1. Watch the video vignette demonstrating TPR assessment (NRSG139 LEO, Assessments tile).
2. Select one of the following NMBA Registered Nurse Standards for Practice (2016) from the Nursing Competency Assessment Schedule (NCAS) document:
a) Standard 2: Engages in therapeutic and professional relationships
OR
b) Standard 4: Comprehensively conducts assessments.
3. Using Gibb's Cycle of Reflection [refer below] as a structured framework, reflect on the challenges that exist in completing objective and accurate clinical assessment, and what this will mean for you as a student on clinical placement next semester. The relevant NCAS Standard (Standard 2 or Standard 4) must be referred to
throughout your reflection.
4. Upload your reflection as a MS Word document via the Turnitin link in the NRSG139 LEO Assessment tile.
5. Keep an electronic copy of your reflection to add to your personal professional portfolio.

Description

I undertook the TPR (Temperature, Pulse, and Respiratory Rate) an assessment of the selected patient in the clinical setting. I promptly updated the patient regarding the requirement of vitals assessment and asked about his well-being and experience in the clinical facility. Indeed, the consistent vital signs' assessment is necessarily required with the objective of improving patient safety in the clinical unit (Watkins, Whisman, & Booker, 2016). I ascertained the existence of amicable conditions before attempting to record the vital signs of the selected patient. I felt the requirement of assessing the multi-parameter vital signs with the objective of minimizing patient's predisposition towards serious adverse events. I tried to undertake patient's subjective assessment while effectively acquiring the objective data (Toney-Butler & Whitten, 2018). I attempted to gather substantial information regarding patient's disease condition, ongoing treatment as well as the associated challenges. I also investigated the patient's behavior and attitude regarding the disease complications and recommended healthcare interventions. The patient's response provided several verbal and non-verbal cues that assisted in understanding his overall health status and treatment outcomes. Most importantly, the assessment of patient's experience in the clinical setting proved highly significant in evaluating his medication compliance and psychosocial outcomes. The patient eventually inquired regarding the pending medication and the number of days left for continuing the medication administration. I believe that the effective configuration of therapeutic communication through TPR assessment helped in recording the significant clinical information and cues that required effective utilization in patient's healthcare planning. 

Feelings

The clinical assessment improved my knowledge and awareness related to the significance of undertaking the TPR analysis. I effectively utilized the opportunity of vital signs' assessment for configuring a therapeutic relationship with the selected patient. In this manner, I attempted to gain patient's trust and confidence while concomitantly receiving his coordination and support in undertaking the process of TPR evaluation. Evidence-based research literature reveals the positive influence of an effective nurse/physician-patient relationship on the healthcare outcomes (Kelley, Kraft-Todd, Schapira, Kossowsky, & Riess, 2014). I kept this fact in mind while evaluating patient's vital signs in the clinical setting. Indeed, professional and therapeutic relationships with the treated patients prove to be highly significant in administering the person-centered, holistic, palliative, restorative, supportive, formative, curative, and preventive healthcare interventions (NMBA, 2016). I realized the significance of respect and mutual trust between the treating nurse and patient in the context of improving the healthcare outcomes. I realized the elevation in patient's responsiveness and cooperation following the establishment of an effective therapeutic and professional relationship during the process of TPR evaluation. I think and feel the requirement of an effective therapeutic communication while considering patient's rights, beliefs, values, culture, and dignity (NMBA, 2016). I considered patient's experience and challenges on top priority before the initiation of a professional conversation. I feel that these steps are highly required for the optimization of patient's treatment interventions and health-related decisions in the clinical setting.  

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