Simulation (SIM) Lab Reflection Essay Example

  • Category:
  • Document type:
  • Level:
  • Page:
  • Words:

Sim laboratory critical reflection


Adam undergoes a surgery aimed at removing subdural haematoma as well as repair his fractured tibia and fibula. This comes after he was involved in a car accident. After being operated, he requires to be dressed up daily especially on his leg and head and a lot of care has to be taken considering that he has lot of pain. The patient requires a pain management plan and it is my role as a nurse to support him and avail the necessary medications to him. The purpose of this paper is to reflect critically on the positives and barriers of communication, apply SIM in a clinical practice as well as suggest several strategies aimed at improving communication.

Critical reflection

Nursing is all about experimental learning and so being part of the team attending to Adam I will gain good knowledge and experience as well as gain confidence in nursing care (Jane, 2005, p. 131). I understand that patient safety and quality of care are the most important aspects that guide the nursing profession and practice. Also, getting involved in Adam’s case gives me the opportunity to understand the ethics behind nursing documentation as well as protection of patient rights. Ethics in nursing documentation may include storage of data gathered for easy retrieval and also ensuring that patient data is always confidential (Nursing & Council, 2005, p. 2).

The main issue in Adam’s case is over-sedation. Normally, when a patient is being operated, he or she has to undergo sedation so as to help reduce agitation and irritability and this majorly done through the use of sedative drugs (Egerod et al. 2010, p. 1). However, over-sedation may come with a lot of risks to the patient. Over-sedation can lead to potential or actual harm to the patient as it may lead to respiratory depression, aspiration and falls. As indicated in the case, Adam was subjected to oxycodone (opioid analgesia) injection in an attempt to reduce pain and Adam reacted adversely to this drug. This indicated chances of over-sedation and it is my role is to ensure that I inform the doctor of the same. Over-dosage of this drug may cause shallow breathing, circulatory collapse, respiratory arrest, cold skin and even death in some cases (Ricardo, Rajive & Nalini, 2008, p. 105). As part of the team attending to Adam, I need to ensure that such risks of over-sedation do not extend further and compromise the patient’s safety (Egerod et al. 2010, p. 1).

As the team attending to Adam, we ensured that we monitored the ABC (air way, breathing, circulation) aspect of the patient. After reviewing the patient, the MET team advised us to stop administering the Oxycodone so as to avoid the described risks of over-sedation (Ricardo, Rajive & Nalini, 2008, p. 105). He was on Oxycodone medication so as to help him manage pain. He was subjected to oxycodone medication of dosage 50mg/ml which was later increased to 75mg/ml as pain had increased. However, after monitoring the ABC, the MET team advised us to administer Naloxone, a drug that reverses the effects of over-dosage of Oxycodone/opioid medication (Ricardo, Rajive & Nalini, 2008, p. 107). Oxycodone/opioid medication usually has side effects which include slow breath of the patient, low blood pressure and effects on eyes. Adam showed some of these side effects and that led us to remove the medication. His GSC score increased from 3 to 13, respiratory rate reduced from 12 breath per minute to 8 breath per minute and rate of pulse shifted from 75 to 60 (Ricardo, Rajive & Nalini, 2008, p. 110). The main side effect in Adam’s case was the reduction of the rate of breathing. In addition, the size of his eye’s pupil was two and reacted to light at a very slow rate (Ricardo, Rajive & Nalini, 2008, p. 108).

There are certain things that worked well for us when attending to Adam, with other things not working as planned. For example, we were able to notice the side effects of Oxycodone/opioid medication, which we informed the MET team and had to be dropped. This prevented further side effects of the drug. Also, good communication between members of the tem helped to solve the crisis and we were able to save Adam’s life as a team. On the other hand, some things did not work well for the team. For instance, we were not making all the appropriate documentation as this was a case of emergency and the patient needed instant intervention. We were in a way risking as our profession values documentation very much (Nursing & Council, 2005, p. 1).

Attending to Adam gave me the opportunity to apply the nursing skills and knowledge that I have amassed. Nursing practice is not only about taking care of the patient alone, but it still extends to protecting the integrity of the clinical information and data gathered and documented. According to the Nursing & Council, 2005, pp. 1-2), I have to be careful when making primary data entries or any other nursing information so as to avoid making unnecessary errors. Also, teamwork in nursing is very critical and I had to ensure that I worked seamlessly with the rest of the team attending to Adam (Cant & Cooper, 2010, p. 13).

Communication is key for quality nursing care. In a hospital setting, communication needs to be fast and efficient especially in cases that involve emergency (Jane, 2005, p. 131). For example, in the current case of Adam, we needed to work as a team not only in the nursing department, but also across the healthcare facility. We needed to inform the doctors on the progress of Adam as well as on any new medication that should be given. The mindset of working together as a team proved to be beneficial to Adam as we were able to deliver quality nursing care and save him from pain after surgery (Blum, Borglund & Parcells, 2010, p. 1).


To conclude, I can state that the process of simulation has greatly improved my critical thinking, communication, and teamwork. I worked as a team in Adam’s case and ensured that I delivered quality nursing care and save him from pain after surgery.

Reference List

Blum, CA, Borglund, S & Parcells, D 2010, ‘High-fidelity nursing simulation: Impact on student self-confidence and clinical competence,’ International Journal of Nursing Education Scholarship, Vol. 7, p. 1.

Cant, RP & Cooper, SJ 2010, ‘Simulation‐based learning in nurse education: systematic review. Journal of advanced nursing,’ Vol. 66, No. 1, pp.3-15.

Egerod, I., Jensen, MB, Herling, SF & Welling, KL 2010,’ Effect of an analgo-sedation protocol for neuro-intensive patients: a two-phase interventional non-randomized pilot study,’ Critical care, Vol. 14, No. 2, p.1.

Jane Cioffi PhD, RN, 2005, ‘A pilot study to investigate the effect of a simulation strategy on the clinical decision making of midwifery students,’ Journal of Nursing Education, Vol. 44, No. 3, p.131.

Nursing, A. & Council, M., 2005, National Competency Standards for the Registered Nurse [electronic Resource]. Australian Nursing and Midwifery Council.

Ricardo, M, Rajive M & Nalini M 2008, ‘Opioid complications and side effects,’ Pain physician, Vol. 11, pp.105-120.