Dubé and Ducharme (2015) argue that to ensure proper professional development one needs to first identify positive experiences, challenges, limitations, and personal strengths. In this regard, there are some positive aspects I identified during the encounter with Mr K. Firstly, my interview with the patient offered the opportunity to practice the theories learned in the medical field. Secondly, the experience was able to reveal my enthusiastic and passionate characteristics and I was motivated to work independently. Again, as an RN the experience obtained from the encounter with my patient presented one of the serious challenges in my career which become an opportunity for me to begin building my knowledge and self-confidence. Khanade et al. (2017) claim that self- efficiency and self- confidence is important in the profession of nursing. The reason is that RNs mostly work under highly stressful conditions and are not required to hesitate in making complex decisions. The experience also allowed me to bridge the gap between practice and knowledge. Mainly, such an experience was important to increase my techniques and skills for interviewing future patients and obtaining their mindful clinical history. Another positive thing about my experience is that I have been stimulated into the application of effective clinical decision making and critical thinking. In this regard, I have been able to recognize the importance of prioritizing patients needs and identifying their desired levels of care. Victor-Chmil (2013) advocates for the proactive approaches of clinical judgment and critical thinking and clinical judgment since they are the evidence-based course of action. Mainly, this is important especially when determining a good clinical history and can result in safe and quality nursing care. Nevertheless, the case of preoperative assessment of Mr K prompted doubts and debates about various important aspects of nursing for me. For example, I have realized that surgical cancellation due to the inadequate preparation patient before surgery, workload, lack of counselling and absence of advanced nursing practitioner role and specialist in the preoperative setting all have a negative impact on the hospital setting. The Australian Incident Monitoring Study database reveals that about 11 per cent of reports indicated an incorrect or inadequate preoperative assessment (Hemanth Kumar et al., 2013). Consequently, decreasing work productivity, quality of clinical history taking/examination, patients satisfaction toward healthcare and job satisfaction among clinicians. Undoubtedly, one of the main long-standing challenges in healthcare organizations globally has been the cancellations of planned surgical procedures They result in wastage of resources and revenue and have significant financial, social and psychological implications for families and patients (Bass and Gill, 2014. Tobias, 2018). According to the study, the studied general hospital indicated the cost of surgery cancellation to be considerably high. More than half of the cost (62.1%) of surgery cancellation was due to avoidable reasons (Bass and Gill, 2014). Therefore, I believed that preoperative ANPs have a positive impact to overcome such issues.
Preoperative Medical Assessment