Reflection on Action
Reem Matar A00054191
EHS301: Medical conditions
Description:
The incident I will be reflecting on occurred during one of the medical conditions lab sessions.
We discussed a variety of abdominal conditions and explored different assessment tools to
evaluate the seriousness of the patient’s condition. During this session, our instructor assessed
the student’s knowledge of abdominal emergencies and patient assessment. The main areas of
reflection are how I learned my weaknesses in patient assessment and learned from them as well
as growing my knowledge as a student paramedic.
Feelings:
In that session, I felt overwhelmed with the difficulty of the assessments, as it holds many
variables to it. While the abdominal conditions are vague in their presentation, it can be
challenging to find out the cause of the patient's complaint. I was left confused and unsure about
the decisions that I would have to make if I had to conduct an actual assessment. I also feared
the thought of making a faulty diagnosis if I'm not careful enough because I imagined that
abdominal conditions are hard to distinguish from one another. After the class, I knew the lack
of confidence was due to doubting myself and my capabilities.
Evaluation:
In hindsight, this experience had both good and faulty elements to it which opened my eyes to
things I was oblivious about. I think I did well on conducting my primary assessment, I adhered
to a systemic approach that helped me remain focused and organized. As I got into my secondary
assessment, I went with the SAMPLE mnemonic to gain a current history of the presenting
complaint yet skipped to elaborate on the patient’s pain with the OPQRST mnemonic.
Additionally, I overlooked the patient's need for their pain to get treated. I happened to learn
that it is a vital part of the patient's management, particularly with abdominal pain. I received
good and encouraging feedback from my instructor and made notes of my mistakes to learn from
them and avoid on future assessments. This experience has been challenging for me but
educational on the other hand, which I always appreciate when it comes to learning. Overcoming
the challenges is the best part of it.
Analysis:
Upon reflection on my performance, one poor aspect of my assessment was the pain assessment.
According to Caporale et al. (2016), abdominal pain is the most common presenting symptom of
abdominal injury or disease implied by statistical evidence. As abdominal pain is prevalent with
most abdominal conditions, pain evaluation is significant. When I got into the secondary
assessment, I did not expand on the patient's history of pain because I was too focused on getting
the correct condition instead of limiting myself to recognizing life-threatening conditions which
left me distracted. When conducting a pain assessment, the OPQRST mnemonic helps the
healthcare practitioner explore the patient's pain and seek to understand the underlying medical
condition. Obtaining complete history is critical to producing an accurate working diagnosis
(Macaluso & McNamara, 2012). I completely missed the opportunity to gain more information
with OPQRST pain assessment and explore past medical history, which would have helped
narrow down my list of differential diagnoses. Past medical history is a very important aspect of
history taking as it can disclose a lot of information about the patient's current medical status
(Jenkins, 2013). Another notable mistake I made was disregarding pain treatment and evaluating
the pain according to my pain threshold and not my patient's. Pain is different for everyone. As
pain is subjective, it is important not to neglect to assess and treat it. There is a variety of
analgesics used to manage pain depending on severity. "In managing an acute abdomen, Entonox
and morphine are most appropriate due to their rapid onset" ("Managing Abdominal Pain: A
Guide for Paramedics", 2011). A good viewpoint on my performance is my systemic and
organized approach with the patient in the primary assessment. Overall, this was a positive
learning experience with lots of educational opportunities. Even though I made mistakes, I was
optimistic about learning from them and enjoyed the practical session.
Conclusion:
I think that my increased level of anxiety caused me to struggle to think clearly and failed to make
concise decisions. From this experience, I am more mindful of the significance of conducting pain
assessment as it discloses a lot of information about the patient's presenting complaint. The
purpose of obtaining patient history is to gain more information and understanding about the
patient and the events surrounding their complaint (Nancy Caroline’s Emergency Care in the
Streets, 2018, p. 519). The insight I have earned from this experience means that I should not
undervalue history taking, especially with abdominal conditions. I would always explore the
patient's pain as it is subjective and can differ from one person to another.
Action Plan:
In future lab sessions, I will aim to be more attentive with conducting my secondary assessment
and will routinely take a detailed history to further understand the patient's nature of the illness.
Moreover, I will regularly question the patient about pain and expand on it with the OPQRST
mnemonic. I will not assume that my patient is not in severe pain or does not require treatment
and always address the patient's need for analgesia when appropriate and indicated. Also, I will
have more faith in my knowledge and capabilities and implement critical thinking into my
practice to make the safest decisions and improve the patient’s outcome.
References:
Caporale, N., Morselli-Labate, A. M., Nardi, E., Cogliandro, R., Cavazza, M., & Stanghellini, V.
(2016). Acute abdominal pain in the emergency department of a university hospital in
italy. United
European
Gastroenterology
Journal, 4(2),
297-
304. https://doi.org/10.1177/2050640615606012
Caroline, N. L., American Academy of Orthopaedic Surgeons, & College of Paramedics.
(2018). Nancy caroline's emergency care in the streets (Eight ed.). Jones & Bartlett Learning.
Continuing professional development: Managing abdominal pain: A guide for paramedics.
(2011). Journal of Paramedic Practice : The Clinical Monthly for Emergency Care
Professionals, 3(6), 1-8. https://doi.org/10.12968/jpar.2011.3.6.CPD1
Jenkins, S. (2013). History taking, assessment and documentation for paramedics.Journal of
Paramedic Practice : The Clinical Monthly for Emergency Care Professionals, 5(6), 310316. https://doi.org/10.12968/jpar.2013.5.6.310
Macaluso, C. R., & McNamara, R. M. (2012). Evaluation and management of acute abdominal
pain in the emergency department. International journal of general medicine, 5, 789–797.
https://doi.org/10.2147/IJGM.S25936