CASE STUDY As a new nursing student

CASE STUDY As a new nursing student during the acute care clinical this week, I was assigned a third patient. As I completed my morning assessments for the first assigned patients by prioritizing the care related to the patient’s diagnosis and physician care plan, I felt overwhelmed as I ran behind the other patient’s scheduled tasks because I was constantly distracted by healthcare aids while performing my assessments and medication checks. Upon my second prioritized patient for Vitals assessment and physical examination, I found the patient in semi-Fowler positioned in bed on O2 nasal cannula on room air, with diminished LOC, cyanotic lips, and dry epistaxis bilaterally from the nose. Upon assessing his vital signs, the patient’s O2 saturation was 54% below average. I immediately assessed the patient’s nares patency, increased the oxygen level slowly to 10 L per minute while encouraging deep breathing exercises, and continuously monitored the patient oxygen levels on the vitals machine. Initiating with respiratory lung assessment noted adventitious sounds bilaterally; the patient kept verbalizing his nose hurt. Next, with the patient’s permission, I cleaned dry epistaxis bilaterally nares with normal saline in the isolation patient room. I noted a red, inflamed area on the patient’s right nares with yellow and bright red new discharge. After ten minutes of nursing intervention, the patient oxygen level wasn’t improving by more than 76%; I found myself concerned and needing advice from Graduating Nurse assigned to the same patient. I verbalized to the patient that I was stepping out for a second for advice and to call the bell if feeling worse. Reporting to the nurse in charge of the patient, I found myself left with harsh, not supportive, constructive feedback that will help me in the future to remember to not ever leave a patient in respiratory distress but call the bell. I followed up with documentation and reassessed the patient’s vitals, confirming with the floor charge nurse to follow up with the patient’s scheduled cardiac medication based on improved patient vital signs. 1. What is the analysis and conclusion on this student experience and on what should the student focus so can avoid further negative outcomes in the acute care hospital practice?

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