The rural Kentucky urgent care medical institution is a significant healthcare center that caters to many patients, including people of various ages, socioeconomic backgrounds, and cultural diversities. The medical institution is fundamental in offering medical services and effortlessly available healthcare awareness to the area’s people, particularly prone populations, including the elderly, socioeconomically challenged individuals, and people with urgent health problems. This health facility is efficiently operated by a group of dedicated specialists, which includes nurse practitioners, nursing staff, and an on-site, online x-ray technologist. They treat acute illnesses, chronic illnesses, injuries, and preventive care. The health facility continuously serves 35 to eighty patients daily, demonstrating its determination to supply exceptional patron care, training, and service to significant populations in rural areas.
Throughout the practicum encounter, the focus was on thorough patient reviews, imposing therapeutic interventions, and effectively handling acute and persistent fitness conditions. The surroundings supplied a possibility to immediately revel in instances, facilitating the usage of superior nursing competencies in evaluating patients with distinct ailments, including influenza, COVID-19 infections, respiration troubles, persistent ailments, and traumas (Miller et al., 2021). Despite her independence lifestyle with assistance from her family, her declining conditions required an immediate transfer to a more advanced healthcare facility due to the existence of severe hypoxemia and unilateral pneumonia, as indicated by a chest X-ray.
Direct care sports on the practicum involved a multidisciplinary team, which includes 1-2 family nurse practitioner providers, a clerk table, 2-three assistive nursing staff, and an on-site x-ray technician. The hospital’s services encompass the treatment of acute ailments, injuries, and continual fitness situations. This includes well-being checkups, diagnostic testing, and screening offerings. Practicum activities include observing and collaborating with the treatment of sufferers throughout a wide age variety, from newborns to geriatric individuals.
APIE (Assessment, Plan, Implementation, Evaluation)
Describe the APIE of the patient and population.
Applying the APIE framework, a thorough assessment was conducted on the patient, Mrs. S, beginning with a complete exam of her health records, which blanketed her scientific history, family support machine, and present signs and symptoms. The bodily tests encompassed essential signs, assessment of breathing and cardiovascular functions, and a targeted examination of the bodily systems associated with her suggested symptoms (Estes et al., 2019). The obtained records facilitated the identity of nursing diagnoses, formulation of interventions, and subsequent assessment of the care administered.
Explain how you assessed the needs of the patient and population.
Mrs. S’s requirements have been evaluated thoroughly, including her signs and symptoms, medical records, and bodily manifestations. Her respiration soreness, decreasing oxygen saturation values, and the COVID prognosis indicated a right away need for motion (Stawicki et al., 2020). The assessment method entailed operating with the mentor and taking into account the urgency and severity of Mrs. S’s circumstance, ensuring the identification of essential nursing diagnoses associated with inadequate airway clearance and acute respiration diagnoses.
State a minimum of three short-term goals.
- Mrs. S’s airway will be patent during clinic therapy and discharge.
- Mrs. S will finish the clinic appointment with oxygen saturation above 90% and no tachypnea or dyspnea.
- Mrs. S will verbalize an understanding and perform adequate deep breathing exercises to increase oxygenation and reduce hyperventilation before clinic release.
Prioritize a plan of action.
The initial method centered on ensuring the patency of Mrs. S’s airway, using oxygen supplementation and providing a mixed nebulizer remedy to relieve respiration issues. Concurrently, arrangements have been organized in anticipation of a possible transfer to an extra advanced level of scientific attention, considering the crucial nature of her situation.
Describe the interventions that were implemented.
Mrs. S’s acute respiratory distress was treated by administering a nebulizer remedy that protected albuterol and ipratropium. Monitoring of vital signs and oxygen saturation changes started without interruption. Upon noticing a deterioration in her condition after the treatment, prompt measures were taken, including positioning Mrs. S upright, providing emotional assistance, and contacting EMS for prospective relocation.
Describe the evaluation of the interventions.
The assessment indicated a slight degree of success in maintaining enough airway, as Mrs. S did not come across any respiratory or cardiac arrest throughout her medical institution. Nevertheless, maintaining oxygen saturation tiers above 90% and efficiently showcasing deep birthing activities still had to be accomplished. The deteriorating nation of the patient required immediate transportation to a hospital, emphasizing the extreme severity of her breathing distress and underlying pneumonia (Andersen et al., 2019). The efficacy of the interventions becomes continuously evaluated at some point in the patient’s life in the clinic, resulting in the determination to transfer the patient for additional assessment and remedy promptly.
Interprofessional Collaboration.
The conflicts have been successfully addressed, more often than not focusing on the urgency of Mrs. S’s declining fitness. There became a consensus in a number of the collaborating events, mainly focusing on the patient’s exceptional hobby. The decision was made with the entire agreement: prioritizing the patient’s requirement for sophisticated clinical treatment by ensuring an easy switch and providing targeted information to the healthcare body of workers at the receiving medical institution. The collaboration stayed unified, directing efforts towards assuring Mrs. S had excellent care for the duration of her extreme situation.
Self-Reflection
A revolutionary direct care practicum gave me critical insights into advanced nursing care. Multiple sides of this message were successful. The urgent care facility’s data sharing and teamwork were astounding. The staff were quite organized and dedicated and took pride in handling a large population of patients. They were also susceptible to the patient’s cultural and other socially sensitive aspects, creating a very welcoming environment for them. Through closely working with my mentor, I acquired and improved my science by continuously conducting various patient tests and actively taking part in patient care practices.
Other troubles arose during this experience, such as an immoderate affected person workload, mainly for a single health practitioner treating multiple patients. This environment strained workflow and made time management hard, which, from time to time, reduced the quality of service provided to the patients. Those who wanted net access had trouble using a web appointment device, underscoring healthcare disparities.
All through the issues, the experiences were very educational, and I got to learn and confirm some of the skills I already had. Despite these issues, the experience was very educational. Interacting with varied patient communities helped me understand cultural and social healthcare factors. Mrs. S’s rapid deterioration due to COVID-19-related headaches highlighted the importance of quick intervention and cooperative treatment in acute settings. My knowledge of acute breathing distress improves my ability to prioritize and effectively address patient needs. In conclusion, this practicum helped me understand direct patient care dynamics, improve my knowledge, and strengthen my willpower to deliver complete and affected person-targeted care in my future career.
Ultimately, my direct care practicum occurred in rural Kentucky’s vital access urgent care clinic. This health center catered to a vast patient community, which includes people of all ages, socioeconomic backgrounds, and fitness necessities. The primary emphasis of my APIE technique was on Mrs. S, a senior woman experiencing intense signs and symptoms due to a COVID-19 infection, thereby illustrating the problems encountered by marginalized groups in faraway areas. The executive brief included an outline of the practicum, encompassing the medical institution’s mission, the various patient groups it catered to, and the particular patient care tasks performed under the guidance of a family nurse practitioner. The APIE manner was detailed, highlighting the assessment, making plans, implementing, and evaluating Mrs. S’s remedy, demonstrating the intricacies of dealing with acute repository distress in aged COVID sufferers.
Interprofessional collaboration played an important function, combining EMS, urgent care experts, and the local clinic team, emphasizing effective communication and teamwork to guarantee that Mrs. S received prompt and suitable care. The self-reflection element supplied accomplishments and difficulties at some stage in the practicum, highlighting the academic encounters and precious perspectives acquired from this traumatic and varied medical environment. It demonstrated the importance of collaborative practice and provided more details into the complex challenges faced by susceptible patients in rural healthcare settings. These skills will have an impact on my future role as a nurse educator.
Recommendations for future enhancements involve resolving workload difficulties investigating approaches to time management obstacles, and improving internet accessibility for individuals impacted. Furthermore, regular educational and training initiatives for medical staff can enhance adaptability, proficiency in communication, and patient-centered care procedures. This practicum experience highlights the need of versatile and patient-centered care, presenting valuable insights to influence the practitioner’s role in nursing education. The practicum experience underlined the significance of comprehensive patient care, working together, and flexibility when coping with the challenges confronted in rural healthcare environments. The information acquired and capabilities gained from this experience will surely influence my future role as a nurse educator, highlighting the need of full treatment and advocating for patients. Suggestions comprise solving workload issues and improving access to healthcare resources to ensure better execution of patient care in critical medical settings.
References
Stawicki, S. P., Jeanmonod, R., Miller, A. C., Paladino, L., Gaieski, D. F., Yaffee, A. Q., Annelies De Wulf, Grover, J., Papadimos, T. J., Bloem, C., Sagar Galwankar, Chauhan, V., Firstenberg, M. S., Salvatore Di Somma, Jeanmonod, D., G., S. M., T., V., A., H. L., L., F., & Worlton, T. J. (2020). The 2019–2020 novel coronavirus (severe acute respiratory syndrome coronavirus 2) pandemic: A joint American college of academic international medicine-world academic council of emergency medicine multidisciplinary COVID-19 working group consensus paper. Journal of Global Infectious Diseases, 12(2), 47–47. https://doi.org/10.4103/jgid.jgid_86_20
Andersen, L. W., Holmberg, M. J., Berg, K. M., Donnino, M. W., & Asger Granfeldt. (2019). In-Hospital Cardiac Arrest. JAMA, 321(12), 1200–1200. https://doi.org/10.1001/jama.2019.1696
Wilson, E., Hanson, L. C., Tori, K., & Perrin, B. (2021). Nurse practitioner-led model of after-hours emergency care in an Australian rural urgent care Centre: health service stakeholder perceptions. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-06864-9
Miller, C., Stangl, R., Adler, C., Strohm, M., Bernardo, C., Lechleuthner, A., & Viethen, A. (2021). Silent hypoxemia of COVID-19 pneumonia: Typical courses with implications for outpatient care. Deutsches Aerzteblatt International, 118(1/2), 8-9. https://doi.org/10.3238/arztebl.m2021.0115
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