Enhancing the patient experience needs partnerships amongst inter-professional groups. Clinical reasoning is a methodical and cyclical framework that drives medical decision-making, especially in unanticipated, unexpected, and non-routine circumstances, and results in precise and well-informed clinical assessments (Gummesson et al., 2018). The Ten Caritas Processes allow practitioners to exercise the craft of serving, provide empathy to alleviate the pain of patients and their families, and support their recovery and respect while contributing to the nurse’s fulfillment (Costello, 2018). Therefore, utilizing the supplied case situation, this essay analyzes the significant medical scenario components and illustrates the Caritas processes by addressing their relationship to the clinical judgment cycle. In addition, the report describes how the Caritas processes and clinical reasoning procedure could be utilized to develop wellness solutions for Mr. Parker.
The Key Aspects of the Clinical Scenario
Mr. Parker feels pain in his chest, a painful emotional and sensory sensation that may or may not is caused by existing or perceived tissue damage. According to Haack et al. (2020), it is crucial to consider any modifications in a person’s physiological parameters when evaluating their pain. These adjustments include a rise or fall in heart rate, adjustments to breathing sequence and incidence, pulmonary function that can be seen, and breathing difficulty, all of which are present in Parker. When Mr. Parker is admitted to the cardiac unit, his irritability and shouting at the personnel worsen.
Agitation is a generalized cluster of apparently unrelated habits that can be observed in various clinical settings and typically manifests as a changeable course. A care plan aids clinicians and other representatives of the medical team in scheduling multiple aspects of patient care (Gilissen et al., 2018). The caregivers are tasked with developing a care pathway for David Parker focused on short-term care objectives and informed by pertinent elements of the heart foundation resource as Mr. Parker begins to recover.
The Caritas Process and Clinical Reasoning Cycle
A substantial amount of thought has been established to guide the nursing profession. Human Caring Theory by Watson is one of the theories. The theory is widely utilized to inform nursing education, practices, and research (Wei & Watson, 2019). Interventions founded on Watson’s Human Caring Theory can potentially improve patients’ psychological health and nurses’ work satisfaction. According to the theory, the caregiving Caritas process consists of Carative elements that consist of practicing loving-kindness to all people, authentically available to enable faith and hope to others (Levett-Jones, 2018). It involves fostering one’s own spiritual beliefs, establishing trusting interpersonal relationships, tolerance, and demonstrating compassion to self and several others.
Cues and Information
Mr. Parker is a middle-aged man taken to the emergency room in an ambulance. He is on an oxygen mask, and his face appears pale and grey on observation. The staff should be aware of his status since pallor indicates diminished blood circulation in the body (Smilowitz & Berger, 2020). The patient has shortness of breath, seems nervous, and complains of chest pains. The physician examines him and prescribes a start dose of intravenous morphine. Additional exams reveal that he has ischemic damage and is in excruciating agony owing to the infarction. Ischemia is often characterized by heavy chest pressure or tightness, a burning sensation, or breathing problems (Uikey & Patel, 2019). Mr. Parker has a family and lives with his wife and children.
Process Information
For Mr. Parker to be deemed stable, he must have a regular respiration rate. In addition, the patient’s discomfort must be significantly decreased to his satisfaction. A spike in vital indicators, such as the heart rate and respiratory rate, may be caused by pain. The intensification of the patient’s discomfort and shortness of breath may be an indicator of his or his deterioration. Anxiety may induce shortness of breath, whether acute and transient or a persistent issue. Therefore, it is essential to instill optimism in Mr. Parker and assure him that his ailment will be treated and he will return to his usual lifestyle. Watson asserts that faith and hope are crucial to preventative and therapeutic processes (Wei & Watson, 2019). When contemporary science has nothing more to give the individual, the nurse may continue to create a feeling of well-being via the client’s significant religious beliefs.
Care Plan Goals
The main goal of Mr. Parker’s care is to alleviate his pain. Acute myocardial infarction (AMI) reduces coronary blood flow, which is the cause of pain. AMI causes irreversible heart muscle injury due to diminished oxygen levels (Mechanic et al., 2022). Following Watson’s theory, the scientific problem-solving approach to decision-making is essential for patient management. This encompasses pharmacologic management in which sick patients are given medications. Due to Mr. Parker’s excruciating pain, intravenous morphine is the most effective pain medication. Intravenous morphine is an opioid increasingly utilized in various clinical settings, such as breakthrough pain and inadequate pain management.
Another goal is to alleviate the patient’s anxiety, which is shown when he yells at the staff to call his children and wife. As a nurse, explaining their condition and the management process to the patient is critical. This will significantly decrease the patient’s anxiety about the possible outcome of the disease. Watson explains that promoting interpersonal teaching-learning to the patient is critical (Wei & Watson, 2019). The caring nurse must focus on the learning process as much as the teaching process. Understanding the person’s perception of the situation assists the nurse in preparing a cognitive plan. Caring can be effectively demonstrated and practiced only interpersonally.
The Caritas Processes and Clinical Reasoning Cycle in Achieving Care Solutions
This incident research will evaluate how the nursing team can treat Mr. Parker during his admission to the cardiac unit. The clinical reasoning cycle and the Caritas process addressed his acute clinical presentation and guaranteed a successful outcome for him as a client.
Consider Patient Situation
Middle-aged Mr. David Parker is transported in an ambulance and is upright and wearing an oxygen mask over his pale, grey face. He is agitated, struggling to breathe, and experiencing chest pain. After examining him, the doctor prescribes an immediate IV morphine dose. When David’s ECG is examined, the anterior leads exhibit ischemic damage and ST elevation. Mr. Parker experienced an acute myocardial infarction (AMI), which is verified. Under this cycle, the appropriate Caritas process would be in the framework of caring awareness, the practice of loving-kindness, and serenity, where the nurses practice authentic presence and getting to know Mr. Parker.
Collect Cues and Information
The ECG of David is monitored and reveals ischemic damage (ST elevation) in the anterior leads and has been confirmed to have suffered an AMI. AMI is a life-threatening illness characterized by the sudden cessation of blood supply to the heart muscle, resulting in tissue damage (Samsky et al., 2021). A lack of data on Parker should have been supplied to obtain a comprehensive picture of his condition and give holistic care. This dataset comprises a history of drug dependence, smoking, obesity, and other comorbidities. Caregivers can use the Caritas processes to investigate Mr. Parker’s existential issues and life assessment to decide the optimal course of action.
Process Information
Mr. Parker’s vital signs must be within specified appropriate limits to be stable. Cross et al. (2019) state that critical signs assess metabolic body functions. In addition, Cross et al. (2019) imply that the typical range for vital adult signs is RR12-22 breaths per minute, saturation over 95%, systolic blood pressure 90-139mmHg, and heart rate 60-100 beats per minute. Mr. Parker must have at least two vital sign anomalies and a culture-proven or identifiable source of infection to be diagnosed with AMI. The ECG of David is monitored and reveals ischemic damage (ST elevation) in the anterior leads. In delivering appropriate care to Mr. David Parker, nurses might apply the Caritas method of engaging in genuine teaching-learning encounter that responds to completeness and purpose, seeking to remain within others’ basis of comparison.
Identify Problems
Mr. David Parker experiences pain, a negative psychological and sensory encounter connected with tissue damage. David Parker has shortness of breath, anxiety, and chest pain. Haack et al. (2020) agree that physiological characteristics should be included when judging pain. These alterations include increased or decreased heart rate and alterations in breathing rate and rhythm. In addition, Mr. David Parker shows signs of ischemic cell damage is cell harm caused by inadequate blood flow. The procedure entails hypoxia due to a blood supply interruption, a shortage of nutrition, and the buildup of hazardous substances (Basalay et al., 2020). In applying care, nurses may utilize Caritas techniques, such as mental meditation, music, deep relaxation, and relaxation techniques intended to improve the patient’s condition.
Establish Goals
In giving care, nurses may eliminate Mr. David Parker’s chest pain or at least reduce it to a manageable level, allowing him to return and engage in daily activities without much suffering as soon as feasible. In addition, professionals should treat Mr. David Parker’s ischemic injury so that his essential organs receive more blood and oxygen. Using the Caritas process for Mr. David Parker, caregivers can cultivate an atmosphere conducive to recovery on all dimensions, fostering completeness, comfort, and peace.
Take Action
Ineffective acute pain administration can result in adverse outcomes such as postoperative complications and extended hospitalization, which heighten medical costs and client discomfort. As the principal nurse, the first responsibility upon Mr. David Parker’s admission to the ward is to regulate his chest pain levels and ensure his well-being. Pergolizzi and LeQuang (2020) recommend continuous intravenous (IV) injection of opioids for acute complications as the effective pain treatment option for patients requiring intense cardiac unit, such as Mr. David Parker. Nurses can follow the Caritas process here by aiding Mr. David Parker with basic requirements, a deliberate caring mindset, and providing the basics of human care.
Evaluate Outcomes
Mr. David Parker’s pain levels should be evaluated and reevaluated until he reports tolerable pain severity and allows him to carry out his daily activities. Mr. Parker’s self-report of distress appears to be the best method for determining if the patient’s pain has reduced. Still, the hospital staff should also use the psychosocial rating scale and critical-care anguish monitoring tool to assess the efficacy of pain relievers to determine the outcome of other treatment modalities. Mr. David should be reevaluated for evidence of ischemic damage, which requires qualitative and continuous assessment of his breathing rate.
Reflection
Next time, the healthcare personnel must ensure an appropriate patient transfer, as critical data about Mr. Parker, such as the client’s other physiological parameters since his hospitalization, is missing. Clinicians should have requested all records relating to his patient care to refer him to the appropriate multidisciplinary healthcare practitioners who should have been involved in his treatment.
References
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