In adherence with the Nursing and Midwifery Code (2008) consent has been obtained from all individuals involved and information will be under strict confidentiality. A qualified mentor supervised all patient procedures; the individuals concerned were made aware I was a nursing student, as per the ‘Guidance for Students’ of NMC code.
This essay is to reflect on a clinical nursing skill of which I have gained experience of during clinical placement on an acute paediatric ward. Of the various proficiencies required of a child nurse, the monitoring and recording of a child’s temperature is a skill where accurate record keeping is evidentially important. The British Journal of Nursing has advised us of the clinical and legal significance of record keeping and the linked improvements in patient care. The following documents the processes of caring for a child with a fever in hospital up until their discharge home.
Within a 12 hour period I have monitored a child under 5 years old who had a febrile convulsion at home and was admitted with a fever. Supervised by my mentor, I proceeded to gain a set of baseline observations by recording the child’s vital signs. Baseline observations are defined as being the ‘Information or data gathered at the beginning of a period from which variations that subsequently develop are compared’ (Medicine Net).
Vital Signs are defined as ‘the temperature, pulse of heart rate, respiratory rate, blood pressure and capillary refill time of a person’. These signs enable the assessment of the level of functioning of a person
(Surgery Encyclopaedia 2007). The recording of vital signs must be accurate and clear, it is a fundamental aspect of delivering good quality patient care
(Vital Signs for Nurses 2011). The most accurate method to record the human body temperature is rectally however, The National Institute of Health and Clinical Excellence recommends that temperature is measured using a Tympanic thermometer in children under the age of 5 years as it is a more convenient and less intrusive manner in taking a temperature. The tympanic membrane is located in the ear, the blood vessels covering the membrane are close to the core temperature of the body but not as accurate as a rectal reading (Fundamental & Advanced Nursing Skills).
The core and body surface temperature can differ by 0.5c° under normal circumstances (Casey 2000). The core or ‘set point’ as determined by the hypothalamus is the body’s internal temperature. A child under five is considered to be ‘pyrexial’ with a high temperature with a reading in excess of 38.5c° (NHS 2010). Consideration should be made to the human body temperature being lower in the morning due to the body resting overnight and the temperature is higher at night due to the muscular activity and food consumption during the day (The Physics Factbook).
Prior to performing any procedures on the child I gained consent from the parents in accordance with the Nursing and...