Author Archives: Bertha Adjei Ampomah

Learning from other feedback.

Posted on by
Reply

Reflect on your learning in outreach/short placements or with members of the multi-disciplinary team who are supervising your learning.

Where the learning took place

The name or description of the practice area

MDT Meeting Room, Devonshire ward

When the learning took place,

You can provide a single date or date range

25/03/2024

Who you learn from?

You can list one or more people or provide a team name

Kate Frost Occupational Therapist Senior, Adele Tomlinson Clinical fellow.

Student reflection

 

I had the opportunity to meet with multidisciplinary teams to review patient progress in their treatments. I learned how the MTD teams discuss patients who are yet to be discharged and patients who need another review. The meeting involves a doctor, a social worker, nurses, a dietician, and a psychotherapist.

I gained knowledge on how patient cases are reviewed. The patient’s EEG is reviewed due to the risk of seizures, not to wean. This can be kept under review, and if necessary, levetiracetam would be reduced first if we felt it was inhibiting potential behaviours.

The patient must complete ciprofloxacin treatment, which is an ongoing, vulnerable chest. Also, patients need more behavioural support from therapy staff. MDT has plans for the patient by calling the patient’s father to discuss the EEG and refer the patient to a salivary clinic for botox.

Due to their situation, I learned in the MDT meeting that the team can reduce the patient’s medication. This patient’s Cipro medication is to be continued for two weeks, and the cough assist was ongoing yesterday after nebulisers and thick and clear secretions. I also learned how the MDT discusses patient discharge and ongoing treatment after the patient is discharged from rehabilitation.

Practice Supervisor’s comments:

 

Bertha was able to have the opportunity to participate in the MDT case reviews, which is very helpful in knowing our patients more as the discussion is about overall patient care, from doctors’ point of view to therapy team to nursing team, sharing valuable information on how to help improve patient’s overall health and progress during their rehab phase here in Devonshire ward.

It is a very good experience for her as she will be able to learn how nursing staff would escalate/share what they know about patients during 24 hours of care and also be able to share about patient’s guidelines to see if they work, if they’re manageable for the team and the patient, and if they’re not,  with doctor’s appointments and for any medication adjustments.

Bertha enjoyed participating in the meeting, as she was able to learn a lot about patients and how the MDT works together as a team.

Learning from other feedback.

Posted on by
Reply

Reflect on your learning in outreach, short placements or with members of the multi-disciplinary team who are supervising your learning.

Where the learning took place

The name or description of the practice area

GYM session

When the learning took place,

You can provide a single date or date range

21/03/2023

Who you learn from?

You can list one or more people or provide a team name

Sydney Lai, occupational therapy.

Student reflection

 

I had the opportunity to observe an occupational therapist assessing a 56-year-old patient who had suffered from an acquired brain injury stroke. During the observation, I learned about the methods used by occupational therapists to evaluate stroke patients. I discovered that occupational therapy focuses on improving motor control and hand function in the affected upper limb after a stroke to help patients perform their daily self-care tasks more efficiently.

Occupational therapy interventions are tailored to maintain or enhance the soft tissue properties of the upper limb. For instance, stretching is a technique used to reduce spasticity and improve the patient’s overall condition. This specific approach in occupational therapy is crucial to enhancing motor control and hand function in the affected upper limb. Occupational therapy teaches stroke patients strategies to manage cognitive, perceptual, and behavioural changes and prepares the home and work environment for their return.

Practice Supervisor’s comments:

 

Bertha spent a morning shadowing several occupational therapy rehabilitation sessions. These included sessions in the gym aimed at improving upper-limb strength and cognitive function. Bertha showed her interest in the role of an occupational therapist by asking appropriate questions.

Feedback from Practice Assessor Final interview Reflection.

Posted on by
Reply

Knowledge

 

Bertha has learned quite a lot of background knowledge regarding patients with brain injury and how to care for them day to day. She does not hesitate to ask questions when she is not familiar with things or information, which is a good attitude as a nurse. She also always participates to Therapy sessions in order to observe how the PT, OT, or SLT assess patients level of care needs and capacity to help themselves. Bertha has also been attending some in-house hospital training in order to expand her knowledge and skills relating to brain injury. She has been doing well during her shifts.

Skills

 

Bertha has learned numerous skills like cough assistance, PEG care, administration of PEG medications and suctioning. She has been performing all these skills day to day during her shifts and has mastered them. She also knows the indication why these are being done for the patient. Bertha is easy to work with and knows how to deal with patient needs independently with minimal supervision. She has performed routine PEG care daily, which is part of our morning medication rounds routine. She is also able to operate the feeding pump, suction machine and Cough assist equipment with minimal supervision.

Attitudes and values

 

Bertha enjoy working in the ward with our patients. She is very dedicated and proactive in all her shifts. She also never hesitates to lend a hand to other staff members when the need arises, which is a very good trait in becoming a professional nurse. She also always shows compassion, kindness and empathy for each and every patient. She has good working relationship with all staff members and is able to work with anyone in the ward. Her attitude towards working in the ward is very good, as she always thinks positively and upholds RHN values every time she works. I enjoy working with her during our shifts together.

Learning and Development Needs: To be agreed between the Practice Assessor and the student.

Practice Assessor to identify specific areas to take forward to the next placement

 

Bertha should continue to practice the skills she has learned here in RHN in order to fully master her skills, especially in tracheostomy care and suctioning and in gastrostomy care and medication administration. It will help her professional growth and enhance more her knowledge and learning as she continue on to her other placements.

Feed back from Practice Assessors Midpoint Interview Reflection.

Posted on by
Reply

Knowledge

 

Bertha has exhibited a good amount of knowledge with regards to patients with brain injury through her research and through attending MDT meetings and trainings provided in the hospital. She is very keen to learn new things and work with our patients. She is able to identify NEWS 2 scores that need attention and refers immediately to the staff nurse.

Bertha is also a fast learner when it comes to doing daily routines for our patients, like doing buried bumper checks, suctioning orally and tracheostomy patients, and other routines that we do for patient care. She also learned about tracheostomy care and weaning during the course of her placement, which is one of the vital things that we do for patients whom we aim to decannulate.

Skills

 

Bertha has acquired numerous skills in Devonshire ward during her stay. She has learned to do PEG care and administration of medications, feed, and flush via PEG/gastrostomy tube and balloon water change. She was able to receive tracheostomy care, suctioning, and participate in those cares as part of her daily routine. She was also able to learn how to do bladder scans, washes, and daily suprapubic catheter care for patients who have suprapubic/indwelling catheters.

Bertha is very eager to participate in daily patient care and does not hesitate to try things for the first time. She also does not hesitate to ask questions when she is unsure of something, which is a good attitude for a nurse in order to learn and grow.

Attitudes and values

 

Bertha is able to showcase a good attitude and values in her placement in RHN. She has good character and is able to work well with anyone in the wars, may it be a patient, a relative or staff member. She values the importance of good nursing care and is able to work well under a busy environment. She also takes the initiative to do nursing tasks with minimal supervision. She observes RHN values, which are an integral part of our nursing care. She is an excellent student and she can perform well under any circumstances.

Ongoing learning and development needs: The student is to identify their learning and development needs for the remainder of the placement and negotiate with their Practice Assessor how these will be achieved.

Learning and development needs

 

Bertha will continue to practice what she has already learned in the ward to master her nursing skills and for her professional growth.

How will these be achieved?

 

To apply it onto her daily nursing routines when in the ward.

Professional Values Reflection

Posted on by
Reply

Ensure confidentiality is maintained.

The first few weeks of my experience in the trauma brain injury service were incredibly diverse. I worked alongside many healthcare professionals, witnessing various tracheostomy tube and percutaneous endoscopic gastrostomy (PEG feeding) procedures. This experience helped me become a successful clinical nurse, and I realised that exceptional communication skills were necessary. I learned that my tone while speaking and delivering patient information must be compassionate. As a student nurse, I must advocate for patients by supporting and defending their rights. I have to make sure that I deliver the fundamentals of care effectively.

In my nursing practice, I have always followed the six Cs: care, compassion, competence, communication, courage, and commitment to patient care. I demonstrate empathy by imagining myself in the patient’s shoes and treating them as I want. Respecting the patient’s autonomy, protecting their privacy and confidentiality, and actively listening to their concerns are all essential components of my practice. This approach has helped me establish a strong rapport with my patients. I am committed to advocating for their health, respecting their values and cultural differences, and ensuring effective communication with the multi-disciplinary team for coordinated patient care and management.

During my second placement in a brain injury ward, I encountered a situation that brought to light the delicate balance between my professional development and the immediate needs of a patient. My practice assessor asked me to research a drug I needed clarification on. On my way to conduct the research, a healthcare assistant approached me with an urgent request for assistance with a patient lying in a filthy bed. Recognising the situation’s urgency, I prioritised the patient’s needs and assisted the healthcare assistant first. After attending to the patient, I researched the drug as my assessor had requested. However, she pointed out that I needed to improve my time management skills, emphasising the importance of drug knowledge and application as a student nurse. This incident caused me to reflect on the delicate balance between my professional development and the patient’s immediate requirements.

 

I provided the healthcare assistant with automatic assistance in ensuring the patient’s comfort, as I believed this to be of utmost importance, even above researching drugs. I could offer this assistance from my home if the ward becomes too busy. While I regret not addressing the issue with my practice assessor, I remain confident in my decision to prioritise the patient’s comfort. It was imperative to me that the patient did not stay in a filthy bed while I researched a drug. As per NMC 2008a, nurses need to justify their decisions. Following an incident, my assessor advised me to work on my time management skills due to my decision to assist a health care assistant. At first, I needed clarification on this feedback, but it ultimately motivated me to learn more about time management. Despite my belief that my time management skills were adequate since I was always punctual and had a prioritised task list, this experience made me realise that I needed to reevaluate how I prioritised my workload.

In this situation, I prioritised ensuring the patient was comfortable and clean. As a responsible student nurse, it is essential to prioritise the care of individuals, respect their dignity, and treat them as such, as the author emphasises. While shadowing my supervisor, I learned that, as a student nurse, I must possess knowledge about the different types of drugs and their uses. It is crucial to work within the limits of my competence, recognise my strengths and weaknesses, and develop the necessary skills for safe and effective practice when working independently. It is also essential to keep current with the latest advancements in practice by participating in appropriate learning and reflective activities. Post-registration education and practice are there to help healthcare professionals like myself provide high-quality care and maintain a high standard of training. It is an excellent framework for continuing professional development and a crucial component of clinical governance, although it cannot guarantee competence. This experience has made me realise the importance of prioritising patient care while maintaining the knowledge and skills necessary for safe and effective practice. Researching the drug was required, but not at the expense of leaving the patient in a filthy bed.

As individuals, we do not originate the notion of time, but we acquire knowledge of it from a young age as both a concept and a societal construct. In the Western world, time revolves around measurement tools like clocks, calendars, and schedules. As a student nurse, I know that the importance of time management will become increasingly apparent throughout my career. I will inevitably face a heavy workload and must determine the most effective way to manage my time. Time management involves consistent action and communication with my goals while adapting to changing circumstances. Developing strong prioritisation skills is crucial for effective time management. That consists in making difficult decisions about allocating my time and planning accordingly. By managing my time effectively, I can reduce stress and increase productivity, ultimately benefiting myself and my patients. Effective time management entails following three fundamental steps. Firstly, it involves dedicating time to plan and determine priorities. Secondly, it entails tackling the most crucial task first and completing it before starting another. Lastly, the nurse must reassess and reorganise their priorities based on any new information received. Effective time management entails following three fundamental steps. Planning is vital in all areas of our lives, including nursing, where it is used as a ‘care plan.’ Nurses rely on this process to guide their practice. The nursing process, or ‘Assess, Plan, Implement, and Evaluate (APIE),’ can be an effective time management tool. By adapting the meaning to “a systematic, rational method of planning and achieving a practical time management plan,” nurses can utilise APIE to manage their time efficiently. Assess/Analyse: Collect and organise data and form a statement of actual or potential time management needs.

Final interview Reflection

Posted on by
Reply

Knowledge

 

Medication was one of the learning objectives for this placement, and I learned about various types of medicine and why they are prescribed to patients with neuro-disabilities. I have learned that an acquired brain injury is an injury to the brain from any cause that results in neurological impairment. This can cause trauma, tumours, infections, metabolic insults, and disorders of the blood supply. The resulting impairments may improve, progress or remain relatively stable over time. I have gained knowledge of cough assist equipment used to assist in the mobilisation and clearance of chest secretions by inflating the lungs with a positive airway pressure and then providing a rapid change to negative pressure to help the patient cough. A turbine compresses ambient air and delivers it to the patient through a close-fitting facemask. I discovered why patients require cough assistance, commonly used in patients who cannot cough and effectively clear secretions due to neuromuscular disorders and spinal cord injuries associated with lung disease. Also, secretions are usually cleared from the mouth after coughing, so yankeur suction may be required.

In the Devonshire ward, most patients undergo percutaneous endoscopic gastrostomy (PEG). A gastrostomy tube is a surgically inserted device that provides direct access to the stomach for supplemental feeding, hydration, and medication. It is inserted into the patient’s abdomen and delivers nutrients directly to the stomach.

I learned about brain disorders. When a patient’s brain is damaged, it can affect various factors, including memory, sensations, and personality. I also learned about the multiple types of brain injuries.

Nurses must work with multidisciplinary teams when caring for patients with neurodisabilities. I work with speech and language therapists (SLT) to care for patients with difficulty communicating, eating, drinking, and swallowing. I discovered that SLT can assist adult patients who are having difficulty communicating due to a stroke or brain injury.

Finally, I invite you to the MDT meeting to review the patient’s treatment progress and discuss the next steps, including whether the doctor should increase or decrease the prescribed medication. Please attend the conference for patients about to be discharged to a family or care home.

Skills

With the guidance of my practice supervisor, I have gained appropriate skills in preparing and administering medication to patients through a PEG feeding tube. Additionally, I can administer nebulizer medication to help clear secretions from their lungs. I perform cough-assisted procedures for patients who cannot cough effectively due to neuromuscular disorders. I clear secretions from the patient’s mouth using yankeur suction during these procedures. I also practice tracheostomy care under my supervisor.

As a part of wound care, I must demonstrate my skills in using patient care technologies while being mindful, sensitive, and respectful of each patient’s values, beliefs, and needs.

I have experience caring for patients who require tracheostomy care. My duties include performing tracheostomy care for patients who have tracheostomy tubes. During this process, I suction the tracheostomy tube to clear any secretions from the airway, making it easier for the patient to breathe. To ensure the patient’s safety, I follow specific guidelines, including cleaning the suction catheter to prevent infections, replacing the inner cannula to prevent blockages, cleaning the skin around the tracheostomy to avoid irritation, and moisturising the air the patient breathes. This helps to loosen any secretions, making them easier to suction.

It is recommended that patients with PEG tubes be supplied with additional nutrients. I can administer the nutrients using the following steps: First, I will use a gravity feeding set and make sure the roller clamp is closed. Then, please attach the set to the feeding container with the right amount of feed and hang the container on the pole. To begin the process, squeeze the drip chamber until it is one-third full of the feeding solution. Next, remove the protective cap from the end of the giving set and open the roller clamp. Allow the feed to run down to the back to prime the line, then close the roller clamp. After that, connect the giving set to the enteral tube connector at the end of the tube. Open the roller clamp and set the flow rate by counting the drops per minute. As a guideline, 20 drops of standard feed equal 1 ml. The following equation calculates the drip rate: (ml/hour) / 3 = drops/minute. Open and close the roller clamp until the desired drip rate is set correctly. Finally, I will check the drip rate regularly to ensure the feed runs at the required rate.

I administer medication to patients through a PEG tube when they are unable to swallow oral medicines. Before administering medication to the patient, I have to gain consent. Before administering medication through peg feed, I have to use a 60-ml syringe filled with water to flush the peg tube to ensure it is not blocked before administering glycopyronium bromide 800 mcg. The preparation is calculated by dividing 800 by 1000, which equals 0.8, and then multiplying that by 5, which results in 4 ml. This is then administered through peg feed. After administering one medication, I must flush 60 ml of water before administering the following medications. A drug chart indicates The amount of water a doctor prescribes.

I observed and assisted my supervisor in performing a bladder wash on a patient with a suprapubic catheter.

Attitudes and values

 

With the guidance of my practice supervisor, I have gained appropriate skills in preparing and administering medication to patients through a PEG feeding tube. Additionally, I can administer nebuliser medication to help clear secretions from their lungs. I perform cough-assisted procedures for patients who cannot cough effectively due to neuromuscular disorders. I clear secretions from the patient’s mouth using yankeur suction during these procedures. I also practice tracheostomy care under my supervisor.

As a part of wound care, I must demonstrate my skills in using patient care technologies while being mindful, sensitive, and respectful of each patient’s values, beliefs, and needs.

I have experience caring for patients who require tracheostomy care. My duties include performing tracheostomy care for patients who have tracheostomy tubes. During this process, I suction the tracheostomy tube to clear any secretions from the airway, making it easier for the patient to breathe. To ensure the patient’s safety, I follow specific guidelines, including cleaning the suction catheter to prevent infections, replacing the inner cannula to prevent blockages, cleaning the skin around the tracheostomy to avoid irritation, and moisturising the air the patient breathes. This helps to loosen any secretions, making them easier to suction.

It is recommended that patients with PEG tubes be supplied with additional nutrients. I can administer the nutrients using the following steps: First, I will use a gravity feeding set and make sure the roller clamp is closed. Then, please attach the set to the feeding container with the right amount of feed and hang the container on the pole. To begin the process, squeeze the drip chamber until it is one-third full of the feeding solution. Next, remove the protective cap from the end of the giving set and open the roller clamp. Allow the feed to run down to the back to prime the line, then close the roller clamp. After that, connect the giving set to the enteral tube connector at the end of the tube. Open the roller clamp and set the flow rate by counting the drops per minute. As a guideline, 20 drops of standard feed equal 1 ml. The following equation calculates the drip rate: (ml/hour) / 3 = drops/minute. Open and close the roller clamp until the desired drip rate is set correctly. Finally, I will check the drip rate regularly to ensure the feed runs at the required rate.

I administer medication to patients through a PEG tube when they are unable to swallow oral medicines. Before administering medication to the patient, I have to gain consent. Before administering medication through peg feed, I have to use a 60-ml syringe filled with water to flush the peg tube to ensure it is not blocked before administering glycopyronium bromide 800 mcg. The preparation is calculated by dividing 800 by 1000, which equals 0.8, and then multiplying that by 5, which results in 4 ml. This is then administered through peg feed. After administering one medication, I must flush 60 mL of water before administering the following medications. A drug chart indicates The amount of water a doctor prescribes.

I observed and assisted my supervisor in performing a bladder wash on a patient with a suprapubic catheter.

As a student nurse, one of the most critical values in nursing is respecting patients’ dignity. This means treating patients with kindness and thoughtfulness while providing care, being aware of their emotions when talking to them, caring for them, and educating them about their health. Valuing human dignity also means recognising each patient’s right to choose healthcare services and maintaining privacy, which are crucial nursing values.

Placement Midpoint Reflection

Posted on by
Reply

Knowledge

I have learned about two types of brain injuries: traumatic and acquired brain injuries. Traumatic brain injuries can be classified into two main categories: open-head injuries and closed-head injuries. Traumatic brain injuries can cause various medical conditions, such as hematoma, haemorrhage, concussion, and skull fractures. There are multiple types of acquired brain injuries, which include meningitis, asphyxia, hydrocephalus, and anoxia. During my time in the traumatic brain injury unit as a student nurse, I gained extensive knowledge and honed my nursing skills in caring for patients with brain injuries. I learned how to provide a wide range of care to patients with tracheotomies who required constant monitoring and management due to their brain injuries.

I also learned how to monitor and assess patients, take vital signs, and maintain hygiene while providing patient care. Brain injuries can be mild or severe, ranging from concussions to comas. The damage can also be focal.

I have learned about two types of tracheostomy tubes. Cuffed tubes have a soft balloon around the end that inflates to seal the airway. They are used when airway protection is crucial to prevent the aspiration of oral or gastric secretions. The patient cannot breathe around the tube if the cuff is inflated while the tracheotomy tube lumen is blocked. This assumes that the cuff is correctly placed and inflated within the trachea.

On the other hand, acquired brain injuries include meningitis, hypoxia, hydrocephalus, and anoxia. Understanding these types of injuries is crucial for providing adequate care to patients with brain injuries.

I learned about oral and peg feeding medication, stoma care, catheter management, and input/output monitoring.

Skills

 

Through my experience, I have developed the skills to gather patient information, prioritise their needs, and make informed decisions to positively impact their care. I have also improved my ability to assess News 2 scores, bladder scans, blood glucose levels, urine output, and suction patients.

Skills in promoting independence, understanding and managing cognitive and behavioural changes, and building rapport with individuals.

My adaptability as a student nurse in a brain injury unit is evident in my ability to demonstrate excellent teamwork skills and work using my initiative, regardless of the healthcare environment.

After taking the handover for the first time, I learned I should check all my patients to see if they are awake or sleeping. I use intentional rounding to monitor patients hourly and ensure their safety, especially if they can’t do so themselves. I also perform safety checks to manage tracheotomies, secretions, and chest health.

When working under a supervisor, I perform bumper-retained tube advances and rotate records. To do this, I must gain consent from the patient to perform a bumper check, clean the peg tube, and rotate it 5 inches to check for infection or blockage. I also perform cough assists to help mobilise and clear chest secretions if necessary. This involves inflating the lungs with positive airway pressure and shifting rapidly to negative pressure to help the patient cough.

As a nurse, I have learned that patients need a sodium chloride nebuliser before performing cough assists to help clear their secretions. Once the cough assist is complete, the secretions are usually removed from the mouth, which allows me to suction mucus from the patient’s mouth using a Yankee.

My approach to preparing and administering oral and peg-feed medications, as well as injections, is meticulous. As a student nurse, I always double-check the prescribed medication and dosage before administration, ensuring patient safety and protocol adherence.

My commitment to patient-centred care is evident in my performance of personal hygiene tasks, catheter care, food and drink monitoring, vital sign recording, oral care, bladder scanning, Waterloo assessment, and MUST assessment. Each task is carried out with the patient’s comfort and well-being in mind.

Before administering medication through peg feed, I have to use a 60-ml syringe filled with water to flush the peg tube to ensure it is not blocked before administering clonazepam 500 mcg. The preparation is calculated by dividing 500 by 1000, which equals 0.5, and then multiplying that by 5, which results in 2.5 ml. This is then administered through peg feed. After administering one medication, I must flush 600 ml of water before the following medicines. A drug chart indicates The amount of water a doctor prescribes.

I observed and practiced under the supervision of a senior healthcare professional to perform a bladder washout for a patient who had a suprapubic catheter. Before the procedure, I explained to the patient what I would do and gained their consent. The purpose of the bladder washout was to prevent the catheter from getting blocked and to flush out any mucus buildup within the bladder.

Attitudes and values

 

As a student nurse, I play a crucial role in the care of patients who are suffering from moderate to severe traumatic brain injuries during acute care. As an essential interdisciplinary team member, I have various responsibilities to assist in the patient’s treatment and recovery. These responsibilities include assessing the patient, coordinating and communicating care, providing technical and physical care, offering emotional support to the patient and their family, and advocating for the patient.

Autonomy is vital to patient care, as it allows patients to make informed decisions about their health. Nurses who value freedom should prioritise caring for their patients. Proactively advocating for patients and developing friendly relationships can also help enhance patient discretion in decision-making.

Reflection IP Speech, Language capacity, and Communication.

Posted on by
Reply

This week, I attended IP Speech, Language Capacity, and Communication, where I learned how to communicate with patients when they consent. Through group discussions, I was able to delve deeper into the subject. We discussed the benefits of communication with both the patient and the nurse. I have gained knowledge of communication disorders. Communication disorders can involve voice issues, but they are different. I learned that

Communication difficulties can significantly impact patient engagement with healthcare professionals. These issues may result from a need for more shared language, leading to misunderstandings about treatment plans or clinical situations. Poor communication can result in patients not seeking timely treatment, potentially leading to more severe health issues. It can also cause frustration and a sense of inadequacy among healthcare professionals, especially if complaints are made; improving communication has been shown to enhance the quality of patient care and lower costs.

I also learned that there are various types of communication disorders. Although they are different, most individuals with autism share common impairments in verbal and nonverbal communication, displaying difficulties in the following areas: Language comprehension, speech, social cues, facial expressions, gestures, and emotional perception. I gained knowledge in speech and Language therapy, which provides treatment, support, and care for individual who faces challenges with communication as well as difficulties related to eating, drinking, and swallowing.

I had a placement in the neuro-disability ward, where I had to administer medication to a patient. Who had a brain injury? I had to introduce myself to the patient, explain what I would do, and gain consent. Brain injuries are caused by blunt trauma, which can damage your brain tissue, neurons, and nerves. This damage affects your brain’s ability to communicate with the rest of your body.

During my shift, I assisted a patient named Emmanuel, who had a percutaneous endoscopic gastrotomy (PEG) for enteral feeding and medication administration. Before giving the afternoon medication, I obtained consent from the patient. However, the patient refused to take the medication, and I respected their decision, as patients have the right to refuse treatment. I explained to the patient that the medication, levetiracetam, was necessary for preventing focal seizures, but the patient still declined. I waited a few minutes to ensure the patient was not distressed. I discovered that the patient had been tired from interacting with a physiotherapist, which was why he refused the medication. I informed my practice assessor about the situation and waited an hour before asking for consent again. After an hour, I explained to the patient that I would administer the medication through the PEG. The patient gave consent, signalling this with a blink, so I flushed the PEG with 60 mL of water to ensure it was not blocked. Then, I administered the Levetiracetam medication and provided 250 mL of water to the patient through PEG feeding. This experience taught me the importance of understanding the patient’s condition and advocating for them if they cannot consent to treatment.