Assisting a Client with Eating and Drinking - Essay Example

Foundation Skills in Nursing: Reflections on Assisting a Client with Eating and Drinking Introduction: The core of nursing activities is dependent on certain skills that are necessary for patient care that involve techniques of the care that are supported by knowledge and attitudes required to attend a particular client. A nurse would need to assist the client for eating and drinking, and this assistance according to Roper-Logan-Tierney model of nursing requires certain skills apart from the knowledge about nutrition (Mooney and OBrien, 2006, 887-892). In this assignment, I am going to reflect on the care of a patient, 76-year-old John where I assisted the patient with eating and drinking. Eating and drinking are integral parts of human existence, and this is a very important part of activities of daily living in Roper et als model of living. I was given to understand that as a nurse, I have a primary role within the multidisciplinary team to ensure that my patient receive food, fluids, and adequate nutrition when he is under my care. My plan also involved educating him regarding a healthy diet (Mentes, Chang, and Morris, 2006, 392-406). This patient had difficulty in eating and drinking due to stroke and resultant paralysis. Being fully aware that it was primarily my responsibility to feed him and ensure that he meets his nutritional requirements, I first assessed his clinical situation (Fowles and Feucht, 2004, 429-433). Assistance would be necessary, but my goal would be to set a goal of achieving independence in terms of eating and drinking. I knew that the thought of having to be fed is a threat to the patients individual integrity and self-esteem. Similar feelings were happening in the patient, and I demonstrated considerable care and sensitivity to handle the whole affair of feeding and drinking and made every effort to minimise the negative aspects (Wilson, 2006, 413-416). Before preparing and serving the meal, this patient was offered a bedpan followed by facilities for hand washing. Eating would have been easier if the patient could have been able to sit out of bed, but this was next to impossible in this case, since he was bedfast and had no balance to maintain a straight posture. As a result, support was arranged to make him sit upright on the bed, and a suitable table was arranged and placed in front of him where the food and drink can be kept. This would allow him to see his food and indicate preferences. I offered the patient also the opportunity to clean his teeth and use a mouthwash. To ensure a relaxed social atmosphere, I sat at the same level as him. Prior to this, I identified the patient’s preferred food habits, and he was encouraged to eat in his usual pattern and pace of eating. He had some problem chewing and swallowing, and many a times, it was necessary to pause between mouthfuls to allow him to chew, and he was given a drink when he asked for (Dunea, G., 2005, 1217). I had the intention to allow him to feed himself and allowed some control. The food and drink were positioned on his unparalysed side. To be honest, I should have given my full attention allowing the patient to control the process of feeding and drinking as much as possible, and I could not do it due to pressure of work in the ward (Lou et al., 2007, 470-477). Short Summary 1 Nijs, KAND, de Graaf, C., Kok, FJ., and van Staveren, WA, (2006). Effect of family style mealtimes on quality of life, physical performance, and body weight of nursing home residents: cluster randomised controlled trial. BMJ; 332: 1180 - 1184. This is an article that studies the effect of family style mealtime on different parameters of patients that have no dementia yet need nursing care. To study these, the authors did a study on 178 nursing home residents of mean age of 77 years that were randomized into two groups. Although many different parameters were studied, the meal time in the nursing homes is an opportunity to study, implement, and integrate physical care that is targeted to improve the quality of life. The relevant information that can be helpful for this assignment are many. Food and nutrition are essential components of the patients’ perceptions about their lives, where they desire to socialize, exert personal preferences about their foods, and may improve satisfaction of life. It has been commented that assistance with feeding in an isolated environment may lead to a nonstimulating social environment. This may tend to provide task oriented care rather than client oriented care. The education in nursing is that although nurses are required to assist the patients in feeding, they need to compassionate care to the individuals in need taking full considerations of the above factors. This was a controlled trial comparing two forms of meals, and it demonstrated improved quality of life, nutrition, physical activities among patients who enjoy meals in a social environment amongst other where social reactions are possible, and the clients can exert their choices. This indicates family style mealtime among patients in a care situation prevents decline in the quality of life, physical performance, and body weight in nursing home patients. With motivated staff, this programme can be easy to achieve (Nijs, de Graaf, Kok, and van Staveren, 2006, 1180-1184). Short Summary 2. Mastos, M., Miller, K., Eliasson, A C., and Imms, C., (2007). Goal-directed training: linking theories of treatment to clinical practice for improved functional activities in daily life. Clinical Rehabilitation; 21: 47 - 55. In this article, the authors have recorded their findings in a study that aims to demonstrate how goal-directed training coupled with learning theories can be used to achieve independence in self-care tasks. To this end, analysis of baseline performance was done in a cognitively impaired patient. The specific patient described here was analyzed on feeding practices, and the patient was noted to use her nondominant hand ineffectively, and she could move the hand without any meaningful motion. After different interventions over a four-week period from being fed to feeding herself if there would be adequate environmental set up and verbal cueing. These interventions were obviously goal-directed interventions to make her independent. On a goal attainment scale, her achievement was maintained for over a period of 3 months. The clinical messages that may be relevant to nursing are, while feeding and drinking is assisted by nurse, it is not sufficient to assist in feeding, it is also important to guide a goal-directed training that aims to promote independence in feeding. Targeting the task to be achieved is the matter of essence, and such approach should be individualized on a client-centered approach. Intensity of practice is important, and the nurse must promote that in a suitable client where the residual physical or cognitive abilities must be analysed by task analysis and the goal must be set depending on a mutual participation and engaging the client in solving his own problem with a target not on the deficit, but on the achievement (Mastos, Miller, Eliasson, and Imms, 2007, 47-55). References Dunea, G., (2005). Compassionate care. BMJ; 330: 1217. Fowles, ER and Feucht, J., (2004). Testing the Barriers to Healthy Eating Scale. West J Nurs Res; 26: 429 - 443. Lou, MF., Dai, YT., Huang, GS., and Yu, PJ., (2007). Nutritional status and health outcomes for older people with dementia living in institutions. J Adv Nurs; 60(5): 470-477. Mastos, M., Miller, K., Eliasson, A C., and Imms, C., (2007). Goal-directed training: linking theories of treatment to clinical practice for improved functional activities in daily life. Clinical Rehabilitation; 21: 47 - 55. Mentes, JC., Chang, BL., and Morris, J., (2006). Keeping Nursing Home Residents Hydrated. West J Nurs Res; 28: 392 - 406. Mooney, M. and OBrien, F., (2006). Developing a plan of care using the Roper, Logan and Tierney model. Br J Nurs; 15(16): 887-92. Nijs, KAND, de Graaf, C., Kok, FJ., and van Staveren, WA, (2006). Effect of family style mealtimes on quality of life, physical performance, and body weight of nursing home residents: cluster randomised controlled trial. BMJ; 332: 1180 - 1184. Wilson, DM., (2006). Commentary by Wilson. West J Nurs Res; 28: 413 - 416. Read More