Nurse as Educator

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Introduction
There is an increasing emphasis of the importance of the role of nurses as educators and therefore is important to have an understanding of how to implement a teaching plan in clinical practice. Education of patients and family is the professional responsibility of the nurse. The nurse should aim for the patient to achieve independence in the management of their own health. This assignment will compromise of a proposed teaching plan regarding self-administration of sub-cutaneous insulin in diabetes. It will encompass a one-to-one teaching session with a diabetic patient. The aim of the teaching plan is to provide insulin dependent diabetics with the skills and knowledge to independently control their diabetes through self-administration of sub-cutaneous insulin.

Diabetes Mellitus is a metabolic disorder characterised by disturbances of carbohydrates, fat and protein metabolism which results from defects in insulin secretion or action or both (Alexander et al. 2006). There are two categories of diabetes type 1 diabetes (insulin dependent diabetes) or type 2 (non-insulin dependent diabetes). Type 1 diabetes occur when the pancreas is no longer able to secrete insulin which usually is a condition of children or young adults representing 5- 10% of cases of diabetes (Gulanick et al. 2003). Type 2 diabetes results due to a failure of pancreatic beta cells to produce sufficient amounts of insulin usually occurring in older adults (Gulanick et al. 2003).

I selected this topic as it is extremely relevant to practice as diabetes is one of the most common chronic illnesses worldwide and is predicted to increase further in coming years. According to the Diabetes Federation of Ireland (2011) 191,000 people in Ireland have diabetes, 14,000 of these accounting for type 1 diabetes. The rational for choosing to teach self-administration of insulin was influenced by the magnitude of suffers of diabetes. According to Brod et al. (2008) over 50% of diabetics are treated with insulin whether orally or via sub-cutaneous injections. Therefore I thought this was an important skill to teach to empower individuals.

For the purpose of this assignment I will discuss the development of a teaching plan using the nursing process for the following hypothetical case study. Denis is a 53 year old man who has previously diagnosed with type 2 diabetes. Measures such as diet, exercise and oral medication proved to be ineffective in lowering his blood sugars level. It was decided that Denis was to be commenced on sub-cutaneous insulin to treat the problem. Denis already has a good understanding of diabetes but needs to be thought insulin therapy.

Assessment
The assessment process will look at aspects of the individuals learning needs to determine an appropriate teaching plan specific for the individual. Gulanick et al, (2003) states that the assessment process should determine the individuals learning needs to dictate the type and amount of information needed. Neary (2000) outlines three reasons for carrying out assessments these ascertain the following: The level of theoretical knowledge

The level of practical skills
Insight into attitudes
The nurse as educator completes the assessment to gain insight into patient’s prior knowledge, skills and attitudes towards their condition. This enables the nurse to establish an appropriate teaching plan. According to Bastable (2008) assessment of the learner must include: Learning needs- what the learner needs and wants to know

Readiness to learn- if the learner receptive to learning
Learning styles- how the learner best learns

Learning needs are defined as gaps in knowledge that exist between a desired level of performance and the actual level of performance (Healthcare Education Association, 1985). Essentially this is the gap of what someone knows and what they need to know. To obtain this information assessment strategies are implied such as informal assessments...
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