This case study will use the patient’s alias “Mrs. Johnson.” The name is consistent with the Nursing and Midwifery Council’s (NMC) code (2015) which purports that the confidentiality and privacy of patients must be respected. Mrs. Johnson is an older patient who uses mobility aids and has a record of pressure ulcers. The main objective of this case study is to examine the role of the student nurse during the skin assessment process and in the identification of the pressure sores which they had to do under the supervision of a clinical instructor. Within the case study, the student’s actions will be evaluated, and the motivations behind their interventions will be discussed, backed by evidence-based practice.
Assessment and Safe Delivery of Foundational Practice
The nursing student is assigned to Mrs. Johnson and she begins with a review of her medical records and care plan. The student points out the necessity of periodic self-skin examinations for patients with restricted mobility and those having a history of pressure ulcers. The student works under the supervision of a clinical instructor and assists Mrs. Johnson in doing her morning bath, paying special attention if any skin breakdown is noticed or the presence of pressure sores. It shows that the student recognizes how crucial it is in pressure ulcer development to use preventive measures and to detect them early.
The student nurse adheres to proper skin assessment techniques. The student nurse observes areas of skin that are reddish, warm, and showing signs of breakdown. The student discovers a reddened area on Mrs. Johnson’s sacrum and quickly reports it to the clinical instructor. This means that the student has demonstrated the ability to identify unexpected findings and respond appropriately. In unison with the instructor, they appraise the extent of the pressure sore and adopt the proper remedies, e.g., relocation and dressing (Lovegrove et al., 2021). This collaboration guarantees the provision of timely and effective care for Mrs. Johnson’s pressure ulcer. The student nurse also helps Mrs. Johnson recognize the pressure ulcers and educates her on the significance of routine repositioning, proper nutrition as well as skin protection. Through evidence-based knowledge development and assisting in self-care therapy, the student nurse becomes a critical part of preventing further skin breakdown and enhancing wound healing.
Self-Management in a Variety of Settings
Through their clinical rotation, the student nurse meets different problems such as effective time management, prioritization of tasks, and interaction with patients and nurse team members. Along with the guidance of the supervising nurse practitioner, the student nurse learns how to delegate the workload while keeping the focus on patient safety and quality care. The student nurse takes up leadership and starts organising the tasks by supervising and delegating the responsibilities.
The student communicates successfully with Mrs. Johnson and other healthcare team members. Proper communication concerning patients and their healthcare team is critical in patient care. Through personal and active patient engagement, the student ensures they are informed and involved in their treatment decisions, contributing to patient-focused care. Additionally, teamwork with the multidisciplinary team is another approach, through the sharing of relevant patient information and seeking input from other team members. This type of care develops a cooperative attitude when all team members are working towards the best results for patients (Morley & Cashell, 2017).
As the day unfolds, the student nurse handles stressful and uncertain situations. Nevertheless, the student displays that they are resilient and adaptable by seeking help when needed, taking a breather to recharge, and reflecting on the experiences to find areas for improvement. Analyzing experiences directs nurses to improvements and developing strategies for future obstacles (Patel & Metersky, 2022). Further, self-awareness and the willingness to learn are the two attributes necessary for a nurse to prosper (Rasheed et al., 2019). Nurses can cope with stress and burnout by preventing stressful events by requesting help from colleagues, the supervisor, and support services. Taking breaks helps nurses rejuvenate and stay physically and mentally sound so as to protect them from burnout (Savic et al., 2019).
With the use of the aforementioned strategies, nurses are able to cope with stress and uncertainty during practice leading to the delivery of the best possible care to patients. The student nurse realizes the significance of self-care in nursing practice. The student practises mindfulness, stress-management activities during their free time, and seeks help from the supervisor and others when overwhelmed. Through their self-care, the student makes sure that they are fully equipped to successfully care for their patients.
Integration of Theory with Practice
Impaired circulation reduces blood flow to vulnerable areas, increasing the risk of tissue damage (Kottner et al., 2018). These factors, often seen in elderly or bedridden individuals, contribute to the development of pressure ulcers and highlight the importance of preventive measures and early intervention in healthcare settings. The student also utilizes evidence-based guidelines and best practices for pressure ulcer prevention and management. The student stays up-to-date on the latest research and incorporates new findings into practice, ensuring that Mrs. Johnson receives the highest quality of care possible.
The nursing student constantly employs theoretical concepts to realistic patient care scenarios. The student nurse becomes conversant with to risk factors of pressure ulcers; for example immobility, poor nutrition, and poor circulation, and adopts this information in both assessment and intervention strategies for Mrs. Johnson (Jaul et al., 2018). Immobility results in long-term pressure on particular areas of the body, while a poor diet denies tissues enough nutrients required for healing. Impaired blood flow increases the likelihood of tissue damage (Kottner et al. 2018). Such factors, which are often seen in elderly/bedridden persons are the drivers in the development of pressure ulcers and imply the need for preventive measures and early intervention. Similarly, the student applies evidence-based guidelines and optimal practices in pressure ulcer prevention and management. The student’s continuous research and incorporation of the newest studies ensures that the patient gets the best quality of care possible.
In summary, this case study demonstrates how the student nurse carries out skin assessment and pressure ulcer detection for their patient, Mrs. Johnson. The student demonstrates competent nursing skills, and management skills in the form of effective communication skills, time management, and self-care. Through their interventions, the student nurse gains nursing competencies and knowledge. The case study draws attention to how theory and practice are integrated and how a patient-centered approach is taken into account in care.
References
Jaul, E., Barron, J., Rosenzweig, J. P., & Menczel, J. (2018). An overview of co-morbidities and the development of pressure ulcers among older adults. BMC Geriatrics, 18(1), 1-11. https://doi.org/10.1186/s12877-018-0997-7
Kottner, J., Black, J., Call, E., Gefen, A., & Santamaria, N. (2018). Microclimate: a critical review in the context of pressure ulcer prevention. Clinical Biomechanics, 59, 62-70. https://doi.org/10.1016/j.clinbiomech.2018.09.010
Lovegrove, J., Fulbrook, P., Miles, S. J., & Steele, M. (2021). Effectiveness of interventions to prevent pressure injury in adults admitted to acute hospital settings: a systematic review and meta-analysis of randomised controlled trials. International Journal of Nursing Studies, 122, 104027. https://doi.org/10.1016/j.ijnurstu.2021.104027
Morley, L., & Cashell, A. (2017). Collaboration in health care. Journal of Medical Imaging and Radiation Sciences, 48(2), 207-216. https://doi.org/10.1016/j.jmir.2017.02.071
NMC. (2015). The code. https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf
Patel, K. M., & Metersky, K. (2022). Reflective practice in nursing: A concept analysis. International Journal of Nursing Knowledge, 33(3), 180-187. https://doi.org/10.1111/2047-3095.12350
Rasheed, S. P., Younas, A., & Sundus, A. (2019). Self‐awareness in nursing: A scoping review. Journal of Clinical Nursing, 28(5-6), 762-774. https://doi.org/10.1111/jocn.14708
Savic, M., Ogeil, R. P., Sechtig, M. J., Lee-Tobin, P., Ferguson, N., & Lubman, D. I. (2019). How do nurses cope with shift work? A qualitative analysis of open-ended responses from a survey of nurses. International Journal of Environmental Research and Public Health, 16(20), 3821. https://doi.org/10.3390/ijerph16203821
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