Models and Framework

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Nursing model is a collection of ideas, knowledge and values about nursing which determines the way nurses, as individuals and groups, work with their patients or clients (Hogston et al. 2002). Models therefore help nurses to organise their thinking about nursing and then set about their practice in an orderly and logical way (Hogston et al. 2002). A nursing framework is a structure used to organise care given to patients (Siviter,2))000)

This essay will explore a needs orientated approach to the care that is delivered to a patient and examine the significance of the use of models and frameworks in the nursing process. The nursing process is a framework for organising individualised care. It involves four phases: assessment, planning, implementation and evaluation (Richards and Edwards 2003). For the intention of this essay the above mentioned phases would be used to enable continuity of care through documentations of information, to provide continuous observation and ensure effective interventions (Hogston et al. 2002).

The model discussed in this essay is the Tidal model; the underpinning philosophy of this model is that people can recover their lives after it has been interrupted by the experience and stress of breakdown (Barker 2005). This has been chosen because of the branch specific nature.

In this essay the pseudonym ‘Mary’ will be used, to protect the patient’s confidentiality, which is in line with the NMC code of conduct guidelines (NMC 2008). Being a student on the ward the nurse in charge asked me, under her supervision, to admit Mary and allocate her to a room. Before I approached Mary I had a few minutes to look at her hospital notes. Mary is a 38-year-old lady who resides in a three bedroom flat. She has 2 children aged 9 and 11 years old. She lost her husband 1 year ago in a car accident and since his death she has had difficulty grieving. I noticed that this was her first onset admission into a psychiatric ward. Mary was accompanied to the ward by her mother who is her next of kin. She was admitted to the ward following an overdose of aspirin tablets, Paracetamol and a full bottle of brandy taken with suicidal intent. The notes stated her diagnosis as major depressive disorder, which is a disturbance of mood characterized by a loss of interest or pleasure in normal everyday activities. People who are depressed may feel "down in the dumps" for weeks, months, or even years at a time (http://www.psychnet-uk.com/dsm_iv/major_depression.htm 20th July 2003). As the first phase of the nursing process I had to do an holistic assessment on Mary. According to Barker (2005) wherever possible, an holistic assessment should be written by the person in care or by the nurse using the persons own words and while they are present. I introduced myself to Mary, explained that I was a student nurse and with the supervision of the nurse would be part of her care team whilst she was on the ward. She turned away and looking out of the window. So I then tapped her softly on the arm. Sheinider (1996) states that touch is the most universal of our bodily senses and in many circumstances may be the first sign of communication with patients. Adler and Towne (1999) analysed many studies carried out on different forms of communication and the response. They found that the most effective method was a light touch on the arm, which highlighted that people are more likely to co-operate. You must ensure that you gain consent before you begin any treatment or care (NMC 2008). I asked Mary if she would consent to me taking her assessment; she nodded her head in agreement. I then mentioned briefly how long this assessment would take, at which point Mary suddenly became tearful. After this Mary was assigned to her room and I closed the door behind us to protect the patient’s privacy. Protecting a patient’s privacy and dignity is in line with the NMC Code of Conduct 2008. At this point I noticed that Mary looked much older than her...
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