Article Citation
Gilmartin, J. (2003). Day surgery: Patients’ perceptions of a nurse-led preadmission clinic. Journal of Clinical Nursing 13, 243-250.
Initial Reaction
This research article is from the UK and the writer questions if the findings from this study will have heuristic relevance and applicability to nursing and healthcare in the United States (U.S.). Primary healthcare in the UK is provided through the National Health Service (NHS); this writer has little knowledge as to how it works and its impact on patient care and nursing. This limited knowledge may introduce bias in this critique.
Descriptive Vividness
The significance of this study is to determine if a preadmission clinic process can be developed and implemented to positively impact the physical, psychological, and social healthcare needs of patients undergoing day surgery. The purpose of this study is “to elucidate patients’ perceptions of the preassessment preparation prior to day surgery” (Gilmartin, 2003, p. 244).
This researcher identifies four themes related to patients’ perceptions of the preassessment preparation prior to day surgery; efficient functioning, assessment of patient suitability, the experience of information giving, and the problem of cancellation. Minimal excerpts are provided for three of the four themes; the fourth theme, the problem of cancellation is completely in narrative format. Although the emphasis of the findings was on the majority of excerpts, this researcher included negative case studies under two themes; efficient functioning and the experience of information giving. Efficient functioning was described by the majority of participants as being provided to in a timely manner, in contrast some (numbers not men...
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.... This study could have been improved by expanding the sample group from various preassessment clinics and to include diverse ethnicities and representation across various surgical specialties. In addition, another credible author would have increased trustworthiness of the entire study. This writer suggests the study be replicated in the U.S., with the suggested enhancements, for application in the U.S. healthcare system.
Works Cited
Burns, N., & Grove, S.K. (2009). The practice of nursing research: Appraisal, synthesis, and generation of evidence (6th ed.). St. Louis, MO: Saunders Elsevier.
Gilmartin, J. (2003). Day surgery: Patients’ perceptions of a nurse-led preadmission clinic. Journal of Clinical Nursing 13, 243-250.
Tappen, R.M. (2011). Advanced nursing research: From theory to practice. Sudbury, MA: Jones & Bartlett Learning.
Often time, nurses has been viewed by patients, their family members and the medical team as basic emotional care givers, pill crushers or cart pullers and not as healthcare professionals who are more interesting in health promotion, disease prevention and better patient outcomes. They also often forget the emotional, physical, mental, and caring part that is involved with the profession. And to make matters worse, nurses are continued to be viewed as a threat by doctors more than ever before especially with the opening of Nurse Practitioners programs.
Rothrock, J. C. (2007). Alexander's Care of the Patient in Surgery. St Louis, MO: Mosby Elsevier.
Although nurses do not wield the power of doctors in hospital settings, they are still able to effectively compensate for a doctor’s deficits in a variety of ways to assure patient recovery. Nurses meet a patient’s physical needs, which assures comfort and dignity Nurses explain and translate unfamiliar procedures and treatments to patients which makes the patient a partner in his own care and aids in patient compliance. Nurses communicate patient symptoms and concerns to physicians so treatment can be altered if necessary and most importantly, nurses provide emotional support to patients in distress.
LoBiondo-Wood, G., & Haber, J. (2014). Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice (8th ed.). St. Louis, MO: Elsevier, Inc.
Ignatavicius, D. D., & Workman, M. L. (2013). Care of Intraoperative Patients. Medical-surgical nursing: patient-centered collaborative care (7th ed.). St. Louis: Elsevier.
More often than not positive patient outcomes come from these procedures, but not without challenges along the road to recovery. Recently I had a patient that underwent a bowel resection with establishment of an end colostomy for the treatment of her diverticulitis. Fortunate, the procedure went without complications from a surgeon’s point of view, but sadly this was not the case for the patient. Caring for this patient postoperatively presented great opportunity for me to practice presence. The pain and suffering my patient was experiencing had nothing to do with the mechanical aspect of her surgery, but rather the emotional craters created by discovering her colostomy bag. For the patient, a colostomy was the absolute worst case scenario. New colostomies require frequent attention from nurses; checking for viable tissue, emptying output, and watching for signs of infection. Each time I assessed the ostomy humiliation and shame consumed her spirit and body. After the second flood of these emotions, I stopped dead in my tracks, pulled up a chair and asked the patient “how are you feeling”. A constant stream of tears ran down her face as she expresses to me the fear she has in telling her significant other that she will forever have “a bad of feces” on the outside of her abdomen. My heart cried for her! I couldn’t imagine how she must feel. As a woman, she previously viewed her body as a sacred part of her that she was able to share with her partner, but she no longer felt beautiful and sexy, but rather a disgrace. Her painful emotions struck my heart like a bolt of lightning, how was I supposed to help her see the beauty of this colostomy? In the end, it was my time and patience coupled with positive affirmations that relieved her fears of the unknown. I had every opportunity to place ignorance at the frontline of my care and ignore the obvious
Nursing research is a systematic enquiry that seeks to add new nursing knowledge to benefit patients, families and communities. It encompasses all aspects of health that are of interest to nursing, including promotion of health, prevention of illness, care of people of all ages during illness and recovery (or) towards a peaceful and dignified death (ICN 2009)
Thorne, S. (2010). Theoretical Foundation of Nursing Practice. In P.A, Potter, A.G. Perry, J.C, Ross-Kerr, & M.J. Wood (Eds.). Canadian fundamentals of nursing (Revised 4th ed.). (pp.63-73). Toronto, ON: Elsevier.
Burns, N., & Grove, S. K. (2011). Understanding nursing research: building an evidence-based practice (5th ed.). Maryland Heights, MO: Elsevier/Saunders
Polit, D., & Beck, C. (2006). Essentials of nursing research: appraising evidence for nursing practice (7th ed.). Phildelphia: Lippencott Wilkins & Williams.
Ignatavicius, D. D., & Workman, M. L. (2013). Medical-surgical nursing: patient-centered collaborative care (7th ed.). St. Louis: Elsevier Saunders.
middle of paper ... ... The priority for this patient was to establish that she was fully aware of what the procedure involved and the possible risks and complications. I feel that the pre-assessment form used within the unit is far too fundamental, if elements of the roper et al activities of daily living were to be incorporated this would help in achieving a much more in-depth holistic nursing assessment enabling for the best quality and level of care to be given to all patients arriving in the unit. Whilst I feel a full nursing assessment is not fully necessary for a day case unit, as previously stated I feel that the communication element is an excellent way of ensuring a better holistic approach is achieved, it will also help to achieve better documentation and communication between all staff members.
1.I currently work in the surgical unit and one of the major recovery enhancements is early ambulation after any surgery, especially orthopedic and abdominal. Early ambulation will accelerate the return of bowel function (as evidenced by passage of stool and flatus) reduce the rate of overall complications and decrease the length of hospital stays. Evidence-based practices have shown that early post-operative ambulation contributes to decreased pulmonary complications. “When exploring postoperative activity in the general and orthopedic nursing literature, there is sparse evidence outlining nursing's critical thinking skills associated with decreasing the first postoperative activity from the historical 14-day mark to the most current model of day 1 or 2 for the joint replacement population. Also, there were no recently published reports describing a contemporary
Polit, D. F., & Beck, C. T. (2010). Essentials of Nursing Research (7th ed): Lippincott, Williams & Wilkins.
The role of the nurse in the preoperative area is to determine the patient’s psychological status to help with the use of coping during the surgery process. Determine physiologic factors directly or indirectly related to the surgical procedure that may cause operative risk factors. Establish baseline data for comparison in the intraoperative and postoperative period. Participate in the identification and documentation of the surgical site and or side of body on which the procedure is to be performed. Identify prescription drugs, over the counter, and herbal supplements that are taken by the patient that may interact and affect the surgical outcome. Document the results of all preoperative laboratory and diagnostic tests in the patient’s record