Narratives have become a wonderful and exciting way of learning the practice of caring for patients, especially for a Clinical Nurse Specialist (CNS). This is because the idea of looking at the nursing practice through the use of narratives does not only provide the relational and contextual knowledge required for the clinical practice, but also uncovers hidden feelings and meanings in various nursing circumstances. When a Clinical Nurse Specialist is able to see vital issues in patients before they get out of hand, then that is a distinct demonstration of expert care. Being capable of sensing such problems before they worsen is truly a sign of profound expert care. Therefore, expert care is an essential component and aspect in the field of nursing, which each and every employee in a health care setting must strive to achieve, up to the level of an expert.
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According to Benner (Benner et al., 2009), expert care is portrayed when there is an increased intuitive capability of ascertaining critical issues and responses in a health care setting. It is through the narratives that the nursing practice can progress from the stage of being a novice to the final stage of becoming a clinical expert. Through studying the characteristics of expert practice, which prevail in Benner’s research, a Clinical Nurse Specialist is able to identify such examples in their daily nursing practice. Apart from that, Benner’s research also helps a CNS to be capable of differentiating between the Aristotelian practical reasoning and the national reasoning and, therefore, to be able to gauge and handle various situations at one’s workplace.
Working as a Clinical Nurse Specialist (CNS) provided me with an opportunity to see and work with patients of different ages and with diverse ailments. Having experienced clinical practice only for two weeks and a half, I had to handle a 48 year old patient through determining a diagnosis and coming up with a plan for the patient’s treatment. The patient attends clinic twice a month to get the medication needed for curing her pains. In fact, she came to the medial facility to seek medication for the chest pains she had been feeling since morning. Assessing the patient while being observed by my instructor enabled me to know the patient’s problem and ascertain that the patient’s pressure seemed to be higher as compared to that of the last visit. The patient’s heart rate also stood at 110 and, after carrying out the physical assessment, I recommended the patient for EKG straight away. All in all, I avoided being judgmental given the fact that the patient was using a different type of medication. Thus, I opted to treat her just like a drug seeker. I further made recommendations for the patient to go for ER and to be seen by the physician. I was very confident and objective in my interaction with the patient and I was determined to provide the best health and nursing care with a view of helping the patient’s life come back to normal (Locsin et al., 2009).
Having a vast experience working in the cardiac department, I quickly noticed that the patient’s EKG test results were abnormal. Therefore, I recommended the patient to undergo a bypass surgery. After the bypass surgery was performed, the patient felt much better. Thus, due to my experience and knowledge, I was able to save the patient’s life. The expert care I provided in that patient’s case enabled me to become confident in the clinical knowledge I had acquired (Jansen et al., 2009).
Being capable of seeing the unexpected, like, for instance, noticing the abnormal EKG in the patient who was complaining of pains, provided me with a mature practical knowledge regarding what was to be expected in a particular population of patients. Such an action resembled that of the nurses’ who were practicing at an expert level which, according to Benner (2009), was ‘the big picture that includes the sense of the future while recognizing the anticipated trajectories through grasping a sense of future possibilities’.
The provision of expert care by professional nurses does not only involve an attunement towards an environment, which gives room for responses to be modeled at the present time while analyzing the actual picture. It also anticipates the next relevant sequence of actions that should be taken. As a result, expert nurses do not have a specific tunnel vision, but instead they are known to implement various protocols simultaneously, which are aimed at improving the patient’s situation or condition (Benner et al., 2009). Such actions have enable patients to receive best health and nursing care from health institutions. The idea of giving an increased level of emotional involvement and comfort towards patients, their friends and relatives is what can be best referred to as expert nursing. Apart from that, professional nurses are known to rely on their former experience and situations when responding to new medical cases or illnesses.
A Summary of the Expertise Knowledge that was Provided
My major aim of joining the nursing unit was actually to become a Clinical Nurse Specialist capable of effectively solving people’s health problems to their satisfaction. I also intended to carry out patient education and complete the chart interviews. I was able to come into contact with a patient who had a past history of HTN and numerous pains. After doing an assessment of the patient, I was able to notice an increase in the patient’s blood pressure and an abnormal EKG. Therefore, I recommended that the patient to go for ER and to be examined by a physician. A set of cardiac enzyme was drawn from the clinic and set up. Having worked in the cardiac department for some time, I was able to provide the much needed experience in the area which greatly helped to save the patient’s life when a bypass surgery was performed (Alligood et al., 2006).
Expert care involves a collaboration of anticipatory healthcare, holism, theoretical and practical experience, intuition, experience and the application of principles aimed at achieving success in a patient’s condition. Despite the fact that I was still a novice in the nursing practice and had not reached the status of being a true expert, I believed that I was capable of performing some important expert medical care aspects, which made me become more proficient and confident. For instance, my ability to notice the abnormal EKG and being capable of associating the relationship between the aches felt by the patient and its implication on the condition was a great step in my application of expert care.
Upon assessing the patient, I was able to note some of the physical indicators that I positively used in evaluating the overall patient’s condition. General assessment of the patient was conducted in order to come up with an effective plan which ensured that life was saved. The capability of using the patient’s past medical history greatly assisted me in handling the patient’s current situation. Thus, I was able to view the observed patient as a normal human being who was inclined towards both cognitive and mental alterations. Due to the moral responsibilities and obligations, which go hand in hand with the responsibilities and demands bestowed upon an expert practitioner, I had a great feeling that indeed, expert care had been heavily provided to the patient by me. Thus, expert practitioners are compelled by moral urgency to abide by notions which advocate for the best nursing care of all patients (Benner et al., 2011).