Orthopedic nursing care

Placement Reflection

Orthopedic nursing care has been essential in the management of conditions that affect the musculoskeletal, connective and joint systems of the human body (Goldberg & Quinlan, 2014). As orthopedic nurses, we are charged with the responsibility of providing clinical, surgical and rehabilitation services to debilitating patients (Hommel & Bååth, 2015). During my placement, I learned about the progression of most orthopedic diseases which tend to have a slow progression; a process that is full of pain and compromises the daily activities of a patient as well as their quality of life. The conditions of the patients considerably influenced my delivery of care and development of specific abilities. Research has indicated that the impact of these conditions can be expressed either verbally or non-verbally and it may interfere with the student’s learning and delivery of quality patient care (Faut, 2013; Taraldsen et al., 2013).

The concept of student placement has had a huge impact on practice based professions such as orthopedic nursing. Placement enabled me to ostensibly look at actions, thoughts, and feelings in my bid to learn from experience. According to Gupta & Havelock (2014), learning from practice is the pillar of professional development and it is a crucial aspect of sustaining growth in nursing practice. Sunderland et al., (2013) and McIntyre (2013), argue that if practitioners fail to challenge their practice, chances of perceiving the practice as a ritual or habit are likely to occur. In my placement, I came across several patients. Each case was a learning milestone. A case in point is this female patient who came to the ward complaining of pain on her left knee. Her records indicated that she had a history of arthroscopy in her right hip (reporting). Upon assessment, it was determined that the patient had symptoms of groin pain, catching, and popping in her knee (Ong et al., 2013). She was in intense pain to the extent that she could not answer the questions she was being asked. During my placement, we received several patients complaining of knee pain. What really could have been the cause of this high incidence of patients suffering from pain on their knees? I considered this to be an area that called for sufficient research and an amicable solution implemented (responding). As I was examining at the patient, I wondered what could have been the cause of her intense pain. Arthritis and mechanical injury topped the list of the most likely causes. These were the most recurring diagnoses in patients presenting these kinds of symptom. Arthritis is a common disorder affecting the musculoskeletal system of the elderly patients (Chen & Hung, 2015; Brennan et al., 2014; Harrison et al., 2013). If the age of this patient is anything to go by, this could be the most likely diagnosis (reasoning). However, upon further diagnosis it was proven that the patient did not have arthritis. She later reported that she had fallen while alighting from her car and hurt her knee (reconstruction). This was a learning point. More often than not, patients undergo misdiagnosis due to misguided assumptions (Parchi et al., 2013; Instone & Palmer, 2013). For instance, the patient in the case study could have been put on anti-arthritic medications had further diagnosis not been conducted.

It is well documented that the demand of orthopedic care will increase with the aging population (Rankin et al., 2014). As a result, there will be greater challenges associated with the diagnosis and delivery of care. Currently, nurses are being trained on effective procedures to observe when carrying out diagnosis. For instance, the use of SOAP note has been of great value in conducting diagnosis. However, the future of orthopedic nursing care is aimed at developing new technologies, robotics, instruments, and bone substitutes that will be less invasive, but provide  accurate during diagnosis (Close, 2013). Computer programs are also being developed to further help in scanning patient trends and give effective prognosis.

References

Brennan, S. L., Lane, S. E., Lorimer, M., Buchbinder, R., Wluka, A. E., Page, R. S., & Ebeling, P. R. (2014). Associations between socioeconomic status and primary total knee joint replacements performed for osteoarthritis across Australia 2003–10: data from the Australian Orthopaedic Association National Joint Replacement Registry. BMC musculoskeletal disorders15(1), 356.

 Chen, P., & Hung, W. W. (2015). Geriatric orthopedic co-management of older adults with hip fracture: an emerging standard. Annals of translational medicine3(16).

Close, J. C. T. (2013). Hip fracture in Australia: missed opportunities and a chance to improve care. Internal medicine journal43(12), 1262-1264.

Faut, R. M. (2013). Orthopaedic competencies put to the real test.Orthopedic nursing32(3), 135.

Goldberg, S., & Quinlan, P. (2014). Professional Nursing Practice in the Orthopedic Care Setting. In Perioperative Care of the Orthopedic Patient (pp. 333-338). Springer New York.

Gupta, A., & Havelock, W. (2014). A new future for hip fracture care–orthogeriatrician lead in an ‘Acute’Hip Unit. Clinical Medicine14(6), 591-596.

Harrison, C., Britt, H., Miller, G., & Henderson, J. (2013). Prevalence of chronic conditions in Australia. PloS one8(7), e67494.

Hommel, A., & Bååth, C. (2015). Working with Core Competencies in Orthopedic Nursing. In The 7th international Australia New Zealand orthopaedic nurses association (anzona) conference 11-13 nov, Sidney Australien.

Instone, S. L., & Palmer, D. M. (2013). Bringing the Institute of Medicine’s report to life: Developing a doctor of nursing practice orthopedic residency.Journal of Nursing Education52(2), 116-119.

 McIntyre, L. F. (2013). Exploring new practice models delivering orthopedic care: can we significantly decrease delivery costs and improve quality?.Sports medicine and arthroscopy review21(3), 152-154.\

Morris, J., Grimmer, K., Gilmore, L., Perera, C., Waddington, G., Kyle, G., … & Murphy, K. (2014). Principles to guide sustainable implementation of extended-scope-of-practice physiotherapy workforce redesign initiatives in Australia: stakeholder perspectives, barriers, supports, and incentives.Journal of multidisciplinary healthcare7, 249.

Ong, K. L., Wu, B. J., Cheung, B. M., Barter, P. J., & Rye, K. A. (2013). Arthritis: its prevalence, risk factors, and association with cardiovascular diseases in the United States, 1999 to 2008. Annals of epidemiology23(2), 80-86.

Parchi, P. D., Vittorio, O., Andreani, L., Piolanti, N., Cirillo, G., Iemma, F., & Lisanti, M. (2013). How nanotechnology can really improve the future of orthopedic implants and scaffolds for bone and cartilage defects. Journal of Nanomedicine & Biotherapeutic Discovery2013.

Rankin, K. S., Sprowson, A. P., McNamara, I., Akiyama, T., Buchbinder, R., Costa, M. L., & Rangan, A. (2014). The orthopaedic research scene and strategies to improve it. Bone & Joint Journal96(12), 1578-1585.

Sunderland, M., Newby, J. M., & Andrews, G. (2013). Health anxiety in Australia: prevalence, comorbidity, disability and service use. The British Journal of Psychiatry202(1), 56-61.

Taraldsen, K., Sletvold, O., Thingstad, P., Saltvedt, I., Granat, M. H., Lydersen, S., & Helbostad, J. L. (2013). Physical behavior and function early after hip fracture surgery in patients receiving comprehensive geriatric care or orthopedic care—a randomized controlled trial. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, glt097.

Taylor, A. (2015). A day in the life of orthopaedic and trauma practitioners: Orthopaedic Nurse Practitioner–Hip Fracture. International journal of orthopaedic and trauma nursing19(1), 50-51.

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