This is a nursing case study prepared on the basis of the observations made by the author while on a practice placement. The paper discusses the observations made about the nursing care given to a patient with paranoid schizophrenia…
This is a nursing case study prepared on the basis of the observations made by the author while on a practice placement. The paper discusses the observations made about the nursing care given to a patient with paranoid schizophrenia.The study is also intended to show the role of a nurse in care; including assessment, planning, implementation and evaluation and also in the care given to the patient’s family. In this particular case, the method used was Orems Self-care model (2001) which emphasizes on improving the patient’s state of health and making them feel responsible for their own health. It is not possible to undermine the role of a nurse in this system which is mainly to promote physical, mental and social health through developing a good, trust-based relation with the patient. In addition, this case study will show how client-centered nursing models are used in which the patient’s interests and rights are respected and protected to the maximum possible extent. As Rogers C (1990) opines, the nursing team in this particular case develops strong relationship with the patient with real exhibition of sympathy, originality, and willingness to listen while dealing with the patient. As per the NMC (2008) directive that nurses should develop a deep and reliable relationship with the patient, the author engaged in conversation with the patient; and the expected result was a relationship based on respect and belief (Baker 2003). In this particular case, the patient’s individual freedom to decide her own life was preserved as far as possible (Ewles & Simnett, 2003). As per the definition by Lowden, (2002) autonomy means allowing the patient to make decisions in personal matters. The Patient The patient in this case study is named Mary. The name is imaginary to comply with NMC professional code of conduct (2002). She was 54, and was admitted to the hospital with Paranoid Schizophrenia. Before her entry into the Ward, there was a holistic and thorough assessment by the duty doctor. The basic concepts of care The method of care is totally holistic in nature. In this case, Orems (2001) Self Care Model of Nursing is used as the basic criteria and it follows the four stage nursing process of assessment, planning implementation and evaluation. As Barker (2003) observes, this holistic approach will explore the physical, psychological and social spheres of nursing assessment. Assessment The nursing process starts with assessment (Roper et al 2000) which includes all the present and historical information about the patient This must include as much information about all spheres of life as possible including the mental health, family background, education, religion, beliefs and occupation. Family history of mental disorders and other genetic factors are also taken into consideration. In addition, adequate attention is paid to the patient’s lifestyle and living situations. There are a number of ways suggested by Townsend (2006) for the assessment of patients which include consultation with other health professionals, collecting data from family members, watching and interview. In addition, according to the Oxford Nurses Dictionary (2002), a holistic assessment will consider a patient’s psychological, physiological and social life. In the opinion of Jenkins & Field (1996), collecting all these information from a patient will help a nurse in developing a healing relation with the patient. In fact, Mary had a long history of schizophrenia. For her, the disease had its beginning about thirty years ago but the disease was not diagnosed accurately in the beginning. The disease at first started in the form of tension along with sleeping problems and difficulty concentrating. But no one including her parents took the change seriously as there was a tragic incident. It was during those days that her husband died in a car accident. When she shrank more and more into her own private world, all including her parents and friends thought it as a result of the shock caused by her husband’ ...
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