Reflection, Activities of Daily Living

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For the purpose of this essay the Kolb’s model of reflection (1984) has been chosen as a guide to reflect on administration of oxygen therapy. Administration of oxygen therapy is the aspect of nursing practice that I selected as a result of completing the case-based learning scenarios. I will explain how the administration of oxygen therapy can have an effect on a patient’s activities of daily living (ADL), including some of the psychological and ethical issues. Breathing is the selected ADL that has been chosen to demonstrate how I implemented the aspect of nursing practice on clinical placement. Changes have been made to protect the anonymity and maintain confidentiality of the patient and clinical placement, in accordance with the NMC (2008, 2009f).

After reading the adult case based learning material, I chose to write and reflect on the administration of oxygen therapy .Oxygen therapy was widely used on my clinical placement as a treatment to help patients who were suffering from shortness of breath. (NICE, 2010). On my recent clinical placement, my mentor asked me to administer two litres of oxygen to a patient who was suffering from shortness of breath. The patient had been prescribed the oxygen therapy due to deterioration in their breathing ability (Higgins, 2005). The patient in question had been diagnosed with Chronic Obstructive Pulmonary Disease (COPD). COPD comprises of a number of illnesses including chronic bronchitis and emphysema; in each of the conditions there is an obstruction to airflow (NICE 2010). COPD is a long term condition that is usually progressive and

cannot be reversed, however in some cases there can be a degree of reversibility in a patients airways. The predominant cause of COPD is smoking (NICE 2010). The patients’ oxygen was to be administered via a nasal cannula, which seems to be the preferred choice of administering oxygen therapy. (Dougherty et al , 2011). A nasal cannula is less restrictive than other oxygen delivery systems, which can prevent a patient from participating in their ADL (Roper et al 2008a). Prior to administering the oxygen to the patient, my mentor explained to me the correct procedures that should be followed, ensuring safe administration of the oxygen. (NMC, 2008d). The prescribed dose of oxygen was checked against the patients medication chart, the amount and the correct duration of therapy was also checked (NMC, 2008d). The patients breathing had become laboured and more rapid since been admitted onto the ward. I had noticed that the patients’ persona had changed over a short period of time, and he was not as interactive with the other patients as he had been previously (Roper et al, 2008b). Before the patient received the oxygen therapy he had conveyed to me that he was feeling dejected due to a constant shortness of breath. The patient was finding it hard to participate in his personal hygiene requirements without having assistance; this had caused the patient to feel agitated and impatient with himself. I gave the patient reassurance and ask if he wanted a word with one of the healthcare professionals, or if he preferred, I would advocate on his behalf (NMC, 2008b). I explained to the patient that if my mentor was aware of the situation the appropriate support and advice would be

implemented. (DH 2010a) The patient specified that he was happy for someone other than himself to inform the relevant healthcare professional of the situation (NMC, 2008a). After I had explained the situation to my mentor, she stated that the patient would hopefully start to feel when the oxygen therapy commenced, she said that she would record how the patient was feeling and that he would be closely monitored (NMC, 2009c). Before administering the oxygen to the patient I explained what type of oxygen deliver system was going to be used, I also informed the patient that his oxygen saturation had to be monitored for about five minutes after the oxygen therapy had...
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