Challenges of Adult Nursing - Essay Example

Adult nursing practice Adult nursing care is a challenging job, which requires the practice of good standards of models. However, despite a significant research in the nursing models, their practical application in the area of need is many times not significant. In the present essay we present one such case where the nursing model was not explicitly addressed. Several loopholes presented their dominant stand in the nursing care practice in the Anonymous hospital under the focus of the present study. The patient under consideration had reported for being in depression and exhibiting psychosomatic pain as problems. The responses from the nursing care practice efficiency and inefficiency as understood by observation and research was collected. It was found that good documentation was not performed and there were several other loopholes in the present nursing care practice. It was therefore proposed that the acceptance of Roger’s (1980) model can prove beneficial in this area of application. Moreover, the Roger’s model provides base for sound documentation techniques and delivery of quality nursing care. Introduction It is crucial to mention here that modeling refers to the process of generating a model that has the conceptual representation of some phenomenon. Mostly, a model refers to only some aspects of the phenomenon in question. It is also crucial to understand that two models of the same phenomenon are essentially different. Thus, we might state that to the same phenomenon there can exists more than one model such that each model has a different base and reason for application and projection. The differences in models of the same phenomenon also finds its existence because of the pervasive fact of differing requirements of the model’s end users or due to conceptual differences by the modelers and decisions made during the modeling process. Esthetic consideration of the model ‘s structure is also essential for consideration point of view. It is with this reason in mind that we present the need for the expert involved in the application of model to understand the original purpose and assumptions of its validity. The destination for the designation of the present research was on the nursing care practices as forwarded to an adult patient. It is essential to mention here that in the delivery of care to the patient we have recommended nursing model described by Logan and Tierney (1980). We therefore have mentioned the possible corrections in the delivery of health services by the nursing staff in the hospital under consideration. The nursing model that we present for acceptance by the hospital for better functioning is the one described by Roper, Logan and Tierney (1980). The philosophy of the model states that the nursing care should be delivered using the nursing process. The patient under consideration in the area of focus for the purpose of ease in communication can be entitled as XYZ. The patient had 3 problems as related to physical and mental health. At the time of admission of the patient in the nurse one problem of a patient was identified. The nursing interventions were held in the area of identification and prescriptions on all care plans. It is crucial to understand here that though the care plan had a section for evaluation, it was not completed on the care plans studied. It is essential to bring to the knowledge that only few actual functional health patterns were addressed. Also, the highest incidence of occurrence was the added medical diagnosis or treatment category. The pain assessment was included in the area of projection as pertinent to the cognitive-perceptual pattern. Three problems that were identified had their relevance with pain and included poor mobility and bedfast due to pain. The patient XYZ was admitted for a period of five days and was suffering from depression and psychosomatic pain. The Anonymous hospital, which we happened to study in terms of knowing the modeling used for nursing practice on the patient XYZ thus followed no rigid modeling plan. It is essential to note that a steep rise in the complex nature of care delivery and rapid patient turnover instills a dominant requirement on nurses who aim to deliver care in the manner that is supportive in all essential areas. To help realize this requirement a planned approach to care delivery is mandatory. In order to accommodate this essential requirement it is crucial to adopt a planned approach to care delivery. The need of educating the nurses in an a attempt to make them realize plan, deliver and record care, the format known as nursing process have been taken since past thirty years (General Nursing Council 1977). The information as collected by virtue of following certain specific and pre-decided steps needs to be to be recorded. Maintenance of a permanent record can serve the essential need of this. This recorded the record the United Kingdom Central Council for Nursing, Midwifery and Health Visitors (UKCC, 1993 p. 2) as a crucial tool for practice and application. In addition to this, it is also recommended that the nurse should form a theoretical base so as to address the patient’s needs with effectiveness and scientific approach. The patient’s need is thus to be addressed with sound documentation and there should be significant consideration of psychological and sociological problems (Miller, 1985, Savage 1991, Howse & Bailey 1992, Davis et al. 1994, Johns, 1994,). The standardization of nursing language, as pertinent to the nursing diagnosis was not followed in the case of patient XYZ in Anonymous hospital. The definition as presented by the North American Nursing Diagnosis Association (NANDA) states that … a clinical judgment about individual, family or community responses to actual or potential health problems/life processes. Nursing diagnosis provides the basis for selection of nursing interventions to achieve outcomes for which the nurse is accountable (Carpentio 1993 p. 5). McCloskey &Bulechek (1994) have pointed that the acceptance of NANDA can certainly add an advantage to the diagnosis as practiced by the nurses. However, inefficiency did breathe even in this corner of the expectations. The nurses involved in the care of the patient XYZ did not stick to NANDA nor to UK nursing (Mason & Webb, 1993). Thus, the application of Roger’s (1980) model certainly assures the following of the nursing diagnosis in its efficient form and with sound documentation. Since in the hospital Anonymous no medical model has been applied, it is being presented that the application of model can certainly help substantiate the quality of care delivered to the patient by the nurses. This area approves attention also because the role of nursing as pertinent to diagnosis is crucial (Burns & Thompson, 1984, Carnevali, 1984). Discussion We would like to discuss three important areas where the reference to the need of the patient was neglected by the Anonymous hospital. These three important areas under the roof of our attention are as under: Ø Verbal and written problem identification Ø Medical diagnosis or treatment Ø Psychological and sociological needs Verbal and written problem identification The nurse in the intimacy of patient XYZ considered the psychosocial needs during the verbal handover. However, the emphasis even then was on the physical needs of the patient. Thus, the focus of attention was held only on the medical condition being treated and the physical observations pertinent to that treatment option. The findings were such that they concurred with the findings of other experts (Liukkonen, 1963, Savage, 1991) in the same area of function and research. It is also important to note that after discussion of psychological and social aspects of the patient a recording of the same was not performed in the care plans. The Roper (1980) model emphasis the need of adaptation of good quality documentation of the required necessitates of the patient. Its emphasis is on the need of realizing the essential need of documentation of psychological and sociological factors as linked with the patient. We can therefore state that the Roper’s (1980) nursing model holds a benefit of imparting better health care service to the patient as compared to the service provided by the model being used in the hospital Anonymous. Also, the model being used has not been explicitly stated this further sets a question mark on its capability of applicability. Medical diagnosis or treatment The diagnosis and presentation of the patient’s needs was being copied from the doctors record. Thus, independent contribution of the nurses in the area of medical diagnosis was dominantly inhibited and therefore called upon the need to consider the advantage of using the Roper et al. (1980) model which initiates the need of diagnosis of essential physical and other elements as performed by the nurses themselves. This, concept holds its base of acceptance on even the biophysical aspects (Norberg, & Asplund, 1987). Psychological and sociological needs The verbal hand over and the written reports were contradictory in their direction of presence. This survival of contradiction disables the personnel involved to answer to the needs of the patients. The contradiction in the verbal statements and the written statements has also fallen in the knowledge of several other experts including Lelean (1995). Therefore the application of Roger’s 91980) model becomes all the more crucial in the premises of Anonymous hospital for the patient XYZ. Since Roger’s model emphasis on the need of communicating through written means only to the content that holds true at the time of verbal hand over. Thus, accuracy and reliability are encompassed within the working zone of Roger’s model, which we recommend with prominence of confidence for the present study. We would therefore like to mention that effective use of the approach developed to the delivery of care for nursing must present a perspective that is nursing specific (Woolley, 1990). Conclusion The present research holds its essential area of focus on the identification of problem or diagnosis of nursing as practiced in the UK. The knowledge of the practice being practiced in UK can help in a movement that holds its essential direction to the formal classification such as those developed with integrity by NANDA. However, since the sample size of the present study holds its limitation of application, further research in this area is crucial for a concrete base of understanding the problem. The differences is between the practiced set of principles and the ones desirable for a quality service holds in the depth of its existence a suggestion that the nursing model used in the ward made no differences to the nursing care delivered. This is essentially so because attention to application of theory to the practical world was not made. From the procedure as followed in the hospital for the patient XYZ, we noticed that a written record of the patient ‘s problem was not made. Also, the current needs of the patient remained un-addressed. It was also noted that the medical reason for admission of the patient XYZ was recorded as the patient’s problem but the diagnosis reason for the same was not addressed. Thus, we conclude that the UK nurse is required to have in the boundaries of their knowledge a need to understand the concept of nursing diagnosis. This shall also enable the nurses to involve themselves actively and effectively in the validation of nursing diagnosis. References Burns C. & Thompson M.K. (1984) Developing a nursing diagnosis classification system for pediatric (sic) nurse practitioners. Pediatric Nursing 10, 411 414. Carnevali D.L. (1984) The nursing domain for diagnostic reasoning. In Diagnostic reasoning in Nursing. (Carnevali D.L., Mitchell P.H., Woods N.F. & Tanner C.A. eds), J.B. Lippincott, London. Carpenito L.J. (1993) Nursing Diagnosis: Application to Clinical Practice 5th edn. J.B. Lippincott, Philadelphia. Davis B.D., Billings J.R., Ryland R.K. 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