Transforming Nursing Practice

Introduction to Old Patient’s Care Critical Analysis

According toBatterham et al.(2016), older patients face many complications like muscle weakness or others. The registered nurse’s responses are very important in taking care of the old or aged patient especially when they had suffered a fall or a fracture due to a fall. This is so because a fall might be associated with many other complications like mental stability, cognitive functioning, pain, fractures, unexpected swelling, skin texture changes, and many others. According to Salminenet al. (2016),nursesare a very important part of health care teams that ensure to deliver high quality and safe care or care services. However, in their practice workplace,they face many ethical challenges; therefore it is required that a nurse should be awareofthe concept of ethical codes of conduct and ethical decision making. This essay will discuss the role of a registered nurse for the case study of Wei Leung.

The Registered Nurse Responses

When it comes to caring delivery to an aged care patient then it becomes a very sensitive matter for a registered nurse (RN). The RN has to take care of the priority issues and timely or frequently monitor and evaluate the patient to ensure the patient’s safety and well-being. In this case, study, as the patient has experienced a fall, so the RN should assess for her vital signs like blood pressure, blood glucose levels, cholesterol levels, temperature, and others as the patient will soon be prepared for the surgery. Therefore, it would be appropriate to assess her vitals to ensure that her health status is normal so that a safe surgery can get executed (Brooks, 2020). The RN should assess for the pain levels by us pain scale scoring to measure the intensity and levels of pain experienced by the patient. The RN should assess the cognitive, behavioral, and physical function ability of older patients. The EN should also encourage them for healthy diet, self-management, physical exercises, and providing a safe environment to the old patient (Brooks, 2020). This ensures that the chances of anxiety or stress can be lowered if any. If the nurse performs effective monitoring, assessments, and evaluation of the patients then the signs of cognitive decline, functional decline, and other health-related deterioration can be timely reported and treated. If the nurse is not performing effective communication and professionalism in his/her duties then the patient will not be able to maintain healthy aging on his/her own (Andrews, 2016). If nurse uses spiritual and cultural approaches like prayers, and others with safe, respectful, and continued care; then the old adults will also get empowered to live their lives with healthy aging and without depending on others for their care. For this, the nurse can introduce the patients to digital systems like My Health Records or others to get their visit or medication alerts, information about signs or symptoms of diseases, and other report or prescription-related information (Willettset al., 2017). These will ensure that a respectful, culturally safe,independent,and long-term care is ensured. The policy directions and issues in aging care are Australia is – promotion of positive aging, healthy promotion for healthy aging, encourage self-funded retirement, and continued marketization of aged care. As per the center health care policy of Australia, this role ensures a holistic, patient-centered, and environmentally and socially safe care to the patient. This shows that using technology a culturally and practical safe care is ensured.

3 Nursing Priorities

The 3 chosen nursing priorities in this case study are fluid output and fluid input, infection elimination, and pain. The patient is draining low through the catheter; it shows that there is low fluid input. This can lead to an imbalance of osmotic and electrolyte in the body. Therefore, it is required that the patient should be provided with sufficient water or fluid intake so that the output levels are maintained. If not maintained then it might lead to dehydration and electrolyte abnormalities (Batterhamet al., 2016). With the use of a catheter for urine removal, the risk of infection might increase in older patients (Brooks, 2020). Therefore, it is required to maintain the hygiene level of the patient and educate her as well for her hygiene. This will also help in preventing the risk of infection in the bladder and kidneys as well. If untreated it might lead to the severity of the health condition of the patient. Furthermore, due to falls, the old patient might be suffering from pain or swellings. Therefore, she should be assessed immediately for pain, swelling, and associated injury issues. The patient is having difficulty in hearing and does not speak Englishtherefore,she might not communicate her issues effectively. So, frequent monitor and assessment should be performed. Due to pain, there can be stress, anxiety, and change in the skin texture of the patient (Batterhamet al., 2016). The pain can also be related to muscle stiffness, joint pain, strains, or sprains. These need to be assessed for the patient and approximately one-third of the seniors of more than 65 years of age experience fall (Batterhamet al., 2016). The fall in olds also impacts cognitive, physical, and other abilities if the patient. Therefore, all the factors contributing to pain should be prioritized to resolve the associated health complications.

Critical Evaluation of the RN’s Role

According to Furunes et al. (2018), the role of a registered nurse (RN) in ensuring the health and well-being of older adults is very important. The RN ensures that the needs and services of the old adults are met and supported. This will ensure that the preferences are fulfilled and they are promoted for independency. If the RN performs effective monitoring, assessments, and evaluation of the patients then the signs of cognitive decline, functional decline, and other health-related deterioration can be timely reported and treated. As with aging, the cognitive and other functions start deteriorating so the RN should perform tests for these byconducting assessments for testing the cognitive, behavioral, and physical functioning of the patient (O’Loughlin et al., 2018). According to Schmidtet al. (2017), cognitive skill tests give information about the candidate’s motor, orientation, language, and attention skills (Briggs et al., 2019). For social function assessments, the RN should motivate and develop courage among old adults to join social gatherings and take part in community activities and programs. All these activities will encourage old adult to talk to friends and participate in cultural functions or family functions. The nurses are not supposed to judge the patient instead they should provide self-less and continued care. According to the Nursing and Midwifery Board of Australia (2018), principle 2.1 states that under decision-making the nurses should support the rights and decisions of the patients regarding the acceptance or refusal of the treatment. Moreover, as per the code of ethics, the registered nurse should inform the patient about the risks, benefits, and other information related to the treatments so that the patient has complete information and he/she does not take decisions that can affect their health. According to principle 6.2 of the code of ethics, the nurse should prevent the situation that can potentially harm the patient or hospital’s workplace healthcare services (Birks et al., 2018). According to Brooks (2020), the patient who is old often forgets about their medication timings and specialist visits, therefore, self-management will be effective if they have a written document about their health issues explaining them in simple language about their management plans and symptoms as well. This will also ensure effective communication that can result in patient-centered care. Another, the advantage of written health literacy is it helps in documenting the information for the older adults. So, they do not have to depend on others for their health-related data like information about the signs, symptoms, diagnosis, or other relevant information.

Conclusion on Old Patient’s Care Critical Analysis

It is found that with age if the patient did not take care of the environment in which he/she lives then it can affect his healthy aging. The RN can help in empowering the old adults by educating them about their diseases, self-management, rights, or health care services, by increasing the level of involvement in decision-making, and ensuring that their preferences and values are met. The RN can help in empowering the old adults to encourage them for healthy aging by assessing, monitoring, evaluating them, and encouraging them to live an independent life. All the nurses should respect their patients, protect and maintain their rights, dignity, and respect. If the nurse works according to the ethics and code of conduct then she/he can win the patent’s trust, this can prevent unexpected arguments that might hurt the patient’s feelings and peaceful state of health or mind.

References for Old Patient’s Care Critical Analysis

Andrews G. R. (2016). Promoting health and function in an ageing population. BMJ (Clinical Research)322(7288), 728–729. https://doi.org/10.1136/bmj.322.7288.728

Batterham, R. W., Hawkins, M., Collins, P. A., Buchbinder, R., & Osborne, R. H. (2016). Health literacy: Applying current concepts to improve health services and reduce health inequalities. Public Health132, 3-12.https://doi.org/10.1016/j.puhe.2016.01.001

Birks, M., Smithson, J., Lindsay, D. & Davis, J. (2018). How registered nurses determine their scope of practice: A cross-sectional study. Contemporary Nurse, 54(6),578-591. https://doi.org/10.1080/10376178.2018.1520605

Brooks, C. (2020). Nursing and allied health professionals’ views about using health literacy screening tools and a universal precautions approach to communication with older adults: A qualitative study. Disability and Rehabilitation42(13), 1819-1825.https://doi.org/10.1080/09638288.2018.1538392

Furunes, T., Kaltveit, A., &Akerjordet, K. (2018). Health‐promoting leadership: A qualitative study from experienced nurses’ perspective. Journal of Clinical Nursing27(23-24), 4290-4301.https://doi.org/10.1111/jocn.14621

Halcomb, E. (2017). Australian primary health care nurses most and least satisfying aspects of work. Journal of Clinical Nursing26(3-4), 535-545.https://doi.org/10.1111/jocn.13479

Johnstone, M. J., Hutchinson, A. M., Redley, B., & Rawson, H. (2016). Nursing roles and strategies in end-of-life decision making concerning elderly immigrants admitted to acute care hospitals: An Australian study. Journal of Transcultural Nursing27(5), 471-479.https://doi.org/10.1177%2F1043659615582088

Nursing and Midwifery Board of Australia.(2018). Code of ethics. Retrieved from: https://www.nursingmidwiferyboard.gov.au/News/2018-03-01-new-codes-of-ethics-in-effect.aspx

O’Loughlin. (2017). Challenges and opportunities for an ageing Australia.Ageing in Australia, 1-10.https://doi.org/10.1007/978-1-4939-6466-6_1

Salminen, L., Stolt, M., Metsämäki, R., Rinne, J., Kasen, A., &Leino-Kilpi, H. (2016).Ethical principles in the work of nurse educator—A cross-sectional study. Nurse Education Today36, 18-22.https://doi.org/10.1016/j.nedt.2015.07.001

Schmidt, B.J., MacWilliams, B.R. & Neal-Boylan, L. (2017).Becoming inclusive: A code of conduct for inclusion and diversity. Journal of Professional Nursing33(2), 102-107. https://doi.org/10.1016/j.profnurs.2016.08.014

Willetts, G., Aberdeen, S., Hood, K., & Cross, W. (2017). The dynamic role of the graduate nurse in aged care: An Australian experience of delivering an aged care graduate nurse program. Collegian24(4), 397-402.https://doi.org/10.1016/j.colegn.2016.07.002

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