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Transforming Nursing Practice 

Appropriate registered nurse response would be to treat older patients with dementia with quality care. It is important for the nurse to pay attention to acute problems that are troubling the patient. The nurse should focus on valuable care and should be more attentive while interacting with the patient. This helps the patient to convey his emotions and feelings to the nurse and would reduce the number of aggressive outburst by the patient. The nurse needs to emphasize their attention on older patient's safety. They should also take care that the patient does not harm themselves or other staff members. In all, the nurse should provide person-centred care which preserves the dignity of the patient. The nurse in addition to that should provide culturally safe care to the person and should understand the patient background, values, cultures and beliefs (Moyle, Borbasi, Wallis Olorenshaw & Gracia, 2011). The nurse should also take care of the older patient's psychosocial needs. The nurses with that also educate the patient family and friends and other staff members about patient condition. Moreover, a registered nurse should act in a way which is empathetic to the patient. The nurse should be warm and sensitive to the patient condition. The nurse should help older patients in a day to day activities and also should focus on their personal care. They should treat the patient with respect while they take care of them and should provide them with quality care. They should also look after their medical needs and should keep track of the psychological wellbeing. With that, nurses should also take care of patient’s discomfort (Moyle, Borbasi, Wallis Olorenshaw & Gracia, 2011; Handley, Bunn & Goodman, 2017).

Wound management could be done by a registered nurse by changing the dressing of the wound again and again. Nurses could also assess the type of wound the patient has. This would affect the patient’s well-being in a positive way. Dressing wound will prevent infections caused by microorganisms. Nurses could also assess whether the wound has healed or not or it is healing. Nurses could also apply antibiotic ointments and can give the older patients medicines also so that their wound will heal faster. Nurses could also deal with purulent drainage and could help patients by maintaining the flow (Lindholm& Searle, 2016). Pain could be managed by nurses with the treatment of older patients with the usage of mild to moderate non-opioid medicines. Nurses could also provide patients with anti-inflammatory medicines which are non-steroidal and also acetaminophen. The nurse could also give patients opioid analgesics when there is severe pain in patients. In addition to giving medicines, nurses could help older patients in pain management by providing some non-pharmacological approaches. They are diversional therapy, exercises which could help in relaxation and deep breathing exercises. The nurse could also suggest patients listen to music so that their anxiety could go away when dressing of the wound is going on. Anxiety in older patients increases tension in the muscles and also increases the heart rate, which will ultimately result in more pain which is experienced by patients. Therefore, nurses should provide a clean and dry environment while taking care of the wound and should also apply new techniques so that patient does not feel more pain (Serena, Yaakov, Aslam&Aslam, 2016).

 The first nursing priority is dementia. It is taken as a priority because it causes memory impairment in older people and also results in a decline in functional activities. It also creates problems for patients physically. The patients could not perform normal daily activities easily. Dementia also changes personality traits in people. Dementia limits their memory and also cause cognitive decline. With that, dementia causes loss of ability to interact with other individuals properly solving (Gardner, Valcour&Yaffe, 2013). Patients often cannot explain their feelings and thoughts. They also cannot express their pain and thus exhibits violent behaviours. People with dementia often forget the things they were doing because of memory loss. They can also become depressed because there is a cognitive decline in them. The quality of life also decreases. They also face problems in motor functions and they cannot handle tasks which are complicated. People may also suffer from peripheral inflammation. The patient also faces difficulty in problem-solving (Gardner, Valcour&Yaffe, 2013).

The second nursing priority is wound management. Wounds are linked to increment in the rates of morbidity. They disrupt and injure the normal functioning and structure of the organ which is skin. If the wound is not managed then the break could further extend towards other tissues which are present more inside the body (Okur, Karantas, Şenyiğit, Okur&Siafaka, 2020). It could affect tissues, tendons, bones, muscles and as well as nerves. If wounds are not healed normally then scars or keloids can be formed. For their treatment, clinicians might have to use sutures or skin adhesives. If proper management is not done for the wound initially, it could also form ulcers and will cause extreme pain to the patient. The wound could also get infected or can get contaminated as it the breeding ground for microorganisms. Microorganisms could grow excessively there. If wounds are not treated then serious implications can also occur. Due to the wound, the patient might also have to face psychological problems. They might feel stressed and also experience anxiety (Okur, Karantas, Şenyiğit, Okur&Siafaka, 2020).

The third nursing priority is pain management. Pain can lower the quality of life of a person and could affect the physical functioning of the individuals. Pain causes problems in performing day to day activities by the individuals. It also affects their mental health and causes them the stress of high level (Dueñas, Ojeda, Salazar, Mico, &Failde, 2016). With that, pain also disturbs the person family and social functioning. With the pain also affect the social aspect of the individual's life. It causes work-related troubles. People experience difficulty in doing simple tasks while they are at their workplace. They also experience family and social network problem. Pain in addition to the patient also affects his family members. Moreover, the pain has a psychological effect on the patient. It causes difficulty in sleeping and therefore, creates more troubles. Patients might also experience fear and anxiety. They might feel depressed and sad because they cannot cope with the stress of pain. Pain also causes biological problems such as injury and trauma. There can be nerve damage also which could further complicate the patient’s condition (Dueñas, Ojeda, Salazar, Mico, &Failde, 2016).

 The nurse needs to perform various functions while taking care of an older patient. They need to make an assessment, perform diagnosis, do the planning, implement the plan and then have to evaluate the outcome. The nurse for the first step has to look at the problem faced by the older patient. The nurse needs to acknowledge the main troubles that are experienced by them. They need to adapt to strategies which could improve the health of the patient. Then the nurse needs to make the diagnosis with the participation of the doctor. This step is important so that the nurse could know what the patient is suffering from and what could be the further implications if the situation is not handled (Semachew, 2018). They understand the actual problem or the probable trouble faced by older patients. After this, the nurse needs to plan the holistic care treatment plan for the patient. Then, they should provide the older patient with quality care that will be beneficial for them. If quality care is given to the older patient then nurses could evaluate the results and patient’s outcome (Semachew, 2018). The nurse should provide the care to the older patient which is person-centred. The care should improvise their quality of life and should also help patients to function in a normal way. The care should decrease the interdependency on other people for their task and should promote independence. The nurse should also take care of the disease management and should make a plan which is appropriate for them. The plan should be made with accordance to their age and also by assessing the problems that they are facing. Nurses should also focus on older people activities of daily living as they are very much important for functioning independently. Nurses should also evaluate older people mental health and that they not suffering from stress or depression (Bell et al., 2016). Nurses should also recognize and identify the problems which are treatable or reversible. Nurses should also refer the patients to other specialists for their problems so that they can get holistic care regarding their problem. Nurses should identify the potential risks towards the safety of older patient that can cause trouble for them. They should make sure that older people live more safely despite having problems which are associated with their age and disease. Nurses should also update their knowledge while they are working with older patients so that they can help in the diagnosis of their disease. Late diagnosis can cause more troubles for the patient. They should assess the signs and symptoms and should help the patient as early as possible. They should also be able to take care of inflammation and pain which is experienced by older patients (Bell et al., 2016).

References for Nursing Older People

Bell, S. P., Patel, N., Patel, N., Sonani, R., Badheka, A., & Forman, D. E. (2016). Care of older adults. Journal of Geriatric Cardiology: JGC13(1), 1. 10.11909/j.issn.1671-5411.2016.01.019

Dueñas, M., Ojeda, B., Salazar, A., Mico, J. A., &Failde, I. (2016).A review of chronic pain impact on patients, their social environment and the health care system. Journal of Pain Research9, 457.10.2147/JPR.S105892

Gardner, R. C., Valcour, V., &Yaffe, K. (2013). Dementia in the oldest old: A multi-factorial and growing public health issue. Alzheimer's Research & Therapy5(4), 27.https://doi.org/10.1186/alzrt181

Handley, M., Bunn, F., & Goodman, C. (2017). Dementia-friendly interventions to improve the care of people living with dementia admitted to hospitals: A realist review. BMJ Open7(7). https://doi.org/10.1136/bmjopen-2016-015257

Lindholm, C., & Searle, R. (2016). Wound management for the 21st century: Combining effectiveness and efficiency. International Wound Journal13, 5-15. https://doi.org/10.1111/iwj.12623

Moyle, W., Borbasi, S., Wallis, M., Olorenshaw, R., &Gracia, N. (2011). Acute care management of older people with dementia: A qualitative perspective. Journal of Clinical Nursing20(3‐4), 420-428. https://doi.org/10.1111/j.1365-2702.2010.03521.x

Okur, M. E., Karantas, I. D., Şenyiğit, Z., Okur, N. Ü., &Siafaka, P. I. (2020). Recent trends on wound management: New therapeutic choices based on polymeric carriers. Asian Journal of Pharmaceutical Sciences.

Semachew, A. (2018). Implementation of nursing process in clinical settings: The case of three governmental hospitals in Ethiopia, 2017. BMC Research Notes11(1), 173.10.1186/s13104-018-3275-z

Serena, T. E., Yaakov, R. A., Aslam, S., &Aslam, R. S. (2016). Preventing, minimizing, and managing pain in patients with chronic wounds: Challenges and solutions. Chronic Wound Care Management and Research3, 85. 10.2147/CWCMR.S85436

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