A 61 year old male Caucasian with acute abdominal pain, presents to the ED observation unit with diaphoretic and panting respirations when experiencing abdominal cramp, BP: 168/84 HR: 92, RR: 18, SPO2: 98% on room air, Temp: 98.7(37.05C); EKG shows NSR. No ectopy patient reported decrease in pain from 10 to 7 due to pain medication received few minutes before transfer to observation unit. Abdomen distended with hypoactive, high pitch bowel sounds; tenderness around umbilical and lower quadrant. Ambulates to the bathroom to void. Unsteady on feet. Previous night he hardly slept because of abdominal pain. Vomited once before arrival to the ED. When assessed, PERRLA, alert and oriented x 4. He has IV 0.9Normal saline infusing at 100ml/hour. This patient was represented by a mane in the simulation lab and was assigned to three nursing student. The issue is the emergence of a complication during nursing care process and our ability to recognize the abrupt drop in SPO2 from 98% to 92%. This was followed by confirmation of physician order for oxygen and subsequent administration of oxygen through a nasal cannula. If we had not recognized the change early enough to intervene appropriately, crisis would have resulted. This is indication that caring is the essence of nursing practice. Being knowledgeable, skillful and focused is important in the achievement of patient optimal goal. This single act of carefulness protected patient against complications. According to ANA’s Scope and Standard of Nursing Practice (2011), caring is a beautiful and mysterious power that one human being can have on another through the mere act of caring. It is the first step in the power to heal. ANA Code of Ethics for nurses in Provision six, made it clear that professional nurses make decisions that significantly affect lives of others on daily basis. They further emphasized that caring is the essence of nursing practice and as a moral ideal rather than a task-oriented behavior. Knowledge of correct administration techniques and possible complications is required in all aspect of nursing care to optimize patient recovery time. Response to changes in patient condition or any observable parameters should be prompt enough to arrest early onset of complications. This was related to our ability to notice a sharp drop in the oxygen saturation of the patient from 98% to 92% and subsequent administration of oxygen through nasal cannula. I believe that the act of assigning three student nurses to a patient was designed to encourage and enforce team effort in patient care. The importance was evident when patient comfort was restored within a short period of time. Consequently, collective skills, knowledge and effort are necessary to achieve timely interventions in patient care.

Reference
American Nurses Association (ANA); Scope and Standard of Practice for Nurses 2011, 2, (p. 25)
American Nurses Association (ANA) ;Guide to the Code of Ethics for Nurses 2013, P.74-75