Nursing for Idiosyncratic Experience - MyAssignmenthelp.com

Question: Discuss about theNursing for Idiosyncratic Experience. Answer: Introduction: During clinical practice, nurses are involved in sensitive communication with patients to understand their concern as well as inform patients about specific treatment process. Effective communication process is dependent on the nurses ability to understand patients idiosyncratic experience of illness and to transmit meaningful message to patients to promote their well-being (Chang Daly, 2015). The main purpose of communication with patients is to establish a therapeutic relationship with patient and reduce the vulnerabilities of patients by meeting their clinical needs and providing appropriate health support. As nurses are in constant contact with different group of patients, communication event analysis is important for them to explore the event and analyze how far nursing practice is delivered according to professional standards, clinical organization policies and core communication theories (Kourkouta and Papathanasiou 2014, p.65). With this purpose, this report gives a descript ion about a communication event related to drug administration to an elderly patient and explain how the event took place. Finally, the evaluation of the communication event helps to determine whether professional and the communication process meets organization objective in care or not. The reflection on lesions learnt through the event describes how this experienced enhances professional practice. Description of the Communication Event: During my nursing placement, I had been allocated to the aged care facility of Estia Health. The Estia Health is a residential care home where high quality and individualized care is given to elderly people. It is renowned for quality-aged care across Australia by means of innovative quality care and contribution of specialized health care team (Estia Health - The Leading Aged Care Provider in Australia, 2017).I had been involved in several clinical responsibilities at the organization such as assessing vital signs and blood glucose level of patients, managing oral medications and supporting them in activities of daily living (ADLs). I worked with interprofessional team of physiotherapist, podiatrist, registered and enrolled nurse and physicians enrolled in care of elderly. I had been allocated to care of elderly patients with different illness and disabilities. However, for this communication event analysis, I would like to describe about an elderly patients who was struggling with dementia. For confidentiality reason, I will not disclose the actual name of patient and henceforth refer her as Mrs. A. She was admitted to Estia Health due to her failing memory and increase in disorientation due to dementia. Due to lack of her ability to understand risk, she was vulnerable to get lost and talk with complete strangers. As she lived alone, admitting her to the aged care facility was necessary. I will explain in detail my duties while being assigned for the care of Mrs. A and how I communicated with her during the care process. When Mrs. A arrived at the clinic, she was very suscpicious and frightened. She could not understand the reason for her admission to the hospital and being shifted from the comforts of her home. As a nurse assigned to care of her, the clinician explained me about my duty of symptom assessment of patient, managing her behavior, validating feelings, providing medication and assistance in ADLs. During the my first contact with Mrs. A, I greeted her warmly and told her Welcome to Estia Health mam, I am glad to tell you that I have been assigned to care for you during your stay at this facility. I hope you have a positive experience under my care. Next, I told her my name and my duty while caring for her. During the initial contact with patient, I noticed that she hardly responded to my greetings and looked at me with raised eyes. This gave me the indication that Mrs. A was doubtful and lacked clarity about everything. However, I kept my patience and preferred to give her time so that sh e does not get angry. This is because feelings of frustration and distress are common in people with dementia due to symptoms of memory loss, poor comprehension and word finding difficulties (Turner et al., 2017, pp. 66-76). The care of patient with dementia is a complex process and my goal of interaction with Mrs. A the next day was to validate her feelings and understand her symptoms of disorientation (Finnema et al., 2017). I greeted her and asked her did she liked the dinner that was serve last night. She was again struggling to recall what she ate and finally said Dont know. Instead of exposing the weakness of Mrs. A in memory recall, I said her Nevermind, you had oatmeal and chicken soup last night. Secondly, throughout my contact with Mrs. A, I emphasized more on non-verbal communication than verbal communication strategy. This is because the patient was not expressing much. Hence, I relied on body posture, gesture, facial expression, eye-contact and touch with Mrs. A to facilitate a two-way process of engagement (Little et al., 2015). After two or three days, Mrs. A became more comfortable with me as I was constantly responding to her physical discomfort, hunger, thirst and toileting needs. This indicates that behavioral symptoms of restlessness and agitation are an expression of unmet needs of patients and patient-centered approach helps to address these needs (Brooker Latham, 2015). It tried to address her agitation by means of small conversation and made sure she did not felt humiliated while attending to her toileting and ADLs need. Before carrying out any new medical procedure, I made sure to take consent from her and explain her the rational for it. However, the medicine related activities was the most complex part of this communication event due to the failing memory of Mrs. A. Analysis of the Communication Event: Nurses in health care setting have the responsibility of addressing the biopsychosocial and spiritual needs of patient. This is dependent not just on clinical and technical knowledge but also on interpersonal communication skills. Good communication skill is vital for the engagement with patient and building a therapeutic relationship. Hence, a two-way process is necessary in communication so that patients convey their concerns and nurses adequately respond to them to promote their recovery and satisfaction with care. Effective communication is also dependent on understanding of patient and the experiences they face in illness (Riley, 2015). In the communication event of dementia patient, I was able to establish therapeutic relationship with patient because I was aware about the feelings and experiences faced by patient due to dementia. As dementia is associated with declining memory, mental ability, concentration and perception, I took care not to expose this weakness in patient. In stead, I used patient-centered approach to respond to her non-verbal cues. For example, when she showed signs of confusion and fear, I used touch gesture to give her comfort. Secondly, to avoid irritation in patient, I made sure to inform her of any activities before hand. This is because dementia patients tend to get disturbed by out of pattern changes. Assessment of pain in patients with dementia is also a challenging task and understanding of the neurobiology of pain experience and expression important (Hadjistavropoulos et al., 2014). The identification of non-verbal cues like facial expressions of Mrs. A. helped me to respond to her pain issues. While working in a clinical facility, it is also necessary to comply with communication policies and procedures of the health care organization. As Estia Health focused on providing a home like environment to elderly patient, their communication policies focused on providing specialized care to individual patient. Following the code of ethics of health care organization is also important during communication process such as respecting patient dignity during care, promoting safety and right of people, preventing conflict of interest and engaging in ethical consent process. Hence, I followed ethical means of communication by introducing myself to Mrs. A and explaining her about my duty for the day. Sharing information with patient is a means to develop mutual satisfaction of patients with care. Hence, initially Mrs. A was frightened to talk, however she became comfortable after shared information to her and engaged in honest conversation (Day, Levett-Jones Kenny 2015, pp. 520-521).Sec ondly, I took care not to humiliate Mrs. A by respecting her dignity while attending to her toileting needs and assistance with ADLs. Use of open-ended questions and familiar conversation with patient facilitated me in assessment and treatment process. Finally, recovery of patient was possible. Reflection on Impact of the Event in Nursing Practice From the experience of my clinical placement with dementia patient at Estia Health, I learnt many things about the complexities in such patients. Although I was aware of symptoms of dementia patient, however actual communication and treatment of dementia was a challenging task for me due to Mrs. As symptom of disorientation. Hence, my strategy was to implement patient-centered approach of communication so that I identify the concerns and feeling of Mrs. A which was leading to feelings of irritation in her. By this approach, I collected non-verbal cues of patients to understand the reason for her aggression and took care to respond to her needs accordingly. This approach helped Mrs. A to finally trust me and engage in favorable communication to enhance the delivery of care. However, this experience also exposed my weakness in medication related activities with such patient. It created stressful situation for me because of symptoms of forgetfulness and disorientation. I had to consult my senior nurse all the time regarding ways to monitor such patients. A research study by Smith et al., (2015, pp. 44-51) also showed that medication management activities in dementia patients lead to carer burden and stress. This create dilemma in care and adequate support from health professionals is required in such cases. I would like to work on this skill in the future to fulfill my professional responsibility and achieve desired clinical outcome. Reference Brooker, D., Latham, I. (2015).Person-centred dementia care: Making services better with the VIPS framework. Jessica Kingsley Publishers. Chang, E., Daly, J. (2015).Transitions in nursing: Preparing for professional practice. Elsevier Health Sciences. Day, J, Levett-Jones, T and Kenny, R 2015, Communicating and relating, in A Berman, SJ Snyder, B Kozier, GL Erb, T Levett-Jones, T Dwyer, M Hales, N Harvey, L Moxham, T Park, B Parker (eds), KozierErb's Fundamentals of Nursing, vol. 2, KozierErb's Fundamentals of Nursing Australian Edition, 3rdedn, Pearson Higher Education, Melbourne, Australia. 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