You must use this form to record five written reflective accounts on your CPD and/or practice-related feedback and/or an event or experience in your practice and how this relates to the Code. Please fill in a page for each of your reflective accounts, making sure you do not include any information that might identify a specific patient, service user, colleague or other individuals. Please refer to our guidance on preserving anonymity in the section on non-identifiable information in How to revalidate with the NMC.
Reflective account:
What was the nature of the CPD activity and/or practice-related feedback and/or event or experience in your practice?
During my time at the neonatal I have had to familiarise myself with all common medications given on the neonatal ward such as- Abidec, calcium tablets, cefotaxime, colecalciferol, benzylpenicillin and nystatin.
During my shift I was allocated one person to look after in the neonatal unit under supervision of my Practice Assessor.
During medicines management I was asked to calculate all the drugs on all four patients drug charts in the bay. Making sure to check my BNF to ensure the right dosage was being prescribed. One of the medications being given was Vancomycin which is a second line antibiotic. Common indications for administering Vancomycin are clostridioides difficile infection, cellulitis and Erysipelas, Complicated skin and soft tissue infections.
So, my practice assessor tested me on all Rights such as right patient, right medication, right time, right dose, and right route also the right to refuse. Showing my Practice assessor being able to draw up medications correctly and very small amounts on a syringe! My second medication was nystatin and is given to protect the stomach and intestines when having antibiotics, also prevents getting oral thrush. Side effects to look out for when using nystatin are Abdominal distress; angioedema; diarrhoea; face oedema; nausea; sensitisation; skin reactions; Stevens-Johnson syndrome; vomiting.
Also looking at calcium carbonate which is given by dissolving with water for Phosphate binding in renal failure and hyper-phosphataemia and calcium deficiency. Uncommon side effects of this medication are : Constipation; diarrhoea; hypercalcaemia; nausea
With my practice assessor we also looked at calculating TPN which is Total Parental Nutrition many pre-term neonates start off with tpn due to not being able to tolerate full enteral feeds. We were able to calculate and check dosages for patients by using medicine charts and on neonatal ward two nurses have to check and sign every patient’s medications. With intra-venous medications these are recorded every hour of rate of infusion, iv site and the volume that is being infused.
What did you learn from the CPD activity and/or feedback and/or event or experience in your practice?
I have learnt how to interpret information on drug charts and be able to check that the dosage being administered is correct to enable safe administration. I have understood the importance of knowing the side effects and contra-indications of medications when administering. Understanding why the patient is receiving certain medications to promote overall patients’ wellbeing. Being able to safe administer by checking right patient, medication,dose,time,expiry date, right route, right to refuse this will reduce medication-related harm such as wrong medications, time or route.
How did you change or improve your practice as a result?
Pharmacology enables me to familiarise myself of newly learnt drugs understand what they are doing to their body.
I have continued to practice weight-based medications as this is essential to children’s nursing and will have to continue learning as I still struggle with calculating complex iv.
I will improve my practice as understanding why we are giving medications to a patient by keep going over what we have learnt previously.
How is this relevant to the Code?
Select one or more themes: Prioritise people – Practise effectively – Preserve safety – Promote professionalism and trust
Preserve safety is essential when safe administering medications to ensure the patients safety. Knowing how to report an error. Building on my knowledge to give me more experience and competency.
Category Archives: Reflections: Year 2
SLOT Analysis Reflection LIP day
Strengths
During this placement I have had to do lots of research in order for me to understand why neonates come into the ward and why they are having medicines, treatment or procedures.
I can do observations, calculate and measure medications (checking with bnf ) and feeds. Knowing how to escalate if needed. Not being afraid to alert the doctor if needed. Handing over to nurse in charge and staff members. Working with the discharge nurse. Talking to parents and explaining things to them.
Multitasking
Looking after a patient on my own and documenting only checking with nurse for medications, feed and ph.
Learning needs
Learning how to effectively offer my assistance to someone.
Before placement completing more research about what I’m going to be witnessing- more preparation.
Being confident in what we have practiced at university.
Refresh my memory of biology more often.
Opportunities
Witnessed one baby turn blue (emergency call), one c-section where mu was awake and one emergency c-section where mum was sedated. I have watched a registrar intubate a neonate. Be involved in the admissions and discharge process. Being involved with ward rounds with doctors, dietician, pharmacist, occupational therapist, speech and language therapist and the neonatal psychologists.
Threats
Balancing time between working long hours and going home to the children.
Falling sick for two days of placement.