IMPLEMENTING CARE (NJ104)
IMPLEMENTING CARE (NJ104) This essay describe the nursing processes, with implementing as the fourth phase in the nursing process, or intervention phase through the use of Roper, Logan and Tierney (1996), models of nursing which is based to the priority nursing actions or interventions performed to accomplish a specified goal stated in the holistic assessment and planning care of my client. The use of a pseudonym John is also going to be used as a way of protecting client confidentiality as required by the Nursing and Midwifery Council (2004). I will focus on Mr John care implementing in return to the activities of living that I had used during assessment and planning which was breathing. I will try to implement the nursing care plan follows the planning component of the nursing process and diagnosis, which I had established the priority of care to identify the nursing interventions that I will provide to John with the help of my Mentor and the Multidisciplinary team. The actions are also selected after goals are established. However, to implement these actions occurs during the phase of implementation of 7the nursing process. Synder (1985) proposes that nursing intervention is a model of decision making. Implementation is the delivery of nursing care, including the initiation and completion of the actions necessary for achieving the set goals: which means to perform,
substance use history taking report
Substance use history taking report Introduction Mr. A is a 68 years old Caucasian man who lives in a residential home. He was admitted to the ward two weeks before mainly for problematic alcohol use and plan is to detoxify him. Mr. A is known to psychiatric services for 20 years and he was diagnosed as Korsakoff's psychosis, central pontine myelinosis and recurrent depression secondary to alcohol abuse. According to Mr. A, he had several admissions to the hospital due to alcohol problem. He used to live alone and was not able to care for him so was placed in present residential home. Currently his problems are related to alcohol use. According to staff at this residential home, Mr. A was drinking everyday , non-compliant to his medications, trying to steal things from other residents rooms and was also caught by police couple of times, for shoplifting. He was also encouraging fellow residents to drink alcohol into the home. The staffs was finding it very difficult to manage him, hence this admission was planned. Since his admission to the ward he is under care of multidisciplinary team. He is on alcohol detoxification regimen for severe alcohol dependence. He has been prescribed Tab. Chlordizepoxide 20mg QID. He is on Mirtazepine 30mg nocte, temazepam 20mg nocte, folic acid 5mg mone and thiamine 100mg mone. He is also being prescribed spironolactone 2.5mg and senna
Determination of the validity of consent.
VALID CONSENT INTRODUCTION Consent to investigation or treatment is fundamental to the delivery of all healthcare Department of Health (2001) For consent to be valid it must be given voluntarily by an appropriately informed person who has the capacity to consent to the intervention in question Department of Health (2001) A recent clinical supervision session I facilitated reflected on the dilemma involved when a patient initially refused a CT scan. Undertaking clinical supervision for nursing staff is one aspect of my role within the Trust. The patient, an 83 year old gentleman had advanced, inoperable malignant disease. He had undergone courses of chemotherapy and radiotherapy following diagnosis of the disease. On this admission, there was suspected intestinal obstruction. The consultant had ordered an urgent CT scan. The patient informed the staff nurse that he did not want to have the scan. Discussion of the patient's wishes with the consultant resulted in the consultant re-visiting the patient and informing him that in his opinion the scan should go ahead as planned. The patient decided that he should do as the doctor said. Analysis from reflection suggested that the nurse was unsure how to determine if consent was legally valid or ethically sound. Therefore, from the legal standpoint this essay will give an account of the determinates of valid consent. Using a
Based on the twelve activities of living, assess the patients support during admission.
Assessment Introduction I have collected information on my patient whom I had admitted onto the ward whilst on my first placement. This essay is based on the twelve activities of living, recommended by Nancy Roper, Winifred Logan and Alison Tierney. Every patient has an assessment done when they are first admitted into hospital, so that the nursing staff and other members of the multi- disciplinary team can access the patient's medical records, at any time. Assessment is the first component of the nursing process, there are three other areas to the patients assessment during the admission, they are, planning, implementation and evaluation. The process is an ongoing and continuous activity using a problem-solving framework. during the patients stay whilst they are in hospital. I will be using a framework of care that will help me assess my patient holistically and is used within my hospitals local trust. The most used model in nursing is the Roper, Logan and Tierney model of nursing (Roper, Logan and Tierney 1994). It reflects on the 12 activities of living (AL) and is based on the patients needs whilst in hospital and in the community, other influencing factors I have to take into consideration in the assessment are the physical, psychological, environmental, socio-cultural and politico economic needs in order for an holistic approach to the assessment of my patient.
Experiencing a Crisis: the nurse's role
Experiencing a Crisis: the nurse's role module assessment (Module code: HCN14-2) Martina Bazikova This assessment will demonstrate an understanding of learning and teaching processes and theories in relation to a teaching session given on the subject of oral health. This topic was chosen as the writer feels that, in her experience, effective oral care is provided by nurses on an infrequent basis. Maintaining appropriate and successful oral care can have an enormous impact on an individual's well-being and also can enhance their self-image (Xavier 2000, Shepherd 2002). The nurse's role is to provide mouth care or to supervise self-care or care by relatives as necessary (Turner 1996). Yet many nurses seem to have little awareness of their responsibility to provide oral care, and those that do are often neglectful in their care (Fitzpatrick 2000). This view is supported by Adams (1996), whose research indicates that both pre- and post-registration nurses had a definite lack of knowledge from which to assess their patients' oral status. Kenworthy and Nicklin (1989) expand the definition of teaching from how it has been traditionally thought of: as a planned or structured activity which is designed to increase or improve the student's knowledge of a subject. They believe that the days of the passive teaching-learning relationship are gone and that a teaching definition
Discussing a patient with type 2 Diabetes Mellitus.
Introduction The author of this essay will be discussing a patient with type 2 Diabetes Mellitus and will also be discussing the nursing care that will be received by the patient following a hypoglycaemic attack. The patient being described is a fictitious seventy year old lady called Mabel Gordon; she lives in a flat in a city centre with her husband Bert. Mabel has had type 2 diabetes for years which has been poorly controlled by medication and diet. Mabel's diabetes has now progressively worsened; she has been commenced on a self-managed insulin therapy plan. She is cared for by the community nursing team and her GP; she attends the regular diabetic clinic. Mabel has no other medical conditions but is currently suffering a cold. On a trip to the chemists Mabel feels unwell, clammy, trembling and confused; the chemist calls Bert and the district nurse. On her arrival the district nurse treats Mabel for a hypoglycaemic attack, to which Mabel responds, but is concerned about Mabel's high temperature, she arranges for Mabel to be admitted to hospital. Aetiology and Pathophysiology Diabetes Mellitus has two principle classes, type 1 and type 2; approximately 90% of people with diabetes suffer from type 2, (Burden, 2003a). Type 1 diabetes is characterised by the destruction of the Beta cells. The Islets of Langerhans within the pancreas contain two types of cells,
Nursing is a caring discipline, although the role of the nurse changed dramatically over the centuries
Illness or Health business This essay will discuss the role and stereotype of the nurse from a historical view as portrayed by the public up to the present day. It will then outline ways, which could extend the nurses role in working for health. Nursing is and always has been a caring profession, although the role of the nurse changed dramatically over the centuries. Historically, the community saw the nurse as a nourishing and protecting person, who was willing to care for the ill, injured and elderly. A nurse was also simplified as a woman who suckled and took care of children. (Ellis and Hartlay, 2000: 165; Taylor and Field, 1997: 235) For the reason, that only a female can suckle children, it is clear, why the public associated nursing with women. Through the decades, the role of the nurse moved from just motherhood, nourishing and fostering children, towards a role of a person with rising responsibilities, expanding tasks and no specific gender. Today, nursing is related with caring for an individual in a variety of health related situations. (Ellis and Hartlay, 2000: 165) However, caring and curing is not the only important task for the nurse. He or she also participates in health promotion, for example educating clients about health and the prevention of infirmity. In today's society, nursing takes place in many different contexts including patients' homes,
Family Presence During Resuscitation Attempts.
Running Head: FAMILY PRESENCE Family Presence During Resuscitation Attempts Fort Hays State University Family Presence During Resuscitation Attempts Its five AM and an unresponsive patient is wheeled into an emergency suite. The scene is like that from a movie including nurses, doctors, chest compressions, IV drips, and alarms. But what is missing? The family. They've been strategically placed in the cold impersonal waiting room. Wondering, with great anticipation, what is happening on the other side of that door. It is at this moment that you must leave your nursing background behind and find yourself inside the minds of those loved ones. Can you imagine the helpless feeling? The intense anxiety? The ultimate loss of control? This leads us to the loaded question, should family members be allowed in the room during resuscitation attempts? A review of history indicates that only a mire thirty years ago families weren't even encouraged to be in the delivery room, which today is now common practice. As a new nurse I enter this profession expecting families to witness life begin, but find myself in shock when I think of them watching life end. The question of family presence exists due to the high number of fatalities related to CPR efforts. Family presence at the deathbed has both its supporters and its opposers. Those against it claim that family members will be in the way
The individual Accessing Health and Social Care
The Individual Accessing Health and Social Care This essay is going to explore factors that effect health and health choices of people who have learning disabilities, by linking these issues of accessing health care to a patient with learning difficulties outlined in a case study. It will also look at the Government White Paper "Valuing People" (Department of Health 2001) as well as other current and relevant literature. Investigating further more, the implications it has on the changing and developing role of the nurse and the health care system. The term learning disability means different things to different people and cannot be cured by medical or nursing intervention. However, the condition can be greatly improved by appropriate support and care. A definition of learning disability is included in the "Valuing People" and states that learning disability includes the presence of: "A significantly reduced ability to understand new or complex information, to learn new skills (impaired intelligence), with; a reduced ability to cope independently (impaired social functioning); which started before adulthood, with a lasting effect on development" (DoH 2001). It is well documented that there has been a change in attitudes towards people with learning disabilities over the past 30-40 years (Gates 2003). Wolfensberger (1972) developed the concept of normalisation and largely
The reason for this essay is to reflect on a critical incident experience during my six Week placement as a student nurse, on an orthopaedic ward,
CRITICAL INCIDENT: Reflection on a critical incident: According to the Flanagan (1954) "critical incident is defined as an incident Which is critical as long as it makes significant contribution positively to the general Aim of the activity". Critical incident is defined by Tripp (1993) "as an incident which has happened and Are produced by the way we look at the situation. It is an interpretation of the Significance of the event" The reason for this essay is to reflect on a critical incident experience during my six Week placement as a student nurse, on an orthopaedic ward, in my opinion the incident chosen has made an impact on me due to the fact those side effects of surgery can be very critical to patient's lives, as would be demonstrated in the critical incident chosen (D.V.T). Deep vein thrombosis. There are various reflective models written by various theorists and they include: Atkins and Murphy (1993) Stephenson (1993) Johns (1998) Gibbs (1988) For this critical incident the model I have chosen to use is Gibbs (1988) reflective model as a guide because it is more understandable and will reflect more clearly on this critical incident. It is widely known that experience alone is met adequate enough to guarantee that any learning takes place, so it is important that integration of past experiences with new experiences occurs. This is