Transition in Care - Understanding Needs and Experiences in Social Context - Essay Example

Transition in Care Transition in Care Introduction Young people have diverse physical, emotional, psychological need. Therefore, they require different health care needs in their stages of adolescence (Abu-Saad, 1981). Studies highlight adolescence often interchanges with their cultural and social context. This essay studies the case of Kelly, to understanding her social needs and experiences of an adolescent patient. Furthermore, it analyzes the acute condition that has exerted an impact on her anatomy and physiology. The study illustrates the relationship between the stress and pain leading to delay wound healing. A number of challenges shall also be taken under account regarding the ethical and legal issues in the health care settings (Christian et al., 2006). Pain management techniques and community care setting are illustrated in the paper to develop understanding of the patient’s health, furthermore it shall discuss the obstacles and challenged faced in the application and implementation of health care management for adolescences. Understanding Needs and Experiences in Social Context It is an integral function of nursing to understand the condition of a patient as an individual to address their health needs (Abu-Saad, 1981). This means that the nursing practitioners will have to assess social experiences and needs of the patients (Begum & Johnson, 2010). The need for doing this is because it presents a case in front of the health care professional that will help them formulate a strategy for their treatment. According to the study Begum and Johnson (2010), Young people have specific and different health need (Begum & Johnson, 2010). In addition, their environment plays a major role in the development and overcoming the process of injury (Dumont et al., 2012). Looking at the case of Kelly, it comes to our understanding that she is a young girl who is spending her days in an acute adult hospital ward. This is serving as a great challenge for Kelly in her process of recovery that may lead to delay healing, trauma, cognitive abilities (academic performance), and restoring herself as an athlete (Dumont et al., 2012). In the case of it shall be noted that Kelly has been accommodated in a general ward, where she has different people belonging from different ages (Begum & Johnson, 2010). Briere and Lanktree (2011) argue that the services offered to adolescence in wards and home does not address their special need (Briere & Lanktree, 2011). They required psychological and special health care services to enhance their recovery. Therefore, Kelly shall be accommodated in the adolescence wards or with the people who are considered being ‘elder’(parents, guardians or siblings). The psychological impacts and sense of belongingness, which young people find in parents and age fellows provide mental and psychological assistance that, allow them to recover effectively (Department of Health, 2003). In case of Kelly, it shall be noted at home the special treatment is note provided to Kelly that has made her recovery more painful. It is evident from the study of Collin (2007) that for a faster recovery, children friendly environment and skilled staff should be provided to adolescent patient (Kelly) to ensure her effective recovery (Collin, 2007). Acute condition impacting Anatomy or Physiology It is an evident fact that surgical conditions may affect a patient in several ways. It could either be in the form of effect on cognition or physiology. Effects like these may lead to delayed recovery of the injury or surgical condition (Dumont et al., 2012). Athletes who participate in sports, such as, biking, football etc anterior Cruciate Ligament injuries are one the most common injuries (Dumont et al., 2012). The surgical treatment for anterior cruciate ligament has less pain from surgery, less time being hospitalized but the growth takes times for six or more than six months to return to sports (Dumont et al., 2012). Kelly has undergone the surgery, the swollenness, stiffness and server pain are likely to occur during 1 to 2 weeks of surgery (Canadian Paediatric Society, 2008). The use of cryo-cuff or raising the leg is advice to the patient (Christian et al., 2006). Looking at the case of Kelly, it shall be noted that the injury has affected her anatomy that has influenced her mental condition. This has impacted her cognitive condition; Kelly seems to be stressed out, severe pains due to the infected wound (due to coagulase negative staphylococci) has caused her body temperature to rise. Injuries and surgeries cause a great impact on the anatomy and physiology of an individual (Briere & Lanktree, 2011). Due to which Kelly seems to be stressed out. Moreover, Kelly is reported to have 4/4 pains, severe pains can lead to fever, nausea and vomiting. The disturbance in the anatomy of Kelly has impacted her mental condition (Gouin et al., 2012). According to the study of Upton and Solowiej (2010) points that the stress and pain can contribute to the delay wound healing (Upton & Solowiej, 2010). It suggests that the wound related pain could cause a negative impact on the wound healing of an individual that delays recovery from injury (Masteron et al., 2007). This stress and pain of Kelly can influence her perception of pain, emotions, cognitive, social factors or behaviors (Department of Health, 2003). Therefore, appropriate dressing selection and pain management strategies should be adopted in order to divert the stress of Kelly (Vileikyte, 2007). The previous painful experiences related to the sports or event can be developed by Kelly (Romain et al., 2012). The trauma can cause Kelly to built barriers and fear to get back into athletics; in addition it can cause negative impacts on her academics as she shall be more concerned about her pain rather than concentrating on herself (Upton & Solowiej, 2010). The stress Kelly encounters can lead to the consequences to failure of the human body can adversely affect physical or emotional threats to Kelly (Abu-Saad, 1981). This can influence her academic performance, delay her recovery or develop trauma for the injury. It is evident from the study of Ferguson (2004) that Kelly’s injury is affecting her anatomy and physiology leading into delayed recovery (Ferguson, 2004). Rationale In order to provide treatment to Kelly, it is necessary to examine and investigate methods through which pain can be managed effectively in terms of physiology and psychological assessments (Dumont et al., 2012). Kelly is suffering from chronic pain because her wound fails to heal. In this respect, research indicates that patients undergo stress due to which the immune system reduces its capacity to work effectively (Christian et al., 2006). In order to interpret what Kelly is going through it is necessary to instill a rationale study and evidence that provides a basis of nursing care and effective management, which are discussed as follows; Role of Nursing Staff in terms of Wound Healing The report of Department of Health (2003) highlights, that it is necessary that the nursing practitioners are able to recognize and assess pain and also identify risks involved. As Kelly is undergoing problems in wound healing, and she is on antibiotics it is necessary that she remains hydrated (Abu-Saad, 1981). In this regard, it is necessary that there are accurate pain assessments tools used which provide reports on improvements and make assessments through observations (Begum & Johnson, 2010). These tools may include; frequency and intensity of pain, delay healing process and characteristics as well as few cultural influences for example a belief that gives rise to a certain attitude that pain persists (Ryan & Deci, 2001). Pain History and Behavioral Observations According to the study of Nelson and Gordon (2007) it is necessary that when individuals like Kelly enter the nursing home, they provide pain history. Analyzing the case of Kelly, it shall be noted that Kelly does not has any pain history, this indicated that the cause of her current condition is the injury (Dumont et al., 2012). However, as suggested adolescence are not be able to communicate openly about the chronic pain they are going through as it is affecting their cognitive ability and they are in their adolescence age when they it is difficult for them to locate vital signs of pain (Dumont et al., 2012). Adolescents require privacy as they tend to be more sensitive about their situations hence for this purpose, The Mc Gill Pain Questionnaire (MPQ) can be used. This questionnaire was developed by Melzack and provides answers relating to pain management in terms sensory, affective, and evaluative. The questionnaires provided a brief insight and understanding about the pain an individual is unable to communicate. Furthermore, the information can identify the severity of the pain, which can assess health care professionals to take adequate measures for the treatment (Srouji et al., 2010). Wound care The healing process of Kelly requires a period of 2week this is because of the reason that the process of wound healing wound healing requires three phases; first it undergoes inflammation then a new tissue is formed and then remodeling stage where it is altered to provide the same functions (Collin, 2007). The tissues that were damaged, requires time to redevelop, that may result in a scar. In order to overcome the scar, Kelly is advices to increase intake of foods and supplements that are rich in vitamins like Vitamin A, C, and E, which will help in wound healing. (Briere & Lanktree, 2011). The intake of these vitamins shall boost healing of her wound and tissue; in addition, it shall prevent scars. Dehydration Kelly is reported to suffer through dehydration, therefore she should increase the intake of water and fluids as possible, she needs to keep her water and electrolyte level high as she experienced vomiting which is not a good sign and it may cause her dehydration (Begum & Johnson, 2010). As cited by the scholar Begum and Johnson (2010), dehydration can increase confusion, disorientation and also affects the individual’s thinking ability (Begum & Johnson, 2010). Use of Antibiotics and IVI Care Use of Antibiotics as aspirins may relieve pain symptoms as they help in stimulating the brain and sensory nerves. According to the study of Christian, nurses and doctors shall scrutinize the antibotics as there can be few side effects of antibiotics as well (Christian et al., 2006). Research indicates frequent use of Rifampicin and Flucloxacillin, which are being used on Kelly are effective and will help her to discharge earlier from the hospital (Schrenzel et al., 2010). Legal and Ethical Concerns According to the Children Act 1989, article 21; health care professionals are required to carefully determine ethical and legal responsibilities of the case of Kelly (Department of Health, 2003). In the health care setting, it is essential to address issues of consent between the parents and child, as conflicts between them may lead to several ethical and legal issues (Department of Health, 2003). Kelly is 17, therefore while getting the consent for the treatment it is essential for the staff to address Children Act (1989) through the access of legal advices to develop an understanding of the child’s interest (Burns et al., 2008). In addition, confidentiality is one of the essential aspects to ensure privacy of the child. For the purpose effective communication patterns, method, peer supports and leisure pursuits shall be incorporated in order to sustain confidentiality and consent of the child (Burns et al., 2008). Royal College of Pediatric and Child health suggest that for the intensive therapies, Kelly’s consent is one of major ethical and legal concern that should be effectively addressed through appropriate consultancy and advocacy (Royal College of Paediatrics and Child Health, 2003). Pain Management in Adolescence According to Biere and Lanktree (2011), it is difficult to manage pain in young adolescences as compared to older people and they are more likely to get into anxiety because their cognitive development as well physical attributes are still developing (Collin, 2007). Effective pain management techniques and strategies should be adopted to motivate young people. It can assess them to cope in this situation far more easily and recover more effectively (Resnick et al., 1993). Interventions & Coping Strategies- Community Care As stated by Rout (2002), team therapies, social workers, health professionals and a support system can help patients overcome anxiety and also increase recovery. In this regard, community, counselors and family support play a vital role in establishing a treatment plan that caters to their issues of beliefs and other environmental considerations (Nelson & Gordon, 2007). For instance, in the case of Kelly, she could be under stress because she has to go back to school. In her, peer influences and her family can help her cope so that stress does not act as a barrier in her recovery. In order to treat Kelly, she requires intervention strategies and group treatment which will help her connect to others and provide mobility to her support (Abu-Saad, 1981). Due to her knee injury, for the period of six month Kelly cannot restore her sports activities (Begum & Johnson, 2010). In this case, she needs motivation to remain optimistic, she needs to meditate and take proper rest to recovery effectively from her injury (Resnick et al., 1993). Assessing the case of Kelly, it is evident that the social context plays an essential role on adolescence cognition. Health care settings and health care management for adolescence should be developed considering their special health needs (Dumont et al., 2012). It is evident from the case, the environment and special health care services influences cognitive behavior of the young people towards the pain that eventually affects the healing process of the patient (Department of Health, 2003). In addition, to address these issues, adolescences are required to accommodate in the adolescences wards, where the health care professionals are equipped with special skills to address their special needs. Furthermore, adequate health care techniques and strategies should be adopted, that incorporated ethical and legal concerns to persuade further treatment (Begum & Johnson, 2010). Absence of the skilled staff, health care and social context has caused negative impact on the patient that has caused delay recovery from the injury (Briere & Lanktree, 2011). List of References Abu-Saad, H., 1981. The Assessment of Pain in Children. School of Nursing, 5(5), pp. 327-335. Begum, M.N. & Johnson, C.S., 2010. A review of the literature on dehydration in the institutionalized elderly. The European e-Journal of Clinical Nutrition and Metabolism, 5(1), pp.e47-53. Briere, J.N. & Lanktree, C.B., 2011. Treating Complex Trauma in Adolescents and Young Adults. London: SAGE Publishers. Burns, M.K., Jacob, S. & Wagner, A., 2008. Ethical and legal issues associated with using response to intervention to assess learning disabilities. Journal of School Psychology, 46(3), pp.263-79. 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Gouin, J.P., Kiecolt-Glaser & K, J., 2012. The Impact of Psychological Stress on Wound Healing: Methods and Mechanism. Immunol Allergy Clin North Am, 31(1), pp.81-93. Masteron, L., Sturrock, T. & Steinbeck, K., 2007. Adolescent Appropriate care in an Adult Hospital: The use of a Youth Care Plan. Australian Journal of Advance Nursing, 24(3), pp.49-51. Nelson, S. & Gordon, S., 2007. The complexities of care: Nursing reconsidered. ILR Press, 39, pp.28-34. Nortvedt, P., Hem, M.H. & Skirbek, H., 2011. The Ethics of Care: Role Obligations and Moderate Partiality in Health Care. Nursing Ethics, 18(2), pp.192-200. Resnick, M.D., Harris, L.J. & BLUM, R.W., 1993. The impact of caring and connectedness on adolescent health and well-being. Journal of Paediatrics and Child Health, 29(1), pp.3-9. Romain, S., Wilmes, P., Pape & Dietich, 2012. ACL injuries in children. Sports Injuries, pp.1023-31. Rout, U.R. & Rout, J.K., 2002. Stress Management for Primary Health Care Professionals. London: Springer. Royal College of Paediatrics and Child Health, 2003. Bridging the Gaps: Health Care for Adolescents. Health. London: Royal College of Paediatrics and Child Health Royal College of Paediatrics and Child Health. Ryan, R.M. & Deci, E.L., 2001. ON HAPPINESS AND HUMAN POTENTIALS: A Review of Research on Hedonic and Eudaimonic Well-Being. Annual Review of Psychology, 52(1), pp.141-166. Schrenzel, J. et al., 2010. A Randomized Clinical Trial to Compare Fleroxacin-Rifampicin with Flucloxacillin or Vancomycin for the Treatment of Staphylococcal Infection. Oxford Journals: Clinical Infectious Diseases, 39(9), pp.1285-92. Srouji, R., Ratnapalan, S. & Schneeweiss, S., 2010. Pain in Children: Assessment and Nonpharmacological Management. International Journal of Pediatrics, pp.1-11. Upton, D. & Solowiej, K., 2010. Pain and stress as contruibutors to delay wound healing. Wound Practice and Research, 18(3), pp.114-22. Vileikyte, 2007. Stress and wound healing. 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