The aim of this patient care study is to discuss the care and nursing interventions that a particular patient received whilst staying on acute medical ward. Clause five of the Nursing and Midwifery Council's Code of Professional Conduct (2002) states that "as a registered nurse or midwife you must protect confidential information" and if information is to be revealed the patient's consent must be sought. The patient's permission was obtained after an explanation of the purpose and proposed content of the care study, with a staff nurse present. For reasons of confidentiality, the patient will be referred to under the pseudonym of Kirsty. Kirsty is a seventeen-year-old young lady who was diagnosed with Crohn's Disease when she was thirteen years old. She lives in a terraced house with her mother and is a hairdressing student. She was admitted to the ward from the Children's Outpatient Department following a routine check-up, where she presented with right-sided abdominal pain and loose stools. She was diagnosed with a flare-up of Crohn's Disease. Kirsty was chosen for the purpose of this care study because her strength of character was admired and a good relationship was established.
Kirsty was admitted to a twenty-six bedded acute medical ward, which is primarily gastrointestinal conditions, however medical outliers are admitted. There are three bays: one male, and two female, one called the Day Room (as it used to be the patient's day room, but was opened as a bay as there was a bed shortage) and the second is called the Female Bay.
[...] The scoring system on the chart is on a scale of 0 being no pain; 1 being mild (no pain at rest but mild pain on movement); 2 is moderate (intermittent pain at rest, moderate pain on movement); and 3 severe (continuous pain at rest, severe pain on movement). If the chart was used as it was intended, Kirsty's occurrence and severity of pain and the effects of analgesia could be monitored and assessed four hourly (or as necessary) more effectively. [...]
[...] (2000). Nursing Models and Nursing Practice. 2nd Edition. London: Macmillan Press Ltd. Archibold, G. (2000). A post-modern nursing model. Nursing Standard. 14(34), 40-42. Cunningham, J. (2001). A Palliative Approach to Pain Management. Nurse 2 Nurse. 1(12) Freeman, L. (2002). Food record charts. Nursing Times, 98(34), 53-54. Harris, G. and Bond, P. (2002). Nutritional care for adults in hospital. [...]
[...] On the ward there is very little in the way of pain assessment. Paracetomol was offered on the drug rounds and unless Kirsty informed a nurse of her pain very little was in the way of assessment and monitoring. There are a variety of tools available that nurses can use with their communication skills in order to effectively assess pain (Lawler, 1997). The hospital trust where Kirsty was admitted had brought in a new ‘TPR/BP Assessment and Observation Chart' to replace the old one that was used for all patients. [...]
[...] Another framework may be implemented, such as team nursing. Team nursing involves a team of nurses who are responsible for the delivery of patient care to a group of patients and each team has an experienced qualified nurse as a team leader and patients are assigned to a team throughout their stay in hospital (Walsh, 1997). Within this framework, however it is still possible for divided, task-orientated care to happen (Walsh, 1997) therefore primary nursing is much more holistic, patient-centered framework for Kirsty (Mead cited in Walsh, 1997). [...]
[...] The ward philosophy of care is very patient-centered and this reflects in the practice of all of the staff on the ward. They involve the patient and family in assessing, planning, implementing and evaluating care, they ensure honest and open communication with the patient and their family and educate patients and respect their hopes and limitations. The overall care Kirsty received was good. Good relationships were built up between Kirsty and the primary nurse and the associate nurses and myself. [...]
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