Reflective account: recognising a deteriorating patient using NEWS2

Introduction

This reflection examines an incident during my second-year placement on a surgical ward, when I was involved in recognising and escalating the care of a post-operative patient whose condition was deteriorating. Gibbs' reflective cycle (1988) has been used because its separate evaluation and analysis stages encourage a move beyond description towards understanding. In line with the NMC Code (2018), the patient is referred to as Mrs J and the ward is not named.

Description

During a routine observation round, I recorded Mrs J's respiratory rate as 23 breaths per minute, her oxygen saturation as 94% on room air and her heart rate as 108. Her NEWS2 score was 5. I informed my practice supervisor, who reviewed the patient with me and escalated to the surgical registrar. Mrs J was later diagnosed with a hospital-acquired pneumonia and began treatment within the hour.

Feelings

My first reaction was uncertainty. The patient told me she felt fine, and I worried that raising a concern would waste a senior colleague's time. Looking back, that hesitation is the most important part of this reflection, because it is exactly the kind of doubt that national guidance is designed to override.