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University Degree: Nursing
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Preparation for Practice Reflective Account. I have been working with patient A, who has a past medical history and for medical reasons has Dysphasia
Unfortunately due to medical reasons patient A suffered a setback which had worsened there dysphasia and was unable to communicate as well as they had done before. One occasion I want to reflect on is when I struggled to understand what patient A wanted to eat for lunch as everything I had asked, was answered with what sounded like ?yes?. I had seen in the past, a Health Care Assistant (HCA), giving patient A food which they disliked, because they didn?t allow time to fully understand what patient A wanted.
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The aim of this literature review is to critically analyse and synthesise relevant studies pertinent to the quality and standards of the current protocols on Preoperative fasting for elective surgical patients
Not all research is of good quality or of a high standard, and therefore nurses should not simply take research at face value simply because it has been published (Cullum and Droogan 1999, Polit and Beck 2006). The methodology used for this literature review was both Quantitative and Qualitative research; quantitative research enables the collection of data by means of numbers, proportions and statistics (Coughlan et al 2007). According to Streubert and Carpenter (2011), guidelines are often based on positivist, quantitative data in accordance with the still prevalent biomedical paradigm.
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Case Study. This essay will examine the nursing process involved in managing chronic venous leg ulcers (CVLU).
Living alone, Agnes suffers social restriction and isolation due to reduced mobility. Palfreyman (2008) concurs this is common amongst CVLU patients. Agnes presented with recurrence of an ulcer on the medial gaiter region of her left leg. She was previously diagnosed with chronic venous insufficiency through assessment of medical history, leg, ulcer, symptoms & ankle brachial pulse index (ABPI) measurement. Ousey and Cook (2011) specify the importance of specialised training & expertise in wound assessment as it forms the basis of wound care & management and their efficacy.
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Within this assignment I will be looking at effective discharge planning to include all members of the Multi Disciplinary Team in order to meet all needs of the individual
He has a carer who comes in twice daily to help him with his personal care. Mr S cooks his own frozen microwave meals for lunch and his family or carers? help with other meals, his family do his shopping. Mr S was admitted to hospital following a series of transient ischaemic attacks (TIA?s) , his most recent attack lead him to stumble from which he suffered a wound to his leg, the wound became infected and is not healing very quickly.
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Explore in relation to a client you have nursed psychosocial influences on the individuals perception and response to health and illness
On a routine visit to the home, Katy had stated that she had been omitting her insulin at times, was finding it hard to keep to a healthy diet and was not doing as many blood glucose checks as she should be. She felt under a lot of pressure with upcoming exams and the demands of home life were causing to put her health at the bottom of her priorities. Katy was diagnosed with diabetes mellitus type one after an admission to hospital three months ago.
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Promoting learning in Health. The aim of the teaching session was to develop the knowledge and practical skills required to be able to set up an arterial line
planned solely to meet educational needs?. (UKCC 1986, cited in Nicklin., Kenworthy 2000). In the following assignment, I will discuss and evaluate my influence on promoting learning referring to the clinical teaching session I undertook within my own clinical setting the Intensive Care Unit. Relevant research and learning theories will be discussed to show how theory influences learning. The physical, social, and educational aspect of the learning environment will be explored, as will the framework of the nursing process compromising four stages , these are; Assessment ? where the author discuss how to identify any learning deficits the student has .
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stated that all group members needed to be willing to participate in order for the team to work. Having worked together on the formation of statements (see Appendix I) regarding our views on the issues facing interprofessional working we were able to realise together the boundaries and constraints facing us all in our chosen professions. Communication alerted its self as being paramount in order to provide the most efficient and effective care for our client/service user. The practice of good communication, being both honest and open is dependent upon the participation of all those involved in order to draw conclusion and make decisions (Stapleton 1998)
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Several new therapies are in development and amongst these is inhaled Insulin. Inhaled insulin (INH) could prove to be an ideal non-invasive alternative to subcutaneous injections of insulin. It is believed that increased satisfaction would result in better adherence to medication which would in turn lead to a better glycaemic control (Royle P et al., 2009). The pulmonary route exploits a large vascular bed and permeability of the alveoli to deliver insulin directly into the bloodstream (Paton et al., 2004). Inhaled insulin is under investigation for the preprandial administration of rapid onset in type 1 and type 2 diabetes and has been shown in preliminary short term clinical studies to provide a safe and effective control of meal related glycaemia.
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When software is used for this purpose, I am aware thia will mean it will be held on a (secure) external database for the sole purpose of detecting plagiarism. When requested by the module tutor, I agree to provide an electoronic copy of the work. This work has not been submitted previously towards any credit bearing component of an award Please sign and enter your student number here to confirm adherence to the above: Signed: Sophia Olanrewaju Student No: M00355297 Items Submitted (please tick as appropriate)
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Pain Assessment. The implementation and rationale for using pain assessment tools is focused on within this essay, with limitations of use being discussed and analysed.
Patient profile Mrs Green (patient name has been changed to maintain client confidentiality, Nursing & Midwifery Council 2004), aged 33, was admitted to a female surgical ward after initial assessment in the medical assessment unit. Mrs Green had acute abdominal pain, had a slight pyrexia and had been vomiting. Relevant medical history included pancreatitus, asthma and agoraphobia. Due to Mrs Green?s anxiety it was decided that a side room would be more appropriate as she found staying in a bay in the medical assessment unit heightened her anxiety levels.
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Research critique of Alun Woodhouse's 2006 article Pre-operative fasting for elective surgical patients
When critiquing, it is important to understand and appreciate the process and the framework used. However, the complexity of theories into practice within the field of research can be challenging as the one critiquing should understand the connection between theory, research and practice. Several frameworks are used to critique research, but the chosen one is by Caldwell, Henshaw and Taylor (2005). Critiquing the research The title of the research paper is one of the leading constituents. It should be developed with positive impression, instil curiosity and attract the reader?s attention and interest. It should be informative, narrowed and formatted correctly to an area of investigation, using current terminology of the field to indicate subject and scope with some accuracy which identifies key variables with substantive words limited from 15 to 20.
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How does hand hygiene compliance amongst nurses reduce the risks of infection to vulnerable patients?
Evidence- based practice is becoming extremely important within the healthcare sector (Craig and Smyth 2007). All health care professionals need to base their professional practice on evidence based practice to insure that they are delivering the best possible care to patients instead of providing patients with out of date practice which may no longer seen as good practice (Aveyard and Sharp 2009). But in doing so will also improve patient experiences within health care (Craig and Smyth 2007). For nurses, the Nursing and Midwifery Council (NMC) also includes within their code of conduct that all practitioners should deliver should maintain ?high standards of care and practice at all times? and to ?deliver care based on the best available evidence or best practice? (NMC 2008 P.4).
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Reflective writing, I have decided to reflect upon the development of my confidence and practical skills, during the case of a stroke patient I treated over a period of time.
After being taught the ?ABCDE? assessment tool, I was asked to perform it with supervision. However, due to hesitation, my C.E. prompted me towards the right answers. Mr A had crackles in most areas of the lungs indicating secretions and no breathing sounds in his left basal segment. Our objective was to clear the secretions, however, Mr A was only responsive to pain and would therefore be unable to follow the breathing commands of ACBT to remove secretions. Initial treatment was the use of ?the bird?, which is a form of non-invasive ventilation that produces intermittent positive pressure we hoped would ventilate the distal areas of Mr A?s lungs.
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The purpose of this essay will be to analyse and evaluate the nursing care given to an individual during their stay at a respiratory ward whilst using the nursing process as its foundation
His longer-term concern was how long he would be admitted for. His physiological measurements on admission were: 1. Temperature 36.6 degrees Celsius 2. Heart rate 106bpm 3. BP 145/68mmHg 4. Respirations 24 per minute 5. O2 saturations 75% on 28% oxygen. Cecil?s O2 saturations increased to 92% once 40% oxygen was administered, once stable Cecil was admitted to the respiratory ward. The overall assessment of his immediate actual needs by paramedics and staff at the A&E department was his shortness of breath and low O2 saturations.
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This assignment will use a case study of a fictitious patient to examine continence. Its management will be discussed within the context of current guidelines
for her needs. She takes aspirin once daily, ibuprofen and gaviscon when required but has not visited her General Practitioner for several years. She also smokes 10-15 cigarettes daily, has lost weight due to her decreased appetite, is sleep-deprived, unkempt and has been urinary incontinent for over three days. So continence was chosen because it is a fundamental aspect of everyday life (Department of Health, 2001a). Urinary incontinence is the complaint of any involuntary loss of urine (Abrams et al, 2009).
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Empowerment in Nursing Practice. The relationship between empowerment and health promotion is discussed in the World Health Organisation Health Report by Nutbeam, 1998
This can be linked to Ewles and Simnetts? definition regarding empowerment, about helping people change how they feel about themselves by supporting and encouraging them to change their behaviour to increase their chance of living a healthier and more fulfilled and extended life. They go on to define empowerment as ?modifying the way people feel about themselves through improving their self-awareness and self-esteem. It involves helping them to think critically about their values and beliefs and build up their own values and beliefs system?.
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Firstly because it was an exposure I had never had previously, and secondly I simply felt somewhat uncomfortable washing male gentiles. But I knew I had to overcome this situation sooner rather than later, because on a busy ward there was not going to be any shying away accepted. I spoke to my associate mentor, who is also male, about my worries. He reassured me and said that he would assist me with a male bed bath and let me take the lead, and he would then guide me where he felt I needed to do things differently.
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The definitions of the concept of role in relation to role theory include description of the behaviours, characteristics, norms and values of a person or position (Major 2003; Thomas & Biddle, 1966). An individual role describe attributes of the nurse that are socially accepted and expected by individual nurses, their peers, other health professionals and the wider community in which the role is embedded (Major, 2003). Literature states that the general role of a Registered nurse can be broken down into six sub-roles that have been commonly identified.
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Also, Health promotion in terms of what is believed to be is strategies of encouraging people to get involved in activities that will help to alter undesirable behaviour that negatively impact on their health. For instance, if an individual is prone to infections combined with unawareness of hand hygiene with encouragement allows positive alteration in behaviour to keep themselves free from bacteria by carrying hand gel or wash their frequently. In the case of health promotion, there will be a discussion on hand hygiene.
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Assessment and Care Planning for the Adult in Hospital. This essay will include a case study of a patient I have nursed in practice.
Van Dyke Hayes & Sparks Ralph (2009) point out that nurses use several ways of collecting information about their patient, such as observational skills, interviewing and conduction of physical examinations. An experienced nurse can usually assess a patient using these methods simultaneously. A thorough patient assessment should include the collection of a past medical history (collection of subjective data). Collection of objective data via physical examination is also a vital part of patient assessment. Measurements of the patient?s weight, height, respiration, temperature and blood pressure are recorded.
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Discuss the way in which age impacts on peoples health and well-being in Britain today. What challenges does this pose for professional practice and how might you respond to this?
It is important to make sure that every child has a balanced diet to enable growth and development. An inadequate diet can result in restricted growth and development; short-term health can be affected as well as long term. Short term conditions such as dental problems, anaemia and obesity can occur and conditions such as coronary heart disease, strokes, osteoporosis and diabetes in the long term. (Dowler et al, 2001). Meggit, C et al (2008) explains that all children are entitled to basic rights, these include food, healthcare, a safe home and protection: However children need to rely on an adult for their needs to be met and this can vary considerably according to their family?s circumstances.
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Communication is a difficult concept to define, described by Anderson (1959) as a multifaceted phenomenon, involving various means of verbal and non-verbal communication. These interacting factors can be physical, psychological or social; each situation requiring self-awareness and self actualisation by the nurse in order to effectively communicate with the patient (Sully and Dallas, 2010). Interpersonal skills are imperative when dealing with person centred care and creating therapeutic relationships between nurses and patients (Marquis and Huston 2009). Communication has been described by Miller and Nicholson (1976) as an interpersonal activity involving the transmission of messages from a source to a receiver for the purpose of influencing the receiver?s behaviour.
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Specific action plans will be put into place to support people to make healthier choices including: introducing a cooking bus that will highlight the importance of food and nutrition for schools and communities, It will allow people to develop a better understanding on how to eat healthier and what food can do to your health. (Scottish Government, 2008) Hungry for Success was developed by the Scottish Government (2003) and introduced nutritional guidelines for school meals. The Scottish Standards indicate that oily fish should be served at least once a week and processed meat products only once a week; Brown bread
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and affect their ability to exchange information through verbal and non verbal ?communication?, another key benchmark for patient care (DH 2010). Nurses are in a key position to facilitate and promote high standards of oral hygiene (Wood 2008, Xavier 2000), through providing assistance, equipment, a suitable environment and possessing specialist knowledge and skills to provide mouth care (DH 2010). Elderly patients may require more assistance with mouth care due to the prevalence of physical and mental conditions that can affect this age group, notably vision and motor control impairments and states of confusion such as dementia (Fitzpatrick 2000).
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Research and Study Skills: Interpersonal Skills to build a therapeutic relationship in mental health nursing
In my previous clinical placement I went to an acute admission ward (NMC, 2008, p3).Simpson (2009, p404) identifies the development of a supportive nurse-patient relationship with people in acute distress is an important goal for nurses working in acute care. This process, along with my clinical placement experience, highlighted how challenging it can be to form therapeutic relationships with people suffering multiple and often complex presentations of distress (Simpson, 2009, p404). This made me consider how interpersonal skills and communication skills interact within this context. This experience has led me to investigate the evidence base behind the use of interpersonal skills to help build a therapeutic relationship with clients suffering with mental health problems.
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