SUBSTATIATION OF CARE
Bugando Medical Centre – Mwanza, Tanzania
Name student: Milou Linderhof (383072)
Education: Bachelor of Nursing – Hanze University of Applied Science,
Groningen
Subject: PLP3, Internship
Osiris code: HVVB21MBVZ
Lecturer: Joya Smit
Practical Guider: Lucas Dominico Alfred
Date: 15-12-2023
,Prologue
For a period of 20 weeks, I was able to do an internship at Bugando Medical Centre in Mwanza,
Tanzania. This was a period during my studies that I will never forget. At the emergency department I
conducted the module “substantiation of care”, which I hereby present.
During this internship I developed both personal and professional skills. Especially the ability to
adapt, and use different solutions when something is not available, is an important skill I learned. I
will take these skills with me in my future profession.
I would like to thank all the staff of the emergency department for the friendly and welcoming
approach. The guidance and trust that they gave me was very helpful in my development as a nurse.
Besides this, I would like to thank my teacher Joya Smit for following my learning process and the
given feedback.
I hope you enjoy reading the following module!
Mwanza, December 2023
Milou Linderhof
1
,Table of Contents
Prologue.......................................................................................................................................1
Introduction.................................................................................................................................2
Appreciation forms and reflections...............................................................................................4
Appreciation form PLP2..................................................................................................................................4
Reflection PLP2...............................................................................................................................................4
Appreciation form PLP3..................................................................................................................................5
Reflections PLP3..............................................................................................................................................9
Chapter 1: Orientation of the situation.......................................................................................12
1.1 SBAR........................................................................................................................................................13
1.2 Social.......................................................................................................................................................19
1.3 ICT...........................................................................................................................................................20
Chapter 2: Clinical reasoning......................................................................................................20
2.1 Care themes............................................................................................................................................21
Chapter 3: Clinical information...................................................................................................30
3.1 Anamneses..............................................................................................................................................30
3.2 Nursing diagnoses...................................................................................................................................31
Chapter 4: Additional clinical investigation.................................................................................39
4.1 Physical examination...............................................................................................................................39
4.2 Ample method........................................................................................................................................39
4.3 Medical investigation..............................................................................................................................39
Chapter 5: Clinical management.................................................................................................42
5.1 Nursing care management......................................................................................................................42
5.2 Practical management............................................................................................................................44
Chapter 6: Clinical progress.........................................................................................................46
6.1 Desirable process....................................................................................................................................47
6.2 Undesirable process................................................................................................................................47
Chapter 7: Evaluation..................................................................................................................47
7.1 Evaluate...................................................................................................................................................48
7.2 Ethical dilemma.......................................................................................................................................48
7.3 CanMEDS-roles.......................................................................................................................................49
7.4 Evaluation of nursing outcomes.............................................................................................................50
References..................................................................................................................................53
Appendix 1: Protocol for trauma patients...................................................................................58
Appendix 2: Protocol for rapid intubation...................................................................................59
Appendix 3: Protocol for acute pain............................................................................................61
Appendix 4: Anti-plagiarism certificate.......................................................................................61
Appendix 5: Summary of how I participated at the department.................................................62
Introduction
This module focuses on the concepts of clinical reasoning, clinical thinking, and the practical
application of the nursing process. It delves into a detailed and intricate case study involving a
2
, patient within the emergency department of Bugando Medical Centre (BMC). Situated in Mwanza,
Tanzania, BMC is a prestigious university-affiliated medical facility with a strong commitment to
providing quality healthcare services by well-trained healthcare professionals. The emergency
department comprises three sections: a female ward, male ward, and pediatric care. Patients from
different regions seek medical care at BMC. Other local hospitals often seek the help of the
emergency department of BMC and transport their patient to this hospital.
For the substantiation of care the method of proActive Nursing was used (Bakker & van Heycop ten
Ham, 2017). ProActive Nursing hinges on a comprehensive grasp of various body systems,
encompassing organ systems. It leverages the knowledge of physiology to delineate the relationship
between different parts of the body. This method entails a structured sequence of six stages:
becoming familiar with the situation, formulating a clinical problem statement, conducting
supplementary examinations, devising a plan, implementing the chosen course of action, and finally,
evaluating the outcomes. This systematic approach serves as a reliable framework to ensure that no
critical information is overlooked.
The following learning outcomes belong to this module:
- The student demonstrates the ability to collect and combine information from various
sources in the different phases of the nursing process within an authentic highly complex
context.
- The student establishes the nursing process based on clinical reasoning within an authentic
highly complex context.
- Using EBP, the student justifies the nursing process within an authentic highly complex
context.
- The student carries out the nursing process independently and evaluates the nursing process
within an authentic highly complex context.
- The student communicates in a person-oriented and professional manner with the care
recipient and his/her informal network, ensuring optimal information exchange.
- The student applies information and communication technologies to supplement personal
contact with the care recipient and his informal network.
3
Bugando Medical Centre – Mwanza, Tanzania
Name student: Milou Linderhof (383072)
Education: Bachelor of Nursing – Hanze University of Applied Science,
Groningen
Subject: PLP3, Internship
Osiris code: HVVB21MBVZ
Lecturer: Joya Smit
Practical Guider: Lucas Dominico Alfred
Date: 15-12-2023
,Prologue
For a period of 20 weeks, I was able to do an internship at Bugando Medical Centre in Mwanza,
Tanzania. This was a period during my studies that I will never forget. At the emergency department I
conducted the module “substantiation of care”, which I hereby present.
During this internship I developed both personal and professional skills. Especially the ability to
adapt, and use different solutions when something is not available, is an important skill I learned. I
will take these skills with me in my future profession.
I would like to thank all the staff of the emergency department for the friendly and welcoming
approach. The guidance and trust that they gave me was very helpful in my development as a nurse.
Besides this, I would like to thank my teacher Joya Smit for following my learning process and the
given feedback.
I hope you enjoy reading the following module!
Mwanza, December 2023
Milou Linderhof
1
,Table of Contents
Prologue.......................................................................................................................................1
Introduction.................................................................................................................................2
Appreciation forms and reflections...............................................................................................4
Appreciation form PLP2..................................................................................................................................4
Reflection PLP2...............................................................................................................................................4
Appreciation form PLP3..................................................................................................................................5
Reflections PLP3..............................................................................................................................................9
Chapter 1: Orientation of the situation.......................................................................................12
1.1 SBAR........................................................................................................................................................13
1.2 Social.......................................................................................................................................................19
1.3 ICT...........................................................................................................................................................20
Chapter 2: Clinical reasoning......................................................................................................20
2.1 Care themes............................................................................................................................................21
Chapter 3: Clinical information...................................................................................................30
3.1 Anamneses..............................................................................................................................................30
3.2 Nursing diagnoses...................................................................................................................................31
Chapter 4: Additional clinical investigation.................................................................................39
4.1 Physical examination...............................................................................................................................39
4.2 Ample method........................................................................................................................................39
4.3 Medical investigation..............................................................................................................................39
Chapter 5: Clinical management.................................................................................................42
5.1 Nursing care management......................................................................................................................42
5.2 Practical management............................................................................................................................44
Chapter 6: Clinical progress.........................................................................................................46
6.1 Desirable process....................................................................................................................................47
6.2 Undesirable process................................................................................................................................47
Chapter 7: Evaluation..................................................................................................................47
7.1 Evaluate...................................................................................................................................................48
7.2 Ethical dilemma.......................................................................................................................................48
7.3 CanMEDS-roles.......................................................................................................................................49
7.4 Evaluation of nursing outcomes.............................................................................................................50
References..................................................................................................................................53
Appendix 1: Protocol for trauma patients...................................................................................58
Appendix 2: Protocol for rapid intubation...................................................................................59
Appendix 3: Protocol for acute pain............................................................................................61
Appendix 4: Anti-plagiarism certificate.......................................................................................61
Appendix 5: Summary of how I participated at the department.................................................62
Introduction
This module focuses on the concepts of clinical reasoning, clinical thinking, and the practical
application of the nursing process. It delves into a detailed and intricate case study involving a
2
, patient within the emergency department of Bugando Medical Centre (BMC). Situated in Mwanza,
Tanzania, BMC is a prestigious university-affiliated medical facility with a strong commitment to
providing quality healthcare services by well-trained healthcare professionals. The emergency
department comprises three sections: a female ward, male ward, and pediatric care. Patients from
different regions seek medical care at BMC. Other local hospitals often seek the help of the
emergency department of BMC and transport their patient to this hospital.
For the substantiation of care the method of proActive Nursing was used (Bakker & van Heycop ten
Ham, 2017). ProActive Nursing hinges on a comprehensive grasp of various body systems,
encompassing organ systems. It leverages the knowledge of physiology to delineate the relationship
between different parts of the body. This method entails a structured sequence of six stages:
becoming familiar with the situation, formulating a clinical problem statement, conducting
supplementary examinations, devising a plan, implementing the chosen course of action, and finally,
evaluating the outcomes. This systematic approach serves as a reliable framework to ensure that no
critical information is overlooked.
The following learning outcomes belong to this module:
- The student demonstrates the ability to collect and combine information from various
sources in the different phases of the nursing process within an authentic highly complex
context.
- The student establishes the nursing process based on clinical reasoning within an authentic
highly complex context.
- Using EBP, the student justifies the nursing process within an authentic highly complex
context.
- The student carries out the nursing process independently and evaluates the nursing process
within an authentic highly complex context.
- The student communicates in a person-oriented and professional manner with the care
recipient and his/her informal network, ensuring optimal information exchange.
- The student applies information and communication technologies to supplement personal
contact with the care recipient and his informal network.
3
