Holistic Nursing

2/10/2016, 1600, Vital Signs: BP 140/85 P132 RR32 Temp 102.2 SpO2 85% on 2 liter by nasal cannula. Jacquline Catanzaro is 45 years old female on disability admitted to Medical Unit Hospital. Sister with patient. Reason to admit is can’t breathe. Diagnosis is 30 year of asthma exacerbation, psychiatric schizophrenia, obesity, pneumonia and herniated disc. Smokes 40 packs year. Drinks 2 pots of coffee a day. Drinks 3 beers each day. Frequency ED visits and hospitalization dependence on rescue inhaler. Patient refuses wear nasal cannula because of worry that it contains poison. Patient has a long history of stopping taking psychiatric medication and asthma medications. Patient has isolated herself from others. Sister is only caregiver. Neuro

This week, I was given the opportunity to care for two female patients – 205(1) and (2). The first patient, 205-1, was admitted with respiratory distress and had a past medical history of hypertension, schizophrenia and bipolar disorder. She was initially put on 2 L/min of oxygen and placed on oxygen titration protocol with orders to maintain O2 saturations between 88-92%. The patient was oriented to person and place, but had difficulty with time. She was also obese (BMI 30) and deemed a moderate assist with ambulation. Her care plan included total assistance with ADLs, smoking cessation and oxygen protocols, limited salt intake (3mg), and chronic pain management. The second patient, 205-2, was admitted with a right pelvic fracture and had

On the early morning of August 17, 2002, James C., a patient in one of the wards under the supervision of Ellen Hughes Finnerty, RN, went into respiratory depression. Between 3:00 and 4:00 a.m., Ann Mugi, the patient’s primary nurse, sought the assistance of a respiratory therapist, Hiran Obeyesekere, to help her care for the patient. As Obeyesekere suctioned the patient airway, Mugi called the service of the patient’s primary care physician, Dr. Jackson, to report the changes in the patient’s respiratory status, e.g., respiratory rate of 40 breaths per minute and low urine output.

The patient did have black soot around his nose and mouth. Thats when first responders started manual ventilation's via BVM and 02 at 15 LPM. At this time Medic 1 assumed patient care. Medic 1 assigned first responders to obtaining vitals signs that are stated in the vital section of the report. It was at this time that Medic 1 applied a OPA after first measuring on what size to use. First responders also applied fast patches to the patients right upper chest and left midaxillary line At this time Medic 1 assigned first responders to start chest compressions a 15:2 ratio. Medic 1 at this time started a IO in the patients plateau region of the right leg. The Plateau region is inferior and lateral to the knee cap. At this time Normal Saline bolus was started with a 60 drop per ML set. Medic 1 found the patient to be in a sinus rhythm At this time miscommunication with Medic 1 and first responders happen with chest comparisons started. We then secured the patient on the cot via 4 straps and transported a code red patient to the nearest hospital. While enroute to hospital radio report was given with chief compliant and treatments listed in the appropriate category of the report. Vitals was continued to be taken every 5

Nursing theories have been a fundamental tool used to explain, guide and improve the practice of nursing. Theorists have contributed enormously to the growth of nursing as a profession. The four grand theorists I chose are Virginia Henderson, Peplau, Myra Levine and Jean Watson. These theorists have contributed tremendously in the field of nursing through their theories, and research. One thing the theorists have in common is that they are patient centered. They are all concerned on ways we can improve our responsibility to the patients, their families and the environment. They have different ideas but they are all aiming towards achieving the same goal, which is patient satisfaction and safety. Their differences are in their areas of

Admitted through the Emergency Room at 4 PM to a semi-private room is Maggie P., a 78-year-old retired Registered Nurse with end-stage Chronic Obstructive Pulmonary Disease (COPD). Her temperature is 98.7, B/P 130/92, heart rate 124 and respirations are labored and irregular at 37 per minute. She appears frail and weighs 89 pounds. She is pale with a bluish hue to her lips and nail beds. Oxygen at 3 liters per minute is applied via nasal cannula. She is alert and oriented to time, place, and person. She coughs intermittently, expectorating copious amount of thick gray, blood-tinged sputum. She complains of back and rib pain and 5mg of Morphine Sulfate in administered intramuscularly. On assessment the nurse lists, between

My colleague and I received an emergency call to reports of a female on the ground. Once on scene an intoxicated male stated that his wife is under investigation for “passing out episodes”. She was lying supine on the kitchen floor and did not respond to A.V.P.U. I measured and inserted a nasopharyngeal airway which was initially accepted by my patient. She then regained consciousness and stated, “Oh it’s happened again has it?” I removed the airway and asked my colleague to complete base line observations and ECG which were all within the normal range. During history taking my patient stated that she did not wish to travel to hospital. However each time my patient stood up she collapsed and we would have to intervene to

In late 2013, Ebola virus disease (EVD), a deadly and lethal disease, remerged in West Africa spreading to various countries in the region. In humans, the disease is spread through contact with infected bodily fluids leading to haemorrhagic fever (World Health Organization [WHO], 2015). Originating in 1976 in equatorial Africa, past outbreaks with a few hundred cases had been contained within rural, forested areas in Uganda and Congo (Piot, 2012). In 2014, a total of 20, 206 cases and 7,905 deaths were reported to have occurred in up to eight countries worldwide. Of all cases and deaths resulting from the disease, 99.8% occurred in three neighbouring West African countries - Liberia, Sierra Leone and Guinea (WHO, 2014). With a case fatality rate from about 50% to 90%, and the absence of preventative or curative therapies, the Ebola epidemic has led to overall global alarm and further elucidated existing global health disparities that perpetuated the epidemic with these West African countries.

We administer oxygen therapy, bronchodilators and preform bronchial hygiene therapy for these patients. We also responsible for managing the ventilators, which is a very important part of care for these patient that can help them recover and prevent barotrauma. Sometimes as Respiratory therapist we must advocate for our patients care. Based on this patient current medical situation I would suggest that this patient be discharged to a skilled nursing home facility. With the patient’s mental status, it is not safe for him to live independently without proper monitor of home oxygen and medication prescribed by his physician. I also would recommend smoke cessation therapy for this

I stayed close to the patient during this whole period, but I was not paying enough attention to her low oxygen level. The patient was a healthcare aid and she kept telling me that, “It’s ok, I am always a shallow breather”. However, I should have my own judgement ability and provide more competent care with timely evaluation of the effectiveness of the interventions.

Nursing is about providing the best possible holistic care for the patient and family. At the same time there’s an imbalance of patient care regarding education and knowledge being provided by nurses. As a nurse I believe we all owe it to ourselves, the profession, and the patient to provide the best possible care. According to American Nurses Association (ANA) online article “Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.” In order to better achieve the nursing ideals of the American Nurses Association we must improve patient care by requiring hospital nurses to become BSN nurses.

As nurses, utilizing the interactive-integrative paradigm, it is our job to establish a client-client system. In this system, the caregiver and the client address the five variables that compose a human being, physiological, psychological, sociocultural, developmental, and spiritual; along with their effects on the four meta-paradigms,

Holistic nursing to me is a practice of applying both subjective and objective patient assessment into the plan of care. Not only do we need to look at the physical condition of the patient, but also their social and environmental factors that influence their state of health. When this application process is incorporated into the patient plan of care, we are incorporating all aspects of the patient’s life that help define and create their ideal state of health. In review of several nursing theories discussed by Montgomery-Dossey and Keegan (2012), which incorporate the aspect of holistic nursing practice, I found that Jean Watson’s Theory of Transpersonal Caring was most closely linked to aspects of my current nursing practice.

Holistic assessments in nursing provide a unique quality of care to the individual patient. Holism in the provision of care includes assessments obtaining data about the physiological, psychological, sociological, spiritual, developmental, cultural and environmental aspects. It is imperative that the nurse conducting these assessments adopts methods in the nursing process that reflects the standards outlined in Australian Nursing and Midwifery Council National Competency Standards for the Registered Nurse to ensure the health and wellbeing of the patient is maximized and maintained throughout the time health care is received. Nursing processes are directed at restoring overall harmony for the patient therefore an understanding of the

The interventions for pneumonia are as follows. First, the patient must have oxygen administered to increase the blood's oxygenation level and ensure proper oxygenation to the body's organ systems. As the patient is treated with oxygen, she should be encouraged to breath deeply, as oxygen is the best cure of pneumonia. Next, vitals should be consistently monitored and oxygen treatment repeated whenever the oxygenation level drops below 90 percent. Finally, the on-call physician should be notified of the patient's condition so that