Encouraging patients to help themselves has positive effects
Whilst caring for a lady in her seventies, one student nurse realised that there must be a clear rationale for everything in her nursing practice.
About two weeks into my first placement on a stroke ward, I was asked by a nurse to help Ms B get dressed. Ms B was in her seventies. She had experienced a mild stroke and had made a full recovery. However, she had early dementia that had existed before her stroke. At times, this caused her to become disoriented.
Ms B chose the clothes that she wanted to wear and I helped her to put her vest on. She then took the blouse she had chosen from the bed and began buttoning it up. It was at this point that I realised that Ms B did not need help with dressing herself, she only needed help in the structuring of the task.
This meant confirming with her what was happening, that she was dressing for the day, showing her which clothes were available, laying them out and communicating with her.
I stepped back and reassessed what she required from me. I realised that my role was to ensure that her privacy and dignity were being respected while she got dressed, and to continue assessing her ability and to be there in case she became confused or disoriented. I wanted to ensure she was comfortable in her environment, and had as much choice as possible.
I think it was my inexperience that drove me to provide assistance without assessing Ms B's needs and abilities properly. Most patients on the ward were highly dependent on the nurses, and this may have influenced my behaviour.
However, even before this incident I felt protective towards Ms B. There were times when she seemed vulnerable, even childlike. I had helped her with nutritional choices and delivered meals to her. I had laughed with her and got to know her and her family when they had visited. She always responded to me in a positive way, and we had a good rapport.
I had never had the experience...
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