Mr. Comer was admitted to his local community hospital for respite care. He has suffered multiple, acute strokes in the past, which has left him with severe disabilities. These include paralysis rendering him immobile, aphasia (speech loss) and dysphagia (swallowing difficulties). He relies on carers for all normal activities required for daily living (Roper et al 1996) and is advised to have a pureed diet and thickened fluids. My mentor asked me to observe her feeding Mr Comer. She had prepared my learning the week previously by providing literature on the subject of feeding elderly patients and discussion on safe practice for feeding patients with dysphagia. I was alarmed and unprepared for the physical sight of this patient, …show more content…
Critical analysis of this experience has pointed to the fact that I have inadequacies in my skills, to identify covert and overt clues provided by Mr. Comer to his needs. I had focussed too much on the presenting task to feed him, with my mind occupied on his safety due to the nature of his swallowing problems. I had not considered his other needs like his wishes or desires and I had not gathered enough personal information about him beforehand to know this (Davis & Fallowfield 1991). I had been unsure about what to say or do to alleviate Mr. Comer?s apparent anxieties and had adopted what Watson & Wilkinson (2001) describe as the blocking technique. By continuing my actions to carry on with the meal, I was cutting short the patients need to communicate a problem. I was influenced in this decision because I felt obliged to be seen to reduce his anxieties, knowing my actions would be judged by an audience of other care workers and patients on the ward. I did not respond efficiently to reduce his distress and this pressure led me to deal with the situation inadequately and for that I felt guilty (Nichols 1993). I should have allowed more time to understand what Mr. Comer was thinking and feeling by putting words to his vocal sounds and actions. I could have shown more empathy in the form of my own body language to promote active listening (Egan 2002) and not worried about other peoples views on my
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2.2 - Describe how mealtime environments and food presentation can be designed to help an individual to eat and drink:
I was interested in learning about PEG feeding from the very first time I saw it in the care home. I was eager to learn the skill. By observing my colleague doing it and by attending training I learned the procedure clearly and gained necessary confidence to perform it. I obtained consent and maintained privacy before carrying out the procedure. I was nervous whilst doing it for the first time but with the support of my colleagues I overcame the stress and mastered the skill.
After I got the assignment, I met my nurse, introduced myself and took the report of the patient. I went in my patient room and introduced myself. I took patient vitals and documented it. With Professor Zentis I did physical assessment. Her fundus was firm and midline 2 fingers below the umbilicus. The patient had scent lochia rubra. Mrs. M has 6year old daughter and concerned that she is not sure the right positions to feed baby. She also had incision pain
This piece of work will be based on the pre-assessment process that patients go through on arrival to an endoscopy unit in which I was placed in during my second year studying Adult diploma Nursing. I will explore one patient’s holistic needs, identifying the priorities of care that the patient requires; I will then highlight a particular priority and give a rational behind this. During an admission I completed under the supervision of my mentor I was pre-assessing a 37 year old lady who had arrived to the unit for an upper gastrointestinal endoscopy. During the pre-assessment it was important that a holistic assessment is performed as every patient is an individual with unique care needs as the patient outline in this piece of work has
While Fisher displayed emotional struggle with food, Goode’s disability forces him to struggle with food physically. Although Goode enjoys food, he finds himself testing all his abilities as a one handed person when he prepares a meal. JJ Goode begins the discomfort he
This essay will highlight one of the key concepts of nursing .The concept that will be discussed in this essay will be communication, the reason for this chosen concept is that communication plays a vital role in everyday occurrences which defines how a situation is perceived by yourself, others and how communication is effectively handled . There will be a definition on what communication is also an evaluation of the chosen concept will be explored throughout this essay.
It is my belief that every patient, regardless of the severity of their condition/presenting complaint deserves my undivided attention and I am also aware of the importance of ‘getting right’ those first crucial moments of a consultation. How the patient is greeted, patient comfort and environment all shape the patients first impression and help to develop communication and rapport (Egan, 1998).
Within this assignment it will be exploring the care of a patient using evidence based practice. The patient being explored is one met during a community nursing placement, though all identifying evidence will either be changed or not used to keep the patient’s confidentiality (as with the nmc code). The patient is currently residing in a residential home in Derbyshire. The patient is a man who is in his fifties. He had been put into the residential care following a hospital admission for a brain tumor, a family member living with the patient had flagged patient safety issues at home and social workers thought it be best for the family to have a respite period and to give the patient more care in a residential home for an undetermined amount of time. The patient themselves seemed very happy to accept this. The patient’s current medical history is that he suffers from diabetes which is kept under control through two insulin injections a day, morning and afternoon. As previously mentioned above he also suffers from a brain tumor, at the moment the effects of this on himself are unknown. It has been recorded that the patient has some difficulties in maneuvering himself and needs some assistance as well as assistance and prompting to eat and drink. Due to the patient’s current medical history three care aspects have been chosen to explore that are considered relevant to this patient. The following are - Infection control / standard precautions, medicine
The learning during lecture will be passive, but the discussion will allow for interaction of patient and nurse in which the patient can ask questions (Beagley, 2011, p. 336). Instantly a nursing diagnosis was being formed.
“Hey there” John looked over his shoulder at the smiling face of his new coworker. John greeted him as hallway smiled back not wanting to talk since he had woken up at 5:00am that morning. He quickly dashed over to his office and switched on his computer. He thought about the nine years of intensive study that he had to go through. The loud ringing of his pager interrupted his thoughts. He answered a few nurses difficult questions about what medicines to prescribe what to do with a few difficult patients. He placed his phone down a little nervous wondering if he had just killed someone by prescribing the wrong medicine. He grabbed his clipboard, jacket and stethoscope and went to go meet his first patient. “Mrs. Anderson, how are
Case study three presents with a possible ethical dilemma. This case presents with a patient who was inconsistently aspirating on all consistencies of food and liquid. Only the effortful breath hold reduced the amount of aspiration on thick liquids and pureed foods. The patient does not want take the speech therapists advice of taking nutrition and hydration nonorally and wants to eat and drink by mouth.
During his first week in medicine he finds himself at the university hospital where he begins interacting with hospital patients. He brings in warmth into the hospital by engaging patient to provider interactions. However, the dean of the college of medicine did not find his action favorable and brought it to his attention. All of which he continues to do what he believes best fit for the patient’s need.
Using this example, we clearly see that the nurse asks the patient a direct and clear question so as to get information and in turn she gets a response. It is suggested that this is a good example of questioning and probing and it is recommended to be used again in future. To provide the most effective care possible, nurses must begin with clear and appropriate verbal skills such as being honest, being concise and keeping emotions out of the conversation (Apler, 2006).
Samuel is offered support to help him self-manage his condition and his doctor offering him leaflets and information about groups and offered him to go see the nurse about self care routines and healthy eating. He leaves the surgery feeling relived, supported and free of concern after talking to his GP. Brian leaves feeling worried, he feels he should have mentioned his move to the doctor but he feels as though his GP is authoritative and his feelings are irrelevant. He knows he has no support from the nurses until two weeks time when he moves in and feels pressure for his blood sugar levels to improve otherwise he will have to get insilin injections. As we can see the approaches from the doctors leaves the patient feeling differently when leaving the surgery.
Dr. Abeer has a hands-on patient care in the center under my direct supervision. She handled a variety of cases ranging from the strictly acute cares to the complex challenging ones. She took and documented patient vital signs, history and performed a proper physical examination. Then, she presented the cases and discussed the appropriate management plans with me. She showed a very good understating of the delivery of the health care system in the United States and the capability of providing excellent patient care in a consistently positive and skillful manner.