It was a busy day at work and one of the things that I have learned is about comprehensive and accurate nursing assessment of clients in the Dementia unit. During this day, I was assigned to care to one of our sick residents and based on my assessment, her condition shows no sign of improvement from her chest infection so I checked her vital signs specifically her respirations. After assessing her, we rang in the GP to inform him about the condition of his patient and asked him to schedule a visit. Also, in the afternoon, we had a new admission from Eversley. Firstly, we greeted the patient, introduced ourselves and oriented the resident to the unit. Secondly, the nurse from Eversley informed us about the relevant information about the patient’s
Clinical day started slow, I was a bit anxious about waking my patient up that morning but I knew I had to go in. I woke him slowly and took his vitals and proceeded with my assessment. As I assessed my patient, his wife came in to his room and I introduced myself. During the morning I found out that my patient was being discharged. Before discharge, my patient was going to be fitted for a LifeVest.
As teams of two we were requested to complete a number of tests on a client my clients name in this scenario will be called Mrs. R (NMC 2015) patients name will remain confidential as detailed in nmc code. she was a female 50years old who came into the general practitioner with a complaint of not feeling very well, I and my team member and fellow student nurse was given the job of working together to assess Mrs. R’s vital signs
Philly should have knocked on the door, before entering into patient`s room. She should have then greeted and introduced herself and the student nurse to Rudd. She should have then started the conversation by addressing him by his name. She should have also enquired about his pain. Philly should have finished her shift assessment and should have assured him that she will come back with the morning medications and then left the room. The behavior was very unprofessional.
As noted, on February 29, 2016, the patient was nonetheless admitted to the UCR hospitalist. This was a senior member of the UCR hospitalist team who knew or should have known all of the policies and procedures for admission, and should never have admitted the patient as an attending to the hospital. In so doing, he was directly and deliberately interfering with the doctor patient relationship.
for England (QCF) and Edexcel Level 3 Diploma in Health and Social Care (Adults) for Wales and
Dementia is a progressive disorder that will affect how you’re brain functions and particularly your ability to remember, think and reason. Dementia usually affects older people and are approximately 820,000 people in the UK with the disorder, and around 15,000 are under the age of 65. If the dementia is recognised early enough that are a lot of things that you can be done to make the quality of life better. In a lot of dementia cases the symptoms and quality of life will progress and get worse over a number of years. The most common symptoms of a dementia patient are:
On august 13, 2016 I was assigned to follow one of the ICU Nurse. It was a very calm day. She had two patient one was more critical than the other. Both patients were on the ventilator because they had to be intubated the night before. The lady is obese and had gastric bypass surgery two years ago and suffering from severe sleep apnea, but the patient is non-compliance to the CPAP treatment. That was her second time being intubated. She was admitted for seizure monitoring because she was constantly having seizures the day before while she was at home. Due to the fact that she did not want to wear her CPAP machine while in the hospital, after pain medication was administered she was found unresponsive, that was the reason for her intubation the night before. Patient was on intermittent suctioning, she has sinus tachycardia . I had the opportunity to observe some of her daily care. The patient was on fentanyl but when the Dr. try to wean her out of the ventilator she stop breathing, therefore, the DR. discontinue the fentanyl temporarily in other to retest her later.
Both of the gentlemen stated they had been in other homes and that this was the nicest home they had been in. Kenneth complained of his first home ¡°smelling more like a zoo than a nursing home.¡± John told me that his last home was on the South Side and that the neighborhood was filled with gang bangers and hoodlums. When his family visits here though, they wheel him through the Lincoln Park neighborhoods and it¡¯s nice. For all of the questions that I asked these two men, they had just as many questions for me. Heading in to this assignment, I hadn¡¯t really considered that someone would be asking ME questions. In the midst of all that happens in nursing homes, it¡¯s important to remember that these residents aren¡¯t just dependent, older people, but that they are still people just like you and I.
I am a second year nursing student in my third week of the practicum placement on a surgical ward with my co-student and the morning shift registered nurses. We had just finished analysing the patients handover report (Levett-Jones & Bourgeois, 2015) and I had been assigned to work with the registered nurse. I was looking after Mrs. Brown (pseudonym) is 82 years old New Zealander was admitted to surgical ward on the 08/06/16 for multiple SCC removals from L) hand and L) foot with skin grafts.
During a late shift on the ward, my mentor asked if I would stay with Mrs Smith whilst she gave out medication in order to ensure she wouldn’t be left on her own and fall. I introduced myself to Mrs Smith and sat with her in her room. It became apparent to me quite quickly that she was obviously very confused and she was not fully aware that she was in a hospital, as she repeatedly asked me where she was. On being told she was in hospital she would say no and shake her head. It wasn’t long before she asked me when her husband would be there to take her home, to which I replied
A topic I learned more of this semester in regards to the older population was dementia. Some loss in memory function is an inevitable consequence of aging, and as one ages, it takes more time to process information and retrieve memories. However, "Dementia is a general term that refers to progressive, degenerative brain dysfunction, including deterioration in memory, concentration, language skills, visuospatial skills, and reasoning, that interferes with a person's daily functioning" (Mauk, 2014, p. 377). This loss of mental skills affects the ability to function over time, causing problems with memory and how one thinks, impacting these individual's overall quality of life.
During the home health observation day, there were several opportunities to observe a variety of patients with varying levels of functioning ability, different illnesses, and different needs and levels of interaction with the nurse. The first patient seen was a seventy-three year old Caucasian female with an ulcer on her right heel. Several weeks prior, she had scratched her left leg and she also had several small wounds on her left leg. The orders were to clean and redress the ulcer. She has a history of end stage renal disease, pneumonia, weakness, diabetes, dialysis, and right hip fracture. Upon entering the home, the patient was found to be sitting in a wheel chair in the living room watching television with her husband close by her side. She greeted the nurse with a smile and began to update her on her current condition. Her heel was “hurting” and she rated her pain an 8 on a scale of 1 to 10. She also had some “swelling” that she could not “get to go away; because, she could not get up and walk. They need to fix my foot so that I can get up and get around.” She told the nurse that she had been to see the doctor “yesterday” and the doctor had given her a written order that she wanted her to see. The order was written for an evaluation for a soft pressure shoe fitting. The nurse read the order to
Last week Thursday on the orthopedic clinic was a slow but eye opening experience. When I got to the clinic at 8AM, after I was introduced to some of the nurses there, I was immediately assigned to a Medical Assistant (MA) that I had shadow for half of the day. The MA shows me around the clinical and explained her role and responsibility in the clinic setting. During the first several hours, and MA and I were quite busy rooming the patient. Because the MA want me to see how to do thoroughly assessment on a new patient, the MA did a thoroughly assessment and examinations on the first patient we saw. During the assessment, the MA also explained some of the medical procedures to the patient. She did a set of vitals on the patient, particular on new patient, such as blood pressure, height, and weight. We had a total of 15 patients during the morning.
Dementia is an umbrella term used to explain the gradual decline in multiple areas of functions, which includes thinking, perception, communication, memory, languages, reasoning, and the ability to function (Harrison-Dening 2013). Worldwide, 47.5 million people have dementia and there are 7.7 million new cases every year. Alzheimer's disease is the most common cause of dementia and may contribute to 60–70% of cases. (Alzheimer's society 2014). The complexity of dementia presents a number of behavioural challenges to those who live with dementia and their care providers. Aggressive behaviour seems to be one of the most prevalent challenging behaviours in the different stages of dementia (Weitzel et al 2011). As acute care
Another day of my clinical placement 420 in orthopaedic unit began on July 4, 2015. I received my patient and started to research a patient history and medications. At 0700 a shift report started, I received information that my patient had fall at night shift without witnesses. By the policy of Providence Healthcare a patient who had fall without witnesses should be automatically monitored for head injury therefore, a Glasgow Coma Scale was initiated by previous nurse: every 15 minutes, then every hour, every two hours, and every 4 hours. This scale is to check and monitor level of consciousness which possibly may decline after head injury. At this day we had a student as a "nurse in charge", she volunteered to come with me to patient room and to supervise my work. For this particular patient close monitoring of vital signs and neurologic assessment required. I explained to the patient the purpose of frequent health assessment and started to work. Close patient monitoring in addition to all daily routine activities was challenging to me because I never had a patient with this diagnosis. Despite my explanation of the purpose of frequent assessments patient stated that "I am fine, do not feel any discomfort, there is no need for that". While assessing patient she keep asking a lot of questions such as why so many time why do I need to drink more than one mouthful of water with my tablets, what these tablets for, why do I need to wait few minutes after