Fact Essay
INTRODUCTION
The purpose of this essay is to carry out an assessment of a patient and present a plan of care of three specific problems that the patient has encountered. The model chosen to guide the care plan is the Roper, Logan and Tierney’s Model of Nursing (Roper et al 2000). This will enable me to develop my skills in assessment, problem-solving and planning care.
The essay will begin by introducing the patient and outlining the rationale for choice. Following this, I will identify and discuss the care required through all stages of the nursing process (Roper et al 2000). I will discuss this in relation to assessment of three patient needs. I plan to show an understanding of holistic care and how it is used in each stage of the nursing process.
Pseudonyms will be used in accordance with the Nursing and Midwifery Council (2004) which states that “you must guard against all breaches of confidentiality by protecting information from improper disclosure at all times.
CHOSEN PATIENT AND RATIONALE FOR CHOICE
Jane is 81 years old, widow who lives alone in a bungalow, married for 54 years and has 2 daughters, one of which lives abroad and the other locally. She stated she has had a good life with many memories and had travelled to several countries with her late husband. She had enjoyed going to dance halls and outdoor bowling. Jane suffers with osteoarthritis which is a degenerative disorder in bone and cartilage (Hinchliff et al, 1998). She had fallen at home and was presented at the Accident and Emergency department. After a short stay on Medical Assessment ward, she was transferred to the unit for rehabilitation following her fall she developed urinary tract infection, with catheter in situ and reduce mobility. More than 300,000 pensioners each year require hospital treatment because of falls-related injury (Alexander 2000).
The rationale for choosing Jane was because I was involved in her care. I also wanted to emphasize on the function of nursing, which is to assist the individual to prevent, alleviate or cope positively with problems (actual and potential) related to activities of living (Roper et al 2000).
IDENTIFICATION AND ANALYSIS OF THE ROPER-LOGAN TIERNEY MODEL OF NURSING
The ward uses the roper, Logan, Tierney (2000) model as its theoretical framework for assessment. The model is applicable to the lifespan of a person from infancy to old age and contains the idea that actual and potential problems can place a person anywhere along a continuum from total dependency to independence. This idea promotes the goal of nursing to advance the patient from a state of dependence to independence to one of optimum (Dougherty and Lister 2004).
Roper et al (2000) identify the nursing process as a four stage dynamic, cyclical and continual process and the four stages are, assessing, planning, implementing and evaluating. The twelve integral and interdependent activities which form the core of the model of living are, maintaining a safe environment, communicating, breathing, eating and drinking, eliminating, personal cleansing and dressing, controlling body temperature, mobilizing, working and playing, expressing sexuality, sleeping and dying. (Roper et al 2000).the five main groups of factors influencing the activities of living are biological, psychological, socio-cultural, environmental and political-economic factors (Roper et al 2000). These factors were considered throughout Jane’s assessment.
Roper et al (2000) suggest that assessment may on some occasions focus on certain activities of living relevant to a particular patient and setting. However, Newton (1991) argues that every activity of living should be considered when assessing a patient with the exception of dying and it may be the one thing the patient fears. For the purpose of this essay I have focused on maintaining safe environment, eating and drinking and elimination.
ASSESSMENT
Assessment is the first stage of the nursing process and it marks the beginning of a nurse-patient relationship. Assessment is an ongoing process When activities of living is used as the criteria for assessment, data is collected, reviewing objective and subjective data about the patient and identifying actual and potential problems which are amenable to nursing intervention (Newton, 1991). Because activities of living are complex and interrelated (Roper et al, 2000) it is difficult to consider each one independently.
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