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A 2000 word reflection on one specific conversation where personal communication and interpersonal skills has had a direct impact on the patient's nursing care.
I am going to change the name of the gentleman for confidentiality reasons and therefore will name him Frank. Frank was admitted to the ward for rehabilitation due to his condition of Huntington's disease (HD) which is an inherited disease causing rapid un-coordinated jerking movement of limbs, personality changes and dementia (Waugh & Grant 2010). He had been admitted to the ward the previous evening and this was my first interaction with him. Along with another nurse I was assigned to Frank to get him washed, dressed and have breakfast. I asked Frank if he would like a wash in his bed or if he would like a shower, Frank just looked at me so I smiled and asked him again thinking that he didn't hear me properly.
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Obesity. The purpose of this assignment is to analyse how an individuals lifestyle and cultural influences has been an underlining factor in causing their medical condition. I will be looking at their lifestyle and the environment in which they
The categories are set out are overweight being over the 85th percentile and obese being over 95th percentile. Nursing and Midwifery Council (NMC) have set out a code of conduct on how to maintain confidentiality within a healthcare setting and state that we must treat information about patients and clients as confidential and use it only for the purpose in which it was given (NMC Code of Conduct, 2008a). Throughout this piece of work I will be maintaining confidentiality at all times by not mentioning the real name of the client, or the trust that they live in therefore I will name him Lewis.
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This paper presents a Portfolio of exemplars from nursing practice, which explores the professional role of the nurse as an advocate with adult patients, where ethical dilemmas are central.
A, 59 yr old widow, was admitted with shortness of breath and acute exacerbations of COPD. Doctors suggested Bipap treatment twice in the course of treatment but both the times Mrs A was alert and she refused consent. The daughters were aware of this situation. When Mrs. A became unresponsive on the fourth day, the daughters agreed with the doctor and Mrs. A. was put on Bipap. As an advocate for Mrs. A, the student nurse and her mentor felt that the treatment was ethically and legally inappropriate. 3. Exemplar 2 - Empowerment Empowerment is defined by Hokansan (1992)
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The purpose of this assignment is to look at psychosocial factors which have influenced an individuals perception and behaviour towards their health and illness. The focus will be on a patient who is a non compliant type II diabetic who is reluct
The district nurse believes that George is not taking his insulin as recommended which is causing side effects of his diabetes to exacerbate. George is a solemn looking man; he is unkempt and takes no pride in his appearance. He comes across as quite depressive in nature and in general in low spirits. Whilst on the ward, it was quite difficult to make conversation with George. He did not converse with other patients and only communicated with the health professionals when needed.
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Pacncreatitis Case Study. This paper summarizes the publishings of Doenges, Moorhouse, and Murr (2010) and Christenson and Kockrow (2011) which describes the disease process pancreatitis. Christenson et al. (2011) discusses common signs and sympt
He described the pain as cramping and wrapping around to his back, worse on the right side. He has nausea, but has not experienced vomiting. In the emergency department he was given diluadid, which relieved the pain. He has had four episodes similar to this since June and has not seen improvement since the cholecystectomy in August. Christenson et al. (2011), states that the pancreas is a gland located in the upper posterior abdomen which is responsible for both endocrine and exocrine functions. The endocrine function refers to the Islets of Langerhans, which produce and secrete insulin into the bloodstream where they travel to distant organs.
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Encouraging parental participation in the NICU. According to Wigert et al (2006) the most difficult aspect of having a baby in NICU for mothers is being unable to take the important first steps to attachment: Haut et al (1994) states that family bonding
Once the baby is admitted to NICU the parents lose the images of having a normal delivery and taking the baby home, holding, feeding, and changing nappies (Dyer 2005). Further stress was added in this case, because the baby is a surviving twin. According to Hazinski (2009) and Shaw et al (2006) parents may display initial coping strategies which they describe as serenity on entering NICU; performing a visual inspection of the machinery and layout, pulling out from the environment, over protectiveness, over focusing on small things like tapes or blood stains on sheets or clothing.
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Consequently, I studied the use of plastic bags, and other techniques at delivery in relation to the physiology of new born skin and the need for thermoregulation at birth in order to better understand these techniques at my workplace. The definition of hypothermia varies depending on the study, but Macintosh (2003) states that temperatures of less than 36 �C can be classed as hypothermia. The normal axillary temperature for preterm infants range between 36.3-36.9 �C (Philip 2005). Costeloe (2000) suggests that for neonates less than 26 weeks gestation, a temperature of less than 35 �C on admission to a neonatal unit could be associated with death.
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Nursing case study. The aspect selected is pressure area care and nursing models, knowledge, and theories necessary to deliver care when assessing the risk of developing pressure ulcer will be discussed. In accord with NMC Code (2008), confidentiality wil
In this ward, nurses use the model developed by Roper, Logan, and Tierney in the 1970s. This model is based in 12 activities of living ( appendix 1) which are linked with biological, social, or psychological needs required for health (Kozier et al, 2008). It is a way of identify and evaluate the care needs of the patient. The nurse's interventions are based in the prevention, resolution, and management of actual or potential problems related with the activities of living, not forgetting that the activities of living may me influenced by biological, psychological, socio-cultural, environmental, and politico-economic factors to some degree (Alexander, Fawcett and Runciman, 2007).
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HIGH DEPENDENCY CARE OF THE NEW BORN. The following discussion will analyse the care of a baby who I have recently looked after in the high dependency who developed necrotising entero colitis(NEC) and consequently had to be re admitted to the NICU.
He had also had a blood transfusion the previous day and his mother had prolonged rupture of membranes. She had also received two doses of steroids prior to delivery. The actual cause of NEC is unknown but there are factors that are thought to contribute to the development of NEC such as birth asphyxia, umbilical catheterisation, artificial milk feeding and early feeding (Thomas and Harvey 1997). Blood transfusion, polycythemia and patent ductus arteriosus are other factors (Pearse and Roberton,1998). Lin &Stoll (2006)
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Broncho Pulmonary Dysplasia. The following discussion will analyse issues related to babies who develop broncho pulmonary dysplasia (BPD). This will include a definition and identify risk factors, treatment and the eventual outcome of babies admitted to
Also that BPD is the most common complication of preterm babies weighing <1kg. Cunha (2005) carried out a prospective cohort study using 86 newborns with a birth weight <1500 g, who received mechanical ventilation during their first week of life and survived 28 days. The findings demonstrated that the most important risk factors for BPD were prematurity, patent ductus arteriosus (PDA), elevated levels of PIP and fluid volume. Oxygen toxicity, mechanical lung trauma, infections or pneumonia added to the risk of developing BPD. In contrast Mantkelow et al (2001) found that the administration of antenatal corticosteroids to the mother, the use of early surfactant therapy and also gentle modalities to the ventilation for the babies at birth minimised the incidence of BPD.
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Intensive care of the newborn. IMPLEMENTATION OF A PAIN ASSESSMENT TOOL IN THE NEONATAL INTENSIVE CARE UNIT
They also suggest that the implementation of a pain assessment using a recognised pain assessment tool is necessary. In the past it was believed that neonates have an immature central nervous system with non myelinated pain fibres and was incapable of perceiving pain (Merenstein & Gardner 2011). However, according to more recent studies babies are capable of feeling pain neurologically from 20 weeks gestation and probably before (D Crawford and Whickson 2002). A study by Ahn (2006) observed a link between behavioural states and pain responses in premature infants, finding that relatively healthy premature infants in a state of quiet or active sleep could express pain related responses to NICU procedures.
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A gap currently exists between the promise and reality of diabetes care (Funnell, 2003). Current literature suggests that practice is the key to successful self management (Taylor & Bury, 2007). However, the reality is that many nurses fail to recognise this and subsequently fail to understand the sheer magnitude of the diabetes regime (Paterson, 2001). A lack of empathy with regards to the impracticalities of total adherence leads to goals that are prescriptive in nature. Consequently, a vast literature in non-compliance exists (Albright, 1994).
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The essay will briefly discuss 3 core conditions of effective helping skills, empathy, genuineness and acceptance (unconditional positive regard). It will focus on empathy and critically discuss the condition and will look at how empathy affects the nurse
McCabe (2006) suggests that the offer of help should not be phony and that nurses should not hide behind the role of a counselor. Schnellbacher and Leijssen (2009) define genuineness as being aware of one's own experience otherwise known as self awareness and their findings also imply that genuiness in communication is imperative for healing. Being genuine also helps develop trust in the relationship (McLeod 2003), if a patient does not trust the nurse a therapeutic relationship will not form (McCabe 2006).
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Lee is a 42 year old man who was admitted to Accident & Emergency Department (A&E) via emergency services with rectal bleeding, a fractured leg, constipation and severe abdominal pain. After emergency surgery he was admitted to the ward. The diagnosis was made that Lee had cancer of the colon. Colon cancer affects the lower part of the digestive system, the large bowel and the rectum and is rare in people under 40 (Myers 1996). Due to surgery and the removal of the affected areas of the colon a colostomy bag had been inserted.
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This essay will identify the key principles a nurse needs to carry out health promotion to enhance patient well being, it will also discuss relevant policies and knowledge needed to carry out health promotion. Drawing upon a clinical example this essay will then examine the barriers and skills a nurse needs to promote health and well being. During a recent clinical placement with a healthvistor, a visit to a new mother in an area of high deprivation brought up issues concerning breastfeeding, the mother assured the health visitor that attachment and positioning was fine as well as the baby's feeding.
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In fact, with older age, the dura's adherence to the skull increases, the vessels become more brittle, and cerebral atrophy occurs (Thompson, McCormick, & Kagan, 2006).Thus, it is becoming increasingly important to acquire knowledge about this type of trauma and its respective management. The application of preventive measures and teaching this category of the population is also crucial, when taking into account that falls is one of the most preventable causes of TBI (Thompson, McCormick, & Kagan, 2006) (other causes include: MVAs, assaults...etc).
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A key part of the mentor role is confirmation that the student has or has not met the assessment criteria required for the placement.
(NMC 2006 pg17). This position requires huge responsibilities and is accountable for supporting and guiding students in the clinical setting. Nearly 2000 states that a mentor assists and supports an adult student who is pre-registration course. Every nursing student requires a mentor. The responsibilities of the mentor are to encourage learning and to assess ongoing progress and achievement. Effective mentorship enables nursing students to strengthen their personal and professional qualities to develop the knowledge and skills required of a competence and practioner. The NMC produced standards to support learning and assessment in practice in 2006 and where updated in 2008.
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The need to obtain a valid consent is a fundamental principle of medical ethics and law (Department of Health (DOH), 2001). A patient was admitted unto a ward with orthopaedic problems. Towards the end of the treatment she encountered grave secondary complications that required immediate treatment. After all relevant information was presented to the patient and the benefits and risks of the treatment examined, the patient initially consented to the treatment. After commencing treatment however, the patient decided that it would be in her best interest and that of the family to discontinue treatment.
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The aim of this essay is to look at how infection control and the theatre environment impact on a patient undergoing surgery. The first part of the essay looks at infection control in the hospital setting in general; touching on issues such as hospital ac
Today, most surgery takes place in operating theatres that are specially designed for that purpose. There are two types of infection, the endogenous and exogenous infection. Endogenous infection occurs when microorganisms that normally exist harmlessly in one part of an individual to become pathogen, whereas exogenous infection happens when microorganisms from other source or from other person, object, animal or the environment (Woodhead 2005). Infection control refers to policies and procedures used to minimise the risk of spreading infection especially in hospitals. Nosocomial or hospital acquired infection (HAI) occur in approximately 5% of all hospital patients.
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Compare and contrast the contribution of two theories of development to one stage of the human lifespan.
from a particular behaviour, this usually encourages them to repeat the behaviour, which Skinner described as reinforcement. However if the consequence from a particular behaviour is unpleasant ("punishments") the behaviour is rarely repeated. Behaviourists are usually reluctant to use words such as "rewards" and "punishments" because some people can perceive what seems to be a reward as a punishment and vice versa (Berger 2005). For example a child may be sent to their room by a parent as a punishment for misbehaviour but the child may perceive this as a reward because all their toys are in their room and they can play.
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The aim of this essay is mainly to explain my understanding and experience of interprofessional working. I will explore the different aspects related to this concept, the reason for interprofessional working and the policies behind it, the notion of user
Part 2. At the beginning of the session, in small groups, we worked through the set triggers. We were six people in my group and, after introducing ourselves, we proceeded to designate a scribe person among us. We failure, however, to designated a chair person, a person that could lead the group, manage feedback and who could encourage all members of the group to participate. This was due, I believe, to the fact that no one in the group felt confident in taking on this role, and also due to a lack of motivation among all of us.
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Evidenced based practice Evidenced based practice includes, the discussion of the research process overshadowed, discussions of the relevance of the findings, and how they related to the clinical work [Potter & Perry's fundamentals of nursing - Crisp &Taylor (2005)]. EBP is the use of the evidence for the improvement of quality and outcomes of health care. Karla should go through the following process of EBP [Medical Surgical Nursing - Lewis S N, Heitkmper M M, Dirksen S R (2000)] Providing a clinical trial She has to prove herself with the new method in the clinical setting a success.
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Reflecting on a specific clinical need, for example pressure area care, nutrition, moving and handling etc; discuss whether the care provided was based on current best evidence
No where in this time was any counselling or advice given to Mr. A as to what he could expect, or how he would feel if his result returned as positive. In this case, the specific clinical need focussed on will be the recommended counselling provided to Mr. A during his consultation with a nurse. According to the Oxford English Dictionary and Thesaurus (2001), counselling is defined as "process in which esp. Professional help is given for emotional or psychological problems". While it could be argued that on arriving at the Genitourinary medicine clinic Mr.
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Discuss the Care of one patient from a participating placement area that demonstrates establishing a therapeutic relationship in the short term setting including advocacy and the use of clinical science knowledge.
The HIV organism belongs to a family of viruses known as retroviruses, meaning that their genetic information is carried as ribonucleic acid (RNA) rather than deoxyribonucleic acid (DNA). The virus itself favours the T-Helper cell of the body's immune system, but must first gain entry to the cell. Within the immune system, the T-helper cell acts as a director: it has no ability to directly fight infection. Rather, antigens from antigen-presenting cells are presented to it, which then bind to the CD4 receptor.
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The recommendation and rationale to withdraw treatment was put to her next of kin, as the patient was incapable of making a decision, to which they agreed (Tilden et al 2001). The decision was then made to ensure the patient remained comfortable and pain free. According to the rulings of the case NHS Trust A v. M and NHS Trust B v. H (2001) regarding the withdrawal of life sustaining treatment from a patient it was shown that it was the right of the patient to receive such treatment according to Article 2 of the Human Rights Act (2000).
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