Nursing Confidentiality Case Studies

In accordance with the Nursing and Midwifery Council,(NMC, 2015) The Code Professional standards of practice and behaviour for nurses and midwives on clause 5 Respect people’s right to privacy and confidentiality safeguarding patient information, no names or places will be disclosed. Therefore, throughout the following reflective case study, the patient will be referred to as Mariam. Patient

Christine Le, an accountant living in Flushing, New York, gave birth to a healthy baby “Nathan” on January 29th, 2010. She found out that she was pregnant with her first child when her period was late. She had the routine prenatal care starting at 12 weeks and delivered at 40 weeks in a hospital with the present of her husband, Robert, and the in-laws. To insure her baby was healthy, Christine underwent several prenatal diagnostic methods like amniocentesis to examine for genetic defects. Another method was ultrasound; its purpose is to assess fetal age, multiple pregnancies, size and shape of the fetus. Christine underwent numerous lab tests to ensure that there are no complications (Berk, pg.43). Lab tests like a complete blood count that screens

For the purpose of this assignment the patient will be given the pseudonym Susan to protect her privacy and confidentiality in line with the guidelines set out by the Nursing and Midwifery Council (NMC) (2015).

Special care and attention must be given to infants in the Neonatal Intensive Care Unit (NICU) because of their small size and the health complications they face. One particular challenge faced by health care professionals in the NICU is the management of pain for preterm babies. Preterm infants must undergo a wide range of tests, procedures, and, often, life-saving measures during their hospitalizations, which not only subjects them to pain, but pain-related stress and anxiety. This has an impact on the infants themselves, as well as on the family members and friends who are involved in their care (Smith, Steelfisher, Salhi, & Shen, 2012). The purpose of this paper is to examine the problem of pain management among preterm NICU patients and propose the implementation of kangaroo care as a pain management technique.

Providing an effective care and support to the patient and for their babies during labour

The National Institute for Health and Clinical Excellence (NICE, 2007) Intrapartum guidelines state that during the first stage of labour women should be encouraged to adopt the position they feel most comfortable in. This is what the student was trying to encourage even though her mentor did not.There are various positions the woman can adopt in labour which are generally grouped into upright and recumbent. The positions classed as upright are; standing, walking, kneeling, squatting, on all fours and sitting, and the recumbent position could include; supine, lithotomy, semi-recumbent or side lying (Johnson and Taylor, 2011). The upright position appeared to be more beneficial in Sarah’s case and the author wants to determine if this is always the case. It is evident that sometimes there will be constraints such as continuous fetal monitoring but it is important that the midwife does

For this assignment I will be writing a reflective account which will identify a significant episode of care in which I had been involved with, by identifying the pathophysiology and the disease process for the chosen patient; this will be presented by giving a brief outline of the psychosocial influences of the illness for the patient and others who may have been involved with the care. I will also reflect upon this episode by using a reflective model and examining the nursing process, using a holistic perspective throughout the reflective framework. Maintaining confidentiality is a key element, outlined in the Nursing Midwifery Council the Code (2008).

Although when it happens, there can be a devastating impact on patients as well as to the multidisciplinary theatre team involved. Consequently, the DAS has produced a consensus set of guidelines for managing failed intubations in adult and paediatric patients, but there are as yet no such nationally-agreed guidelines in obstetrics, therefore each obstetric unit should have their own flowchart with regards to management of failed intubation (Brien and Conlon, 2013). Furthermore, in light of the latest DAS guidelines, several aspects of clinical anaesthetic practise have changed over recent years (Frerk at al, 2015). Amongst the changes are the use of new drugs such as rocuronium and suggamadex and using electronic video-laryngoscopes (Frerk et al, 2015). Further work had also looked at extending the period of apnoea without causing desaturation by optimising the preoxygenation process and adequate patient positioning (Frerk et al, 2015). As a result, updated guidelines for difficult intubations in adult patients were published in 2015; these guidelines provide a flowchart to be used when endotracheal intubation proves difficult or impossible and focus on the central importance of oxygenation while reducing the amount of airway interventions in order to minimize trauma to the delicate airway (Frerk et al, 2015). The main message of the revised guidelines is

In order to gain an insight of what the client’s preferences are, it is essential for good communication to take place between the midwife and the woman. Communication is part of the 6C initiative lead by the NHS’ Compassion In Practice campaign to be implemented to the healthcare workforce. Communication comes in different forms: verbal, non-verbal and written. According to Professor Mehrabian (1972), non-verbal communication such as body language takes up 55% of our overall communication. By implementing certain gestures such as sitting up straight, maintaining eye contact and looking presentable leaves a lasting impression on the client. Thus it is imperative for the midwife to conduct themselves in a professional manner in order to build a good rapport with the woman.

At this point I would anticipate the HCP to order bed rest on the left side to hence placental perfusion, monitoring the fetus heart rate through an external monitor and monitoring vital signs. Also, limiting vaginal examination to prevent infection, monitor both fetus and mother for adverse effects tocolytic drugs and measurement of intake and output and prepare Elinah for birth (Ricci el., 2017. Pg. 813)

Two wide bore cannula, were inserted and a full set of bloods was taken including blood cultures. 15 litres O2 via a rebreather mask was applied. Intravenous fluids were commenced and rapidly infused. An ECG was done by the intern. She was checked and rechecked for any signs of bleeding and an internal examine was done by the consultant to check for any retained products. Intravenous antibiotics were also started and given. All drugs such as anaesthetic drugs or analgesia that Susan had been given that day were also checked to see if it had been an adverse reaction. Over the next 40 minutes she began to improve and was transferred to the labour ward for closer observation.

Permission was consented from the patient to use their condition for this essay; the information was accumulated from their admission, assessment and plan of care. The patient authorized usage of information relating to their period of hospitalisation in agreement that any personal information would not be used. This essay will address this matter in accordance with the Nursing and Midwifery Council (NMC) confidentiality guidelines set out in the Code of Professional Conduct (NMC, 2004). The pseudonym “David” will be used for this reason throughout this essay.

Providing continuous physical and emotional support during labour can reducing maternal fear, stress, and anxiety and protect physiological birth (Steen, 2012). Research shows that fear and anxiety during labour and birth can be detrimental to physiological birth. An environment that women feel unsafe in may stimulate a surge of neuro-hormones that can influence both fetal and maternal physiology, causing irregularity of contractions, fetal distress and subsequent medical inteverntions (Fahy & Parratt, 2006). Conversly, maintaining an environment where women feel safe, protected and supported can facilitate favourable physiological performance (Fahy & Parratt, 2006). Midwives can do this by giving women one-on-one continuous support and placing her at the centre of care throughout childbirth (Steen, 2012). As observed in practice, by constantly reassuring the woman about her progress, her baby’s health and addressing any of her concerns, the midwife can provide a calm and relaxing environment that is conducive to the labouring woman (Buckley, 2015; Steen, 2012). The midwife worked with the woman, encouraging her throughout labour and birth by telling her that she was doing extremely well. The midwife also breathed in-tune with the woman while giving her a back massage, inducing a sense of comfort. The atmosphere was calm and this contributed to the woman garnering confidence in her ability to avoid medical pain relief. Downe (2008) noted that the positive impact of

Pharmacological comfort measures can provide partial or complete pain relief. The epidural is the most efficient way of reducing labor pain. Opioids can be given continuously or in intermittent doses at the patient 's request or through the patient controlled pump. There is the potential for these drugs to have some effect on the fetus, such as breathing difficulties that may require assistance through the use of Narcan. Providing pain relief during the labor process is solely the patient’s choice, and as the nurse only support and encouragement should be given for however she chooses to handle the pain. (Jansen, Gibson, Bowles, & Leach, 2013)

Hands on or hands off the perineum: a survey of care of the perineum in labour (HOOPS) (Trochez, Waterfield and Freeman, 2011).