"Educational Levels of Hospital Nurses and Surgical Patient Mortality" is an outstanding example of a paper on care. The reason by inquiry to a nursing process involves the process of making inquiries from patients by nurses who thereafter derive critical information. Crucial information can be derived by this inquiry which enables nurses to identify a problem, propose solutions, find evidence for and against proposed solutions, and evaluate the solutions based on this evidence. A clinical situation includes a 60-year-old patient who is in ICU because he had an abdominal aortic aneurysm (AAA) surgery in the last 24 hours. Concepts The reasoning by the inquiry process involves the use of inquiry and observation to collect critical information about a patients’ situation.
The can be done in the following steps; look, collect, process, decide, plan, act, evaluate, and reflect. In the above situation of a patient in ICU in the aftermath of an AAA surgery, a nurse can check on the patient history, patient charts, and nursing medical assessments previously undertaken. Information can also be derived by observation of patients’ conditions for example the patients’ blood pressure. Relationships From the observation of the patient and patient history, a nurse can relate the symptoms exhibited with known theoretical knowledge for similar symptoms.
From the above situation, we note that blood pressure is related to the patient’ s fluid status. In the relationships step, a nurse uses collected information to suggest conditions that the patient may be suffering from. In the above situation patients’ hypotension, tachycardia, and oliguria could be signs of impending shock. It could also be inferred that the patients; BP could be low due to blood loss after surgery. Operationalized definitions This involves the measurement of variables to determine patients’ conditions.
It also involves determining procedures to undertake at given time intervals. In the case of an AAA post-surgery patient, the rate of the epidural should be checked; effects after increasing the epidural should also be checked on how it affects the blood pressure Variables These is conditions that if altered affect the patients’ condition. In the above situation where a patient has just undergone an AAA surgery, by relating that AAAs often have hypertension after the operation, then we understand that if the patient is not given more fluids, he could go into hypertension. Assumptions These are the generally accepted presumptions about various conditions and people.
An example of a presumption is; elderly people often have dementia. Therefore in reasoning by inquiry, nurses should be allowed to question their assumptions and prejudices. In the above situation, and accepted presumption is that AAA post-operation patients normally have hypotension. Inquiry questions. This involves posing questions that will help in understanding the patient’ s condition and coming up with possible remedies. Some of the questions include.
What is the issue? What should I do? And are my data valid? which of the following were appropriate in the reasoning process in resolving the process. Why and how were they appropriate? Identifying; This was very appropriate in resolving a nursing situation. In identifying the patient’ s problem, a nurse is able to thereafter come up with acceptable solutions. A nurse should look for abnormal functions or risk problems that may contribute to health problems. The patient’ s strengths are also identified. In the above situation, a nurse should be able to identify an AAA surgery patient who is susceptible to low blood pressure. Relating; this is also important as it enables a nurse to relate a patient’ s condition with known theoretical knowledge.
In the above situation after noting that blood pressure is related to a patients’ body fluids, the nurse can determine the amount of epidural to give to a patient. Understanding this entails a nurse understanding how to deal with a patient’ s condition. Here also a nurse needs to prioritize which patient conditions need to be attended to first.
Also, a nurse needs to set goals of what he expects the patient to accomplish and in what time frame. In the above situation of a post AAA surgery patient, a nurse should be able to prioritize the changes in blood pressure over the changes in body temperature. A nurse can also set the goal of getting the patient’ s BP up and urine output normal in the next hour. Explaining This entails being able to explain a patients’ condition, the variables affecting his condition, and solutions that we can come up with to moderate or treat the condition.
Also, a nurse needs to determine a plan of action and whether to use your own plan or a standard plan of action. Predicting involves the use of known rhetorical knowledge to predict what could happen to a patient in certain conditions. In the above situation predicting that the patient could go into shock if not given bodily fluids is important as it then stimulates a nurse to give the epidural fluid. Influencing this involves putting solutions inferred into action. The planned solution is put into action thoughtfully.
A nurse should access a patient’ s current status before acting. Anything that has happened that requires an immediate change in the plan should be noted. The patient should be monitored appropriately and changes made as needed. Controlling this is important as it enables a nurse to control the patient’ s condition by administering the required solutions. Also controlling enables a nurse to determine whether the desired outcomes have been achieved, whether the interventions were effective, and whether changes need to be made.
ReferencesAiken, L.H., Clarke, S.P., Cheung, R.B., Sloane, D.M., and Silber, J.H. (2003) Educational levels of hospital nurses and surgical patient mortality. JAMA. 290(12), 1617–1620