as he still having his lunch she kept the drug near to him and left .After we finished three more patient she went back to him as remembered something she was looks stressed and panic, I asked her what happened she did not reply instead she asked the patient to give her back the tablet. Patient handed the tablet back to her then she gave him another tablet, I realized this was a drug error it was her luck that patient did not take the medicine, she start to explain to him what happen and asked for apology, the patient was so angry yet feeling sorry for her. He questioned her if he had the drug who will take the responsibility? She did not answer. He was not willing to cause a trouble for her so he kept quiet. She proceeded with her work like nothing happen, I was expecting her to report but she did not, when I asked the reason, she reply as long as no harm happen there is no need to report beside that there is no time to report. This left me thinking how many medication errors left un-reported? Analyze This experience left me disappointed it was hard for me to accept what happen because I have fixed believe that patient safety is first regardless how busy the nurses are. Since then so many question gushed to my head, why this incident happen? What are the causes? Was the staff nurse afraid? Is the nursing negligence acceptable? To answer these questions I have to recall the situation .It was obvious that the circumstances the staff nurse was in made her prone to such incident, her lack of concentration and her unprofessionalism in administering medication made her close to put patient health in danger. However this should not excuse her from responsibility. I can understand that she was in panic and in a stressful situation but she is accountable for her action since she decides to become a nurse and deal with human life. I believe that increased work load made her go for short cuts and malpractice just to finish the care .on the other hand she failed to identify the patient becaus e of distraction. But the main reason why she did not report is maybe she thinks about her colleagues reaction and she may be punished for that. From what I experienced drug error could be preventable if the staff nurses adhere strictly to hospital polices no matter what. Revise There is no exact definition for drug error but, the National Patient Safety Agency and the US National Coordinating Council for Medication Error Reporting and Prevention define it as an any preventable event that may lead or cause inappropriate medication use or patient harm while the medication is in the control of health professional (smith, 2004). According to the latest researches which conducted by Food and drug administration association and the National Patient Safety Agency drug errors always left unreported for many reasons, some of these reasons are related to fear and work overload. These two factors were considered the most dominating factors when it comes to drug errors. Excessive work always leaves the staff fatigued and preoccupied with many task to do and less time to finish it (Mayo, Duncan Chloe, 2004). Work over load lead the staff to go for the shortest and easiest ways which result in poor nursing practice. Failed patient identification is also another result of work overload, health care professional are not able to counter check and verify patient identity correctly with other staff because of excessive work. On the other hand Fear from consequences and the colleagues reaction are always the reason why health care professional tend to hide drug errors and not reporting it. Their self esteem will be badly affected in that moment because of that, they will loose the ability to judge and they will comet more vital mistakes. However not reporting drug error is worse and harmful to the patient life. Professionalism is the only way to develop the nursing practice in administering drugs. Right patient identification, Right dose, Right drug, Right time, Right route and Right documentation are the safest bath to follow(ClaytonStock, 1997). New approach Drug errors are a common problem in health care facilities which always associated with serious events so reporting about errors becoming a must to improve the system and patient safety .Most of the international accredited hospitals such as Alwasl Hospitel are now blame free culture, encouraging staffs to report the errors and not to become intimidated by it. Also they deal with reports in confidential manner so the access to such documentation is restricted to authorize person. Their policy stat that all incident report should be written in narrative description which should be comprehensive description of facts containing no personal judgments or opinion and no implication or accusations (AWH. PP,2004). These hospitals are providing educational session about errors reporting which is important to increase the awareness among the staffs in order to become a positive link in the hospital. These hospitals are maintaining yearly competences in medication management and use for all hea lth care professional. One goal that all health care facilities are trying to achieve is minimizing work load on the health care professional. Most of these hospitals are controlling patient numbers and trying not to go beyond their capacity, they also trying hard to solve the staff shortage in way that will not affect patients and staffs. Other ways in improving medication administration system is by computerize the drug charts for more clarity and using unit dose system. This system helps the health care professional to minimize drug error, it include single unit package with generic and brand name, manufacture, lot number and expiration date. Following this system has many advantages. First it reduces the time spent by nurses in preparing drugs. The pharmacist will have a clear vision about patient situation regarding adverse reaction and contraindication. Patient identification will be easier as each single package has patient name and number so double à ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬check m ay not needed in emergency cases(ClaytonStock,1997).

Attention Seeking Behavior

ATTENTION-SEEKING BEHAVIOR I. PERSONAL DATA NAME: NICKNAME: Hans SEX:male AGE:9 y/o ADDRESS: FATHER: MOTHER: SCHOOL: II. CHILD BEHAVIOR: Many parents and teachers after experienced that inward sigh when the children or the students seem to seek more attention beyond of the normal level. Attention seeking behavior may appear as a child being goofy to make others laugh or constantly requesting someone to play with them. It can also be in the form of  self injury  or aggressive behavior in children. Even though the attention may be considered negative (ie. colding from caregiver), it can still be very reinforcing for a child wanting to get attention no matter what that requires. The child (Hans) catches the attention of his parents or peers to gain attention. He will do something annoying that will catches the attention of those people surrounds him like licking his nose, banging his head on the wall, aggravating others around him by pulling their hats off at home time, poking them or leaning on them during quiet times. He enjoys showing adults and peers his â€Å"sore knees† or â€Å"spots† or â€Å"bleeding nose† to gain sympathy from them. Similar essay: Identify Circumstances When Children or Young People May Need Urgent Medical AttentionThis child constantly does things to get your attention and it can become quite annoying. They will blurt out and tell you what they did etc. Their desire for attention is almost insatiable. Much of what they do is done to get attention. It doesn't seem to matter that you provide lots of attention as they continually seek more. III. SYMPTOMS OF BEHAVIOR: ? Aggravating others (children, friends, classmates, schoolmates even family members) ? Blurts out answers before questions have been completed ? Difficulty awaiting turn Interrupts or intrudes on others (butts into conversations or games) ? Doing something annoying that will catches the attention of people surrounds him/her. ? Hyperactivity ? Attention seeking behavior ? Lacks empathy ? Illusions ? Disregard for others IV. ASSESSMENTS: Schedule special time together: One way to ensure your child is getting the attention he or she des ires is to make sure to schedule a specific time that you spend  one on one with your child for at least 15-30 minutes a day, but preferably longer.Some days may be longer and others only 15 minutes, but what’s important is that your he/she knows this is your special time together. Let your child (him/her) know this is his or her special time and allow your child to choose what activity  you will do or what you will talk about. Avoid any negative conversation  or â€Å"You should do this or that† types of conversation. Remind him of your special time together  when he engages in his typical seeking types of behavior.Then, state that you need to finish what you are doing, but you promise to be able to do what they are asking during your special designated time. Always follow through on this or your child will learn that you are not good on your word. Approach your child every 10-15 minutes: If he is really demanding, try your best to  approach your child every 10-15 minutes  along with  scheduling  a special time during the day. Give frequent words of encouragement and physical affection  (Ex. â€Å"Wow, that is an wesome picture you are drawing! † with a pat on the back). If you have something you need to get done, help him/her to start an activity by also engaging in the activity for at least 5-10 minutes. Once he/she begins to play well, state you will be back in a few minutes. Come back in 5 minutes and give the words of encouragement with some physical affection. Then leave again for 5-10 minutes depending on what he/she will tolerate before attempting to engage in attention seeking behavior.Continue doing this back and forth gradually increasing the time between visits while doing as much as you can to get things done. It may help to have him/her near you, such as at the kitchen table doing an activity while you are trying to make dinner. Involve your child in what you are doing: In addition to the above techniques, if your child just seems to be seeking you all the time and requires your attention so much that you are unable to get things done within the 10 minutes, involve him/her in  the job  you are working on.If this involves dinner, allow them to help in any way possible. For laundry, let them load the washer, switch the loads, pour in soap, etc. Usually, he/she will either be excited to be involved or start seeking other activities that can be done alone without needing your attention as an alternative to helping with the chore. Of course, there are exceptions to this rule depending on your specific situation and if he or she engages in  attention seeking behavior and has a pervasive developmental disorder (PDD NOS)What is most important is that you provide so much attention on a regular basis that he or she will not need to engage in attention seeking behavior as a method to get your attention. V. RISK FACTORS AND MAINTANING VARIABLES: A factor analysis of some attention- seeking behaviors of young children Though knowledge of the process underlying young children’s behavior their general social interaction with both adults and peers, very little is known either about the dimensionality of their attention-seeking or about its antecedents. In the study herein reported an attempt is made to gain some everage on the dimensionality of the behavior classes employed for attention by young children through a factor analysis of the correlations among nine items of behavior judged to be consonant with the characteristics generally attributed to attention-seeking and age. Behavior for the reinforcer provided by the attention of people (attention-seeking) has usually been defined as falling under the more broadly defined concept â€Å"emotional dependence† along with such behaviors as those employed for approval, praise, physical contact and caresses, reassurance and nearness.While the clinical literature is replete with case histories, mostly based on in formal observation in children and adults with adjustment problems, which are described and interpreted in terms of such behavior concepts, the research literature reveals that few systematic attempts have been to study the dimensionality of either emotional dependence or attention-seeking or to determine their antecedents.Typically, relationships involving emotional dependence and attention-seeking in children have been found as by-products of general studies which addressed themselves to the consequences in children’s behavior of broadly defined family attitudes or conditions of socialization, such as overprotection, deprivation, or rejection. In order to further a systematic experimental investigation of the behaviors employed for attention and the antecedents of those behaviors, an experiment was conducted on young children, which employed situation easel paint as long as he wished in the presence of an adult.VI. DEVELOPMENTAL ASPECTS VII. TREATMENT Here are some ways to prevent child’s attention-seeking behavior: ? Promote  self-esteem and confidence every chance you can. Catch your child doing something great and praise him/her. ? Provide opportunities for the child to become responsible. When they take responsibility well, let him/her know. ? Always be objective and understanding – do not lose your patience even though you are tempted to. ? Use your best judgment at all times, remain objective and seek to understand. Patience, patience, patience! Even though you may be very frustrated. Communicate your expectations with a minimal number of rules and routines to be followed. Think big, start small. ? Involve the child when you are establishing  rules and routines. Ask for his/her assistance. Make sure they repeat them – this will help them remember. ? Emphasize the child's strengths  and minimize the weaknesses. ? Set your child up to be successful when the opportunity presents itself. ? Provide opportunities for the chi ld to reiterate expectations.For example: â€Å"What always needs to be done before bed? † ? Encourage the child to participate and monitor their own behavior. For example: â€Å"What is terrific about what you're doing right now? † ? AVOID  power struggles  Ã¢â‚¬â€œ nobody wins! ? Take time to discuss appropriate and inappropriate behaviors. This should be done when a  chilling out period  has occurred. ? Routines – children with behavior difficulties benefit from clearly established routines/structure, I can't say enough about this. Role-play some situations based on unacceptable behaviors and discuss them. ? Set up practice situations and role play those. For example: Tommy just came and stepped on your toe, you even thought he did it intentionally. How will you handle this situation? ? Teach the skills necessary for appropriate behaviors. Following the â€Å"crying baby† model for filling the need as soon as it arises, all Attention Seeking Be havior Disorders can be entirely avoided as well as cured by giving focused attention immediately and as soon as the request has been received.This does not mean one has to put one’s entire life on hold or â€Å"run rings around the creature† – it is literally a simple little flash of attention at the right time and when first asked for it; the classic â€Å"a stitch in time saves nine† principle. Rather than â€Å"rewarding† attention seeking behavior, it never gets to escalate, the creature’s energy system remains balanced and the disturbed behavior never need take place at all.As the babies who are fed when they are hungry cry markedly less or not at all, creatures who receive attention energy (or love or recognition energy) when they ask for it, their attention seeking behaviors become markedly less frequent, markedly less dramatic and may cease altogether once the system has been in operation for a while and the creature has understood that not only can it get what it needs just the for the asking, but also its energy system has become more robust, more healthy, more resilient and won’t collapse when there is a time when attention is in short supply.Let us now look at how to apply this theory in practice when treating severely disturbed forms of animal behaviour, and including trance and repetitive behaviour problems. VIII. DISCUSSION QUESTIONS: 1. How will the parents do to avoid tress from their children that is/are having an attention- seeking problem? 2. What are the causes of attention-seeking behavior in children? 3. How to assess attention-seeking child/children?

Ethical Dilemmas Of A Cloud Of Grey Uncertainty - 1250 Words

Engulfed in a cloud of grey uncertainty, there are many situations that are blemished in the profession of nursing. Ethical dilemmas are often the most challenging to handle as they are interlinked with our own personal values and morals, requiring knowledge and attention to many factors (Burkhardt, Nathaniel, Walton, 2014). Ethical predicaments will cross our paths daily and we need to utilize ethical frameworks, codes and our personal decision making to come to a well-informed conclusion. When we are in the midst of an uncertain quandary our human nature is tested, and we thoroughly scrutinise who we are ethically and morally. I am going to work through an ethical decision making model and discuss my journey with an encounter I have†¦show more content†¦Some care aides were wonderful and went out of their way to go the extra mile; however, I noticed many of them didn’t tell the residents what they were going to be doing before they would do it, which would scare ma ny of them. Often the residents would scream or wince from shock or pain, as the care aides would begin their care without prior disclosure. Many residents were not verbal, or had dementia and that was considered to be the factor in which it was justifiable to treat them this way. I was dismayed at how I witnessed the lights turn on, the blankets torn off, the residents being turned from side to side and their briefs being taken off, leaving them cold and completely exposed without any notice or indication of what was going to happen. There were small sheets of paper in each resident’s room, saying what their favourite things are, what they used to do, about their family and life, which was very touching for me to see the preservation of dignity throughout the facility. Although these write-ups were in everyone’s room it was as if there was not a human laying in that bed. It was like they were all mannequins and there was an indiscernible race, the focus was shifted fr om the individual to the completion of task at hand. Many care aides would have conversations about their weekend, or talk about the resident right in front of them. Some residents could hear and some could not, never the less,Show MoreRelatedDefine the Manager Terrain28443 Words   |  114 PagesThe changing global environment The legal-political and economic environments The cultural environment Summary 20 20 20 24 25 28 Social responsibility and managerial ethics What is social responsibility? Managerial ethics Toward improving ethical behaviour Business ethics in Hong Kong and other countries Summary 30 31 34 40 43 48 The decision-making process and limits to rationality The decision-making process The rational decision maker Limits to rationality Bounded rationality TheRead MoreCase Study148348 Words   |  594 Pagesworkshops and via the online discussion group/discussion board facility. 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The Harlem Renaissance - 1209 Words

The Harlem Renaissance represents the rebirth and flowering of African-American culture. Although the Harlem Renaissance was concentrated in the Harlem district of New York City, its legacy reverberated throughout the United States and even abroad, to regions with large numbers of former slaves or blacks needing to construct ethnic identities amid a dominant white culture. The primary means of cultural expression during the Harlem Renaissance were literature and poetry, although visual art, drama, and music also played a role in the development of the new, urban African-American identity. Urbanization and population migration prompted large numbers of blacks to move away from the Jim Crow south, where slavery had only transformed into institutionalized racism and political disenfranchisement. The urban enclave of Harlem enabled blacks from different parts of the south to coalescence, share experiences, and most importantly, share ideas, visions, and dreams. Therefore, the Harlem Rena issance had a huge impact in framing African-American politics, social life, and public institutions. Poetry became a primary medium by which African-Americans could explore the new Negro identity that flourished during the Harlem Renaissance (Academy of American Poets). Countee Cullen, Claude McKay, Langston Hughes, Jessie Redmon Fauset, Georgia Douglas Johnson, and Gwendolyn Bennett are among the literary greats of the Harlem Renaissance. Although each poet cultivated a unique style, thereShow MoreRelatedHarlem And The Harlem Renaissance Essay2269 Words   |  10 Pagessouthern African Americans migrated to a city called Harlem in New York. They relocated due to dogmatism and intolerance of melanin diverging out the of pores of many white southerners. The African Americans who migrated found new opportunities both economic and artistic that resulted to the creation of a stable middle class Black –Americans (Dover, 2006). 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According to Wintz: The Harlem Renaissance was â€Å"variously known as the New Negro movement, the New Negro Renaissance, and the Negro Renaissance, the movement emerged toward the end of World War I in 1918, blossomed in the mid- to late 1920s, and then withered in the mid-1930sRead MoreHarlem Renaissance Essay1069 Words   |  5 PagesHARLEM RENAISSANCE Throughout the history of African Americans, there have been important historical figures as well as times. Revered and inspirational leaders and eras like, Martin Luther King and the Civil Rights Movement, Nat Turner and the slave revolt, or Huey Newton and the Black Panther Party. One such period that will always remain a significant part of black art and culture is the Harlem Renaissance. It changed the meaning of art and poetry, as it was known then. 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It was the result of Blacks migrating in the North, mostly Chicago and New York. There were many significant figures, both male and female, that had taken part