Posted: March 31st, 2024

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Appendix 5: Analysis of a Work Experience Placement Reflection (PEPAE)

Registered nurses are told to evaluate their work to improve care in a healthcare system that is always changing (Nicol & Dosser, 2016: 2024 – Do my homework – Help write my assignment online). In this paper, I will use Driscoll’s model of reflection to think critically about something that happened during my last clinical placement (Driscoll, 2007). This paper will give a brief summary of the event, an analysis of what happened, and a suggestion for another way to improve the care given.
What is it? The PEPAE in brief

This PEPAE reflection is about a woman in her mid-20s who was moved to the ward for pain management, monitoring of her food and fluid intake, and management of her stools. She had an acute flare-up of Chron’s disease, and when she went to the emergency room, she had severe pain in the lower right quadrant of her abdomen, diarrhea, and bleeding. During the assessment, she was in pain on a scale of 6 out of 10, which led to a priority nursing diagnosis of acute pain. As an intervention, the patient was taught about non-drug techniques (Ackley & Ladwig, 2016: 2024 – Do my homework – Help write my assignment online). Also, the patient didn’t drink enough or eat enough and was losing weight. From these, an unbalanced diet was found to be the second nursing diagnosis. Then she was given high-calorie foods and nutritional supplements to take by mouth (Ackley & Ladwig, 2016: 2024 – Do my homework – Help write my assignment online). She also had a low number of red blood cells and haemoglobin. She was also very stressed out about work.
Then what? Thoughts about the Essay

When first-year nursing students go on clinical placements, they often don’t know enough or have enough skills to give patient-centered care (Ewertsson et al., 2017). This essay was written in my first year, when I didn’t have a lot of clinical experience. As such, I was not able to do a comprehensive assessment on the patient and failed to recognise the possible effects of her condition on her psychosocial wellbeing. People with Chron’s disease may feel very frustrated because they can’t control when they go to the bathroom (LeMone et al., 2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delaya). This

might have gotten in the way of the patient’s personal, social, and work life, and it would have given him or her a bad body image (Ackley & Ladwig, 2016: 2024 – Do my homework – Help write my assignment online; LeMone et al., 2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delaya). I was too focused on getting the head-to-toe evaluation done that I forgot to think about how she felt. I’m now more sure that I can include this in my future assessments and make changes based on that.
I also told the patient that before she could go home, I wanted her weight to be in the normal range. In Chron’s disease, stomach ulcers make it hard for the body to absorb nutrients (Craft & Gordon, 2017; LeMone et al., 2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delaya). Since the patient’s condition got worse, I now think it is unlikely that she will gain weight in a short amount of time. I would instead work with her dietician and suggest an enteral diet like Ensure to replace the nutrients she has lost (Ackley & Ladwig, 2016: 2024 – Do my homework – Help write my assignment online; LeMone et al., 2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delaya).
On the other hand, one good thing I did in the PEPAE was make sure that I and my patients were safe by only doing things that were within my scope. Even though non-drug techniques like deep breathing and relaxation are evidence-based pain management interventions (Ackley & Ladwig, 2016: 2024 – Do my homework – Help write my assignment online), I would now give enough pain medications to supplement these non-drug techniques (Ackley & Ladwig, 2016: 2024 – Do my homework – Help write my assignment online; Szigethy, 2018: 2024 – Write My Essay For Me | Essay Writing Service For Your Papers Online). (Non-pharmaceutical treatments should be used in addition to pharmaceutical treatments.)
What’s next? The new plan

As I already said, the main thing I did for the patient’s acute pain was to teach them non-drug ways to deal with pain, like deep breathing and relaxing. Even though these are evidence-based treatments, I would now give opioid painkillers after a PQRST pain assessment as a new way to help the patient deal with pain better (Ackley & Ladwig, 2016: 2024 – Do my homework – Help write my assignment online; Crisp et al., 2020). There is evidence that opioids can be used to treat abdominal pain caused by Crohn’s disease. This is in line with the guidelines for giving painkillers for moderate pain (MIMS, 2021; NMBA, 2020). The patient’s doctor gave them pro re nata oxycodone, which works best after an hour (Australian Medicines Handbook, 2021). The patient’s pain needs to be taken care of right away because it keeps them from sleeping and getting through their daily tasks. It also causes stress and anxiety, which lowers their quality of life (Szigethy, 2018: 2024 – Write My Essay For Me | Essay Writing Service For Your Papers Online).
It is possible, though, that opioids (multimodal analgesia would be more accurate and effective) can cause side effects in the gut, like paralytic ileus, which makes the symptoms of Chron’s disease worse (Australian Medicines Handbook, 2021; Norton et al., 2017). First and foremost, non-drug interventions support and help analgesia both in pain relief and pain control, reducing the need for oxycodone (Szigethy, 2018: 2024 – Write My Essay For Me | Essay Writing Service For Your Papers Online; Zeilinska et al., 2019: 2024 – Online Assignment Homework Writing Help Service By Expert Research Writers). So, giving analgesics and other ways to deal with pain that don’t involve drugs makes pain management more effective. Oxycodone gives the patient immediate relief, and deep breathing and relaxation help reduce the risk of side effects from using it for a long time (Regueiro et al., 2017; Shallik, 2018: 2024 – Write My Essay For Me | Essay Writing Service For Your Papers Online).
Conclusion

After thinking about my last PEPAE, I was able to think about making some changes to how I care for my patients.

This critical reflection helped me figure out why I didn’t notice the patient’s mental and social health. I would now think about doing a thorough evaluation as part of my practice. Also, in addition to the non-drug methods I mentioned in my previous PEPAE, I would now add the administration of opioid analgesia (THIS WOULD BE MORE OF A PRIORITY, AND NON-DRUG PAIN MANAGEMENT WOULD SUPPLEMENT THIS) to help her manage her pain better.

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