Critical Reflection Humiliating Clinical

Question: Discuss about the Critical Reflection for Humiliating Clinical. Answer: The article is a critical reflection based on a case study where an eighty six year old female was suffering from heel wound, advanced dementia and contractures arrived at the emergency department. The resident medical officer and a medical student were observing her making her gown in an awry position and examining with the gloved finger and were focused on the wound and not on the patient. She was screaming out of pain but they were desensitized towards the patients dignity, her pain and provision of care. During the evening shift at the emergency department, the new graduate nurse was on a rotation. During her rotation, the nurse heard a screaming sound from the patient assessment bay. The nurse saw the resident medical officer and a medical student examining a patients heel. The patient was an eighty six year old female who was suffering from advanced dementia and had contractures. The patient arrived at the emergency department without the assistance of any family member or guardian. The patients gown was awry as the medical student was examining the patients heel. While he was examining her heel, he held the female patients leg straight up in the air and her perineal area was clearly exposed. Moreover, the medical resident was closely examining the heel wound with his gloved finger. The female patient was screaming aloud due to pain. The resident medical officer and the medical student were clearly focused on the heel wound of the patient and not on the patient. They were negligent towards her screaming pain and did not keep in mind the dignity of the patient. When the incident was reported to the clinical preceptor, he was ignorant saying that these incidents occur on a daily basis in nursing homes. I chose this clinical incident as it was demeaning and insensitive. It was disrespectful on the part of the female patient hampering her privacy and dignity. The response of the resident medical officer and the medical student was dissatisfying regarding the patients privacy and her honor. They were desensitized towards her screaming pain and were more focused on the heel wound. Moreover, the attitude of my clinic preceptor was not satisfactory. He was ignorant towards the incident and behavior of the nursing home resident medical officer conveying that in nursing homes, the patients scream and in a doctor profession, this act is normal. This incident is relevant to my future nursing profession. The clinical incident gives a clear idea of the unethical clinical practice, desensitized provision of care, disrespecting patients dignity and privacy and demeaning actions in medical profession. The incident shows the loopholes in the learning and ethical practices in medical profession with respect to desensitized attitude towards a patients dignity and privacy, violation of human rights and nursing profession, ignoring a patients response during the course of examination and treatment and negligent towards the behavior of the medical officer considering it normal in medical profession (Johnstone, 2015). There are many relevant factors that led to this humiliating clinical incident. There was lack of sensitized behavior towards the patient, unethical practice harming the patients dignity and respect, unresponsive behavior of the clinical preceptor and violation of human rights. The medical student and the officer were oblivious towards the patients screaming pain and privacy. The medical officer and the student were more focused on the heel wound rather than on the patient and her screams. They ignored the excruciating pain of the patient and while examining her heel they were negligent towards the patients privacy making her too awry. The medical officer was observing the heel wound with his gloved finger that added to her pain and infection risk. The patient was eighty year old female suffering from contractures and advancing dementia and was in distressed pain but the medical officer was concerned about the wound that led to the unethical clinical practice. According to the Nation al Safety and Quality Health Service Standards, under the standard eight of prevention and management of pressure injuries, it is stated that there should be an evidence based practice of wound management (safetyandquality.gov.au, 2016). There should be a proper documentation and best practice for the management of pressure injuries. The RMO was applying pressure on the wound with his gloved fingers ignoring the ladys screaming pain. According to standard nine of recognition and responsiveness to clinical deterioration in acute pain and health care under NSQHS, the clinicians ensure a patients deteriorating condition and take prompt action to escalate care (safetyandquality.gov.au, 2016). The RMO and medical officer lacked skills in managing a patient, formal systems in response to deterioration and not monitoring the physiological observations. There was unethical clinical practice and violation of human rights. They hampered the patients inherent dignity and safeguard the rights o f the patients in improving the health outcomes. They made the female patients gown in awry position making her perineal area exposed. It is the duty of the medical profession to acknowledge the dignity and respect of the patient to ensure the best quality of care. As a newly graduate nurse, I would act differently if I would have encountered with such a clinical incident. I would handle the situation under three main domains of wound management, safeguard patient dignity in provision of care and reflective and analytical practice mentioned in code of ethics by the Nursing and Midwifery Board of Australia (Cashin et al., 2016). Firstly, I would look into the monitoring of the heel wound keeping in mind the excruciating screaming pain of the patient. I would look into the cause of the screaming pain and provide proper medication for managing her pain. Under the NMBA code of ethics, the nurses should deliver quality nursing care to the patients (nursingmidwiferyboard.gov.au, 2016). The patient required intrinsic care regarding her pain management, empathetic attitude towards the aged female patient as she was already suffering from contractures and advancing dementia. Under the NMBA code of ethics, it is stated that the nursing profession should recognize the human rights and dignity (Butler, 2016). The nursing profession should acknowledge and accept the critical relationship between the human rights and health. The patients dignity that would help to encompass the well being of the people and while examining the lady her inherent dignity and privacy should have been protected. Nurses have a responsibility to understand the code of ethics and human rights, clarify issues during their practice to promote best quality of care to their patients (Cusack, 2016). The clinical preceptor ignored the seriousness of the incident that demanded immediate action. Under the NMBA standards of practice, the nurses have the responsibility to reflect on the evidence based practice, employ essential knowledge and skills, and provide patient care to meet the physical, personal and psychological needs of the patients (Jefford Jomeen, 2015). References Butler, A. (2016). Moral duty to stand up for what matters.Australian Nursing and Midwifery Journal,24(3), 48. 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