M. J. is a female in her late 60’s. Her health problems include an extensive cardiac history. M. J. went into cardiac arrest while at home with her husband. The arrest was witnessed and therefore our hypothermia protocol was initiated by EMS. There were no obvious signs of contraindications to this protocol. The patient was intubated in route to the emergency room. M. J. received a central venous catheter prior to being transferred to the Intensive Care Unit. Once M. J. was attached to the ventilator and consents were signed, the hypothermia protocol was continued and Carolina Donor Services were notified of her condition. If any one has initiated a hypothermia protocol, they will understand how chaotic it is during the beginning stages.
During the first part of cooling, vasopressors, insulin drips, sedative medications, and electrolyte replacements drips have been hung on M. J. This patient is now this nurse’s only patient. Labs are drawn frequently while the patient is gradually cooled to 33 degrees Celsius. An esophageal temperature probe is inserted and then connected to the cooling unit used to lower the patient’s core temperature. M. J.’s labs are drawn every four hours and their electrolytes are being replaced if they are borderline or low. M. J. was cooled for over 24 hours then the re-warming phase in started. Over the next 12 hours M. J.’s temperature is gradually warmed to 36.5 degrees Celsius.
During the re-warming phase is when problems arise. Despite the therapeutic interventions that were in place, M. J. soon started showing signs of deterioration. The patient’s multiple vasopressors were maxed out at the highest infusion rate but their mean arterial pressures were reading low in there...
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...d according to the Dreyfus model while also rewarding them for the advancement in nursing continuum (McEwen & Wills, 2014). Benner’s main concepts of competence, skill acquisition, experience, clinical knowledge, and practical knowledge all shape the foundation we have for nursing. Without Benner’s model, we would not have a concrete way of recognizing ourselves based on our skill set and experience. Benner’s model does acknowledge the five stages of skill acquisition but it also highlights the seven domains of nursing practice. These seven domains outline what it is we do everyday. I have learned through M. J.’s example that Benner’s modal does influence our environment. Nurses are continuously learning from our experiences. This helps shape us into nurses that can move through the continuum of the five stages to one day becoming that expert nurse we strive to be.
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