Comprehensive Nursing Care
Within this essay I will discuss what is meant by healthy living and the perception of health and its impact on the life of a specific patient who I have cared for within a hospital setting. When we think of being healthy we often tend to look at the physical aspects, but being healthy is about the person as a whole, their mind and body which often extends to the whole community. The term health is therefore complex and has many definitions (Forster et al., 1999). The World Health Organisation (1948) has a popular definition which has not been amended since 1948, ‘A state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity’. This definition can assist the nurse in developing a holistic approach to understanding health. I recently completed a placement at a local trust, and cared for a lady who I thought was appropriate to focus on in relation to her health status as she had had many admissions into hospital over the past 12 months. I will refer to this lady as Joan, as a nurse I have a legal, professional and ethical duty to protect all confidential information concerning patients by recognising the privacy of the patient and practice MNC (2008). Joan has had asthma for all of her life, and after contracting TB 2 years ago Joan’s health and state of mind has gradually deteriorated. Joan’s breathing difficulties has caused many admissions into hospital over the past 12 months and consequently has developed MRSA in her sputum.
Joan was admitted into a side ward due to her having the MRSA virus. Her condition caused her to become bed bound for the first two days, she found it difficult to move around the room and relied on the nursing staff to assist her with personal hygiene needs. Joan is a very independent woman and having to have someone else to help her made her very anxious. Moore and Woodrow (2004) state that breathless patients can become confused due to anxiety, therefore I had to ensure that Joan was made to feel comfortable and to give the opportunity for her to do as much as possible without causing added breathlessness. Joan was commenced on oxygen therapy; which relieved the symptoms of breathlessness. Administrating oxygen reduces or corrects hypoxia by compensating for the reduced minute volume (Bennett 2003). Bennett et al (2003) state that oxygen can be delivered in a number of ways, it was important to ensure the method chosen was the appropriate device. Joan had a basic o2 mask and it was decided that she would benefit from a mask providing 8 litres of oxygen. The device used for oxygen administration should reflect the patients’ requirements for oxygen as well as being comfortable for the patient to wear (Jevon and Ewens 2001). In helping Joan managing her breathlessness it was important for me to regularly assess Joan’s condition by observing her general appearance, looking for cyanosis, facial flushing and observing posture as this will indicate if the patient is anxious or afraid. Bennett (2003) states that when questioning breathless patients it is important to remember to use closed questions as talking increases breathlessness. As a nurse caring for Joan I played a big part in reviewing, monitoring and supporting her as she struggled with her breathing. It was particularly important to keep regular checks on all of Joan’s vital signs, tachycardia is common because of anxiety and hypoxia and bronchodilatory medications may increase it (Hoskins et al 2000). Most importantly in patients with respiratory related illnesses the nurse must remain calm and reassuring towards the patient, helping them to sit in an upright position to allow lung expansion.
Joan has always been a busy lady, working and bringing up her children and then helping with the grandchildren. She regularly went to the shop and is a very house proud lady, enjoying all aspects of cleaning and keeping a good home. The unpredictability factor of an asthma