Nursing Care: Strategies, Communication, And Responsibilities

Building a Relationship with Patients and Their Families

As a nurse when dealing with patients, it is important that I build a good relationship with them and their families. To build this relationship, I will show concern in the patient and the family members. This can be done by asking them questions such as how they are feeling or if they need anything. By showing concern the family and client will develop a good relationship with me because they will view me as caring. Some of the communication strategies I will use are; verbal communication where I ask questions, non-verbal communication where I maintain eye contact and visual communication where I can use charts (Dang et al. 2017)

The steps taken when taking client history are:

1. Explanation and planning. Here one gives the patient information on what has happened and if it is correct and that both agree on it.
2. Recall and understanding. Here one makes the information easy for the patient and uses reflection.
3. Ensure the client and nurse understands each other. Here the nurse encourages the patient to interact withthe history taking so that it is not one way.
4. Decision making. Here the nurse involves the patient in planning and making a decision based on the history.
5. Here the nurse explains the findings and offers a plan that the patient finds acceptable (Dubin, 2017).

Some of the community support and resources available in the community are

1. Home help program. Assists in general home cleaning, laundry, cooking and shopping
2. Transportation program. Provides transport from the health care to the home
3. Bath Care program. Assists members who are unable to bath on their own
4. Supportive Housing Program. For those that need personal care
5. LifeLinePersonal Response Program. Help individuals live independently by assuring that help is only a button push away. The person in need of help presses the Personal Help Button on their wristband (Ploeg et al 2017)

My role and responsibility as a nurse when discharging a patient is to ensure effective care even after they leave the healthcare facility. This can be done by providing reminders on when to take medicine and labeling the medicine correctly. Also involving a third party such as a family member to carry on the duties I fulfilled. I will brief them on everything they need to do on a daily basis. (Al-Hashar et al. 2017).

The play is a pleasurable, fun activity that children partake. It is a very valuable experience to children because one, it fosters brain development. The activity involved in playing strengthens and builds brain pathways thus shaping the structural design of the brain (Athey 2018). Two, it enables learning. Most plays are based on life experiences and by partaking in the play a child can learn. Three, it allows development of motor skills through the physical activity involved in playing. Lastly, the child health and well-being significantly improve.  (Dobbins et el. 2017)

When taking an assessment of the caregiver, I will begin by asking the patient’s history which includes allergies, reaction, and a history that is relevant, implants and any family or social history. While taking the patient history, I will ensure that I maintain eye contact and not interrupt the caregiver while they are answering. After the history takes then is the physical assessment and emotional state of the patient. When doing a physical assessment, one needs to take note of the age of the patient and stage of development. The next step is to take the vital signs of the patient, and these include the temperature, heart rate, blood pressure, and pain. The nurse is then supposed to interact with the caregiver to know what they are comfortable with and what they prefer regarding treatment and care for the patient. Finally after treatment is the discharge plan where the nurse ensures that the caregivers will continue providing care to the patient by giving them detailed instructions on what to do and when to do it ( Dubin 2017).

Communication Strategies for Nurses

I will contact the Medical officer and inform them of my findings of the pain medication and offer them an alternative medicine that has fewer effects on neonates (Zerwekh and Gaernau 2017).

Hospitalization over long periods of time can have negative effects on not only the child (patient) but also the family. The child may fear being left alone in the hospital especially when parents come and visit and have to leave. They may fear separation from the family because they are alone. They may become lonely and feel like they are being rejected. They may feel like they are not like other kids because something is wrong with them. They may develop a fear of pain. They may worry a lot about what will happen to them, and this can lead to depression. They may refuse to eat, and this will cause their health to deteriorate. They may develop behaviors such as sucking thumb and wetting the bed to cope. The family, on the other hand, may become stressed and worried all the time. They may develop guilty feelings for leaving their child in the hospital. Some may develop anger because they cannot help their child. (Lee et al. 2017).

Adolescents are among a large number of people that are faced with many health issues. Most adolescents suffer from eating disorders and obesity. This is the time where they are fully aware of their body image and try to adjust to what is accepted in the society. Thus they refrain from eating and become thin. Depression follows suit after this. This happens when they are unable to lose weight and thus find comfort in food. Sexually transmitted diseases are also rampant among adolescents. This is because most of them have unprotected sex due to lack of guidance. Therefore have a higher chance of acquiring STD’s and HIV. Unprotected sex also leads to unwanted pregnancies which become a health issue if there are complications during pregnancy especially in cases where they were not fully developed to carry a pregnancy to term. (Bundy et al. 2017)

Some of the impacts that infertile people may face are: They may develop depression. The individual may fall into depression due to constant thinking and blame oneself for the cause.

They may become unhappy especially in cases where they see children or a parent with a child. It will remind them of their situation and thus make them sad. They may become introverts. One will try as much as possible to avoid situations that will remind them of their conditions thus want to stay indoors. It will lead to loss of intimacy. If it is a couple, the news that they are infertile may take a toll on the relationship and cause them not to involve in any sexual relations (Kushawasha et al. 2018).

Steps for Taking Patient History

The determinants of health in a person are the physical environment, social and economic environment and the personal characteristics and behaviors. For example, a person with a good source of income and high social status is linked to better health. Also if a person lives in an area with clean water and good living conditions, then they are less likely to fall sick. Genes and the environment also affect health outcomes. If one is exposed to an environment of drugs, then they will most likely affect their health in the future. Genes, on the other hand, are inherited from the parent. If a parent has diabetes, there is likely a chance that one of their offspring will inherit the disease (Barer 2017).

The principals of family care:

1. Dignity and respect:  listen and honor patients and family perspectives
2. Information sharing: sharing complete information that is not biased
3. Participation: family members encouraged to participate in the care
4. Collaboration and evaluation: the patient, family, andnurse work together in the delivery of care (McKinnel et al. 2018).

Areas that may be gender-specific are brain and nervous system because women experience more pain than men, heart, because symptoms of heart diseases are not the same in both, lungs because of smoking cause more danger to women than men and immune systems because women can fight viral infections better than men (Pace et al. 2017)

PART A

One can identify clients that are deteriorating through the monitoring of vital signs. These include heart rate, blood pressure, consciousness, body temperature and the urinal output monitored highly. If a client’s blood pressure drops then this can be a sign (Harford et al. 2017)

PART B

Level of consciousness is determined by AVPU

A: Alert and oriented. Documented as Alert (A) or oriented (O) on a scale of 1(weak) to 4(strong)

V: Verbal stimuli respond. Documented as unconscious or conscious

P: response to pain. Documented on a scale of 1(no pain) to 10(extremely painful).

U: Unresponsive. Documented as whether they respond to pain stimuli or not (Harford et al. 2017)

My role is to ensure detection of early signs of deterioration in health to ensure immediate action is taken (Harford et al. 2017)

I will deliver care that ensures standards of good by:

Being professional. This allows me to take care of patients as expected of me without letting my personal life or issues get in the way.

Forming a work alliance. This enables me and my co-workers work together effectively.

Offering excellent service. I will offer the best service to my clients (Al-Shahar et al. 2017)

Nurses’ responsibilities are

1. Assess risk factors and outcomes that lead to poor nutrition
2. Screen and monitor the nutritional status of the patient
3. Ensure that food and drinks are implementedcorrectly
4. Ensure medication being administereddoes not affect swallowing
5. Ensure they are up to date in enteral feeding practice (Al-Hashaar et al. 2017)

The wellness model is a model that ensures the wellbeing of a patient from the social, environmental, spiritual, emotional, and intellectual to physical wellness. I can implement wellness by addressing the patient as a whole, providing assistant to the patient so that they can rise to their maximum potential and asserting qualities that a patient has (Thul and Hudson 2017).

Nurse’s Role and Responsibilities when Discharging a Patient

The different aspects of nursing care vary with age. When administering extra medical care is taken when dealing with infants. When taking a history assessment help is required when dealing with infants. When communicating simple language is used for infants and more mature language for adults. The elderly and the infants require more assistance from the nurse than adults (Bartholomew et al. 2017) 

PART A

1. Basic physical assessment-skin is pink and no lesions detected. Gums are red and swollen.
2. Blood glucose measurement-60mg/dl
3. Blood pressure measurement-140/90 mmHg
4. Temperature, pulse & respirations measurement- 55 beats per minute, shallow breathing, 100.6^oF
5. Mental status examination- the patientis fully conscious
6. Neurological observation-no sensory function in the hands
7. Pain assessment- the patientpain was at a six on the pain scale (Harford et al. 2017)

CARE PLAN

(Mariani 2017)

1. The situation is that which a client is being discharged. Education on the discharge plan is important so that the client can continue taking care of their wellbeing at home. I will teach my client how to take care of their health.
2. The steps I will take are: identify what the client needs, come up with solutions, outline the reasons, and outline the outcomes. I will measure the learning outcomes by asking questions. Delivery method will be a speech. I will deliver in the client’s room.
3.  It will contain ways in which to continue care after leaving the healthcarefacility and why it is important.
4. They include transportation services and home support services (Zernwek and Garneu 2017)

References

Al-Hashar, A., Al-Zakwani, I., Eriksson, T. and Al Za’abi, M., 2017. Whose responsibility is medication reconciliation: Physicians, pharmacists or nurses? A survey in an academic tertiary care hospital. Saudi Pharmaceutical Journal, 25(1), pp.52-58.

Athey, I., 2018. Contributions of play to development. In Child’s play (pp. 8-28). Routledge.

Bartholomew, A., Ganann, J., Kaufman, S., Radcliffe, D. and Smith, B., 2017. 3B2 Online Interventions for Family Caregivers: Employing Patient Engagement Principles & Practice. 

Newman, B.M. and Newman, P.R., 2017. Development through life: A psychosocial approach. Engage Learning. 

Berk, L., 2017. Development through the lifespan. Pearson Education India. 

Bundy, D.A., de Silva, N., Horton, S., Patton, G.C., Schultz, L. and Jamison, D.T., 2017. Investment in child and adolescent health and development: key messages from Disease Control Priorities. The Lancet. 

Dang, B.N., Westbrook, R.A., Njue, S.M. and Giordano, T.P., 2017. Building trust and rapport early in the new doctor-patient relationship: a longitudinal qualitative study. BMC medical education, 17(1), p.32. 

Dobbins, M., DeCorby, K., Robeson, P.H. and H and Tirilis, D., 2017. School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6-18. Cancer. 

Dubin, A., 2017. HISTORY TAKING IN THE PATIENT WITH PAIN. Pain Management Secrets E-Book.

Harford, M., Catherall, J., Gerry, S., Young, D. and Watkinson, P., 2017. Availability and performance of image/video-based vital signs monitoring methods: a systematic review protocol. Systematic reviews, 6(1), p.217.

Kail, R.V. and Cavanaugh, J.C., 2018. Human development: A life-span view. Cengage Learning.

Kushwaha, C., Sinha, P., Gupta, U. and Srivastava, K., 2018. Impact of infertility on marital relationships among infertile couples attending OPD of a tertiary health care centre. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 7(3), pp.1164-1167.

Lee, J.C.Y., Tung, K.T.S., Li, T.M., Ho, F.K.W., Ip, P., Wong, W.H.S. and Chow, C.B., 2017. Fall-related attendance and associated hospitalisation of children and adolescents in Hong Kong: a 12-year retrospective study. BMJ open, 7(2), p.e013724.

Lester, S. and Russell, S., 2008. Play for a change. Play policy and practice: A review of contemporary perspectives. Play England. Retrieved 21.6.2010 from  https://www.worldleisure. org/pdfs/Copy%20of%20book_rev_play_for_change.pdf 

McKinnell, J., Ploeg, J., Duggleby, W., Markle-Reid, M., McAiney, C., Valaitis, R.,

Mariani, E., Chattat, R., Vernooij-Dassen, M., Koopmans, R. and Engels, Y., 2017. Care Plan Improvement in Nursing Homes: An Integrative Review. Journal of Alzheimer’s Disease, 55(4), pp.1621-1638.

Pace, L.E., Chen, G.L., Chai, J., Goldstein, J.M., Orton, P., Bartz, D., Rich-Edwards, J., Manson, J.E. and Johnson, P.A., 2017. Advancing Sex-and Gender-Informed Approaches to Health in an Academic Medical Center. Women’s Health Issues.

Ploeg, J., Denton, M., Hutchison, B., McAiney, C., Moore, A., Brazil, K., Tindale, J. and Lam, A., 2017. Primary care physicians’ perspectives on facilitating older patients’ access to community support services: Qualitative case study. Canadian Family Physician, 63(1), pp.e31-e42.

Perry, H.B., Rassekh, B.M., Gupta, S., Wilhelm, J. and Freeman, P.A., 2017. Comprehensive review of the evidence regarding the effectiveness of community–based primary health care in improving maternal, neonatal and child health: 1. rationale, methods and database description. Journal of global health, 7(1).

Thal, K.I. and Hudson, S., 2017. A Conceptual Model of Wellness Destination Characteristics that Contribute to Psychological Well-Being. Journal of Hospitality & Tourism Research, p.1096348017704498.

Zerwekh, J. and Garneau, A.Z., 2017. Nursing Today-E-Book: Transition and Trends. Elsevier Health Sciences.

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