Question

• You begin your career in an acute care hospital as a newly licensed RN. During your orientation, you observe your preceptor checking gastric feeding tube placement by injecting air and auscultating the abdomen, stopping continuous enteral tube feedings before a patient is turned or repositioned, and instilling normal saline solution before endotracheal suctioning. You know that ALL three (3) of these practices are currently NOT supported by nursing evidence.When asked, your preceptor responds, “This is the way we have always cared for patients with tube feedings and diarrhea.” You prepare to talk to this peer about necessary changes in nursing practice.

Initial Discussion Post:

Address the following:

• Choose ONE (1) of the practices described in the scenario.
• Describe how you will address this gap in nursing practice with your preceptor. Write out exactly what you might say to this RN to professionally address the current evidence for the nursing care of patients.
• Include when and where you would communicate this information.
• Consider any additional information you might provide to your preceptor to support changing nursing practice.

Answer 1

Considering gastric tube feeding and the following procedure...

During an orientation, the preceptor will be surrounded by a crowd of students who respect her /his words.So, if u point on him saying madam/sir you are wrong, that might affect their conidence levels and irk them.The students too will start judging them.So, being more polite and gentle in handling the situation will be accepted and appreciated.

Once he/she is done illustrating the procedure you can just raise your hand and say sir/maam,recently i was going through the updated guidelines on Gastic Feeding tube placement.It mentioned that doing a pH test with the suctioned / aspirated content , a Chest X-ray including upper half of the abdomen, calorimetric capnography,a biphasic pressure change synchronous with compression of epigastric area indicates a gastric placement without causing any iatrogenic(doctor/hospital induced) complications like aspiration of the injected fluid or missing the auscultatory finding after injecting air in a comatose patient who won't respond even if the tube is misplaced.It also mentioned that the newer techniques have a higher accuracy and success rate. Once you finish saying you can ask him or her opinion on the latest guidelines.

If interrupting the class is considered an offence in your place you can meet the preceptor after the class and convey the message.