Essay Based on Essence of Care and My Chosen Scenario Within the Module

Essay Based on Essence of Care and My Chosen Scenario Within the Module

This essay is based on ‘Essence of Care’ and my chosen scenario within the module and is based around the learning outcomes of the module.
During this essay I will be discussing my chosen scenario; Scenario one, I will talk about the circumstances leading up to the evaluation, and the things I learned during my module based around the scenario. I will discuss what I prepared for the evaluation and how the evaluation went for me, including details of what happened during my assessment. Lastly, I will talk about what I feel are my strengths and weaknesses during the duration of scenario one simulation, and the things I think could have been changed, including the lead up to the assessment and the evaluation and what could have been included.

My chosen scenario is, Scenario On, her patient notes read that she is 8 month old girl who is being brought in by her mother to weigh her. Her mother is concerned about her baby’s slow weight gain and is said to have not been well, and has fewer wet nappies. My role within the scenario was to carry out a urinalysis of the baby’s nappy, and carefully take her out of her stroller and weight her, myself and my colleague was also asked to carry out standard observations, such as blood pressure, temperature, pulse and respiratory rate, and discuss our findings with her mother. The patient’s mother was also worried about her baby and how hard it was for her to gain weight, so I and my colleague discussed any information that could help her with the patient’s weight gain, and health.

Leading up to the assessment I was taught a number of items that will help me when it comes to my assignment. Firstly we was taught about homeostasis and anatomy and physiology, these points was essential for me as it helps understand the key points of how the body works, and knowing how the body works and what happens as a result if not working properly enables people to make sense of physical observations of patients and how to act appropriately towards them basing around their illness.

Homeostasis is said to be “the ability of the body as a whole or a single cell to seek and maintain a condition of balance or stability within its internal environment when dealing with external changes.” (Cannon W.B)

Within the first week of scenario one, I learned that homeostasis and anatomy and physiology have a full effect on a person’s body, and if something was to change then their body systems can change control, this is where homeostasis is involved as when something is out of alignment homeostasis comes into effect helping the body adapt to change then controlling the body’s systems, this links to the patient as it sounds that she is having problems in digestion and her urine, and this presentation then gave me an idea how to help and read any changes in her observations, as the presentation helped me learn the key points in a person’s anatomy, knowing this will give me a clearer idea in reading the patient and giving any examples that can help bring her back to a normal reading.

I between the theory sessions, we was asked to have practical sessions, to start we learned about blood pressure, we was given a blood pressure machine and stethoscope, and watched an example that was given to us by module teacher, we was then asked to become pairs, and try it for ourselves. I was first asked to find the radial pulse and whilst the cuff was round the upper arm and being pumped up feel for the pulse to disappear once found prepare the stethoscope on the brachial pulse and slowly let down the pressure in the machine, until we can hear the first beat of the pulse and the last, this indicates the blood pressure of a patient, the top number is the systolic and the bottom is diastolic reading. When I first attempted blood pressure I was worried and found it difficult finding the readings, D’Arcy Lyness stated; “It is natural for new, unfamiliar, or challenging situations to prompt feelings of anxiety or nervousness. Because anxiety makes a person alert, focused, and ready to head off potential problems, a little anxiety can help us do our best in situations that involve performance. But anxiety that's too strong can interfere with doing our best. Too much anxiety can cause people to feel overwhelmed, tongue-tied, or unable to do what they need to do.”

Our second theory lesson of the module was based around the respiratory system and the cardiovascular system, the presentation was based around how the respiratory system worked and the other organs it contains for it to work properly and how the cardiovascular system and the respiratory system is linked together to keep a person alive, this helped give us a understanding of our next practical session, which is taking a patients respiratory rate, and pulse, as both are linked we was taught what to look for if a person’s respiratory, and pulse rate is low, things such as sounds, any difficulty breathing, or abnormal skin tone. We was taught to measure pulse and respirations by firstly being clear to the patient or the patients family to what you are doing, then, to take the pulse a respiratory rate, the Ohio State Medical Centre gives an example to do this. Firstly with pulse, it is said that the patient should be at rest, and then have the palm side showing, once showing use the index finger and the middle finger to feel the pulse, to find the pulse slowly run the two fingers down from your thumb to the top of the wrist, lightly press and measure the pulse, how many beats you can read in a minute is the pulse rate. To measure the respiratory rate make sure the patient is at rest, then slowly watch the chest or stomach move up and down, one count is a breath of inhale and exhale, measure for one minute, and this will be the respiratory rate.

Our last practical lesson before the evaluation is urinalysis, to measure urinalysis we was given a urine sample, then, we was given dipsticks to indicate if there was any problems within the patient’s body shown in the urine, this helped with our evaluation as one observation is urinalysis, and learning what it is and how to read it can give me confidence when taking part in the urine readings. The college of medicine states that, “Urinalysis is an important tool in disease detection, as well as monitoring and screening health. Abnormalities can be indicative of diseases of the urinary system as well as other organ systems, including liver function, acid-base status, and carbohydrate metabolism.”

As one of the patient’s mother worries was her diet, before the evaluation I took the time to research on the internet about different diet ideas in children, and what types of food could help weight gain. I found a website that gave information about what types a food that would help a child gain weight, food such as, cereal, pasta, high carbonate snacks, nuts, meat, and fish, without being unhealthy, and nutritious to help the child gain weight.

During the test we was asked to wear our uniforms, and find a partner to work with whilst being evaluated, firstly we washed our hands to prevent any infection spreading, to learn how to wash my hands properly, I watched a video based on washing hands in the nursing sector, then we introduced ourselves to the patient’s mother, explaining our role, and the things we will be doing today. The patient’s mother was very responsive and was pleased we was helping her daughter, my role within the evaluation was to carefully remove the patient from her stroller and place her in the scales, before weighing her I removed her clothes and sterilized the scales to make sure there is no spread of infection, once complete I placed the patient in the scales, reading out her weight to both her mother and my colleague to document. Once the patient had be re-dressed, I took the time to measure her head circumference and gave the reading for my colleague to document it down, while I was talking to Josie’s mum about my findings, my colleague took the urinalysis, in which the results came out clear, and was described to Josie’s mum in a way she can understand. Next were the basic observations, as we was unable to do them on the patient we was asked to carry them out on our module tutor, who was playing the patients mother, whilst my colleague measures her pulse rate, I was measuring for the respiratory rate so they would be a normal response, I done this because whilst learning about the respiratory rate, our module teacher, told the class that if the patient would recognise the nurse I measuring the respiratory rate, their rate could change, either slower or increasingly faster, out of reaction, so we was taught to do it without them knowing, but both was normal and was documented down, but was still told to the patient’s mother after the observation so she knew everything was covered. Lastly we took the patient’s Temperature and this came out normal with a measure of 37.2 degrees Celsius, as I read off an internet site the normal rate for a child ages 0-3 is 37 degrees Celsius, and was documented down along with the other observations. Once all the observations and the documentation was complete myself and my colleague spoke to the patients mother about the patients weight gain we gave her advice about the foods to feed the patient and ideas to help the patient gain weight. Lastly we asked the patients mother if she had any concerns or any other questions, once complete we was given an evaluation about how we worked during the assessment and the things we could change during the next scenario.

In conclusion I believe that this scenario has taught me to observe patients and understand how the body reacts when they are ill, the things to look out for, and the understandings of abnormal to normal readings. I have also learned how to undertake basic observations on others, and document them clearly. In a personal matter I believe this scenario has given me more confidence and understanding in nursing, in way that helps me talk to patients and their family, and clearly give feedback to family in the information they need without being shy or worry about the things I am saying is wrong, it has taught me to be a confident person, and in that case made me a stronger person who is willing to carry out more tasks and become more involved.

References:

Cannon W.B The Wisdom of the Body 1932

D'Arcy Lyness, PhD, October 2010
http://kidshealth.org/teen/your_mind/mental_health/anxiety.html

McQuillan P. Pilkington S. Allan A et al 1998 “Confidential enquiry into the quality of care before admission to intensive care” British Medical Journal 316 p1853-8

Week 1 Intro to A&P and homeostasis, Thames Valley University Blackboard, Module 1, Scenario 1,Essence Of Care.

Week 2 Intro to the respiratory and cardiovascular systems, Thames Valley University Blackboard, Module 1, Scenario 1, Essence Of Care.

Department of Medical-Surgical Nursing
The Ohio State University Hospitals
http://medicalcenter.osu.edu/PatientEd/Materials/PDFDocs/procedure/pulse...

Cheryl S. Sine, DVM; Paula Krimer, DVM, DVSc; Perry J. Bain, DVM, PhD; and Kenneth S. Latimer, DVM, PhD, Class of 2003 (Sine) and Department of Pathology (Krimer, Bain, Latimer), College of Medicine, The University of Georgia, Athens, GA 30602-7388
http://www.vet.uga.edu/vpp/clerk/sine/index.php

Calorie King Fat and Carbohydrate Counter; Allan Borushek; 2007

http://www.livestrong.com/article/84505-high-calorie-diet-ideas-children...

Kayti Brosnan, eHow Contributor
Kayti Brosnan licensed RN in the state of Texas since 2003. Speciality In Nursing, including CIMC/CPCU
eHow.com http://www.ehow.com/video_4790692_do-cnas-wash-hands-properly_.html#ixzz...

Jill Quinn, Thames Valley University, Essence of Care Module Teacher

http://www.bbc.co.uk/health/physical_health/conditions/fever1.shtml
Dr Trisha Macnair