Clinical Practice Assignment On The Reflection Of Neurological Case

Question

Task: Provide a personal reflection on the clinical practices adopted by you for the case scenario of 25-year-old man who had reported to the hospital and later on diagnosis revealed that the patient was suffering from Parsonage-Turner Syndrome.

Answer

Introduction
The clinical practice assignment is intended towards reflecting on the clinical practices adopted while dealing with a neurological case at the Concord Hospital. The scenario chosen for the purpose is the case of a 25-year-old man who had reported to the hospital for undergoing severe pain in shoulder and head, followed by atrophy of the upper extremity musculature. The diagnosis revealed that the patient was suffering from Parsonage-Turner Syndrome. It was observed that the patient had unilateral scapular winging following post-exposure prophylaxis. In this regard, the paper aims at reflecting on the clinical practices applied to the situation using Driscoll's model of reflection.

What?
It was my first clinical placement held on the concord hospital neuro ward for two weeks. While providing service to the service users, I have faced certain challenges which have challenged me on a professional and personal level. While undertaking PEP, the severe headache of the service user who is of 40 years old has bound to stop the therapy session. A lifting evaluation was going through; when the service user has immediately stopped the trail, and he sits down against the wall. I have never seen a person suffering in that way due to severe headache attacks. This has made me nervous, and I have shifted the service user to a room with lights off so that he can lie and take rest. I have found patches in his eye, and his eyelid was swollen and teary. He was suffering from extreme pain. This made me worried, and I was unable to provide him proper solution or medication for his pain as he became restless and continuous dropping of tears was going on. He was having high blood pressure, heart rates were not normal and pain rate was around 9.

At that point of time, I was unable to provide any medications without any testing or identification of the exact disorder. This has challenged me due to my lack of knowledge about the therapy and medication approach of this particular disorder. The un-ability to provide proper support to the service user has made me sad and it has also discouraged me and affected mentally or personally. I think proper communication was needed to know his problems before starting the therapy process. This could have prevented the occurrence of such a scenario and the therapy session could be completed smoothly (Lynn, 2018).

So what?
It was, indeed a different experience for me. I have never faced such a challenging situation as discussed in clinical practice assignment before. Seeing the patient undergo severe headache and shoulder pain, I tried to calm him down at first. I gave him some water to drink and asked whether he was ready for the diagnosis. I took the patient to the neurology ward for diagnosis and assisted my senior doctor in the process. I was a bit nervous as I had never dealt with such critical situations before. I asked the patient, specific questions to know about his previous treatment and diseases. I found that he had undergone post-exposure prophylaxis treatment. I analyzed that the patient's condition might be the result of his prior treatment (Forster and Caughlan, 2017). Neurological examination was done at first, followed by plain radiography of the shoulders and electromyography. The outcomes of none of the tests showed any additional abnormality. However, the diagnosis of the patient revealed that he was suffering from Parsonage-Turner syndrome. It was the outcome of post-exposure prophylaxis against the possibility of HIV infection (Crawley and Brady, 2016). I was successful in proving moral support to the patient as he was found to be satisfied to get my help throughout the diagnosis process. Moreover, I talked with him in between the diagnosis process to keep him motivated.

However, I feel that I could have made the patient aware of the disease in proper terms (Urden et al. 2017). I saw that it was difficult for him to understand the medical jargon used by the neurologists. Moreover, when the doctors said that the neurological examination did not show any additional abnormalities, the patient got disturbed. It was because he misinterpreted the medical term of abnormality. I feel that it would have been appropriate if I explained to him the medical terms accurately rather than giving him the prescription on his hand. Thus, my inefficiency in explaining the medical jargon to the patient caused him to take unnecessary stress. Though by getting moral and emotional support from me, the patient developed a sense of trust in me, it was improper to talk to him in between the diagnosis process so much. Besides motivating the patient, the senior healthcare executives maintained professionalism while working. I think I got emotionally involved with the patient too much due to which I failed to manage time properly. Though I supported and assisted my seniors in best possible ways, unlike them, I could not maintain efficiency in time management. Other patients needed treatment, as well. Due to mu inefficiency in efficiently managing time, the other patients faced unnecessary delays. Thus, I feel I could have shown professionalism to enhance my performance at the workplace (Schenck and Andrasik, 2019). Moreover, it would have been proper if instead of wasting time in unnecessary talks with the patient, I explained him the nature of the disease that he was suffering from (Schenck and Andrasik, 2019).

Now What?
The case helped me to learn about the importance of interpersonal skills in dealing with patients. Most of the patients suffer from tension and anxiety about the disease from which they suffer. I also learned that it is necessary to provide a proper atmosphere for patients to acquire treatment. The senior healthcare professionals were indeed very caring and helpful while diagnosing the patient. They also showed their professionalism in the entire process and managed time efficiently. Thus, the implications for me in future clinical practice will be the implementation of a proper strategy to manage time and indulge in critical thinking while assessing patients. I will also ensure the provision of mental support to patients (Capra, 2018).

However, the two areas that I need to improve are communication and professionalism. I cannot deny that since this was my first PEP, I lacked professionalism. I got emotionally inclined towards the patient seeing him in distress. Though I provided him with the necessary moral support, I could not manage time efficiently. I also need to enhance my strategy of interaction and communicating with patients (Peloquin et al. 2016). I feel that it is very necessary to make patients aware of the medical jargons and terms to avoid confusion and anxiety. In this sense, it can be said that I must plan effective time management and communication strategy. In the time-management approach, I will ensure that I focus on the most important activities first. I will also try to be professional while dealing with patients in my next PEP. The communication strategy that needs to be used by me in future will include a proper explanation to patients of the diseases and the diagnosis process (Crawley and Brady, 2016). I will also ensure to provide moral support to patients but by being professional at the workplace. Thus, the experience that I gathered while handling this case of clinical practice assignment will assist me in paving the path for my professional career by enhancing my soft skills.

Reference List
Capra, C., 2018. The neurologist of the territory: a filter for the first aid?. Neurological Sciences, 39(1), pp.143-144

Crawley, K. and Brady, M., 2016. The diagnosis and management of acute cluster headache in the out-of-hospital environment. Journal of Paramedic Practice, 8(4), pp.184-192.

Forster, E. and Caughlan, M., 2017. Neurological nursing skills. Paediatric Nursing Skills

Lynn, P., 2018. Taylor's clinical nursing skills: a nursing process approach. clinical practice assignment Lippincott Williams & Wilkins.

Peloquin, S., Carley, A., Bonifacio, S.L. and Glass, H.C., 2016. The neurointensive care nursery and evolving roles for nursing. Neonatal Network, 35(2), pp.87-94.

Schenck, L.A.M. and Andrasik, F., 2019. Behavioral and psychological aspects of cluster headache: an overview. Neurological Sciences, 40(1), pp.3-7.

Urden, L.D., Stacy, K.M. and Lough, M.E., 2017. Critical Care Nursing-E-Book: Diagnosis and Management. Elsevier Health Sciences.