Application of Nursing Skills - Case Study Example

NURSING APPLICATION OF NURSING SKILLS Goal setting /nursing enablement/ practice essay I. Introduction Good nursing considers the whole patient, body, mind and spirit, and recognize him as an individual. It deals with prevention as a well as cure and assumes a large responsibility for planning, delegating, supervising and coordinating patient care as well as for the supervision and instruction of the staff. Her attitude toward patients and their families and friends has a marked influence on the other members of the ward staff and she it is who establishes the standards of care which prevail on her floor. Nursing the individual The attitude of the nurse toward her patients is of paramount importune. Never for a moment should she let members of her staff forget that they are nursing human beings, not diseases. The patient is an individual, the member of a family and of the community. He may be intelligent or unintelligent, educated or uneducated, American or some other nationality, but he has feelings and emotions which influences his emotions which influences his attitudes and actions. Before working as a staff on a nursing care unit, the nurses generally completed their training in mentoring and nursing. Patients will be grateful to a thoughtful nurse who anticipates his personnel needs and remembers his individual preferences, nevertheless he should be given the opportunity to make further requests and to participate in the planning of his care if he is able and desires to do so. During convalescence or a long chronic illness, the patient needs something to occupy his mind, be its pleasant companions, reading, games handwork, or assisting with the work of the ward. He needs faith in his nurses, their knowledge and dependability of judgment. He needs the sense of security that comes from the feeling that are people are working together-doctor, nurses, maids, porters-and not at cross purposes. He needs the confidence which results from knowing that the entire nursing staff is interested in him, is sympatric and understanding, knows his needs, has plan for his care, and is doing everything in its power to help him regain and maintain his health. The patient who has required an injury or an illness which places permanent limitations on his activity or makes necessary a change in his pattern of living needs help in accepting the restrictions, help in marshalling his resources and finding was to live happily and usefully within the limits of its illness. The good nurse recognizes early any social and emotional factors which contribute to the patient's illness and its prolongation and which inhibit his peace of mind. Since man patients need more help than she is prepared to give, nurse refer them to another individual or agency for assistance when necessary. II. Identification of Skills The responsible for a nurse lies on promoting finest health and for preventing ill health. Nurses occupy a primary role in assessing nursing requirements, considering their medical, emotional and family circumstances, then plan and deliver care in hospitals, outpatient departments and in transit between hospitals. Typical work activities will vary according to the role, but they can include: The Nursing process is often Assessment Diagnosis Planning Implementation Evaluation The nurse through her close contact with the patients learns of social problems which may need to be referred to a medial social worker. She also is in position to recognize when the services of a public health nurse would be advantageous and is responsible for supplying the agency with sufficient accurate information. Many patients will feel to receive the necessary home care and supervision unless the hospital staff nurse is alert to his needs and his ability to met hem without help. Teaching of the patient about his condition, his care and the ways of attaining optimum health should begin as early in the patient's hospitalization as his condition will permit. The responsibility for a planned program of instructions for all patients rest with the staff nurse who needs to cooperate closely with the doctor in this matter If the teaching program is to be completed and the discharge of the patient is to be well handled the nurse needs to know at least 24 hours in advance the doctor's intention to discharge the patient. Nursing skills is preferably providing nursing care through negotiation in a spirit of corporation with patients and their families, and in union with other health professionals. In the light of this broad aim the nursing skills is required to develop certain understandings, appreciation, abilities and attitudes for clinical nursing practices. 1. Understandings- To develop an understanding that: a. Each patient's reaction to illness and to hospital experiences (i.e., treatments, operations, restrictions, dependency) varies with his personality and with his past experience. b. The socio-economic effects on the patient and his family vary with different illness c. The spiritual, mental, and physical needs of patients vary with individuals and with specific illness and conditions. d. Bodily comfort and mental; composure affect sleep and rest. e. There are potential hazards in the patient's environment and in ever aspect of his care. f. Cooperation and teamwork are essential to good nursing, good ward management, and the morale of the personnel on the ward. 2. Appreciations a. To appreciate the value of explanation and reassurance in preventing and alleviating fear b. To gain satisfaction from giving total nursing care c. To gain satisfaction from skillful performance 3. Abilities a. To recognize the symptoms and their significance especially in disorders and conditions characteristic of the patients on the service b. To report and record observations accurately and wisely c. To organize a program of total nursing care for any patient on the service d. To give health information in a way that it can be used e. To administer skillfully the comfort and perspective measures required by the patient f. To administer skillfully the comfort and protective measures required by the patients g. To administer skillfully the therapeutic measures prescribed for patients on the service h. To distinguish the relative importance of various aspects of patient are. 4. Attitudes a. To develop the attitude that much illness is preventable that freedom from disease does not signify positive health b. To develop a desire for continuous growth in knowledge, understanding, and ability c. To develop the attitude that the staff nurse and instructors are striving to help the individual become a good nurse III. Knowledge of Nursing Care Nursing care of the patient on admission to the hospital The responsibility of the staff nurse for good nursing begins the moment the patient enters her ward and continues until the time of his discharge. Probably no period in the patient's hospital experience holds greater opportunity for the nurse to show her interest and understanding than at the time of his admission. Or most individuals, entering the hospital as a patient are an unusual experience. It may be fraught with. It is always a cause for excitement. The staffs nurse is responsible for the quality of care which the patient receives from time of admission to his discharge. It is important that she develop in her staff an appreciation that the reception which the patient receives is a great contributing factor in his adjustment to the hospital. Every patient who enters the hospital is beset by uncertainty, sometimes fear. His admission has in all probability created many problems of adjustment in the home or business. An understanding nurse will appreciate the apprehension of the patient and his family and will bend every effort to ease his adjustment to the strange hospital environment by thoughtful considerations for his feelings. The nurse who admits the patient represents the hospital to him and his family. She should introduce herself and show him the courts and consideration she would show guest in her own home. The staff nurse will wish to make herself known to the patient and to members of his family in order that the will realize some one person is responsible for the patient's well being. Nursing measures for the protection and comfort f the patient should be instituted as soon as he enters the ward. Meeting the patients physical needs Organization and management to prevent confusion, delay and interruption in bedside care are highly important to most patients, as are skill and gentleness in handling painful and comfortable parts of the body. Under no circumstances should the patient, through carelessness or neglect of hospital personnel, develop conditions which will impair his health or cause him discomfort, nor should he fail to receive the full benefit of his treatment because of carelessness, haste or lack of understanding of the principle involved. The ability to use various types of equipment as assisting with feeding is also an important feature of nursing work. The knowledge of he following equipments is a must. Cannulars, Pulse oxymeters, Naso-gastric feeds, Drug pumps, Ventilators, Arterial lines and Central venous lines. Dietary service as it relates to quality nursing Food is an extremely important therapeutic measure and as such is of immediate concern to the nurse. To the patient his food often seems of far more importance than many other aspects of his care and a hospital reputation is partially built by the type of meals it serves. In some hospitals the nurse has no responsibility for the serving of diets, her functions being to prepare the patient for his meal and to bring his tray. In others the staff nurse is also in charge of kitchen management and tray service. Under any circumstances the psychological and physical preparation of the patient has decided influence on his appetite and his enjoyment of the food. The general responsibilities of the assistant nurse in charge of supplies and equipment might be listed as follows: 1. To have on hand sufficient equipment and supplies to meet current needs 2. To keep equipment clean and in perfect condition, read for use at all times 3. To place equipment and supplies where they will be convenient 4. To control waste and lessen breakage through preventive measures and staff education 5. To develop an efficient system for taking inventory and ordering materials 6. To avoid oversupply 7. To keep the staff nurse informed of the status of equipment and supplies and the difficulties arising therefore. Understanding patient's needs The patient's reaction to his hospital experiences might be one of fear, inadequacy, shyness, homesickness, worry, enjoyment of attention, relief resignation, or rebellion. The following is a list of actions which would lead the staff nurse possesses the desirable characteristics: 1. Assembles information about patient She reads patient's chart -history, progress notes, and nurses' observations Questions staff nurse about patient's personality Questions other nurses who have cared for the patient Studies the psychology of human behavior Confers with patient about his interests Disuses patient's interests and reactions with members of his family Suggests to nursing staff reasons for patient's behavior 2. Observes the patient's expression and behavior When he is anticipating treatments During treatment When he is in repose 3. Reports observations Reports patients fears and worries and other desirable reactions Recorded observed reactions Report to relief nurse information about patient's personality 4. Treat patient with understanding Explains hospital practice Explains treatments Uses terms patients an understand Shows personal confidence in value of hospitalization and treatment Encourages questions by patient Listens to patient attentively Avoids behavior suggestions until patient is read to accept them Accepts behavior of patient and his family without judging it. IV. Constraints in nursing care Changes in social, political, economic, technological, and legal environment force modern hospitals to change and adapt themselves to changing conditions corporate objectives and priorities. Without this the organization would not be able to grow and survive the process of continuous change and development. Although the quality of nursing is influenced by the size of the staff sand the facilities provided for her use, the staff nurse, who in spite of obstacles never forgets that the patient is a person, is the one who achieves a measure of personnel satisfaction and who exemplifies in the community the true spirit of nursing. Nurses practicing in today's rapidly changing health care environment are increasingly becoming aware of the need to evaluate and improve their practice as well as consider the political, social and structural issues affecting it (Bettie et al 1996:28). Because change is occurring all around us, it is important for nurses to be able to analyze and respond to new and different challenges in a proactive way. Developing critical thinking and reflective skills will assist you to meet the challenges of providing care in a con-text of rapid change and to become critically reflective practitioner. V. Personnel issues & Satisfactions of Nursing The satisfactions in the position of the staff nurse are innumerable, chiefly as a result of intimate contact with people. The staff nurse, more than anyone else, with the possible extension of bedside nurse, has close association with the patient. She is in a favorable position to obtain information concerning his needs through personal contact with him, his family, and his doctor and through knowledge of his history, progress and treatment. She has opportunities for personal assistance to the patient by making and directing plans for his care during hospitalization and in preparation for home-going, through supervision of his bedside care, giving him instructions , answering his questions ands offering sympathetic, understanding counsel. Another satisfaction in the position of staff nurse is her responsibility for the growth and development for the nurses and other ward personnel. The staff nurse who is truly interested in her patient's as people and who possesses high standards of nursing care wishes every nurse her potentialities to the highest possible degree. The staff nurse gains more satisfaction from her opportunities to aid in that development. Through the establishment of good relationships and the adaptation of care to the individual patient, she help to develop in nurses appreciations which recognize that the patient is the hub around which all activities revolve. A learning atmosphere is reacted through formal and informal teaching, good ward management and maintenance of the physical environment conducive to good care. Carefully graded, broad assignments of experience determine in large measure the skills and understandings which nurses attain. Maintenance of espirit de corps among members of the ward personnel rests surely on the shoulders of the staff nurses. It can be achieved by showing a personnel interest in her staff, helping them to feel that they are growing and giving, and maintaining a democratic than a autocratic relationship with them. More than in any other place it is in the hospital place that desirable attitude towards patients and towards nursing are attained and the atmosphere, the ideals the example set by the staff nurse are largely responsible for their development. VI. Cultural & Spiritual Nursing The reputation of the hospital in the opportunity is made to a very large extent on the wards of the Hospital. A hospital is known as much by the kindliness, consideration and thoughtfulness with which its patients are treated as by the understanding personal interest shown in its patient and by the intelligent recognition of their future needs. The hospital which appreciates that its responsibility extends beyond the period that the patient is confined within its walls wins the respect and gratitude of the community of which it is a part. Patients who are given the mental and spiritual as well as the physical aid which helps them adjust to disability are happier, healthier citizens. Those who leave the hospital with the full knowledge of the care they need at home and with plans made as to methods for achieving it, those who are made awake of their need for follow up medical treatment, and those who have received instructions in good hygiene and the maintenance of health - these individuals have found in the hospital of their community more than a place of healing. They have in their midst a center of health teaching. VII. Conclusion Nurses are responsible primarily for providing good nursing are to the patient, for seeing that the medical treatment which is delegated by the doctor to nurse is safely and effectively administrated, that patients learn how to care for themselves at home, how to prevent further illness, how to adjust to their physical defects, how to lie abundant, fruitful healthful lives. All functions related to her position have as their one great aim that of achieving good patient care. The nurses must likewise provide the tools for efficient performance of medial and nursing care. Without supplies and equipments in sufficient amount and in condition for use, workers are handicapped and morale is lowered. To achieve efficiency the nurse is also responsible for the establishment of an organized system for accomplishing the days work which fits in with the programs of other groups in the hospital, particularly those of the medical and other departments. 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