Mr James smith, a fifty two years old patient, a green grocer with a wife and two children who are grown up finds himself in clinical condition that calls for proper diagnosis and intervention. His clinical condition report since he was young indicate several numerous injuries he developed as a result of rugby for which he was a player. He not only suffered the injuries but when a head and suffered from arthritis in both of his knees. He is a chain smoker and takes a minimum of 25 cigarettes per day.
As a result of this, he seems to have developed a chronic obstruction of the pulmonary disease which is the inflammation of lungs and frequently suffers from breathing difficulties and heart problems. Salbutamol and Atrovent inhalants have been prescribed for him and they seem to have very little effect since he has the persistent coughs caused by accumulation of mucus in the bronchial tubes. He continuous to suffer incessantly because he also has hypertension and hypercholesterolemia which have symptoms of difficulty in breathing and continued heart failure.
He is on medication that calls for use of very strong drugs for proper heart functioning. Far from the heart problem, he is experiencing chest pains. Mr Smith is a critical care patient and he faints and diagnosis indicates heart failure due to secondary COPD. He has low spirit, and lacks mobility with painful joints. The admitting Regular Nurse indicate that his O2 sits at 88%, the doctor in the emergency department prescribes 24% of O2 via nasal prong. He is also constantly feeling a red pressure under coccx, and heels. But still experiences the shortness of breath and with decreased chest expansion.
This is a complex situation that when not handled properly can lead to death of the patient. It is case that needs to be handled by a multi-disciplinary team and proper communication has to be put in place. In accordance safety in clinical practise, clinical reasoning has to be well coordinated and the flow of response will have to be maintained. Correct communication cannot be applied independently; some reasoning has to be applied to be able to maintain the flow of a well coordinated response.
It is that process through which knowledge already acquired can be put into practice. It is the expertise that is wanted in any clinical situation for developing solutions to a wide array of problems. Nursing concepts, processes and strategies have been developed to enhance cognition, thinking and possibly the meta-cognition. As a fact, all this possess their own merits and demerits and hence constant research and training needs to be carried out to elevate the standards of practice by physicians and the nurses.
Quality of service should be uncompromised at all level and that should not be contested at any level of reasoning. Clinical reasoning, clinical judgement, problem solving, decision making and creative and critical thinking all apply to the same kind of description and such a case of Mr Smith require this level of intervention because Arthritis, hypertension, and COPD seem to share common symptoms and signs that should be well distinguished professionally. .