Nursing skills at a vascular surgery unit

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Principles of care delivery NM1505 Steve Farley 09/03. 0312768

This account aims to reflect on the skills of a nurse, observed at a vascular surgery unit. It will focus on the principles of the delivery of care and will give an understanding of the tools used to clearly establish the needs of a patient.

Attention will be given to the style of introduction and the effective use of non- verbal communication skills. Observations will be discussed from the event and justification of its learning will be supported by extensive, and documented research.

It will conclude with a reflective account and critical assessment of the shortcomings of the interview, and provide supporting recommendations in an attempt for excellence.


In order to respect the patient’s confidentiality and comply with the Nursing and Midwifery council, code of conduct, the precise location and name of the patient has been changed  (Nursing and Midwifery Council 2002).

Therefore the patient will be called, Mrs Singh.

For reflection a model discussed by (Gibbs1988), cited in (Burns and Bulman 2000), will be followed, as it gives an opportunity to produce a structured account of the discussion, and clearly shows that true reflection in practise has occurred during its research.

The needs of the patient are the primary objective, when considering a plan of care for the continuation of good health and well-being.  Nurses must be made aware that inadequate formal procedures to assess patients' underlying medical problems have been blamed as a contributing factor in around 70% of preoperative deaths, as reported by (Hoile 2002).

The findings of the National Confidential Enquiry into Preoperative Deaths (NCEPOD), was based on reports of deaths within 3 days of a surgical intervention, and follows the patient's journey through an illness and the delivery of hospital care.

Consideration for the psychological, sociological or spiritual needs of the patient, become equally important. And a holistic approach to care, not only provides a clear and specific set of guidelines and objectives, but also tailors the care for the individual. It is been proven to enhance recovery and provide the service user with a seamless approach to care and recovery. (Kozier Erb,Blais,Wilkinson 1998)

Commencing the process, needs the patient to be open in their response at the initial interview stage. And requires a process of two-way communication between the patient and the care provider.  This can only start to take place once a genuine rapport is established between them both. This rapport cannot be demanded and requires skills, from the nurse to make the patient feel at ease by using an appropriate manor of verbal, and non-verbal, communication.

Mrs Singh is an Asian lady, of 53 years.  She has been referred to the surgical team from her GP suffering from an askemic right toe.  It was the observation of the consultant that the toe was in fact, gangrenous, and further investigations, would be required to establish the extent of the condition. The results of these tests may result, in a need to remove the toe. After her discussion with the consultant for consent she accepted his diagnosis, and seemed to be clear of the consequence and severity of her condition. This reflection takes its observation followed by the nurse.

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Although the doctor had obtained consent, studies have shown that a patient may be concerned or uncertain about their treatment and turn to a nurse for clarification and advise (Dickinson, Hargie, and Morrow 1997).

It had become apparent to the staff nurse, that Mrs Singh was starting to become distressed, and was complaining rather a lot about what seemed to be minor issues. She was not happy with being in a public ward. She also complained that her foot required dressing once again. When it was apparent, that the infected area was dressed well, and did not ...

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