Since the early 1900’s nurses have been trying to improve and individualise patient care. In the 1970s this became more structured when the nursing process was introduced by the general nursing council (GNC), (Lloyd, Hancock & Campbell, 2007) .By doing this their intentions were to try and understand the patient in order to give them the best care possible (Cronin & Anderson, 2003). Through the nursing process philosophy care plans were written for patients. It was understood that this relationship would ensure the patient received the best care possible to suit them individually. This would consist of not just the patient as a physical being but their spiritual emotional and holistic being also (Cutler, 2010). The nursing care plan has four main outcomes. It must include an assessment of the patient and their specific needs; a plan of action which must be implemented and evaluated. Moreover it is a process in which patients care is assessed and evaluated and is an imperative part of practice (Hunt & Marks-Maran, 1986). The care plan is the mechanism in which the nurse is able to make informed decisions using the nursing process (Cutler, 2010). However care plans have also been seen as providing nurses with a clear path to assisting the patient and providing the best care possible for them individually, moreover it ensures that nurses recorded their findings which will ensure high standards of care are set and maintained (Hunt & Marks-Maran, 1986). By following the SMART guidelines this should be achieved (Williams & Wilkins 2007).The remainder of this essay will go on to evaluate and critique a particular care plan and show the flaws and also what could have been included. In this care plan the main focus is on Mr McCue’s disrupted sleep pattern, the care plan is therefore aimed at achieving an unbroken sleep pattern. However a blatant thing which is missed from the care plan is that the nurse has not taken any observational skills. The MUST tool (RCN 2004) should have been used to assess the patients weight. This is due to the fact that Mr Mcue is saying he is eating more processed food and doing a lot less daily meaning weight is an issue as it possibly could be affecting his sleep(Williams & Wilkins 2007).BMI is important in this case as obesity can also cause sleep disturbance. The BMI is there to provide the nurse with the patient’s body fat and to alert them to any changes. Therefore knowing the BMI can be important in indentifying health concerns and can be important in the relationship of sleep disturbance (WHO, Updated March 2011).Furthermore Williams (2008) says that weight and sleep are linked and that even small changes in the BMI can effect sleep patterns and also says that alcohol consumption and smoking can be contributed to sleep disturbance (Williams, Tacon & Carter, 2008). Moreover Patel (2008) agrees saying that the growing obesity of the country has resulted in chronic sleep deprivation, furthermore he says that weight gain can occur through lack of physical activity and lack of motivation. Mr McCue has admitted to all of these things; he indicate he cannot be bothered looking after his children and is eating unhealthily (Patel & B.hu, 2008).These factors indicate that through putting on weight he may be sleeping less and therefore becoming more depressed and sleep deprived. Moreover even though the care plan is focusing on sleep the care plan fails to address why he might not be sleeping. Hunt (1986) agrees that the assessment is a lot more than just looking at the obvious but about using the information that has been gathered and making use of it to identify the key problems the patient may have (Hunt & Marks-Maran, 1986). The care plans main aim is to help Mr McCue achieve an unbroken sleep pattern. However In the assessment stage the nurse has clearly indicated that he is drinking a lot more. Nevertheless there has been nothing mentioned about this in the...
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