To protect the resident’s identity, the resident will be called Mrs Florence Nightingale. Mrs Florence Nightingale has been selected to demonstrate how to maximize health using the nursing process. She is a 77 year’s old elderly resident in a private up-market nursing home in an EMI unit, who’s unable to self mobilize and is dependent upon a hoist for transferring. She is unable to verbally communicate, or feed her self. Due to her restricted mouth movement, difficulty with swallowing and fear of choking she is only fed in liquid form, which is thickened. She suffers from multiple disorders such as Alzheimer’s, CVA (stroke) and is doubly incontinent. Issues focusing on sustenance intake and surrounding issues will be explored in order to maximize the health of Mrs Florence Nightingale. Issues include psychological and social impacts of eating alone, ensuring adequate nutritional intake and adequate mouth care. Through the nursing process the patient’s perspective of health is identified in order maximize the patient’s health.
The nursing process is an organised, systematic and cyclical method of giving goal oriented, humanistic care to patients that’s both effective and efficient (Alfaro-LeFevre, R. 1994), it is often supported by nursing models such as Roper, Logan and Tierney model for nursing, based on activities of living and Maslow's Hierarchy of Human Needs etc. It consists of five sequential and interrelated steps - Assessment, Diagnosis, Planning, Implementation and Evaluation – during which you perform deliberate activities designed to maximize long-term results (Alfaro-LeFevre, R. 1994). In the UK the diagnosis stage of the process is omitted, although UK nurses determine a patient's needs or problems, they are not widely regarded as "diagnoses" (Wikipedia 2006). This systematic approach to care is cyclical in nature and can end at any stage if the problem is solved. The nursing process not only focuses on ways to improve the patient's biological needs, but on psychological and social needs as well. Due to patient having no verbal communication skills, poor non-verbal transmission of facial expressions and poor body gestures (Holland, K et al 2003), it is unlikely the patient would be able to participate in the process. Also, the patient’s family will not be involved due to having very little to almost no contact with the patient. Therefore, to respect the autonomy of the patient, the senior nurse and other members of the multidisciplinary health team will be involved in all stages of the process.
The first step of the nursing process is assessment from which the care plan maybe devised. This is an organized and systematic process of data collection from a variety of sources. Data collection contains subjective and objective, current and historical patient information (Kozier, et al., 1998). It is through this, that Mrs Florence Nightingale’s person-centred care plan will be devised. During the assessment, you collect and examine information to get the necessary facts to determine your patient’s health status and to describe not only problems (needs) but also strengths and abilities (Alfaro-LeFevre, R. 1994). The assessment should ensure that modern standards and service models are incorporated (Department of Health 2004). To make the care plan meaningful, it is important to focus on the social, psychological, spiritual and to some extents environmental and politico-economic needs of the patient, rather than just focusing upon medical needs (Roper, N et al., 2002).
Through Mrs Florence Nightingale’s patient notes, examinations, observations, discussions with family, significant others and friend’s data are gathered so that a biography can be created. From the biography, the nurse is able identify what is important to Mrs Florence Nightingale. From her the patients biography it became clear that Mrs Florence Nightingale’s enjoyed social activities like interacting with other...
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