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Hi, I need help with essay on Nursing. Paper must be at least 2500 words. Please, no plagiarized work! The case is also a good reflection on how teamwork, nurse assertiveness, and an open organization environment – that does not impose rigid hierarchy- positively impacts patient care. The case also brings to the fore, issues of accountability and responsibility, which are key concepts in nursing leadership and management.During my branch placement I, (Student Nurse) was appointed in the acute care ward of a large general hospital. The acute care ward had 25 beds and was running at almost full occupancy. The ward was also facing shortage of nurses. The case is of a 59 year old African Caribbean patient who was admitted for back pain and an episode of melena. The patient was suffering from hypertension, type 1 diabetes and prostate cancer. He was diagnosed with spinal cord compression (L4, T5, T4) and had started on radiotherapy. The day the patient was assigned to me (Student Nurse), he was also scheduled for an endoscopy (OGD). The patient was nil by mouth (NBM), since midnight in view of his OGD, but because he was an insulin dependent diabetic he was on the sliding scale of actrapid, and on 5% dextrose infusion. The patient’s blood sugar (BM) reading had to be taken every hour, and the actrapid infusion rate regulated accordingly to the protocol.There was no formal handover procedure to brief on patient condition when they were sent for to another department, and only the patient’s chart and bedside notes were used for this purpose. I (Student Nurse) contacted the respective department to make sure the two procedures did not interfere with each other: radiotherapy was at 11 am and the endoscopy at 3:30 pm. I (Student Nurse) contacted the radiotherapy unit to make sure there was staff, trained to use the sliding scale, and/or to offer my support by going and checking the patient’s BM myself. They replied that nurses there would take care of that. I (Student Nurse), informed the porters about the importance of the sliding scale and put the chart where blood sugar level and the actrapid infusion rate are recorded, on the top of the notes, as a kind of cover sheet so that it would not escape the staff’s attention. The radiotherapy had to last two hours. The patient returned to the ward and did not show any sign of hypoglycaemia. However, I (Student Nurse) still checked his sugar level. It was very low (2.7). Nobody had checked the patient’s BM while he was in radiotherapy, and the dextrose infusion had also been stopped. I (Student Nurse) immediately informed the medical team and the senior nurse (Nurse J) working with me and checked the chart for BMs and the actrapid infusion rate and found that it had not been completed. I (Student Nurse) then checked the infusions and discovered that the dextrose had been stopped. As per the protocol I increased the dextrose infusion of the 30% , stopped the actrapid pump and rechecked the patient’s BM after 20 minutes. Fortunately the patient’s condition was under control.


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