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Situation: A 55-year-old African woman named Amina has a history of sudden crushing chest pain at home.

Background: Amina has a history of hypertension, diabetes, and obesity. She reports feeling short of breath and lightheaded. She denies any recent trauma or illness.

Assessment: Given Amina's age, medical history, and presenting symptoms, the most likely diagnosis is a heart attack (myocardial infarction). Other differential diagnoses to consider include pulmonary embolism, aortic dissection, or unstable angina.

Recommendation: Write a care plan for Amina

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We are now going to spend the rest of our time with a period of debriefing.

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Lesson Goal
To gain knowledge and understanding of decision-making. Using scenario-based learning work in groups through a scenario.

Outcomes

1.  Students will discuss what constitutes decision making
2. Working through scenarios using decision-making tools
3. Explore how decisions are made

4. Participate in peer discussions and self-reflection.

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Please complete Evaluation for today's session

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felt confident, good teamwork, and happy learning.

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How was it working as a team writing the nursing care plan?

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Situation: 9-year-old Ravi has been diagnosed with asthma. His symptoms include coughing, wheezing, and shortness of breath, especially during physical activities.

Background: Ravi has been having a lot of time off school in the past 2 months due to respiratory infections. Parents are concerned that Ravi may be stressed due to preparing for transitioning from primary to secondary school.

Assessment: Ravi's asthma symptoms are impacting his daily activities and quality of life. It is essential to identify and avoid triggers, take prescribed medications regularly, and have an asthma action plan in place to manage exacerbations effectively.

Recommendation: Write a care plan

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How was it working as a team writing the nursing care plan?

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Situation: Malcom is a 25-year-old male with a history of depression and anxiety who has expressed suicidal thoughts and intentions.

Background: Malcolm has been struggling with feelings of hopelessness and worthlessness for several months. He has a history of previous suicide attempts and has recently experienced a significant stressor, such as a relationship breakup.

Assessment: Malcom is at high risk for suicide given his history of depression, anxiety, and previous suicide attempts. He may also be experiencing feelings of isolation and lack of support.

Recommendation: Write a careplan

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How was it working as a team writing the nursing care plan?

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Student nurse first day in clinical placement

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Situation: You are a third-year nursing student about to start your last placement as a student nurse.
Background: You are working a long day in a hospital ward.
Assessment: You are feeling excited and nervous about finishing your course and entering the NMC register.
Recommendation: You are working on a ward with your practice supervisor you have a small caseload of four patients with varying needs.
Decision: How would you deal with the following patients?  Be prepared to feedback to the larger group

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1. Abigail: Due to her expressions of suicidal thoughts, immediate threat to child and others around her, and depressive symptoms, it is recommended that Abigail receive priority for nursing care.

2. Jason: immediate mental health assessment - to identify the root causes of his actions and to check for any underlying mental health issues, such as anxiety, mood disorders, or early signs of psychosis. Safety netting: ue to his recent behavior with dangerous items and wandering, a safety plan is crucial to safeguard him and others from potential harm and placing him under 1:1 care

3. Frank: Post-operative pain relief should include both medicinal and non-medicinal . Encourage mobilisation: To avoid post-surgery DVT it's crucial to promote and support regular movement.

4. Mrs. Armstrong: Medical Review: to explore possible causes of her increased confusion, such as a UTI (take bloods and urine MSC). Safety Measures: to prevent further falls - bay tagging /1:1 and providing patient with mobility aid. Also, cognitive assessment for patient and to provide pain relief.

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Firstly, prioritising Jason is based on the immediate safety concerns posed by his behaviour and the need to prevent potential harm. Second, Abigail's acute mental health crisis and suicidal ideation require immediate intervention to ensure her safety and well-being. Thirdly, focus is on prioritising Frank's post-operative pain management, as it plays a crucial role in ensuring his smooth recovery. Fourth, Mrs. Armstrong's fall-related confusion and pain still need to be assessed and managed in a timely manner.

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We used ADPIE to assess all the patients and prioritised their care in the first session before break.

Post-break, we discussed prioritising the patients in relation to their care.

biopsychosocial model discussed in relation to all the patients.

All require MSE.

1st -Frank, could deteriorate quickly due to PMH, PAIN, discharge query needs to be revisited (discharge planning meeting required with MDT)

2nd- Jason (24-hour crisis team support ) (safeguarding ? parent-child relation needs to be explored.) (safeguarding bully? )

Query Frank and Jason could both be first priority.

3rd - Mrs. Armstrong

4th - Abigail has support from her husband, who is aware of her situation and MDT. daily calls by MDT to monitor mood and any medication queries.

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good/positive experience with nurses.

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It was interesting to discuss different ideas and perspectives and, most importantly, to learn from each other and share our knowledge based on different experiences. We were able to cooperate well and come to an agreement on the care plan. The activity also helped us practise our critical thinking skills.