Reflective Journal - A Nurse's Duty in the Surgical Ward

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PART C: REFLECTIVE JOURNAL AND EVALUATION OF CLINICAL EXPERIENCE Aseptic Technique Although the importance of aseptic technique has been continually reiterated, I have realised its substantial role in the perioperative environment. Aseptic technique refers to the practice of creating and maintaining a sterile environment used for sterile procedures (Laws, 2010a). This is incredibly important as repetitive minor breaches of the sterile environment is one of the major factors increasing the risk of surgical site infection (Harrop et al., 2012). Circulating nurses must check the expiry date and the integrity of the packaging and wear the correct PPE prior to opening the articles. Each article must maintain its sterility; therefore the setup must be continuously monitored. Instrument nurses must create the sterile field using sterile drapes as they minimise the transference of microorganisms. They must also keep their hands at chest level, as areas below table height can be easily contaminated (Australian College of Operating Room Nurses, 2010). Medications Preoperative Phase Pharmacology is a vital component in the perioperative practice. Medication use is monitored closely during the perioperative period. Preoperatively, there are certain drugs that must be discontinued prior to a surgery as they increase surgical risk, including anticoagulants, tranquillisers, corticosteroids and diuretics (Laws, 2010b). In fact, these drugs can increase the risk of respiratory depression, infection, fluid and electrolyte imbalance and increased risk of bleeding (Hamlin, 2010). Open communication is important in obtaining a medication history, and in identifying the drugs taken prior to the surgery. If any of these medications has be... ... middle of paper ... ...the patient’s safety, gathering supplies needed and checking if equipment needed are working, setting up the sterile field, maintaining its sterility, and completing all the documents. Hamlin (2010) further states that RNs may be required to provide emotional support during the induction phase of anaesthesia. Postoperative Phase Although students were not allowed in the recovery unit, I was able to talk to one of the recovery nurses. I learned that a nurse’s duty of care includes monitoring the patient’s vital signs and level of consciousness, and maintaining airway patency. Assessing pain and the effectiveness of pain management is also necessary. Once patients are transferred to the surgical ward, the goal is to assist in the recovery process, as well as providing referral details and education on care required when the patient returns home (Hamlin, 2010).

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