Nursing Care Plan Paper

This author’s personal philosophy in practice is to provide holistic care to my patients and their families. This author feels that encompassing the whole family or the patients support framework in the plan of care is the best approach to returning the patient to their optimum state of health. It is important to this author to evaluate the all of the aspects of the patient’s lives that they will share. It is important to evaluate the patient’s learning style,

This study uses nurse staffing variables, patient outcome variables, and background variables. The nurse staffing variables will involve the number of nurses to skill mix and patient volume. Patient outcome variables will be categorized into infection control, patient safety, subjective and objective outcomes, and complications. The background variables are important to accurate correlation and may relate to both patient outcome and nurse staffing and will include organizational systems, nurse characteristics, patient characteristics, and organizational characteristics.

There are four phases between the nurse and the patient relationship. The phases include orientation, identification, exploitation, and resolution. In reference to the orientation phase, this is introduced by the nurse. During this phase, the nurse and the patient become familiar with one another, as well as establish a dependable relationship. The following phase, identification, starts to recognize the issues to be incorporated into the relationship. For instance, the main goal is to assist the patient in identifying his or her own responsibilities in the treatment plan, in addition to advocating for interdependence and contribution. During the exploitation phase of the nurse-patient relationship, the nurse and

Since the early 1900’s nurses have been trying to improve and individualise patient care. In the 1970s this became more structured when the nursing process was introduced by the general nursing council (GNC), (Lloyd, Hancock & Campbell, 2007) .By doing this their intentions were to try and understand the patient in order to give them the best care possible (Cronin & Anderson, 2003). Through the nursing process philosophy care plans were written for patients. It was understood that this relationship would ensure the patient received the best care possible to suit them individually. This would consist of not just the patient as a physical being but their spiritual emotional and holistic being also (Cutler, 2010). The

This theory describes the different phases that a nurse-client relationship goes through. The phases that my patient and I will most likely be working in are the orientation and the identification phases because our relationship will be new. Our interaction will focus on building a mutual trust and understanding, as well as answer basic questions as to why my patient is here and things that she has been struggling with. Depending on how long my patient has been in the program, she may be open to exploring more of her feelings and sharing more about herself with me. Focusing on developing a good nurse-client relationship will help me during my interaction with my patient and will help me understand her needs better.

This week, I was given the opportunity to care for two female patients – 205(1) and (2). The first patient, 205-1, was admitted with respiratory distress and had a past medical history of hypertension, schizophrenia and bipolar disorder. She was initially put on 2 L/min of oxygen and placed on oxygen titration protocol with orders to maintain O2 saturations between 88-92%. The patient was oriented to person and place, but had difficulty with time. She was also obese (BMI 30) and deemed a moderate assist with ambulation. Her care plan included total assistance with ADLs, smoking cessation and oxygen protocols, limited salt intake (3mg), and chronic pain management. The second patient, 205-2, was admitted with a right pelvic fracture and had

The patient is 22-years-old Travis Walker, who is happily married to Emma. Travis had a boating accident and suffered a spinal cord injury at the level of C-7. He believed his health condition was excellent until the boating accident. Travis’ medical records indicate he had tonsils removed at the age of 3. He is currently at a rehabilitation facility, three weeks after his accident.

In any practice of care, nurses must be able to provide care that is holistic and centred to the individual client. According to the World Health Organisation (WHO), to care for a patient ‘holistically’ is to look beyond their illness or disability and care for them as individuals considering not just physical but also their mental, emotional and spiritual well-being (ref). Whilst, person-centred care is to deliver care moulded to the patients’ personal preferences, treating them with value and respect, ensuring that the care provided is appropriate for their needs (Goodrich and Cornwall, 2008).

William Smith is a 68-year old man who was transferred to the Palliative Care ward from a surgical ward three days ago. The patient was admitted on January 26, 2013 for removal of a sacral abscess that had been a source of a lot of pain to him. Following his surgery, his future management was evaluated and it was decided that he would be transferred to the Palliative Care ward since he could not be discharged home. The palliative assessment of Smith would require the development of a suitable nursing care plan that would help deal with the condition. The nursing plan requires an understanding of the patient’s social history, medical history, physical assessment upon admission, and palliative care unit admission assessment.

The nurse manager I selected to interview is a Baccalaureate degree nurse and has attended several in-house training sessions related to her position within the hospital. She attended Lenoir Rhyne University to obtain her BSN and has been employed with the institution for 13 years and has been in nursing for nearly 20 years. She is currently certified as a Certified Emergency Nurse (CEN) and is also a Sexual Assault Nurse Examiner. The Hospital that she is employed with is a private hospital she manages a 15 bed emergency department and 6 bed express care facility, which also holds several involuntary commitments for several hours at a time waiting on placement.

Nurses are among the largest group in healthcare. If there is a disaster, having the nursing profession on board is important because of the positive impact that could be felt. There is no standardized training for nurses on disaster planning (Gebbie & Qureshi, 2002). So, involving nurses in the disaster assessment and preparedness plan would be helpful so that there can be buy-in from one of the largest groups that is going to be involved. This hospital has done a great job of preparing for disaster and used these plan correctly. The hospital was having several drills per year and made sure that all personal was involved including administration ( Hamlin, 2015).

Analyzing the journey of a hospitalized patient is imperative in nursing practice in order to produce holistic, strengths based care (Gottlieb, 2014). When examining the patient and his or her journey, it is crucial for the nurse to explore many factors including the patient’s personal history leading up to admission, the unique and individualized care plan, impacting strengths and gaps within the healthcare system, as well as the factors affecting discharge care and planning. For the purpose of this paper, a patient by the name of Anna will be explored in order to highlight essential aspects associated with providing holistic care.

Ineffective breathing pattern related to decreased oxygen saturation, poor tissue perfusion, obesity, decreased air entry to bases of both lungs, gout and arthritic pain, decreased cardiac output, disease process of COPD, and stress as evidenced by shortness of breath, BMI > 30 abnormal breathing patterns (rapid, shallow breathing), abnormal skin colour (slightly purplish), excessive diaphoresis, nasal flaring and use of accessory muscles, statement of joint pain, oxygen saturations of 85-95% 2L NP, immobility 95% of the day, and adventitious sounds throughout lungs (crackles) secondary to CHF, hypertension, pain caused by gout and arthritis, and obesity

The orientation process for new hires lasts six weeks. The new nurse attends nursing orientation for one week and then is assign a preceptor on the unit for each shift. The DPCS introduces the new employee to their preceptor. This nurse works three weeks on the day shift, one week on the evening shift and one week on the night shift working with both medically acute rehabilitation patients and surgical patients. Nurses receive extra days of their orientation with patients that the nurse has limited clinical experience such as a nurse with postoperative experience will work more with the medically acute rehabilitation patients to practice new skills. For new graduates their orientation is individualize and can last from 8-16 weeks.

A nursing diagnosis identifies an actual or potential response of a patient to a health problem (Jones 2009). Nursing diagnoses are important because they provide the foundation for the selection of nursing interventions (Walton 2008). This care plan is the concluding half to the initial care plan that identified nursing diagnoses and goals with the aim of promoting the holistic wellbeing, mental health, and independence of a 68 year old Mr. Bertoli who has returned home from hospital after experiencing a stroke. Particular emphasis will be placed on proposed interventions to achieve Mr. Bertoli’s healthcare goals and the provision of rationales. This is important to justify the significance of the interventions and indicate