Driving a Car and Patient assessment or management
The approach to direct patient management (e.g., emergency care and/or patient assessment/rounds) can be described as being similar to parking a vehicle.
When you are trying to park, you approach in the parking lot with care and awareness of others and what state of movement or parking or other vehicles are in and their status. You take care looking for your respective spot and make sure that you are free, safe and able to acquire the space and move into it appropriately to not cause damage or harm to other vehicles nearby and to be cautious of your surroundings and your own personal safety. Once you have determined what your approach will be for parking, you will position yourself appropriately to the space, and employ the correct reversing and or entry techniques and procedures that you’ve learned to guide your vehicle correctly into the space to fulfill your parking. In the process, you may have to assess and adjust your technique to make sure you are aligned appropriately to fulfill your goal of being parked. This may require a number of approaches to be completely successful. Upon completion of parking, you will perform a final assessment making sure both your vehicle and others are correctly positioned and are at limited risk of damage before leaving your vehicle.
The approach to parking and techniques or assessment employed is very similar to an RT’s approach to direct patient care and management. When entering a patient room whether in the case of an emergency intervention (i.e. being paged bedside, rapid or code blue response) or during the process of undertaking patient rounds and assessment, the RT has to evaluate the environment, observing and scanning and taking into account the patient status and condition, the monitors, the ventilator and the other professionals in the room and their activity and roles, and they must be able to ascertain and assess quickly both their approach and role as well as the environment from a safety perspective for both the patient and the team at large. This is the driver evaluating the parking environment and status of other vehicles before entry as aforementioned.
The RRT will quickly assess how they can assist the situation at hand, or in the case of rounds, the initial status of the patient (i.e., cognitive, vitals, respiratory), and determine then what interventions are required to help resolve the issue or to effectively support the patient and their progression in care (i.e. required procedures or alteration to care plans). The RT may then decide to employ basic techniques for assessment (i.e., auscultation, measure BP, RR) and may decide to apply interventions (i.e., oxygen therapy, suctioning etc.). This would need to be based on their assessments, and the interventions they choose will depend on their assessment capability and awareness of patient history and status, as well as the employer and regulatory guidelines, practices and policies. Their approach, similar to a driver’s approach for entry into a parking space, will be measured and follow appropriate technique and procedure and will be based on the patient, the environment, and their needs in that moment, but they will also need to assess post intervention to ensure patient stability and success. In doing so, they may need to employ additional interventions (similar to a person adjusting their vehicle in a parking spot) to ensure the patient is stabilized and or they have achieved the desired outcome with the patient to support or improve their on-going care. At the end of care, similar to the driver, the RT, will assess their ability to support the patient and/or resolve or improve the patient’s issues or condition, and will ensure to seek support, document or inform other allied health practitioners of the changes so that the patient remains safe and supported in their healthcare journey.
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