Critial Incident-Childrens Nursing

Critical incidents can prompt reflication because they highlight something that is important to us (smith and Jack 2005). This assignment will examine my reflection encountered on a paediatric unit in a London Hospital and I will explore the good and bad I pulled from my experience. My aim is to emphasize and summarize my reflection of learning. and also how this effected me as a student and potentially a registerd nurse.

A post- registration student nurse Fiona (all names used in the assignment are pseudonyms), was about to be supervised drawing up and giving an intra-muscular injection to a baby whose family were from abroad and had been moved from the private side in the morning. As she was aware I had never seen this done I asked the supervising nurse if I could observe and she agreed. The supervising nurse then got very busy and handed Fiona the drugs and told her to give them quickly as the injection was over due. Fiona disagreed stating that she had not checked the drugs, the nurse persisted in a de-meaning manner (reminding her of her student status) that Fiona should give the drugs immediately. When the nurse in charge entered the treatment room the supervising nurse persisted in a raised tone that �she’ was being difficult. The patients room was directly across from the treatment room and both doors were open. Fiona persisted and the BNF was consulted, the dose about to given was to high.

Ethics consists of the moral principles governing or influencing conduct (oxford compact dictionary 2007). Many ethical issues are raised in this incident one of the most prominent is the lack of respect shown to Fiona infront of her peers and how

How Fiona will reflect upon this as a learning experience. Mentor qualities include the skills, qualities and attitude of individual mentors are more important to a positive practice placement than the learning environment(Nursing standard:May 24: vol20:no 37:2006). I don’t feel Fiona was shown this from her mentor and therefore this could have had a detrimental effect on her learning experience, and also her her self esteem but most of all the trust in her mentor. I myself who had learnt a lot from Fiona felt uncomfortable with manner she was spoken to in. The Northern Devon Healthcare Trust placed a regional project bid in 1999 to develop formalised, multi-professional learning pathways this included providing consistent support for pre- and post-registration. ( Nursing standard:June:20:vol15:no40:2001). As a post registration student, it may have been more effective for Fiona to have been placed with a more senior member of staff as they would have had more clinical expertise especially as she would be using injectables. I also took into consideration how I would have reacted in this situation as a first year student. Conformity is a change in behaviour or belief toward a group as a result of real or imagined group pressure.”.. (get propa quote).

Would the urgency and the desire to conform to a �qualified nurse’ be more than enough to handle for student who had less experience than Fiona?

A patient safety incident is defined as: �any unintended or unexpected incident which could have or did lead to harm for one or more patients receiving NHS-funded care’(NPSA 2004a). As this incident could be seen as a �near miss incident’ and I was not aware of it being reported. If this happens to a not so confident student the consequences could be much more severe. A more dependable method is necessary to create a more valuable safety culture. If patient safety incidents and near miss events are to be learned from, they need to be reported.(december 14 :: vol 20 no 14-16 :: 2005) Safety critical industries, such as aviation, have used near miss reporting to significantly reduce the number of errors occurring (Leape 1999). So why are these precautions not used in nursing.

The nmc states that’s �you are personally accountable for your practice. This means that you are answerable for your actions and omissions, regardless of advice or

directions from another professional.(NMC 1.3) Fiona adhered to the rules of the NMC but I feel her mentor did not, allowing me to realise that all mentors were not as good as my own, and it would be possible that in future placements I would be in the same position as Fiona. This left me to ponder on the reason’s for the staff nurse’s behaviour and her repeated mention of the lack of time.

lack of time seemed to