Knowledge and Skills for Nursing
The Setting
The setting is a medical ward; patient was admitted credited to diarrhoea and vomiting because of this of alcoholism and malnutrition. Clinic medical ward contains patient that requires proper strategy and nursing health care to shorten their stay in the hospital. The patient will be treated not only bodily and physiologically but also mentally because the patient was having such troubles because of depression. The patient began to become frustrated when her hubby dies. She became an alcohol reliant and her health started to deteriorate anticipated to malnutrition.
The Way
The patient was taken to the hospital with diarrhoea and vomiting. The individual is in physical form not well, pale and has a poor hygiene. Predicated on the background check patient experienced experienced severe depression because her spouse died and live together. The individual became alcoholic and her health deteriorated because of malnutrition. The individual appears underweight but may survive giving proper medication and patient attention.
The medical process can best be described as a framework for planning individualized look after patient with intellectual disabilities. Since the care for patient is an activity it generally does not conclude into not alternatively it changes constantly and it is the nurses' responsibility to react to these changing needs whenever necessary. The medical process usually includes 4 or 5 stages depending on resources available and work setting up, and includes: diagnosis, diagnosis, planning, utilizing and evaluation. The medical process should be carried out using a collaborative and participative way with other professionals, gathering and putting into action resources, to be able to improve the health care process (Department of Health 2000b; Department of Health 2001). The concentrate of this research will be on the look care arrange for our patient on review.
Assessment
Assessment is the most important part of care planning and delivery. It offers areas such as health insurance and health needs, everyday living skills, activity programmes, flexibility, mental health, risks to your client, finance, respite, cultural occasions/outings, support requirements, spiritual needs and, possibly, accommodation issues (Department of Health, 2000b;Sox, 2004a). As a start, a record check is needed to be able to assess the problem of the individual. Our patient is conscious but was not able to act in response properly because of her condition. So we need someone close to the patient or a relative to answer questions necessary for the treatment plan. Data such as earlier hospitalization, medication taken yet others related to the patient condition is important.
Diagnosis
The patient was brought in the hospital because of diarrhoea and vomiting. The original diagnosis is the fact that the patient is dehydrated basic on the physical appearance of the individual. Diarrhoea usually gets better on their own, often with no treatment. In the event the diarrhoea continue within several days it is advisable to check patient's medical history and physical exam.
Planning
In planning, the nurse plays an important role in the recovery and stay of the individual in a healthcare facility. The patient after admission was presented with attention on the main complain which is diarrhoea and vomiting. However further examination and evaluation of the medical team discovered that the individual is suffering from malnutrition. Our plan targets malnutrition; the reasons why the individual is having this type of condition, and the procedure and the protocol that the nurses should follow for the welfare of the patient.
Implementation
Implementation of an attention plan is the most challenging area of the nursing process. The patient is pale and has lost a great deal of weight. The patient also lacks proper hygiene therefore of her appearance after admission. The execution of the health care plan will get started upon admission. The patient will be forwarded and referred to the nursing personnel working in the medical ward and will be given the treatment plan as agreed upon by the medical team and the patients comparative. Malnutrition Analysis will assess the potency of the good care plan and the execution of the care and attention. It is important to evaluate the point for good care to be able to reach its attractive care and attention plan. An updated review should be achieved to improve and improved the plan.
The Model
In simple dialect, a model is referred to by Pearson and Vaughan (1993) as a descriptive picture of practice which properly represents the real thing. Riehl and Roy (1980:11) cited in Roper et al (1990) provide a far more intricate definition of a model as "a systematically constructed, scientifically structured and logically related set of ideas which identify the essential the different parts of nursing practice, together with the theoretical bases of these concepts and the principles required for their use by the practitioner. "
Choosing a proper model is important to help the good care planning effective. In UK, the model of nursing used most mostly is that of Roper et al, 1980 that bases its principals on the model for living. It provides a holistic care and attention approach and involving the important element of the daily activities of any person. The model comprises of five components: Activities of everyday living (ADLs), Lifespan, Dependence/Independence continuum, Factors influencing ADLs, and Personality in living. (Roper, Logan, Tierney, 2002). The truth of our patient must be assessed physically, physiologically but also emotionally. The result of losing a husband has led our patient to be sick. The Roper, Logan and Tierney are believed to be a useful strategy in dealing with our patient since it requires a holistic procedure.
The model was known as after the author of the model, Nancy Roper, Logan and Tierney. It was first developed in 1980 established upon the work by Nancy Roper in 1976. The model is based on the 12 activities of residing in order to live. The model has been revised many times 1985, 1990 and the latest version 1998. The 12 activities involve the following: keeping a protected climate, communication, deep breathing, eating and drinking alcohol, elimination, cleaning and dressing, thermoregulation, mobilisation, working and participating in, expressing sexuality, sleeping, and fatality and dying. Each of the activities might be seen to be conceptualised as resting on a continuum from dependence to independence. There are times in our life that we may be more reliant on others to meet our needs. The role of the nurse is to help people move towards independence in all activities of daily living. Biological, physiological, socio-cultural, environmental and politico-economic parameters are factors that effect on the average person and have an impact on their levels of dependence /independence.
Advantages and Disadvantages of Roper, Logan and Tierney
Based on the analysis done by Pearson and Vaughan (1993) style of medical is important in hospital ward or department. One of the features of the Roper, Logan and Tierney model is that it causes consistency in the design of health care received by patients and therefore to a continuity of care patterns and treatments. The Roper, et. al. Model will give surge to less discord within the team of nurses as a whole. Because of the rationale and definition behind the model other medical care involved will understand better the logic of good care. Roper, et. al model is said to be self explanatory or not too complicated when compared with others. It is stated to be achieved this way in order "to aid learners to develop a way of considering nursing generally terms. " It is mentioned previously that main idea of the Roper, Logan and Tierney model is based mainly on twelve activities of living which is the key elements of medical and is referred to as "basic individuals needs. According to Roper, Logan and Tierney the actions of living have an advantage for medical model being that they are observable, describable, and in some instances, objectively measured.
The model is principally focused on the twelve activities as the theory is built on 'living' and addresses the nursing activities as a deliberative approach to meet the twelve the different parts of nursing care and attention. It conceptualises the individual as a biological being with inseparable mind and body and Health as the capability to function independently in relation to the twelve components (Fitzpatrick and Whall 1989).
The Attention Plan
The original diagnosis on the patient under research is diarrhoea, alcoholism and malnutrition. However as the process of identifying the cause of the patient's condition, nurse joining to her needs found out about the fatality of her spouse. After background check they have got found out that the patients' spouse passed on and became frustrated as a result of situation. During analysis on the patient's health it's been noticed that the individual has mental medical condition. Medical needs of an individual is also important and the nurse involve should be aware of these needs. To help the patient, nursing process and nursing model should be working together to help the individual survive. Assessing the necessity of the patient is important. The Roper, Logan and Tierney model will ensure that the patient can have a protected climate, should be interacting with her nurse joining to her, inhaling, eating and taking in, working. Due to its alternative approached, Rogan. Logan and Tierney model is trusted. To evaluate the situation of our patient, the alcoholism of the patient might lead to liver disease and you will be affecting the day to day activities of life. The patient should trust her nurse and they must have a good romantic relationship to have a powerful health care plan. The chosen model Roper et al have described the span of life as something that starts off at conception and is maintained until death. The model consists of maintaining a safe environment; our patient should be residing in an environment that she will be comfortable and clean. The patient upon entrance has seen to acquire poor health. In identifying the actions of living the individual should be take part in personal cleansing and dressing. As referred to in the admission of the patient, the patient has poor health. The individual may have pressure sore anticipated to her stay in the hospital. This will be cured and approached perfectly by the nurse controlling her. Pressure sore is the consequence of being immobile of the patient. The space of stay of the individual in a healthcare facility should be shortening to avoid such condition. The nurse must determine how to help the individual to cooperate on the agreed health care plan.
Implementing the care and attention plan will require the cooperation of the individual. It is important to help the patient to overcome the depression that she is experiencing. In this case the patient might not cooperate in the beginning of the plan but will be eventually cooperate as the process carries on. The success of the program will depend on the cooperation of the patient and the nurses.
Throughout life, our potential to perform ADLs will move in one extreme and possibly again. This aspect of the model of living, therefore, interlinks with the model of nursing with effectively, each reliant on the other. The individual will have an opportunity in dealing with the health problem that she actually is encountering. The Roper, Logan and Tierney model is suitable to approach the truth of the individual in a holistic way.
Conclusion
The nursing process includes phases that needs to be completed to help the patient overcome the disease she is in. Through this we will be in a position to identify which factors should get enough focus on prevent the incident of such disease. The analysis includes the nature of attention planning, person centred are organizing, care management, health action planning and the health care program methodology. This research also launched some relevant actions that need to be studied. The usage of the Roper, Logan and Tierney model are identified to help the medical process to be successful and effective. The Roper Logan and Tierney is a all natural approach and are important to work with the nursing process. This analysis has also advocated the need for robust, professionally prepared care strategies based on a systematic medical assessment.
Proper planning is important in dealing with the individual especially on the ones that are in admitted in a healthcare facility because of different ailments which can be cured and beat if proper medical process and model will be used. A nursing process is important to judge, assess, stop and eliminated illnesses of person. Our patient became suffering because of depression and problem, which needs to have an effective attention on different aspect. She must be cured physiologically, in physical form and psychologically. Nursing model should be holistic if this is the circumstance. The patient's daily living activity is damaged and she needs to realize why such activity such is performed for her wellness. Patient should be perfectly educated or enlightened on the benefits that she'll be having if she'll cooperate on the agreed care plan.
Reference
Roper, N; Logan, W; Tierney, A; 2002 The Components of Nursing 4th model. Churchill Livingstone, Edinburgh
Department of Health (2000a), Nurses, Midwives and Health Visitors (training) Amendment, London Department of Health.
Department of Health (2000b) The NHS Plan. www. nhs. com. uk
Goddard M, McDonagh MS & Smith DH (2000) Measuring appropriate use of severe beds: a organized review of methods and results. Health Plan 53 157-84.
Coast J, Inglis A & Frankel S (1996) Alternatives to clinic care: what exactly are they and who should decide? British Medical Journal 312 162-6.
Pearson A. and Vaughan B. (1993) Nursing Models for Practice. Oxford. Butterworth Heinemann.
Riehl J. and Roy C. (1980) Conceptual Models for Medical Practice (2nd. Ed. ) New York. Appleton Century Crofts. In Roper N. , Logan W. , and Tierney A. (1990) The Components of Nursing (3rd. Ed. ) London. Churchill Livingstone.
Fitzpatrick J. and Whall A. (1989) Conceptual Models of Nursing: Analysis and Request (2nd. Ed. ) London. Prentice Hall Int.
