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KEYWORDS Extubation, National standards. Recovery
The purpose of this article is to share a recovery room practitioner's experience using reflection and to explore the issues surrounding extubation in the post anaesthetic care unit (PACU). Currendy there are no national standards of practice for practitioners' learning and safe practice of extubation techniques within the PACU. Therefore, the possibility of an adverse incident is significantly increased, potentially causing harm to the patient and damage to any hospital's reputation as well as the practitioners' profession. The authors wish to identify the concerns by citing a clinical incident that lead to reflection and sharing of the experience through this article.
Introduction
The incident happened to a Registered Nurse working in a PACU situated within an acute hospital trust. The incident revolves around a patient who was extubated in the PACU.
Firstly, reflective practice enables practitioners to assess, understand and learn through their experiences. It is a personal process that may result in a change of perspective to a situation or the creation of new learning for the individual (Johns 1995) and is viewed as an important development strategy for practitioners who learn through experience.
The use of reflective practice has emerged as a way of evaluating and developing individual practice. It has the potential to help healthcare professionals to develop, learn and promote autonomous selfdirected practice.
Reflective practice, once seen as a useful tool within formal training and assessment, is now an integral part of everyday practice, especially since the introduction of mandatory re registration. It is appreciated that reflective practice has links with improving the quality of care, professional development and personal growth while also closing the gap between theory and practice.
Reflection
The patient depicted within the reflection arrived in the PACU following a laparoscopic bilateral inguinal hernia repair. They were intubated and appeared to be breathing spontaneously. Basic monitoring was connected (oxygen saturation, electrocardiogram and blood pressure) and supported by the anaesthetist giving an overview of the anaesthetic technique before returning to theatre. Although a preliminary check of the patient suggested their observations were satisfactory, closer inspection of the reservoir bag on the Water circuit, revealed shallow and inconsistent respirations. To determine the stage of emergence, the patient's name was called and they were asked...