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However in actual fact, the DEED tend to see more cases of Chest Pain (CAP), Abdominal Pain (AP) and other medical ailments that patient may present with. However, we could be dealing with a patient who presents with a simple dislocation of the shoulder in one moment and in an instance, preparing to receive a patient who is having a cardiac arrest. That is the beauty of working in the DEED, situation and the types of cases we attend to, changes all the time. Burgess (n. D. Mentions that in order for a nurse to be able to function in the DEED, the nurse are required to have shrewd assessment skills, flexibility to adapt to ever evolving situations and the ability to keep cool and calm in a highly stressed environment. The different areas in the DEED. The DEED consist of many different area assigned to treat different level acuity of patients. The areas that are present in my DEED are: Resuscitation Room or “Ruses” (Pl) – this is the area where the most critically injured and seriously ill patients will be cared for in individual panels.
The staff to patient ration usually will be about two patients to one nurse. The DEED is equipped to treat and established emergency pediatric patients. Critical Care Area (UP) – this is the area where the majority of patients who have moderate medical illness or less serious injury but who need to be cared for on rollers or monitored closely. Ambulatory Area (UP) – This is the area where minor injuries, wounds, musculoskeletal injuries or fractures are likely to be cared for as well as some minor illness.
Observation Ward – This is the area where the patients are usually located to once they have been assessed by a physician and waiting for laboratory test result or waiting for bed placement up in the ward. This area also has the capabilities to Teaching in Nursing Practice By antifundamentalist known as protocol. Examples include; stable head injuries, minor overdoses, elderly tenets requiring a period of physiotherapy and continued supportive services once home. A senior doctor in the DEED will usually do a daily ward round in the observation ward.
Background of Nurses Functioning in the Resuscitation Area (Pl) Prior to being assigned to function in the Resuscitation Area (RA), the nurse must have tallest work in the DEED for a minimum of one year. The nurses must also have completed Basic Electrocardiography (EGG) course and must be have completed the Triage Course. Once the management has deemed that the nurses are competent to perform as a triage officer, they will be selected to attend another set of course to repaper them to function in the RA.
The course is titled as Medical-Trauma Resuscitation Course (METRIC). In this course, the nurses undergo theory and practical training in all aspect of managing patient that may present to the RA. The course covers topics like assisting in a Cardiac Arrest Resuscitation, assisting in Rapid Sequence Intubations, management of patients with Acute Myocardial Infarction, Acute Chemical Stroke, Acute Hemorrhagic Stroke and other medical emergencies that may present to the RA. After successful completion of the course, the nurses will then be assigned to function in the RA.
Once assigned to the area, the nurses are expected to be able to assist in any medical emergencies situations and assists in any life saving procedure. Due to the nature of working in the department, the nurses tend to be expose to many different types of situations that requires them to apply what they have learn during the METRIC. This coincide with Kola’s theory of Experiential Learning which states that learning is a process where knowledge is created through the transformation of information (McLeod, 2010).
With constant exposure to different situations, the nurses working in the DEED tend to be efficient in assisting in medical emergencies when the situation calls for it. Kola’s Theory of Experiential Learning Kola’s theory of experiential learning typically consists of four stages of learning. (Kola, 1974) Do also knows as (a. K. A) Concrete Experience – At this stage, the learner is experiencing a new situation or a reinterpretation of a previously known situation. For example: Assisting in a Rapid Sequence Intubations (RSI) for the first time after the METRIC. Upon the experience of doing. The learner will try to review and evaluate any inconsistencies between experience and understanding. For example: Post intubations, the nurse will reflect upon what he or she could have done better in her ole of assisting the RSI. The nurse will also try to assimilate with what they have Just learned during the METRIC and real life situations. Think a. K. A Abstract Conceptualization – Reflection of the experience and expanding current understanding of the situation will bring about new understanding, ideas or modification of an existing knowledge.
For example: The nurse will read the notes that was give during the METRIC with regards to assisting RSI. This allows the nurse to better understand the theory aspect on why certain things are done. Plan a. K. A Active Experimentation – This stage, the learner will apply what they have understood thus far on the real world and see what is the outcome. For example: The nurse will then apply what they have know and experience from previous RSI and keep on practicing to improve their skills. (McLeod, 2010) & (Clark, 2000) Kola (1974), states that the learning is a dynamic and integrated process in which each stage will lead to the other.
Thus the learner may enter the process of learning at any stage and follow through till the cycle complete and learning has taken place (Kola, 1974). Thus in accordance to Kola’s theory, the more frequent the new nurses experience different situations and opportunities to experiment with their knowledge gain from METRIC, the process of learning will have taken place thus improving the skills and competency of the nurse to function in ruses. However, there is certain procedure that rarely occurs while working in ruses.
For example would be assisting in insertion of the Intra-Arterial (IA) Line. By looking at Kola’s theory, since there is insufficient opportunities for the nurse to experiment or practice in assisting in an IA Line, the knowledge gain from the METRIC may fade away. Scripture says, “When a truth is learned, it must be practiced. Indeed, knowledge that is not put into practice is not truly learned; it soon fades away like a mirage”. Educational Resource Working in the DEED, demand the nurses to be competent in handling an assisting in any procedure that is required of them.
However, nurses are humans too and if a certain set of knowledge that has not been put into practices for an extended period of time, that knowledge may have already faded. So to assist the nurse in to constantly refresh their memory, the department has provided an education tool in a form of a slides handout that is kept in a file in the resuscitation area. The handout notations information in form of pictures and words. It covers IA Line insertion, Central Venous Catheter Insertion and Priming of transducer set.
Like any other profession, nursing comprises of nurses that comes from different background, knowledge, level of competency, level of qualification, expertise and of course different level of work experience (Buchanan & Deal POS, 2002). The nursing workforce profile in Singapore also consists of many foreign nurses to meet the demand of the shortage of nurses on top of the graying nation. This results in an expansion to the diversity of culture in Singapore, which is already diverse (Rare, Gerard, Parker, & Nelson, 2007, p. 57). So by choosing this tool, we can inquire the tool effectiveness for adult learning in the clinical area.
Nab by doing so, indirectly we will identify the weakness of the tool and explore ways to improve it. Critiquing the Tool Having the education handout readily available for nurse’s use at the clinical area makes it very useful. This allows for the nurses to refer to the handout to refresh their memory in assisting the procedure. Nurses will be more motivated to seek knowledge to refresh their memory, as the handout is easily accessible. The tool itself is design in such a way that it contains pictures and words so that people can easily identify the requisite needed for the procedure.
However, is the handout adequate for adult learning and does it adequate for all different styles of learning? The name Malcolm Knowles has becomes synonym with the term androgyny in adult learning theory. Androgyny is a theory that is largely based on a certain set of assumptions of how adult learns (QUOTA. The Clinical Educator’s Resource Kit, 2007). Knowles (1984), states that one characteristic of adult learning is that adult are more titivated to learn if the subject they are learning has immediate relevancy and impact to their Job or life.
Basing on the assumption set by Knowles, this means that nurses will be more inclined to expand their knowledge on assisting in insertion of IA Line, as it will benefit them directly in being able to function competently in ruses. Since motivation of the nurse Using Neil Flemings PARK model, we can critique to identify if the handout is adequate in addressing all the different learning styles of individuals. Fleming and Blame (2006) mentions that every individual learn fervently and it is imperative to identify their learning styles to better facilitate learning. Flemings PARK models consist of four different components.
Visual Learner – This type of learners, learn best by seeing. Graphic display such as notes, handouts, illustrations, demonstration and video are the preferred from of tool to facilitate learning Aural – a. K. A auditory learners learn best by hearing information. These learners excel in extricating information from lectures and tutorials and tend to be able to remember what they have been told. Read/Write – these learners would prefer to take information displayed as words. Learning from materials that are predominantly text-based is strongly preferred. Information and knowledge better by hands-on experience. Cherry, 2014) Based on the PARK model, the handout that was chosen primarily appeals and may benefit more to learners from the Visual and Read learners. Aural and Kinesthesia learner may still benefit from reading the handout, however may find it a challenge to retain the information. Thus the handout is not a comprehensively address all the different learning styles. Feedback to the developer The tool itself is current sufficient to allow nurses to refresh their memory on how to assist in the procedure. However, the tool only focuses on the visual and read learner.
To address this, I suggest in developing an E-Learning system in which nurses can have access to wherever they are in the department. This will decrease the likelihood of the handout of going missing. E-Learning also allows more than one nurse to access it simultaneously. The E-Learning program should consist of video that has narration and demonstration on how to assist in the procedure. This would appeal to the auditory learners while also benefiting the visual learners. For anesthetics learner however, my suggestion would be for the developer to initiate refresher course.
This would allow the kinesthesia learner to have multiple opportunities to hands-on thus allowing the Kola’s learning cycle to take place and cementing the knowledge gain during the METRIC. Conclusion In conclusion, the handout provided by the department is appropriate for adult learning. However, it does not address all the different types of learning styles. Thus improvement mentioned above should be seriously considered. This will ultimately increase nurse’s knowledge and competency, which will ultimately increase quality of patient care.