A 42-year-old patient, Mr. Y, came into the ER complaining of respiratory failure. Given the severity of the condition, Mr. Y was immediately put on life support as further tests were conducted to ascertain the etiology of her condition. While there had been several conditions of patients with acute respiratory distress referred to the facility, this situation was unique in that it was difficult to give a preliminary diagnosis of what the cause was. Each of the three available physicians and two advanced nurse practitioners had conflicting diagnoses. The lab results indicated alarming low levels of blood parameters, particularly WBC. This prompted the physician in charge to order bone marrow aspiration to further investigate the hematopoietic activity. Well, there was another crisis; none of the practitioners available was apt to perform a BMA on a three-month-old baby. I had to offer to intervene and perform the aspiration.
During this experience, my thoughts were on how all the experienced practitioners present could miss such a critical diagnosis, not to mention the lack of expertise to perform a diagnostic procedure. I felt remorseful for the patient because he was in critical condition that required timely intervention.
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The situation, however, presented an opportunity for the need for more practice on BMA. It also created a focus on neonatal hematopoietic conditions, leukemia in particular. My actions were appropriate because an immediate response was needed, given the critical condition of the patient.
My actions were guided by the experience gained in clinical practice and theoretical knowledge, empathy, and composure, assertiveness, and critical thinking. From the experience, I learned that it is imperative to have frequent exposure to critical care and complex diagnostic techniques.
From the experience, I learned that even the best practitioners have their bad days, and it is thus important to be always prepared for such occurrences. Critical thinking and assertiveness are integral elements of caregiving. My assumption that all procedures can be performed by all medical practitioners has changed.
If presented with the same experience again, I will act similarly. It is my responsibility as an NP to ensure that the patients receive the best care promptly. The experience has influenced my practice in ensuring that I stay current with required clinical procedures guided by evidence-based practice.
