Sample Undergraduate Nursing Essay

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A reflective essay using Rolfe’s reflective model to reflect on your role as a student nurse in medicine management

INTRODUCTION

I understand the adverse effects of drugs used in hospital wards, emergency, and outdoor patient in routine. The allergic reactions to antibiotics and many other drugs are common and known to everyone. Daily, I experience the results of medicines in various departments of hospitals to the patients; this has made our approach towards the patient differently.

Another experience we have made about the misinterpretation of the effects of drugs, especially antibiotics, is that our many colleagues have changed the specific antibiotics with broad-spectrum antibiotics. If I consider global publications, it states that many patients remain undiagnosed due to poor screening and lack of awareness among patients and doctors. (Mockenhaupt,2007) This has made to reach the conclusion about the system followed in many public sectors to cope with the difficulties regarding allergies due to drug reactions and other causes of allergies in hospitals (Fernandez et al.2018)

As learner, this issue is important for every person associated with my field i.e., Medical field. As a Healthcare worker, my priority is to take off very basic issues of patients. Almost all the departments in my workplace are at risk of developing allergies as all departments use drugs to treat patients, various kinds of patients with contact dermatitis, and environmental allergens, all of which can cause allergies. In writing this review, I’m going to use Rolfe’s Reflective model, which mainly consists of three questions: What, so what, and Now what.

What:

With the given knowledge from data and research, I have learned about the checking of allergies by three main methods: skin test, blood test, and elimination test. From daily observations and various studies, I have found that the body’s immune system works against the external agents in the body, which makes such substances highly allergic to the body.

Further studies suggested the symptoms of allergies which range from a runny nose to sneezing, blocked sinuses to itching. On further study, I have come to the point about the types of allergens that are maybe inhaled allergens, ingested allergens, and contact allergens.

About the tests necessary to describe, I was curious about the need for testing for allergy. Then I concluded that allergies are responsible for many deaths worldwide, especially allergic asthma due to pollen. And by performing some special tests, many allergens can be found responsible for various allergies.

If a patient comes to me, I’ll ask the patient first about the lifestyle, family history of allergy, and the medication. If any of these factors are responsible, then I’ll first exclude these factors (Demoly et al. nd). I further researched the method of performing these tests.

Normally for a skin test, I try a scratch test before the proper test. I place an allergen in a liquid and then this liquid is placed on the skin with proper instruments that inserts the pollen into the skin. Then I wait for the localized response of the body (Mims,2017). If I find out skin’s reaction towards particular pollen, this will be the pollen from which the patient is allergic. If that test doesn’t work then I try an intradermal skin test.

Secondly, I perform the blood test in which the blood is tested for specific antibodies. The final test is the elimination diet in which I ask the patient to avoid certain foods which are a causative factor for allergy. In all these techniques, my supervisor always clears the ambiguity about the tests and laboratory workers find out the real cause. These checks are necessary for the general public unaware of the allergic responses and their causative factors.

All these studies show that reflection is important for developing managing techniques for some special purposes. Adding more, the patients coming into a hospital are vital and their secrets are vital too for the department. The registrants can’t simply receive their reflection.

They are also guided to get rid of their reflection theories, which may include the systematic and another structured approach with active and participants who are willing to participate. According to NMC, NMC explains that any kind of experience, whether positive or negative, may be small or not, even simple conversation with the colleague can generate the ability and attitude with a lot of learning and meaningful insight.

So, what

I have experienced the basic skills that have helped me understand the testing criteria and how to manage the patient if a patient comes to you with an allergy. Management of allergy is the vast study and different methods I have learned to cope with the issue of allergy.

I have studied the researches about the checking and management of the allergy along with their risk factors, which have clarified the management strategy for allergies. Here are the basic management skills I learned from studies and daily patient experience. For the inhalant, the avoidance technique is basic in which I ask the patient to avoid the allergic environment.

Basic drugs are prescribed and immune therapy is provided to the patients (Mims,2017). Nowadays, I have seen patients being prescribed with the antibody by doctors. I feel the main problem in managing the patients of allergy about the education and awareness about the sources which cause the pollutants and allergens to be inhaled and ingested by the people.

After the basic info about the sources, I recommend the patients use dehumidifiers, pet washing, dust cover, and other methods necessary to rule out the allergens. After using these techniques, I have seen that many patients have recovered from their illness and some have reduced their symptoms.

This reducing allergen technique is found difficult in such patients where there is already the presence of sensitization. I usually counsel the patient about using materials causing increased production of allergens. On the report chart, I daily see the patients being prescribed the non-sedating antihistamines, some of them are prescribed with the intranasal corticosteroid sprays, all these medicines are present over the counter and are used worldwide. I suggest seeking medical care by a health professional about the use of medication for specific allergies. I discovered that there are many areas where the use of medication for allergic rhinitis can be reduced by proper checking and screening.

Some oral antihistamines are sedating and people with allergies usually prefer oral sedating antihistamines. I generally see the chart of patients who are using less sedating on non-sedating antihistamines are getting better more quickly (Church et al.2010) I have read the researches about the combination of oral antihistamines and intranasal corticosteroids and it is not very efficient in its use but it is generally used in people.

But some cases are in such dimension where the combination becomes necessary. One such drug is montelukast, which can be reduced and is overprescribed and falsely used in allergic rhinitis. In special conditions like allergic conjunctivitis, there is a need to consider the combinations where the situation can get complicated if not treated effectively (Lowell et al.1965) Furthermore, a special situation like asthma caused by aspirin and corticosteroids, some special diseases noted but the ENT specialists like polyps and other allergic conditions which are caused by drugs of allergy are generally treated with the antibodies available and IL-5, these are widely used when there is need to treat the disease which is caused by drugs of allergy.

I find these medications related to the direct effect on the immune system are generally used in chronic or severe conditions. On routine checkups, I have experienced sublingual immune therapy, which is the topic of concern among doctors. These medications used in severe cases are tested on several patients and then used on routine examination.

On reading the trial results, I interpret that some of the trials support the argument, while others do not. This sublingual medication is prescribed by the specialist only and given in the form of a tablet, the patient has to put this tablet under the tongue and it is automatically diffused into the main bloodstream.

I wonder why patients prefer sublingual medication, then common observation says that patient finds its easy way to get rid of allergy, as in sublingual therapy, there is no need of supervision, no need to wait in hospitals for their turn and also easy to use as there is no needle pricking. Patients with poly allergy are treated with specific antibodies but I learned about the frequency of such patients, such patients with poly allergy are minimal and others are more in frequency (Leatherman et al.2015)

Many types of research according to my knowledge have failed to answer the effectiveness of allergic drugs and poly allergens (Laidlaw,2018). There is uncertainty about the more effective drug, either it is subcutaneous or sublingual. By following patients’ charts inward, I came to know that both drugs are effective.

No one can say which drug has more power against allergic diseases. As a health care worker, I believe that it is the clinician’s role to decide whether tablet will be more effective or drops, same for sublingual or subcutaneous. I feel if these newly formed studies have not come into regular practice, Patients will suffer a lot. There should be proper check and balance regarding the use of drugs, a form of drugs prescribed to a patient. All these responsibilities are directly linked to the supervisor or the department.

The method of testing and treatment is now advanced, old practitioners must learn the art of modern science, also it gives the chance in the recent advancement of learning. For many years, Patients rely on traditional skin test with subcutaneous immune therapy. Still, advanced therapy should be considered in patients suffering from a severe allergy, including preventive treatment, avoidance of the allergen, other causative agents, sublingual tablets, and inhalants.

These are all new science advancements and must be applied to routine examinations. Talking about the future generation, I feel they can use these methods but face severe complexity among patients as pollutants are rising in the environment daily. In addition, to deal with more complexity, the screening and treatment options should be evolved.

Now, what

Based on my learning, I have concluded the medical system about allergy. To my knowledge, the health care facility for allergic patients is up to the mark. There is always some deficiency in every system, then checking for the allergy is efficient, the only need here is too wide the screening facility as it is the common problem and allergy is not treated as the priority.

I feel that the consumption of medicine which is the main cause of many allergies is beyond the limit. The first step should be to make medical workers especially doctors and nurses, take care of medicines that are the main cause of these allergies. In our system, there is always a lack in the research system due to a lack of education among the doctors about the side effects of drugs commonly used in the routine.

If there is some work on the research in our system, this allergy will be reduced to some extent. Also, I believe there should be proper awareness for the general public to limit the excessive use of such tablets. In addition to drugs, environmental allergens come to mind when I see the increasing pollution in our ecosystem.

Now is the time to treat such conditions to save our planet earth from pollution. This is not merely the responsibility of one country whole world should consider the need for time and plant trees on a vast area in every country to cope with such difficulties and to save our future generation.

If I have to deal with such a situation, I will first look at preventive medicine instead of curative medicine. In our era, every health facility works on curative medicine, which is needed for patients, but no one notices the demand for prevention due to which patient rises every day.

This is not merely the problem with allergic patients, other diseases are also linked with such deficiencies in our system. This experience of studying such patient, in future it will help me to treat allergic patients. The testing of allergy and its management is helpful for every student learning medical knowledge, only a few problems I can face in the future are described earlier.

Suppose there will be some work on such a problem, in the future. In that case, Health care facilities will face a shortage of patients about this specific disease, as it includes preventive medicine which surely reduces the patient burden. I have learned the basics of checking allergy, its risk factor, and the drugs recommended in special cases.

In the future, If I have to decide on prescribing drugs, I will start with a low dosage and with the drugs with the least side effects. Sedating drugs cause the patient to become addict to such drugs, that’s why these drugs should be discouraged in patients who can cure with non-sedating medicine. (GerthvanWijk et al.2017)

Conclusion

Daily, I experience the results of medicines in various departments of hospitals to the patients; this has made our approach towards the patient differently. On the report chart, I daily see the patients being prescribed the non-sedating antihistamines, some of them are prescribed with the intranasal corticosteroid sprays, all these medicines are present over the counter and are used worldwide.

I suggest seeking medical care by health professionals about the use of medication for specific allergies. I discovered that there are many areas where the use of medication for allergic rhinitis can be reduced by proper checking and screening. On routine checkups, I have experienced sublingual immune therapy, which is the topic of concern among doctors.

These medications used in severe cases are tested on several patients and then used on routine examination. On reading the trial results, I interpret that some of the trials support the argument, while others do not. This sublingual medication is prescribed by the specialist only and given in the form of a tablet, a patient has to put this tablet under the tongue and it is automatically diffusing into the main bloodstream.

If I have to deal with such a situation, first of all, I will look upon preventive medicine instead of curative medicine. In our era, every health facility works on curative medicine, which is needed for patients, but no one notices the demand for prevention due to which patient rises every day. This is not merely the problem with allergic patients, other diseases are also linked with such deficiencies in our system.

References

Fernandez, J. M., Fernandez, A. P., & Lang, D. M. (2018). Other antibiotic allergy.Drug Allergy Testing, 157-163. https://doi.org/10.1016/b978-0-323-48551-7.00015-8

Mockenhaupt, M. (2007). Epidemiology and causes of severe cutaneous adverse reactions to drugs. Drug Hypersensitivity, 18-31. https://doi.org/10.1159/000104186

Demoly, P., Pipet, A., & Bousquet, J. (n.d.). Skin testing in diagnosis and management of respiratory allergic diseases. Allergy and Allergic Diseases, 1335-1345. https://doi.org/10.1002/9781444300918.ch64

Mims, J. W. (2017). Advancements and dilemmas in the management of allergy. Otolaryngologic Clinics of North America, 50(6), 1037–1042. https://doi.org/10.1016/j.otc.2017.08.001

Church, M. K., Maurer, M., Simons, F. E., Bindslev-Jensen, C., van Cauwenberge, P., Bousquet, J., … Zuberbier, T. (2010). Risk of first-generation H1-antihistamines: a GA2LEN position paper. Allergy, 65(4), 459–466. https://doi.org/10.1111/j.1398-9995.2009.02325.x

Leatherman, B. D., Khalid, A., Lee, S., McMains, K., Peltier, J., Platt, M. P., … Lin, S. Y. (2015). Dosing ofsublingual immunotherapy for allergic rhinitis: evidence-based review with recommendations. International Forum of Allergy & Rhinology, 5(9), 773–783. https://doi.org/10.1002/alr.21561

Lowell, F. C., Franklin, W., & Williams, M. (1965). A Double-Blind Study of the Effectiveness and Specificity of Injection Therapy in Ragweed Hay Fever. New England Journal of Medicine, 273(13), 675–679. https://doi.org/10.1056/nejm196509232731302

Laidlaw, T. M. (2018). Aspirin-Exacerbated Respiratory Disease. Drug Allergy Testing, 169–175. https://doi.org/10.1016/b978-0-323-48551-7.00017-1

Gerth van Wijk, R., Eguiluz-Gracia, I., Gayraud, J., Gutermuth, J., Hamelmann, E., Heffler, E., … Muelleneisen, N. (2017). The roadmap for allergology in Europe: The subspecialty of allergology as “stop-over” on the way to a full specialty. An EAACI position statement. Allergy, 73(3), 540–548. https://doi.org/10.1111/all.13321

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