The Feeling of Pulse Taking and Tongue Reading During the Observation - Essay Example

A Reflective Essay to Reflect the Feeling of Pulse Taking and Tongue Reading During the Observation A Reflective Essay This essay seeks to reflect critically on an interaction with a patient in my area of specialization as a nurse student. The clinical issues reflected in this essay involve pulse taking and tongue reading, this will be evaluated by using the KOLB reflective model. The reflective essay will assist me to acquire knowledge and improve my professional nursing skills. To comply with the nursing and midwifery code of professional conduct and respect confidentiality, the patient will be referred to as Mr. Y. According to Chen (2007), taking pulse and tongue reading are utilized as strong diagnostic tools in traditional Chinese medicine (TCM). The pulse taking and tongue reading are usually used for TCM diagnosis of ones health condition and are employed to determine the appropriate treatment. Pulse taking is critical in Chinese medicine besides the common determination of the heart rate as used by the Western Medicine; it gives comprehensive information about the health condition of the internal organs(Chen2007). In the same way, the tongue can reflect valuable clinical information in connection with the internal organs, just the same way the pulse does. Though the tongue is less specific than the pulse, it reveals the degree and nature of phenomenon, such as hot or cold, shows imbalances, and it is hardly influenced by short-term conditions, such as nervousness (Chen 2007). The tongue plays a major role as a measuring tool to assess the progress of an illness. Experience As a nursing student looking to become a qualified professional, I appreciate the calm, yet exhilarating moment when I engage with a patient. Nursing is more than just a job, but a profession where you get to connect with the patients body mind and soul. As I gain skills, I have come to realize that diagnosing a patient brings about a connection that goes beyond determining the illness. How a medical practitioner relates with the patient can have a great influence on the observations that will be made at the particular moment. My latest experience was with a Mr. Y who visited the clinic with a persistent headache; this was a test of my theory on applied skills and also a great learning experience. I had always strived to sharpen my skills on critical analysis, but never before did I know that dealing with a patient can be a whole different experience. When it came to taking the patients diagnosis, in this case the most critical tongue reading and pulse taking as preferred by Chinese medicine, things did not work well as I had expected. The very first problem is that the patient seemed very nervous and uncomfortable when I asked him to show me his tongue. Secondly, after carrying out the pulse reading a couple of times, it was evident that same pulses would read completely different despite the fact that I read them at very short intervals. Observations With experience, I realized that patients are not ready for pulse taking and tongue reading especially during their first time. I have learnt why it is possible to give a wrong diagnosis when a medical practitioner does not consider every detail when making any diagnosis. While a pulse rate could be affected by age or gender, a simple mistake of failing to make a patient comfortable could lead to a wrong diagnosis(Deadman& Al-Khafaji2007). As a practitioner, you also have to be confident when taking patient pulses. My experience with Mr. Y was not one of my best especially after realizing that something was not right with the diagnosis. To make the patient comfortable when taking a pulse, you need to show confidence in your skills. Introduce yourself to the patient, answer any questions they have to ask and make them understand why a particular observation needs to be done. The only time you should go ahead with the test is after you ensure your patient is at rest, and you have obtained their consent willingly(Deadman& Al-Khafaji2007). Some patients do not enjoy the idea of sticking out their tongue and pulse taking. Most patients will prefer blood tests and any other kind of diagnosis to these two tests that they find strange. According to Ellis, Wiseman andBoss (2004), lack of confidence is influenced by a number of factors such as age, upbringing, and gender. Some patients are brought up in regions where they do not often employ the Traditional Chinese Medicine, which makes them uncomfortable or deemed as not as effective. At such a case, as it was for Mr. Y, it is advisable to explain to the patient why you have to do the test and its effectiveness. It is the practitioners duty to seek and understand why a client is not comfortable with the diagnosis to be in a position to explain why the tests are important(Fischbachand Dunning 2009). Development of ideas I do believe that TCM is about energy function condition medicine culture; the pulse taking is not just a position touch feeling, but an energy feeling examination. In perfect circumstances, the pulse should be taken in the morning when the patient is still calm and relaxed (Xutian, Cao, Wozniak, Junionand Boisvert2012). It is essential to give the patient some time to rest for a while after arriving even in the morning hours to allow the pulses to normalize. If not, it could be easy to mistake a rapid pulse for another condition, while the reason could be that a person is not fully settled (King, Cobbin, Walsh and Ryan 2002). This reflects the condition of Mr. Y whom I did not give time to rest, leading to abnormal results despite utilizing the right procedure while taking his pulse. Making the patient settle down and relax is also very important while reading the patients tongue. Most patient I have come across find it strange when asked to stick out their tongue. To prevent the patient from feeling uneasy, I have discovered that introducing them to tongue diagnosis and taking time to explain how tongue reading is applied in diagnosis as very important. The TCM recognizes that the tongue acts as a mirror to a number of systemic health conditions. The tongue is a major diagnostic tool, but certain factors have to be put into consideration to avoid a wrong diagnosis. The appearance of the tongue can be affected by, lighting, the food taken prior to the test, brushing the tongue before test, age, time of the day or season of the year. All the common factors that affect the colour, shape and general appearance of the tongue need to be ruled out before making a conclusive decision. The tongues shape and color reflects the Ying (Nutritive condition) or the state of blood. A pale tongue body is an indication of quality of blood, cold or Qi deficiency. A pale thin tongue with other common conditions ruled out indicates Qi and blood deficiency. The appearance of the tongue helps in monitoring the progress of patients condition. Different parts of the tongue and different appearance corresponds to health conditions of specific organs. Tongue reading is objective in comparison with other types of diagnosis, such as pulse taking. Different methods of pulse taking reflect varied health conditions. In a state of a healthy liver, the left middle pulse feels relatively smooth and soft indicating that the liver and the gall bladder energy are well balanced(OBrien, Abbas,Zhang, Guo, Luo, Bensoussan, and Komesaroff2009). In case of a head ache, like in the case of Mr. Y, if the pulse feel tight than normal, pounding and more superficial; this condition can be said to be a liver fire (Yang). The pulse indicates that the energy is rising. Regardless of the access to a number of different pulse taking sites, the standard Chinese medical emphasize more on using the radial artery by placing three fingers. Use of radial artery is almost restricted to the wrist region. The wrist method of reading pulse is the most common and is considered the easiest(OBrien, Abbas,Zhang, Guo, Luo, Bensoussan, and Komesaroff2009). Other methods include, feeling the artery in the knee and feeling the neck artery. These methods are different in terms of ease and procedure used while taking the pulse. The popliteal pulse requires the patient to stand in an upright position when taking the pulse. This can be a challenge for a patient who is not able to stand and a patient may not manage to keep relaxed when the pulse is being taken. it is also relatively easy to take a pulse from the neck artery compared to the knee. When selecting which method to apply, patient condition and comfort should be considered in addition to ensuring the method gives the most accurate readings. Testing and Practicing Ideas With a number of challenges and learning experience, I have learnt a couple of things that will help any medical practitioner improve on their pulse taking and tongue reading. Understanding the basics of pulse reading is very important. Quite often, practitioners will forget to look into basics and concentrate more on complicated conditions. The patient needs to relax and place the arm at the level of the heart. With the patient relaxed, there is smooth circulation of blood and vital energy (Qi). A pulse is examined at three distinct depths which include a superficial level, middle and deep. The three pulse depths suggest a fast idea of the Qi level in the pulse and, the pathological condition that might exist. The superficial level specifically reflects the state of Qi and the middle depth indicates the blood condition(OBrien, Abbas,Zhang, Guo, Luo, Bensoussan, and Komesaroff2009). The state of Yin organs is reflected by the deep level. Evaluating the pulse quality and strength at these levels gives a better idea of the Qi pathology, Blood and Yin Pulse taking is said to be a miraculous method of diagnosis, but I disagree with referring to pulse taking as miraculous. Though different myths label it as miraculous simply because it seems easy at a glance, it is not a miracle. Pulse taking is a science of life, one has to study and understand the science behind pulse taking to make right diagnosis. Pulse taking only makes a right diagnostic tool when utilized correctly and the right information of the process and the related pathological condition is understood. It is quite interesting to think about the tongue as diagnostic tool in accordance to Chinese Medicine. The tongue provides a means to diagnose what is going on in the internal organs in relation to what is manifested externally and emotionally. The tongue basically acts as an organ that helps us see the internal mechanic of the body. Understanding the fundamentals and the most sophisticated details of the tongue is important in making correct diagnosis while utilizing tongue reading. Learning to take diagnosis of your tongue and family even in their healthy condition is also a great way to improve on tongue reading, which I have utilized to help differentiate, a healthy tongue, common conditions and cases of health concerns. This also applies to pulse taking. Practicing after studying the theory helps develop confidence in taking the test and dealing with patient. Hence the skill Pulse and tongue reading can be mastered and improved by way of constant practice, concentrating on the matter, and through the guidance of an experienced professional(Lad 2005). Effective pulse examination involves feeling, touching, experience, monitoring though observation, while tongue reading involves observing, feeling and experience as well; This means that improving on these two important skills does not only involve rhythm, volume and rate and understanding of the parts and health conditions manifested through the tongue and the pulse. Your confidence as a practitioner and skills on handling a patient also play an important role and deserve to be observed during practice(Lad 2005). List of References Chen, J.X., 2007.Chinese Medicine Study Guide: Diagnostics. Beijing: Peoples Medical  Publishing House.  Deadman. P., Al-Khafaji, M., 2007. A Manual of Acupuncture (Second edition). Hove:  Journal of Chinese Medicine.  Ellis, A., Wiseman N. andBoss, K., 2004.The Fundamentals of Chinese Acupuncture (revised  edition). Taos: Paradigm. Fischbach, F. T., and Dunning, M. B., 2009. A manual of laboratory and diagnostic tests.Lippincott Williams & Wilkins. King, E., Cobbin, D., Walsh, S., and Ryan, D., 2002.The reliable measurement of radial pulse characteristics. Acupuncture in Medicine, 20(4), pp. 150-159. Lad, V., 2005. Secrets of the pulse: The ancient art of Ayurvedic pulse diagnosis. MotilalBanarsidass Publisher. OBrien, K. A., Abbas, E., Zhang, J., Guo, Z. X., Luo, R., Bensoussan, A., and Komesaroff, P. A. 2009. Understanding the reliability of diagnostic variables in a Chinese medicine examination. The Journal of Alternative and Complementary Medicine, 15(7), 727-734. Xutian, S., Cao, D., Wozniak, J., Junion, J., and Boisvert, J., 2012.Comprehension of the unique characteristics of traditional Chinese medicine.The American journal of Chinese medicine, 40(02), pp. 231-244. Read More