Patients in the Acute Care Facility Essay

 Introduction

Acute care patients can be difficult for nurses because of the volume of work they generate and the individual attention they want. However, ensuring the patient's health is stable is the most difficult challenge. Working in the Nephrology department means that I rarely encounter patients in need of immediate attention because most kidney diseases are caught in their earliest stages. However, in my first few months of employment, a 50-year-old woman was hospitalized to the hospital with an acute kidney injury, and I had to provide essential nephrology care for her.

Discussion

Since the patient had not gone to the doctor for several years prior to admission, her medical record revealed no history of kidney illness or other chronic health concerns. After being taken to the emergency room with AKI, the woman was quickly stabilized and moved to the Nephrology department for further care. I was given this patient and discovered that she had a long history of substance misuse. Hypotension and chronic renal disease were found in her tests.

Two years after her initial incident, she experienced a sharp drop in blood pressure and multiple episodes of vomiting. I was there when it happened, and the doctor had just left; I beeped the on-call physician right away, but he didn't show up for a few minutes. I knew I had to make sure she was stable in the minutes until the doctor arrived, but I couldn't give her any medication without his orders. However, I decided on the spot to give the patient 10mg of Phenylephrine IV because they were showing symptoms of dysautonomia. When I was about to give the patient the medicine, the doctor stepped in, shocked, but after checking the vitals, he gave me the okay. Her blood pressure remained at a steady 55-60/40 mmHg for the full five minutes following the injection.

After she finally stopped throwing bile, her blood pressure jumped to a healthy 85/40 mmHg, and her skin tone improved. She had not urinated for much of the day, so I placed a urinary catheter after realizing that bladder blockage could be one cause of the unexpected failure. I was too nervous to take any action before the doctor arrived, so the fifteen to twenty minutes that passed felt like an eternity at the moment. Medication to regulate blood calcium and potassium levels, as well as dialysis to flush out blood toxins, were subsequently prescribed for the patient. She is currently participating in treatment, although she still drinks.

This training has prepared me to act independently in life-or-death circumstances, which is essential in the field of acute care. I was under intense pressure the whole time, to the point where many of my responses were reflexive. It's true that I could have solved problems more quickly if I hadn't been so plagued with worry and doubt; this is something I need to improve on.

There is a constant influx of patients requiring kidney transplants due to progressive renal failure in the Nephrology department. Most of the time, we have no trouble arranging a transplant because a family member is a suitable donor and the decision to aid a close relative is made quickly. However, there was once when I was working as a nephrology nurse that I had to deal with a difficult scenario involving a patient's refusal of a kidney transplant. A kidney transplant was necessary for a 12-year-old boy with kidney failure, and the boy's 21-year-old cousin was a suitable match. I requested a written consent for transplantation from the child's parents because he lacked the capacity to make such a decision on his own.

Their main argument was that their faith forbade them to perform such an unnatural act on a human body, hence their response was negative. They shared with me that their church had severe policies around the offering of one's body as a sacrifice to help others. I informed the patient's doctor of the issue, and we agreed to inform the parents of the worst-case scenario and discuss their alternatives with them. I knew that there was no way we could persuade the family to give up their faith. The problem was solved by requesting the family's approval to speak with their church mentor about setting up a meeting to discuss the family's predicament. Since the matter required immediate attention, we requested a ruling by the next day.

They requested that their pastor visit the hospital to pray with them and their son. The pastor visited the hospital the very same day, and he and the patient's parents had a lengthy discussion. The pastor was curious about the outcomes under both circumstances and the dangers to the possible donor, so we spent some time discussing them. The family ultimately decided to go through with the transplant, and their child made a full recovery.

Conclusion

I am not sure how I'd feel if the parents eventually said no to a transplant, even though this story had a nice ending. While it is crucial to show respect for a family's religious beliefs, doing so while a child's life is at stake can be difficult morally. Given the foregoing, it becomes obvious that this religious aspect has a significant impact on treatment because it is at odds with medical concepts and methods. However, I was still able to convince the parents that the transplant was necessary because the youngster was cooperative throughout the case and clearly wanted to live.