Discussion of a Care Plan

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In this essay I will be discussing the importance of a detailed and accurate care plan and the importance of ensuring that it is focused on the client. The NMC guidelines (2008) state the importance of professional values including patient confidentiality, and for this reason I will not be disclosing the clients name, the trust in which I was working or the placement name. I have gained consent from the client for the use of this essay; this ensures that I have maintained a professional standard of care and respect for my client which is important to be able to gain a good rapport and trust discussed in The Essence of Care Document (DoH 2003). The client was an elderly lady who was suffering from a rapid onset of visual and tactile hallucinations into which she had insight. She was known by her doctor’s surgery for long term depression which began when she lost her husband four years previously which led to a recent suicide attempt. She had no immediate family. She was partially blind in one eye and had skin cancer her back and left foot meaning that she was temporarily housebound. My mentor and I had been referred to the client because the GP had concerns of further suicide attempts due to her worsening mood. Callaghan (2006) talks about how depression needs to be monitored so that the clients depression can be adequately controlled, as it is important to ensure the wellbeing of the client is the main priority and understand that further interventions may be needed to aid in the client’s recovery. All aspects of care will be made using decisions based on beliefs and research considered to give the best quality care ‘as patient centred care needs to be the core feature of everything the NHS does’ (Brown, DoH 2001). For this essay I am using Roper et al (1999) nursing approach. This approach looks at the individual and the ADL’s. The authors discuss how it is important for a person to develop as well as the importance of nursing care when a person cannot cope with these daily activities independently, this relates to my client because she no longer could cope with any of these activities individually. As this approach focuses on change it was important for my mentor and I to realise that this loss of independence was a major change for the client as she was a very able woman and therefore may be struggling with her new situation. The client admitted this which helps us identify where help is needed and where we could promote and support her independence as it is important not to take this away, this way my mentor and I would be able to see her progress and intervene if necessary. My mentor and I carried out a mini-mental assessment and a questionnaire on depression in the client’s home which is useful as it gives an idea into their situation. We found the client describing her situation as depressive and asked for help. She knew that her hallucinations were not real but admitted that they scared her and that she felt “hopeless” and “insane”. She admitted to feeling ashamed about her experiences and was concerned about what the outside world would think of her. As my client had been treated for her cancer she had no concerns about her medical health but acknowledged that she was unhappy with life and was thinking about suicide. Whilst devising the care plan I tried to ensure that I considered all aspects of patient care, for example by respecting my clients’ values and personal identity I was able to establish a good partnership with her and therefore aid her better with the challenges that faced her (McKenna et al 2006). It was important to do this because it allows me to gain an all round judgement of my client and her situation as the goals that we set will reflect on all aspects of her life and consequently help with her recovery. By not stereotyping my client I was able to assess her, taking into consideration her family, background, ethnicity and religion as well as her physical, mental and social needs. The NMC (2008)...
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