Assessment can also take a long time, especially with the elderly who are usually slow to respond. Personal details such as name, age, patient care essay, address, nickname, religion, and housing status were recorded. Lack of adequate personnel and lack of adequate training facilities for the available personnel are major problems. Hey, wait! Her confidentiality was not compromised because she agreed to the presence of a family member. All members of the multi-disciplinary team were fully committed to the team approach patient care essay care delivery and this facilitated efficient and organised care delivery. Sullivan, E.
Non-medical Aspects
This is a reflective essay based on an episode of care that I was directly involved in managing during a community placement. This episode of care will be analysed using up to date references, health care policies and relevant models. Issues and theories relating to leadership qualities and management styles will also be explored, taking into consideration any legal, ethical and political factors that may have impacted on patient care. Care delivery, delegation and prioritisation will be examined along with team working, risk assessment and patient safety.
I will also take into consideration my role as a supervised student nurse and analyse the roles and responsibilities of those supervising me and what influence this has on my practice. These issues will be debated and questioned within the framework of leadership and management theory. Starting an patient care essay practice placement as a third year nursing student enables the student to develop their knowledge and skills in management and leadership ready for their role as a qualified adult nurse.
During my extended practice placement there were many opportunities to develop these skills and manage my own caseload of patients and arrange many complex aspects of their care. During this placement an 88 year old patient, to be known as Mrs A, was due to be discharged from a rehab centre following recurrent falls, issues with safety at home, and self neglect, the referral had been made by a concerned General Practitioner. Mrs A had spent the last 6 weeks receiving holistic multidisciplinary care, including; intensive physiotherapy, occupational therapy and nursing care. Mrs A had made much improvement and was able to safely administer her own medication. One of the Physiotherapists called Ken, had commented during handover, that Mrs A had seemed confused during their session together, patient care essay, and asked if the nurses would go in patient care essay review her.
Upon visiting Mrs A it was clearly evident that she was not patient care essay, and seemed confused. Following discussion with my mentor I felt that Mrs A was not safe to administer her own medication. I recommended to the patient to let the rehabilitation staff administer her medication, patient care essay. Mrs A consented to this, thus reducing a great risk of Mrs A causing her-self patient care essay. I delegated to the support workers to obtain a urine sample which was tested and confirmed that Mrs A had a urinary tract infection, antibiotics were prescribed by her GP.
This episode of care was managed effectively as the underlying cause of the patients confusion was discovered and treated, a risk assessment was completed and a referral was promptly made to medicine management and a dossett box was supplied to Mrs A, to help her manage patient care essay own medications safely. All members of the multi-disciplinary team were fully committed to the team approach to care delivery and this facilitated efficient and organised care delivery. The care delivered was patient-centred and teamwork was integral to providing this care. First will be a discussion on the importance of self awareness and how this awareness enabled a more assertive and confidant approach to be made to managing patient care.
Self awareness must be considered as the foundation for management and is a vital skill and quality needed in leadership, patient care essay. If you wish to provide care that is of a high standard and improve your own performance as a skilled health care professional you need to manage the cognitive, affective and behavioural self in order to engage effectively in therapeutic relationships. Without being self aware, recognising personal and cultural beliefs, and understanding interpersonal strengths and limitations, it is impossible to establish and maintain good relationship with co-workers and patients. This relates to the need to maximise potential and achieve a sense of personal fulfilment, competence, and accomplishment Maslow, It is important as a student nurse to be completely aware of strengths and weaknesses, and to be conscious of any limitations, self-awareness helps to exploit strengths and patient care essay with weaknesses Walshe and Smith To understand nursing management it is crucial to understand what nursing management is and the theory behind it.
Another definition of management is a process by which organisational goals are met through the application of skills and the use of resources Huber, com, Borkowski, N. Cameron, K, patient care essay. and Whetten, D. Gopee, N. and Galloway, patient care essay, J. Huber, D. USA: W. B Saunders Company. McGregor, patient care essay, D. The human side of enterprise. Leadership and motivation. Sullivan, E. And Garland, G. WalsheK. And SmithJ. Tags: free essaymanagement theory. Category : Free EssaysHealth. If you enjoyed this article, subscribe to receive more just like it. Including student tips and advice. Click here to ask a question about this article.
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This model is extremely prevalent in the United Kingdom and it is used as a checklist on admission in order to get as much background data about the patient Holland , p. Personal details such as name, age, address, nickname, religion, and housing status were recorded. Information was also recorded about any agency involved, along with next of kin and contact details, and details of the general practitioner. Holland stated that these details should be accurate and legible so that, in case of any concerns about the patient, the next of kin can be contacted easily. The name and age are also vital in order to correctly identify the patient to avoid mistakes.
Knowing what type of a job the patient does or the type of the house she lives in helps to indicate how the patient is going to cope after discharge. Holland also insisted that religion should be known in case the patient would like to have some privacy during prayers, and this should be included in the care plan. The second assessment to be done focused on physical assessment and the activities of living. Barrett, Wilson and Woollands suggested that when enquiring about the activities of living, two elements should be addressed: usual and current routines. During physical assessment, Kate demonstrated laboured, audible breath sounds and breathlessness. Use of accessory muscles and nose flaring was also noted. She was agitated and anxious.
Taking and recording observations is very important because it helps to recognise the significance of changes in vital signs. Carpenito-Moyet stated that it is important to take the first observations before any medical intervention, in order to assist in the diagnosis and to help assess the effects of treatment. How did all this affect her ability to provide you with information during the assessment? How gave the information, Kate or the daughter? Did this affect the way the questions were asked?
Or the information received? Could Kate answer all the questions? Did the daughter know the answer to all the questions? Among the needs identified, breathing and personal hygiene cleansing , being priority needs, will be explored. Breathing will be discussed first being an underlying problem which Kate presented with before moving on to personal cleansing. In old people, muscles become less efficient, resulting in increasing efforts to breathe, causing a high respiratory rate Mallon She was wheezing, cyanosed, anxious and had shortness of breath.
Wilkinson explained that a goal statement is a quantifiable and noticeable criterion that can be used for evaluation. The goal statement in this case would be for Kate to maintain normal breathing, which is normally 12 — 18 breaths per minute in adults Mallon , and to increase air intake. The prescription of care for Kate depended on the assessment, which was achieved by monitoring her breathing rate, rhythm, pattern, and saturation levels. These were documented hourly for early identification of any deterioration of condition; it also encouraged early identification of interventions.
Readings were compared with initial readings to determine changes and to report any concerns. The other part of the plan was to give psychological care to Kate by involving her in her care and informing her about the progress, in order to reduce anxiety. Barrett, Wilson and Woollands a stated that it is very important to give psychological care to patients who are dyspnoeic because they panic and become anxious. Checking and recording of breathing rate and pattern is very important because it is the only good way to assess whether this patient is improving or deteriorating, and it can be a very helpful method for nurses to evaluate the care of the patient Jamieson Mallon stated that, if the breathing rate is more than 20, it indicates that the body is trying to increase its intake of oxygen to meet unusual demands.
This can happen even after doing exercise, not only in people with respiratory problems Blows Griffin and Potter stated that, respirations are normally quiet, and therefore if they are audible it indicates respiratory disease, wheezing sound indicates bronchiole constriction. Oxygen saturation level was also monitored with the use of a pulse oximeter. With nasal catheter, Kate was able to communicate with the nurses and her daughter what about comfort?. The peak expiratory flow was monitored and recorded to identify the obstructive pattern of breathing that takes place in asthma Hilton, This is another method that is used to assess the effectiveness of the medication inhalers the asthmatic patient is taking, and this test should be carried out 20 minutes after medication has been absorbed.
Kate was observed for any blueness in the lips and oral mucosa as this could be a sign of cyanosis. Bronchodilators are given to dilate the bronchioles constricted due to asthma, and corticosteroids reduce inflammation in the airway BNF b. Kate was also started on antibiotics to combat the infection because, on auscultation, the doctor found that the chest was not clear. Kate was being reassured during care, her daughter was encouraged to be visiting her mum regularly because she used to be settled whenever the daughter was around. The call bell was always in reach for to call when in need. Kate was nursed in an upright position using pillows and a profiling bed in order to increase chest capacity and facilitate easy respiratory function by use of gravity Brooker and Nicol, In this position, Kate was comfortable and calm while other vital signs were being checked.
Pulse rate and temperature were also being checked and recorded because if raised, they indicate infection in the blood. NMC encouraged teamwork to maintain good quality care. Kate was referred to the respiratory nurse who is specialised in helping patients with breathing problems. Kate was on oxygen since admission; therefore she was taught about importance of healthy breathing and taught her about breathing exercises to help her wean from oxygen. Due to breathlessness and loss of mobility it was difficulty for Kate to maintain her personal hygiene. Hygiene is the practice of cleanliness that is needed to maintain health, for example bathing, mouth washing and hair washing.
The skin is the first line of defence, so it is vital to maintain personal cleansing to protect the inner organs against injuries and infection Hemming Field and Smith stated that personal cleansing also stimulates the body, produces a sense of well-being, and enables nurses to assess the patient holistically. Personal hygiene is particularly important for the elderly because their skin becomes fragile and more prone to breaking down Holloway and Jones This is due to slower epidermal cell renewal and a reduction in collagen Hess Therefore this need was very important for Kate; she needed to maintain her hygiene as she used to, before she was ill.
The goal for meeting this need was to maintain personal hygiene and comfort. The care plan prescribed involved first gaining consent from Kate, explaining what was going to be done. Identifying usual habits helps individuals to maintain their social life if things are done according to their wishes. Though Hemming said all human beings need personal hygiene, Holland argued that it is important to ask patients how they feel about being cleaned, especially genital area. She preferred washing daily, shower and a hair wash once a week, and a mouth wash every morning and before going to bed. Kate was assisted with personal care after having her medication, especially the nebuliser. Individuals with asthma experience shortness of breath whenever they are physically active Ritz, Rosenfield and Steptoe After having medication Kate was able to participate during personal hygiene.
According to NMC guidelines on confidentiality a , privacy and dignity should be maintained when giving care to patients. Therefore, whenever Kate was being assisted with personal care, it was ensured that the screens were closed and she was properly covered. Field and Smith suggested that assisting a patient with personal hygiene is the time that nurses can assess the patient holistically. Since Kate was immobile, it was very important to check her pressure areas for any redness. She was also checked for any pallor, jaundice, cyanosis or dry skin that needed attention. The care was always carried out according to her wishes. Kate was able to wash and dress herself with minimal assistance. She was discharged on a continuous care package comprising care three times a day, although discharge was delayed by one week so that the care package could be ready.
The model of the twelve activities of living was followed successfully on the whole. The nurse collected subjective and objective data, allowing a nursing diagnosis to be formulated, goals to be identified and a care plan to be constructed and implemented. However, this lower level of privacy has to be balanced against causing anxiety to the patient. This was very important because of the effects of potential panic on breathing; therefore, this was the correct balance to strike. This is a good example of the use of inter-professional skills, as a number of different departments were involved in creating and implementing the care plan. However, the system was not as efficient as it should have been: Kate spent unnecessary time in hospital after recovery because the care plan was not yet in place.
Assessment can also take a long time, especially with the elderly who are usually slow to respond. Therefore, more time is needed to be sure that the necessary progress has been achieved before taking further steps. However, poor staffing also affects performance in this area, an observation supported by the Royal College of Nursing One of the Physiotherapists called Ken, had commented during handover, that Mrs A had seemed confused during their session together, and asked if the nurses would go in and review her. Upon visiting Mrs A it was clearly evident that she was not herself, and seemed confused. Following discussion with my mentor I felt that Mrs A was not safe to administer her own medication.
I recommended to the patient to let the rehabilitation staff administer her medication. Mrs A consented to this, thus reducing a great risk of Mrs A causing her-self harm. I delegated to the support workers to obtain a urine sample which was tested and confirmed that Mrs A had a urinary tract infection, antibiotics were prescribed by her GP. This episode of care was managed effectively as the underlying cause of the patients confusion was discovered and treated, a risk assessment was completed and a referral was promptly made to medicine management and a dossett box was supplied to Mrs A, to help her manage her own medications safely. All members of the multi-disciplinary team were fully committed to the team approach to care delivery and this facilitated efficient and organised care delivery.
The care delivered was patient-centred and teamwork was integral to providing this care. First will be a discussion on the importance of self awareness and how this awareness enabled a more assertive and confidant approach to be made to managing patient care. Self awareness must be considered as the foundation for management and is a vital skill and quality needed in leadership. If you wish to provide care that is of a high standard and improve your own performance as a skilled health care professional you need to manage the cognitive, affective and behavioural self in order to engage effectively in therapeutic relationships. Without being self aware, recognising personal and cultural beliefs, and understanding interpersonal strengths and limitations, it is impossible to establish and maintain good relationship with co-workers and patients.
This relates to the need to maximise potential and achieve a sense of personal fulfilment, competence, and accomplishment Maslow, It is important as a student nurse to be completely aware of strengths and weaknesses, and to be conscious of any limitations, self-awareness helps to exploit strengths and cope with weaknesses Walshe and Smith, To understand nursing management it is crucial to understand what nursing management is and the theory behind it. Another definition of management is a process by which organisational goals are met through the application of skills and the use of resources Huber, com, References Borkowski, N. Gopee, N. and Galloway, J. USA: W. B Saunders Company. Maslow, A.
Sullivan, E. And Garland, G. This essay was written by a fellow student. You can use it as an example when writing your own essay or use it as a source, but you need cite it. Explore how the human body functions as one unit in harmony in order to life. A reflective essay based on an episode of patient care.. Free Essays - PhDessay. A reflective essay based on an episode of patient care. com, Apr 02, Accessed January 7, com , Apr Substandard Patient Care of Health Care Delivery Substandard patient care is a term often used to describe health care agencies failure to meeting in an appropriate manner the health care. Davis Weiss The Patient Protection and Affordable Care Act is a federal statute that was signed into law in America by President Barack Obama on March 23, It is.
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