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Teamwork is an integral part of Accident and Emergency care and if it is jeopardized problems tends to occur. Looking at communication, consent and teamwork I will explore and reflect the ways in which the patient I observed was treated.

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Words 4251 Introduction Teamwork is an integral part of Accident and Emergency care and if it is jeopardized problems tends to occur. Looking at communication, consent and teamwork I will explore and reflect the ways in which the patient I observed was treated and what could be done in the future care and practice of others in order to reach maximum potential with further clients. First Part An emergency call went out for a Chest pain in resuss one, Chest Pain Team required. As I was the student nurse in resuss for that particular shift. I was urged to join the medical team to see what was happening with this patient. As I stood and observed what I was witnessing was Myocardial Infarction. As I was observing the situation, I was surprised to see how calm everybody was. The Resuss room is a room which consists of six bays which have specialist equipment in, if an emergency with a patient was to happen. The patient I was observing was put into the first bay, as this bay has much more space so the team of medics and nurses can work around the patient quite easily. As I was watching I noticed that the nursing staff used the ECG machine. As I was watching the patient's relative seemed concerned with what was happening to the patient. I took it upon myself to reassure the relative by explaining what was happening and why the medics where doing this procedure. The ECG showed that the patient had ST elevation and was having a Heart Attack. I felt apprehension for the relatives and patient when this information was told to them. I observed that the patient remained calm and collected. The patient seemed to accept the diagnosis quite well. I felt sad for the patient's relatives. The Nursing staff then followed with the baseline observations of the patient. For example the blood pressure, respirations, pulse and oxygen saturations were measured every five minutes to monitor any changes. ...read more.


This is usually done by the junior doctor, assisted by the senior practitioner. The cardiologist will be contacted once the heart attack is over so the correct measures can be put into place for the patient to be taken to a cardiology ward (NSF, 2000). Here the patient will be put on close observations monitoring for signs of any further cardiac problems (NSF, 2000). In some trusts across the United Kingdom nurses are beginning to administer thrombolysis treatment. This is so the patient can receive the treatment quickly, as the nurses can be the first on the scene when a patient is brought into the Accident and Emergency department (Improving Services for People with CHD, 2005). Third Part Having identified a number of areas, I will now look further into the consent of a patient and the ethical dilemma behind this. I will also address communication between patient - doctor and nurse. Ethical decision making can perhaps best be described as an active, rational process[ss2] by which we decide what we ought to do through application of moral and professional principles. Traditionally, medical decisions have involved the concepts of autonomy, beneficence, non maleficence, and justice (Brown, 1999). The application of ethical decision making in the emergency setting does not allow for as complete an analysis as would otherwise be possible. A rapid approach to emergency ethical problems can be summarized in three tests. Impartiality test: would you, as the practitioner, be willing to have this assessment or treatment performed if you were in the patient's place? Universalizability test: would you be willing to perform this action in all similar circumstances? Interpersonal justifiability: Are you able to justify your actions to other? (Brown, 1999[ss3]). The decision making was done very quickly and precisely by the doctor in charge. Due to the Heart Attack that the patient was experiencing he provided the treatment quickly and efficiently. ...read more.


This will include the nurses each having an individual nursing role. This is so the relatives will be dealt with and all the caring needs for the patient. If a nurse is given a set role and all the nurses know what they need to do this will help the patient and the relatives. Due to the break down in communication with what was happening with the relative this is why I the Student Nurse was dictating to the relative why certain procedures where happening. If a nurse would have acknowledged the relative then she might have felt less apprehensive. This is why I helped her. I know when I have another relative come to Accident and Emergency with a patient I will make sure I speak to them and try to help them. Accident and Emergency departments are stressful enough. Better communication skills between the doctors and nurses need to be adopted for a smoother running of the Accident and Emergency Department. This is a much better, greatly improved essay Katie and shows that you can work very well when you need to and have the right direction. Thanks - this is an excellent achievement considering what you are going through at the moment As it reads it is a nice, rounded essay that comes to a logical conclusion. Reference List Books Mallet, J & Dougherty, L. (2000) Care in Context, Communication. Manual of Clinical Nursing Procedures. The Royal Marsden. Chapter 1 Mallet, J & Dougherty, L. (2000) Foreword to Fifth Edition, Manual of Clinical Nursing Procedures. The Royal Marsden. Chapter 1 Scrambler, G (2003), The Doctor - Patient Relationship, Sociology as applied to medicine. Chapter Four. Fifth Edition. Articles Albarran, J.W. et al (2000) Are manual gestures, verbal descriptors and pain radiation as reported by patients reliable indicators of myocardial infarction? Preliminary findings and implications. Intensive and Critical Care Nursing; 16: 2, 98-110. Albarran, J. (2002) The Language of Chest Pain. Nursing Standard. VOL 98, NO 04 Albarran JW,(1996) Developments in practice. Exploring the nature of informed consent in coronary care practice. Nursing in Critical Care. 1996 May-Jun; 1(3): 127-33. ...read more.

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