Assistance according to Roper-Logan-Tierney Model of Nursing - Assignment Example

 Foundation Skills in Nursing Reflective report on the shill of assisting a client with eating and drinking summaries of two articles relating to this skill Introduction: The core of nursing activities is dependent on certain skills that are necessary for patient care that involves techniques of the care that are supported by knowledge and attitudes required for 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 O'Brien, 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 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, 429-443). Although I assisted him in feeding and drinking, my goal was to help achieve his independence in terms of eating and drinking (Wilson, 2006, 413-416). During illness, the nutritional demands of the patients are usually high. By assisting him with his nutrition, I was attempting to improve his poor nutritional status that could hasten his recovery. As a nurse, I had a role in prevention of his malnutrition. While executing this, my role was also to identify the risks and plan the intervention accordingly. Given the patient’s clinical status of post-stroke alterations in structure of facial disfigurement, psychological alterations of post-stroke depression, and environmental alterations in terms of hospital setting, I had to design the plan of feeding. This skill would eventually include screening and assessment of client’s nutritional needs, care planning and implementation, evaluation of care and necessary changes, creation of a conducive environment, assistance to eat and drink such as setting the table at proper height under appropriate illumination giving small quantity of food at a time, obtaining food, presentation of food, monitoring of nutrition, and educating the client to have appropriate nutrition. I could understand his physical limitations and design a feeding skill that could accommodate his needs, but there was nothing that I could do to alter the hospital setting other that trying to distract him as much as possible and to do my job. The depression is a very common phenomenon in such patients, and I decided that I will do as much as possible as the therapeutic relationship would advance (Dunea, 2005, 1217). I had the intention to allow him to feed himself and allowed some control. The food and drink were positioned on his non-paralysed 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). On completion of the skill, I must evaluate the skill to know the gaps to implement necessary changes. 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 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 separated into two groups. Although many different areas 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. Food and nutrition are essential components of the patients’ perceptions about their lives, where they desire to socialise, 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 un-stimulating 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 s patient described here was analysed on feeding practices, and the patient was noted to use her non-dominant 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, these interventions were goal-directed 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 individualised on a client-cantered 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 et al., 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 O'Brien, 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