The aim of this nursing care study is to demonstrate that, as a student nurse, the writer is capable of developing and delivering the skills needed for assessing and addressing each individual patient’s care needs. Included in these set of skills, is the ability to develop critical thinking, decisive decision making and the ability to reflect on events so as to become a better health care provider. The patient in which the writer will discuss was based upon an eighty three year old man, pseudonym Mr. Scott who was admitted into accident and emergency via a referral from his general practitioner presenting with exacerbation chronic obstructive pulmonary disease (COPD) with a history of congestive cardiac failure (CCF). On admission to accident and emergency Mr. Scotts’ team took arterial blood gases, ordered a pulmonary function tests and a chest X-ray. Prior to the exacerbation of Mr. Scotts’ condition he regularly attended a cardiac clinic due to being a long term sufferer of congestive cardiac failure and also attended pulmonary function clinic for tests (pulmonary function tests). Through these clinics Mr. Scott was educated on his medications and current condition. On admission of Mr. Scott, the writer decided to use the frameworks Roper Logan and Tierney (2000); Orem’s Self Care Framework (1995) and Gibbs (1988); which incorporates each tool of assessment known as, plan, implementation, evaluation, educate and reflection. Using the above frameworks, an improvement of Mr. Scotts’ current exacerbation of chronic obstructive pulmonary disease (COPD) was seen to have been resolved and a new evaluation of Mr. Scotts’ care was developed.
The chosen tool of reflection used is known as the Gibbs cycle of reflection. The writer applied this tool in order to evaluate the patient care. The rationale behind this was to attempt to fully understand reflection so as to apply this to everyday practice, thus improving as a student nurse. The Gibbs cycle involves a description of the incident, feelings and thoughts experienced plus the evaluation and analysis of the incident, conclusions and action plan (Gibbs, 1988). According to Barnett (2005) using a tool of reflection, to give an account of experiences in the clinical setting can aid the nurse to analyse and explore their feelings regarding patient care.
Eighty three year old Mr. Scott was admitted to accident and emergency with a referral from his general practitioner, presenting with a recurrent upper respiratory tract infection and a history of exacerbation of chronic obstructive pulmonary disease (COPD) and congestive cardiac disease. Due to his history of chronic obstructive pulmonary disease (COPD), Mr. Scott was sent for a chest x ray to assess the deterioration of his lungs due to his condition. (Alexander et al. 2009) Post admission into accident and emergency, Mr. Scott was sent to St. Pat, Thomas, Johns’ ward where the writer was working at the time as a student nurse. The writer found, when assessing Mr. Scott, that he lived alone, locally, was a widower of ten years and had two daughters who also lived near by. Although Mr. Scott had many concerns, he also had a good social network such as the support of family and a home help package of six hours a week, which included meals on wheels. The local public health nurse also called to see Mr Scott on a social capacity. Presently the main health concerns which faced both Mr. Scott and his family were; the deterioration of his dyspnoea, related to his chronic obstructive pulmonary disease; pressure ulcers, due to developing pressure ulcers while in hospital in previous years and anxiety from both Mr. Scott and his family due to the unknown. Reassurance was given and they were explained what care he was to receive.
Issue # 1 Breathing.
The key feature of chronic obstructive pulmonary disease (Barnett, 2009) is that of experiencing breathlessness. Being breathless for...