Foundations of Nursing Practice Essay

A reflection on how the module satiate and associated bore hump has contributed to the students organic evolution as a foster.This es verbalise is a discussion on how the module content and practice experience has contributed to personal development as a nurse. indeed it go out focus on firstly the concept of individualised address and its relevance to solicitude for mind and wish wellspring rake, secondly the estim adequate to(p) and victor issues that impact treat such as confidentiality, consent and gravitas. The essay bequeath also focus on exploring the various talk models and the development of the healing(predicate) affinity between the nurse and the operate user, and finally the organisation and deli truly of misgiving within the practice environment. With particular reference to a recent posture, at a palliative c are treat stem, this essay will discuss Harriet, an 88 year old lady with chronic bronchitis and suffers with septuple sclerosis. Fo r confidentiality purposes the names of benefit users necessitate been changed to comply with the nurse and Midwifery Council, codification of head (NMC 2008).This assignment will firstly discuss the individualised forward motion to precaution for, which developed in the USA during the 1950s and 1960s, which coincided with the development of the nursing opening and models of nursing which began to challenge the medical model of wellness compassionate (Lloyd, autograph, Campbell 2007). The nursing forge thr unrivaled be carried out successfully by implementing a popular model utilise extensively in the UK originally by Roper et al Activities of Living model in which it is based mostly upon the 12 activities of mundane living however Henderson ac fellowships 14 activities that population use in (Kozier, Erb 2008). This model identifies any deficit in their boot unremarkably upon admission it is reviewed as the charge plans of the returns user evolve by and by whic h an intervention may be apt(p) over to the serve up user. The nursing home that was attended for placement had person centred interest plans in which they based them on the 12 activities of daily living from sleeping, eating and drinking to mobility and parley these were curtly term care plans that were reviewed monthly.Another model that is frequently used draw by Ellson (2008, pg22) is the nursing military operation, when it was initially identified Yura and Walsh (1978)showed that it is a four spot cycle that begins with assessment. Harriet was assessed by the Doctor as the registered nurse in load (RGN) noticed a change in her health she had developed a wheeze when talk and had a bosomy cough, the RGN suspected a chest infection. A care plan was then devised to follow up the assessment. Harriet was to be started on a course of antibiotics for a workweek, and was to be resumed on her nebuliser. The care was then implemented the following day during the morning drug s round. An evaluation of that care completes the cycle in which Harriet was to be seen by the Doctor the following week after completing her course of antibiotics and was to remain on her nebuliser.Additionally, more than ace stage nooky be occurring at the same term, for instance assessment may coincide with implementation (Carpenito-Moyet 2007). If goals are achieved after the first cycle, care maybe terminated or in some cases modified and the service user reassessed. (Ellson 2008, pg22) This process is designed to enhance systematic care, drive discourse amongst squad members and encourage continuity (Mason 1999 cited in Habermann, Uys 2006).The RGN wrote in Harriets daily report and updated her care plans, identifying her change in medication and change in her health.Throughout nursing there are umpteen ethical and headmaster issues that impact on it from confidentiality, consent to respect and dignity, to clear and accurate records and working as part of a team. The nurse and Midwifery Council inscribe of Conduct (NMC 2008) clearly states that nurses should en original they gain consent (NMC 2008) from the service user this ignore be anything from examining, providing care and giving treatment. Consequently a nurse has to be prepared if a service user declines their help as they confine a right to refuse treatment based on knowledge of the out surveys and risks (Wilkins and Williams 2008). Informed consent is a communication process between the supplier and the service user this is now recognised as a master key standard of conduct (Westrick and Dempski 2009). merely if there is a case where the service user does not have the mental capacity to give consent, they are protected by the Mental Capacity Act 2005 in which during the finale making process their rights and interests are accounted for (Griffith and Tengnah 2010). My first projection at placement was to try and dedicate Harriet, I introduced myself alongside a health care assist ant and asked if I was competent to predate her lunch, I was refused, on the causal agency that I was a fresh face and that she did not know me so I let the health care assistant feed her. The following day after assisting the RGN with Harriets medication, she kindly said to me that she would let me feed her at present if I was able to so at lunch time I went along with another health care assistant to feed her.Another important ethical issue is maintaining a persons dignity as Watson (1994) citing (Watson 2008) states that maintaining human dignity is a vital nursing duty and function, that needs to be recognised and respected in which people make to their own care and well being (NMC Code 2008). This peck be associated with many aspects of care such as bed bathing, stomate care, peg tube care as Westrick and Dempski (2009) go on to say that it is down to the service user to say what is to be done with his or her physical structure. Fenton and Mitchell (2002) cited in Frank lin, Ternestedt and Nordenfelt (2006) argue that elderly people receiving care regarding dignity is a state of physical, emotional comfort, subsequently when this is not al behaviors adhered to it can vacate the service user fingering embarrassment, shame, humiliation, foolishness and degradation (Mairis 1994 cited in Watson 2008). barely nurses themselves can become emotional if the standard of care given is not sufficient this is supported by the Royal College of treat survey (2008) request nurses for their views on dignity in care in which over 80% said they sometimes or always left work distress due to not being able to deliver the quality of care they thought they should give (Gallagher, Tschudin 2010). When asked to give a bed bath to Harriet, I do sure that only the area being cleaned was exposed thus covering up other private areas in case anybody was to lay her room. When Harriet was seen by the Doctor regarding her chest infection I treated the randomness sensitive ly and maintained confidentiality with all her health records.The presence of the alterative human relationship lies at the heart of patient centred nursing. However the nature of this one to one relationship is rattling dependent on the context in which nursing care is delivered (McCormack 2004 citing OConnell 2008). Therefore the building blocks for this relationship should focus on genuineness, empathy and respect, which should leave the service user feeling supported as well as listened to, whilst the nurse feels value in their role (Dossey, Keegan, American holistic Nurses Association 2008) Whereas Bynum-Grant and TravisDinkins (2010) go on to say that whilst the therapeutic relationship is at the core of nursing it is the knowledge and skill along with the caring attitudes and behaviours utilize that build the foundations of this relationship. I spent a lot of time with Harriet get to know her, and building a relationship of trust with her, in browse for me to attend her personal care needs, give her medication orally under(a) direct supervision.This assignment will now discuss the effective communication skills passim nursing that helps practitioners to engage with the service user, by making sure arrangements are met for peoples language and communication needs (NMC Code 2008) Studies have shown that the relevant communication means given to an individual can improve well-being (Bell 1996, Happ 2001 cited in Batty 2009). Means of communication that have proved successful are non verbal techniques such as writing, muster or by gesture, so communication aids have been make available such as providing a pen and paper, or alphabet charts (Batty 2009).Effective communication is seen as a fundamental competence unavoidable for registration as a nurse (Nursing and Midwifery Council 2004 cited in Timmins 2009) Timmins and Astin (2009) also goes onto explain that continuity of care supports high quality communication as it builds up the relationship between nurse and service user and is a main feature of patient centred care. Crouch and Meurier (2005) cited in Cox and cumulus (2010) defines communication as a two way process in which t severallying is transmitted and received.However listening to service users and their families is central to the communication process (Timmins and Astin 2009) Harriet could communicate easily, her hearing was slightly impaired therefore you had to chatter loudly and clearly she was on eye drops as her sight was deteriorating and she was real well spoken and if I was to say something incorrectly she would be very quick to correct me. Harriet however was slightly confused and sometimes repeated things she had said a few moments ago, she also had imaginary friends she would refer to whilst talking to me.This essay will now explore the delivery of care in nursing which is very important as this can impact the service users experience. There are three ways in which care can be delivered this is by primal care, task allocation and team nursing. particular nursing began in the 1970s as a way to cudgel dissatisfaction with functional and team nursings emphasis on tasks that tell nurses attention away from holistic care of the client (Huber 2006).Walsh and Crumbie (2007) explain that aboriginal care nursing involves one nurse being liable 24 hours a day for all care delivered to a patient. However doubting Thomas (2006) identifies this is not always necessary as care can be de commitised to other nurses or health care assistants yet the primary nurse carries responsibility for writing care plans and ensuring that long term goals are met. Skelton (2001) cited in Timmins and Astin (2009) suggest that this overture fosters autonomy and gets them involved with their care rather than health professionals dictating their care to them. Within the nursing home the primary nursing approach to care was not suitable as there were too many service users for one nurse to focus all their attention to at one time.Many health care settings would deny using task orientated care however in reality it still goes on and tends to induce apathy and reduce team morale. Task allocation on the other hand may be the most suitable way of allocating the workload (Thomas 2006) especially during module shortages or certain health care settings. Despite the nursing home having person centred care plans and making individualising the care needs, the nursing home still took on the task allocated approach as all the residents had breakfast by 8am and were washed and dressed by 9am. However as Harriet was unable to feed and dress herself due to having multiple sclerosis she was often left until last to have these needs addressed as two health care assistants were required.Team nursing was developed in the early 1950s it was designed so that staff strengths can be used to the maximum and aids group productiveness and growth of team members. By using this system nurses should stil l be able to provide individualised nursing care (Lloyd, Hancock and Campbell 2007) therefore nurses take on certain roles such as temperature, medication or a nurse for the right side of the ward (Kalisch and Kalisch 1978 Reverby 1987 cited in Huber 2006). confabulation is therefore key for this model to be effective as the team leader continuously evaluates and communicates changes of the patient to the team members (Zerwekh, Claborn 2006). It also allows the nurse to delegate patients to the strengths of the staff with what their care focuses on (Tiedeman and Lookinland 2004 cited in Zerwekh, Claborn 2006). Unfortunately the care given can become fragmented and thus ineffective and productivity lessen among team members if there are staff shortages. Harriets care followed this approach, as she was bed bound the arjo hoist was the only way of transferring her from bed to chasten this required two people, as did log rolling Harriet for her bed bath so she was cleaned effectively and appropriately.I feel the module content has contributed to my development as a nurse as it taught all the relevant information required for my first placement. I was able to see how the theory coincided with the practice which also contributed to my development as a nurse. For example I was able to see how the individualised care approach was introduced into the person centred care plans used within the nursing home. I was also able to see how the therapeutic relationship was built amongst the nurses in charge, the health care assistants and other members of the multidisciplinary team, they each had their own style of approaching the service user in regards to their attitudes, body language and behaviour, this I was able to pick up and use myself which made me handle situations better.The module content went into great depth and was given in a variety of learning styles which suited my learning pattern having come straight from school I feel the type of learning given has stren gthened my ability to learn and the relevant theory made me feel more confident when attending placement. Having learnt the theory I was able to put some of this knowledgeable experience into practice, as having had no previous experience within health and social care I felt uncomfortable at first but as more faith and trustingness was put into me via my mentor and other staff members, this helped me feel more involved and more comfortable with working within this environment giving me the bureau boost I needed. Throughout the placement I was guided throughout every task that I had to carry out, I was taught it first by mentor and then throughout the weeks I had to improve on what I had learnt, the registered nurses I shadowed were very supportive and approachable which helped me greatly.In stopping point this essay has discussed the concept of individualised care by incorporating the nursing process and models that evaluate the service users health and identifies the care neede d and any deficits in their care. Nurses uphold a reputation in which the ethical and professional issues are the foundations of this. As explored throughout this essay it shows that confidentiality, consent and dignity are fundamental throughout nursing and need to be coordinated into the care provided by the nurses.Various models of communication have been identified throughout this essay its relevance shows how the nurse must interact with service user, this is very important as the service user needs to be able to express their concerns of their health either verbally or non verbally. The therapeutic relationship is at the epicentre of nursing as this can impact a service users experience within a health and social care setting. The essay has also explored the organisation and delivery of care needed to be most effective throughout nursing. Overall the essay has focused on various fundamental aspects of nursing that contribute to the way care is delivered to service users.Refer ence List* Batty S. 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