The nurse is a key link in the care of a person and is present with the patient at all stages of his recovery. At the same time, under nursing care, a complex is considered, including general control over the patient’s condition and the implementation of prescribed medical prescriptions. An important skill for a nurse is the timely provision of first aid to the patient if necessary. Moreover, it is the responsibility of the nurse to recognize, evaluate and respond to the needs of people who may be harmed. Equally important in the work of a nurse is compliance with the policy of the medical institution and medical ethical framework. In addition, any nurse must demonstrate behavior aimed at individualized care for each patient. This work focuses on the need for collaborative decision-making regarding care and interventions and the preparation of competent care plans aimed at a speedy recovery.
When evaluating a patient’s condition, each medical professional considers the patient’s needs, including the physical, mental and psycho-emotional aspects inherent in each individual. During the evaluation process, nurses collect information regarding the patient’s health status and analyze the patient’s medical record and the impact of comorbidities. The health worker is based on the evidence provided about each person’s medical history. Moreover, this process considers the social, cultural and spiritual values of each individual.
After that, the duty of the nurse is to fully document the patient’s condition and the identified abnormalities. Healthcare providers include vital signs, disease symptoms, and problems in their reports. Assessments is a key step and perform a critical role in the treatment of the patient. The absence of such reports or their misinterpretation may pose a danger to the patient, including the possibility of death. In today’s medical community, nursing assessment is seen as a fundamental skill for every individual who chooses to become a nurse. This guarantees the safety of the patient from the first stages of his treatment.
The patient in need of treatment and protection is an elderly farmer, Harold, aged 75. Since Harold hasn’t been seeing a diabetic nurse lately, it can be inferred that the family isn’t taking care of him as much as he should. First of all, Harold is sick not only with type 2 diabetes but suffers from a chronic venous leg ulcer, which causes acute pain. Currently, the abuse of elderly people in need of nursing care is a rather big problem.
Harold, due to his age and illnesses, is a patient at risk. He is vulnerable due to problems after surgery and hip replacement. Therefore, the patient cannot protect himself if necessary. The secretiveness of Harold, who, according to his monsieur, does not let them into the house, raises concerns and is a hint that the person may be a victim of abuse. Important is the fact of skipping a trip to the diabetic nurse. Type 2 diabetes, which is observed in Harold, needs constant monitoring and medication.
Every health worker is responsible for people at risk and is required to take appropriate measures. In Harold’s case, the first thing to do is arrange for an urgent examination and medical care for diabetes. It is important to negotiate with the authorities and social workers in the patient’s area of residence and develop an action plan that will relate to the appointment of recommendations to Harold. However, one should remember about a person’s freedom of choice and independent decision-making. Therefore, a possible solution may be to give the hospital psychologist the opportunity to talk to Harold about his attitude and trust in medicine and family members.
Moreover, Harold may consider help from relatives as a thing that humiliates his human dignity. He can no longer attend the church he used to go to on his own, and now Harold lives in permanent seclusion. It is important to consider a rational care plan for the elderly, which will include possible procedures to reduce leg pain. This will help to restore Harold’s faith in himself and improve communication between him and representatives of medical organizations.
However, the nurse must consider legal, regulatory, and managerial requirements, policies, and ethical considerations when communicating with and caring for a patient. In terms of the regulatory framework, the Nursing and Midwifery Council is responsible for monitoring nurses (Nursing and Midwifery Council, 2018). It promotes higher education and develops professional standards for nurses across the country. The organization publishes cases related to regulatory activities. Moreover, they create recommendations for the nurse and maintain a register of personnel. Thus, Harold can be sure that the medical worker is a highly qualified employee.
In addition, every medical worker is aware of human rights and his right to medical care. The Human Rights Act of 1998 guarantees every individual freedom of choice (McHale et al., 2001). Thus, neither the family nor the medical professional can take away this right and force Harold to accept medical care without his consent. In addition, every medical worker is aware of human rights and his right to medical care.
At the same time, it should be remembered that Harold may have lost his mental abilities, forcing him to stay home, apart from the rest of the world. The Mental Capacity Act established people the right to choose guardians who, in the event of a patient’s mental capacity loss, would make decisions on his behalf (The National Archive, 2005). It can be true that Harold may experience fear of procedures at a rather advanced age. However, in this case, the nurse can notify the patient about The Care Act, which aims to seek an individual approach to each person in treatment and put him at the center of the process. With a detailed explanation of the legal requirements, Harold will feel safe.
In terms of management requirements, NICE guidelines can be explained to the patient. Such recommendations are based on a collection of health and care data collected throughout the country (National Institute for Health and Care Excellence, 2019). They prescribe the steps needed for care and services that are appropriate for most people with certain health problems. These recommendations include many types and can be considered from different angles. In Harold’s case, the most likely is social care use to treat the elderly.
Moreover, any patient is protected by the Care Quality Commission (CQC). The organization regulates all contractors who provide nursing and medical services. The commission’s standards are to take care of people to make sure they receive adequate care and are not mistreated by medical professionals. Additionally, the organization monitors the sterility of the instruments used for treatment (Care Quality Commission, 2018). Furthermore, the Royal College of Nursing provides each nurse with legal support and important information about innovations in healthcare processes. Every healthcare professional operates according to these standards and Harold can be sure that he is receiving the best care.
From an ethical point of view, when working with Harold, a nurse should consider four principles of a medical professional. First of all, it is important to give the patient autonomy and explain his rights to consent or refuse treatment (Haddad and Geiger, 2018). Further, the nurse can describe the process of treatment and talk about treating each person fairly, which will convince Harold of the possibility of treatment. Moreover, it is the duty of the nurse to minimize harm from treatment. The ethical principle of benefit provides a balance of benefits and risks. The fourth principle of non-maleficence can convince Harold that he wants only the best and push him to consent to treatment.
However, when working with Harold, the nurse considers not only ethical standards. When communicating with a patient, it is important to understand that privacy and the need for privacy are key aspects of respect for human dignity. The guarantee of social protection lies in the fact that medical workers do not invade a person’s personal space and touch the patient’s things without his explicit permission for these actions. In order to avoid such unpleasant incidents, the nurse will consider and implement the following recommendations.
First of all, it is necessary to respect Harold’s personal space and notify him and knock on the door every time he goes and sees him. This will help to avoid the patient’s discomfort that he may experience due to a sudden intrusion. In addition, it is important to explain all manipulations carried out in the treatment of the patient (Buchan et al., 2018). In this case, Harold will be sure that nothing superfluous or humiliating his dignity is being done. At the same time, the nurse will take into account his interests and past life to establish a trusting relationship. Respect is a vital aspect of the nurse-patient relationship, so the nurse will respect any patient’s decision regarding treatment (Webb, 2018). During the procedures, the medical worker should explain that for a certain manipulation, it is necessary to touch the patient. These factors will help Harold feel special and trust the staff during his treatment.
The self-determination of the patient is the basis for protecting his interests. A person feels free and can realize his ideal idea of himself when he has information. If a person has information, then he can choose, which means that he can act adequately. Without information, he cannot make a choice; he cannot distinguish what is harmful from what is useful for himself. The patient’s consent to the use of treatment will then be complete when informed.
Closely related to this is the question of telling the patient the truth. If the patient receives incomplete or false information, he cannot make the right decision. If a nurse offers a patient one treatment and does not say anything about other treatments, he will not be able to make the right decision about these other treatments because he does not know anything about them. Another moral obligation and legal requirement to keep in mind is that information must be given to the patient in a sensitive manner. Delicate means, first of all, in small portions, taking into account the patient’s emotional reaction, using precise but less emotionally charged words.
An individual approach is one of the most effective types of rehabilitation. Thanks to this approach, constant work is carried out with the patient, his condition is regularly monitored, and the effectiveness of the developed programs is monitored. Comprehensive solutions allow hundreds of patients to recover and feel much better. The results of treatment depend on the initial data, the individual approach, the reaction of the body, the right preparations and their respective prescription. After determining the necessary therapy, formed on the basis of the patient’s performance, the nurse does everything possible to achieve an excellent result, applying knowledge and experience and offering individual treatment.
Diabetes mellitus is a chronic disease, and in most cases, the key place in its therapy is given not even to drugs but to self-control. The self-control of a patient with diabetes mellitus is a broad concept, including the discipline of insulin administration, nutrition and fixing the number of bread units, daily routine and physical activity, taking medications and other steps that allow the patient to avoid deterioration in health. However, the central element of self-control is the regular measurement of glycemia, which minimizes the risk of complications. Moreover, due to diabetes, Harold developed an ulcer on his leg. He can monitor the disease at home by treating the affected area regularly and using an ointment.
Thus, Harold’s treatment must take into account many aspects. First of all, it is important to mentally prepare the elderly patient, as he has stopped coming to see the diabetic nurse. This may be due to many factors and it is vital to establish the root cause of Harold’s reclusiveness. The step of establishing a trusting relationship and a discussion about treatment methods is extremely important in this situation. Moreover, the treatment methods should be built in accordance with the patient’s requests and with his full consent.
Table. Patient Assessment – Activities of Daily Living (ADLs) (Roper et al., 2000)
Care Plan
- Patient Name: Harold
- Care plan created by:
- Date initiated:
Reference List
Buchan, J., Seccombe, I., & Smith, G. (2018). Nurses work: an analysis of the UK nursing labour market. Routledge.
National Institute for Health and Care Excellence. (2019). Nice Guidelines. NICE.
Care Quality Commission (2019) Who we are. Care Quality Commission.
The National Archive (2005) The Mental Capacity Act. UK Public General Acts. Web.
Nursing and Midwifery Council (2018) The Code Professional standards of practice and behaviour for nurses, midwives and nursing associates. London: Nursing and Midwifery Council.
Robichaux, C. (2016) Ethical competence in nursing practice: Competencies, skills, decision-making. Springer Publishing Company.
McHale, J., Gallagher, A., & Mason, I. (2001). ‘The UK Human Rights Act 1998: implications for nurses’. Nursing Ethics, 8(3), pp. 220.
Haddad, L. M., and Geiger, R. A. (2018). Nursing ethical considerations. Florida: StatPearls Publishing, Treasure Island.
Webb, W. A. (2018). ‘Nursing management of people experiencing homelessness at the end of life’. Nursing Standard, 32(27), pp. 19-27.