Reflection on the development of your clinical practice – consultation

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The continuous involvement in the outpatient department in the medical facility has positively influenced my career knowledge and development as a nurse. First, through my active role, I have been able to transit through the various non-medical prescribing levels and develop as a professional. Secondly, having dealt with quite a large number and cases of superficial vein thrombosis, I have adequately gained the mastery of medicating the epidemic, a factor that has thus promoted me to be a consultant. The latter is a fundamental component in the nursing field especially because of the increment in the number of superficial vein thrombosis and the advancement of medical technology as well as the development of patient care (Perry, 2011).

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Normally, through exposure and experience, my clinical practice consultation has been impressive and positive. With this kind of a program, I have comprehensively understood the various types of superficial thrombosis and the numerous methods of monitoring anticoagulation therapy. In addition, I have increasingly known the protocols and the guideline for providing quality patient care at the outpatient department by effectively assessing the patient, considering the viable treatment options, reaching a shared decision, and ultimately monitoring and review the patient (Ford, Stephenson & Stephenson, 2003).

Assess the patient

Normally, due to the diverse needs and patient setting assessment has been a crucial component in the consultation sessions. Assessment aids in assuming the appropriate social, medical, and even the medication history of the respective patients (Décousus, Bertoletti, & Frappé, 2015). By so doing, I am in a position to identify the effective channels of diagnosing and medicating the patient. Besides, assessment has significantly helped me to thoroughly access and interpret all the available health records to keep track of the patient health condition up to date. For instance, the assessment course has significantly helped me in conducting the VTE services in the nurse led clinic, outpatient department, by keenly assessing the patients and initializing treatment or escalating their condition to the medics if required (Perry, 2011). Therefore, assessment has typically been an essential tool through my consultation journey since it has adequately aided in understanding the patient’s condition under treatment and their response to the recommended mode of treatment.

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Consider the options

On the other hand, after assessing the patient, consultation requires that I consider the appropriate options for treating the patient. Some of the most adopted options in the outpatient department include non-pharmacological and pharmacological approaches, which in this case are used to either modify the epidemic or promote the patient health status (Uptodate, 2017). Low molecular heparin, for instance, is a pharmacological mode of treatment that I adopted when dealing with patients suffering from VTE or AF (atrial fibrillation). On the same note, biatrial or multisite right atrial pacing is a non-pharmacological mode of treatment that I effect on patients who are or have a possibility of being affected by a drug therapy (Anfinsen, 2002). Choice of the medication mode effective for a VTE or AF patient has significantly help me to understand the various treatment methods and the manner in which they can be altered (Cosmi, 2015). Therefore, this particular stage has enabled me to grow not only as a non-medical prescriber but as a clinical consultant in the outpatient department.

Reach a shared decision

Normally, after choosing the appropriate treatment method for patients with VTE and AF, it is crucial that the patient and I comes up with a shared decision. The latter aids in establishing and checking the patient commitment towards medication and follow up (McLellan et al., n.d). In addition, it enables the patient to identify my strength regarding their condition, VTE or AF, and the applicable patient management strategy. Involving the patient in the decision-making process has also enabled the patient and me to clearly understand and access information regarding the prescribed medicine. Most importantly, sharing the decision with the patient has helped me in identifying alternate treatment methods in case the effected one fails within the set period.

Monitor and review

Ultimately, my clinical nurse led consultation concerning patients suffering from VTE and AF in the outpatient department has profoundly influenced my monitoring and review skills (Maddox, 2017). Through the latter, for instance, I have been enabled to establish and maintain the patient’s treatment plan. In addition, it helps me in detecting and reporting the suspected adverse drug reaction by adopting the appropriate reporting channels. By monitoring and reviewing the patient’s health condition regarding VTE or AF has positively influenced my clinical nurse led consultation by adapting the management plan in response to the ongoing patient’s condition and preference (Maddox, 2017). Generally, my clinical nurse led consultation in the outpatient medical facility has been a progressive success especially when dealing the VTE and AF patients. Through the competent consultation services, I have empowered and influenced the lives of superficial and deep vein thrombosis patients positively hence a healthy demographic.

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  1. Anfinsen, O. (2002). Non-pharmacological Treatment of Atrial Fibrillation. [online] PubMed Central (PMC). Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1569901/ [Accessed 25 Aug. 2017].
  2. Cosmi, B. (2015). Management of superficial vein thrombosis. Journal of Thrombosis and Haemostasis, 13(7), pp.1175-1183.
  3. Décousus, H., Bertoletti, L., and Frappé, P. (2015). Spontaneous acute superficial vein thrombosis of the legs: do we really need to treat? Journal of Thrombosis and Haemostasis, 13, pp.S230-S237.
  4. Ford, S., Ford, S., Stephenson, J. and Stephenson, J. (2003). A nurse-led outpatient service for patients with DVT.. [online] Nursing Times. Available at: https://www.nursingtimes.net/roles/practice-nurses/a-nurse-led-outpatient-service-for-patients-with-dvt/205778.article [Accessed 25 Aug. 2017].
  5. MacLellan, L., Collins, R., Gibbs, H., MacLellan, D. and Fletcher, J. (n.d.). Venous Thromboembolism Prophylaxis: The role of the nurse in changing practice and saving lives. [ebook] Available at: http://www.ajan.com.au/Vol27/27-3_Collins.pdf [Accessed 25 Aug. 2017].
  6. Maddox, R. and Seupaul, R. (2017). What Is the Most Effective Treatment of Superficial Thrombophlebitis?
  7. Perry, G. (2011) Conducting a nurse consultation British Journal of Cardiac Nursing, 6(9)pp 433.
  8. Uptodate (2017). Venous thromboembolism: Anticoagulation after initial management. [online] Uptodate.com. Available at: http://www.uptodate.com/contents/venous-thromboembolism-anticoagulation-after-initial-management [Accessed 25 Aug. 2017].
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