Graded Unit Planning process I’m currently studying HEN Care & Administrative Practice (Clinical Route) which involves doing placement hours at a local hospital and complete a Graded Unit which consists of three stages: planning, development and evaluation. In the planning process I must complete and develop a plan to show that I can help a patient I have chosen with a nursing activity. After having a meeting with my mentor to discuss which patient we felt would be a suitable candidate for me to complete this task with, gained consent from him.
I also gained consent from the patient after explaining what and why I was doing the activity, and all information about her would be kept confidential. For this matter I will refer to the patient as Mrs. B which keeps her identity anonymous. (Data Protection Act, 1 998) Mrs. B is 76 years old and has been a widow for 8 years, she has four children and 5 grandchildren who visit her most days, she also has a small dog. Mrs. B told me she was a waitress and continued to work up until she took retirement.
Before being admitted into hospital she was very much an independent, active lady, she ekes going for walks with her dog three times daily, and also likes to going shopping. Mrs. B was putting rubbish into her outside bin but lost her footing, tripped and fell, this caused her to have severe pain and her neighbor called for an ambulance. She was admitted into accident and emergency at hospital where they done grays of her head and body and found out that she had broken her hip, she underwent a hip replacement operation.
Mrs. B was admitted to the orthopedic ward and is now embroiling with a simmer frame ND assistance of one nurse on the recommendation from the physiotherapists, it is important that all members of the multi-disciplinary team work together in harmony to promote a better quality of life for the patient. Activities of Daily Living and Physiological needs On assessing Mrs. Bi’s needs I decided that the Roper Logan & Tierney nursing model which entails twelve activities of daily living would be the best way to assist her. These activities help a nurse to make a holistic person centered assessment on the individual patients’ needs.
When used correctly a nursing model should lead to continuity and consistency of the nursing care received by patients’ (Unresisting. Net 2002). As Mrs. B is in pain from her hip will be empathetic towards her and do this activity with as little movement as possible. Mrs. B needs assistance with embroiling so I have chosen to assist her with the activity of washing and dressing and plan to do this on 20/03/2015. Mrs. B is in a six bedded room on a hospital ward so I will ensure the curtains around her bed are closed and this will give her the privacy, aspect and dignity that the NC codes of conduct state (NC 2015).
Mrs. B likes to choose her own clothing and I will oversee this to make sure it’s suitable. Before we Start the activity will have all necessary equipment in place. While Mrs. B is washing herself will assist her by ensuring her simmer frame is at hand so she can stand and support herself, I will offer to wash the areas she cannot reach and I will assist Mrs. B by following the correct moving and handling techniques (Manual Handling Act 1992). Abiding by this act will maintain the safety for Mrs. B and myself.
At all times doing this activity I will ensure that I obey the infection control policies that are in place in the hospital by wearing the correct personal protective equipment (PEP) which will protect both Mrs. B and myself from any cross contamination, by doing this I am abiding the legislation in place and when carrying out the activity will be aware of any risks & hazards i. E. Infection control, moving & handling, proper disposal of equipment/linen used (Health and Safety at Work Act 1974).
Eve been able to assess Mrs. Bi’s needs by spending time with her for a ewe weeks and by using SPECS have built a therapeutic relationship with her and in turn Mrs. B trusts me which makes the activity a more relaxed environment for her, by spending time with Mrs. B I recognize what person centered care is more suitable for her holistic needs and can then deliver that care to her. As Mrs. B has diminished mobility we have to make sure she gets enough exercise and movement so she doesn’t get stiff, so its important that she goes for small assisted walks in the ward.
Mrs. B has a healthy appetite and likes to choose her own meals. Sociological and Psychological needs Mrs. B is an independent woman that’s always looked after herself and her family but now she’s the one receiving care and this can be related to the functionalism theory of sociology, which focuses on the Norms, Roles and Values, stability and continuity interdependence and integration and dysfunctional. She feels as the head of her family she should be the one giving the care, but the role has been taken away from her so she has become deviant.
She feels that she has been labeled that she can no longer look after herself and this can be related to the symbolic interactions theory f sociology. She fears that her family will put her into a care home but she is adamant to go back to her own home, this behavior can be understood using the humanistic theory in psychology which is focused on free will and personal choice. Mrs. B has low self-esteem since the accident, she feels she has no personal worth and her friends and family would resent her if she accepts any help from them and because of this she wont reach self- actualization.
In relation to Mason’s theory in psychology, and understanding the hierarchy of needs method, where a persons’ lower needs must be met before they can progress onto the higher one and eventually reach self- actualization, was able to understand her behavior. Carl Rogers believed that if a care worker displayed congruence by being genuine, open and sincere with their patient and by showing empathy towards them, it would help them to better understand why their patient was displaying the behavior they are having and that they can demonstrate a helping, positive, healing relationship.
Socio-Economical Factors Mrs. B will need to have homemaker set in place before she leaves the hospital UT because the Scottish government are aiming to keep people in their own homes to live independently (Caroline 2014) there’s a backlog of patients in the area she lives so this means that she cannot leave the hospital, because of this Mrs. B is losing faith in the healthcare system and may hesitate to seek help from the INS in future. Contingency Plan If Mrs. B refuses to have the activity done to her due to illness/tiredness then I will attempt to do the activity at a later time that suits her.