Reflective Account on Taking Blood Pressure
This reflective account aims to identify what learning achievements have arisen from taking part in the formative simulation. I am going to use Driscoll??™s (2000) model of reflection, which will enable me to reflect upon my experience. This will help me to gain knowledge and understanding, whilst also enhancing my personal and professional learning to develop my nursing skills (Howatson-Jones and Standing, 2010). To adhere to the Nursing and Midwifery Code of Professional Conduct (2008), pseudonyms shall be used to preserve confidentiality.
The clinical skill reflected on within this essay is taking an adult blood pressure. Blood pressure is the force that the blood produces against the walls of the blood vessels and is measured in millimetres of mercury (mmHg) by using digital sphygmomanometer or a sphygmomanometer and stethoscope (Hegner, Acello and Caldwin, 2009). Blood pressure consists of finding the systolic and diastolic reading. The systolic reading is the pressure that blood exerts on arteries and vessels while the heart is beating. The diastolic reading is the measurement of pressure that is exerted on the walls of the different arteries around the body in between heart beats whilst the heart is relaxed. It is important that blood pressure is kept within normal limits, as if it becomes too high blood vessels can become damaged and if it is too low, blood supply through tissue beds may be inadequate, causing restricted blood flow to the vital organs, causing dangerous implications (Waugh and Grant, 2006). This is why all student nurses need to be competent in measuring and recording blood pressure.
From my experience as a care assistant, I have been used to using a digital sphygmomanometer when taking blood pressure, and have also noticed this is the same in many clinical settings. However, I believe that learning how to take blood pressure with a manual sphygmomanometer and stethoscope helps nursing students understand the complete process of this vital skill. The skill of taking blood pressure is a necessity of basic nursing, as it is one method of checking the vital signs of a patient and can present early warning signs of deterioration.
Jane and I introduced ourselves to the patient called Jo, I gave him the option to have the curtains in his cubical open or closed as it states in the NMC (2008) to promote patient respect and dignity. Jo wanted the curtains closed, so Jane shut them for me, this showed good team work, which is essential within a nursing environment. I gained verbal consent from Jo, as the NMC (2008) states that consent must be gained before any treatment or care is implemented. I insisted that he let me put a pillow under his arm for comfort, once I ensured that he was comfortable I explained what I was doing step by step, as it is important to explain to the patient what you are doing and why, to involve them in their care (Mallik, Hall, and Howard, 2009). I warned Jo that it may be uncomfortable for a few minutes before I started to inflate the cuff of the sphygmomanometer, I proceeded to take Jo??™s blood pressure, after recording the results I told Jo that his blood pressure was healthy for his age group, the results that I recorded were 129/72mmHg. A healthy blood pressure for an adult is 120/80mmHg (Richards and Edwards, 2012), but as you get older it rises (Waugh and Grant, 2006), as presented in Jo??™s results. Jo thanked me for taking his blood pressure and Jane began to proceed with taking the other vital signs.
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Having experienced a realistic scenario, I feel more confident in the skill of taking and recording blood pressure, reassured by good feedback, receiving full marks on my feedback form. Although my feedback was all complimentary, I noticed my own errors such as forgetting to use anti bacteria wipes to clean the ear pieces of my stethoscope at the end of the procedure. I also forgot to put the time of recording on the national early warning chart. These were the two main aspects that I feel I need to improve on. Firstly, I will concentrate more on infection control by ensuring hand hygiene is carried out before and after contact with the patient, I will also make sure that the stethoscope I use is always cleaned before and after usage, to reduce the likelihood of spreading infection (Timby, 2009). Secondly, I will practise recording data on the national early warning chart in practical skills sessions, as it is important that data recorded is accurate and clear, as stated by the NMC (2008).
Overall I feel like I have achieved a better understanding of my ability to do a basic nursing skill and what improvements I can implement in future practise. I have purchased a sphygmomanometer and stethoscope so I can carry on practising this skill to feel fully competent in what I am doing, to promote my confidence as a student nurse.
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