• Subject Code : NRSG138
  • Subject Name : Nursing

Transition to Nursing 

Description: Gibbs Cycle- Person-Centered Care

As observed in the case, when Tula was admitted to the hospital, it was observed how the patient had a rising temperature, was having a dry cough, and also was showing the signs of the paroxysmal expiratory wheeze. The patient was facing the condition due to the acute dyspnoea after her 12-hour factory shift. and the patient had reported a high breathing problem, showed an increased restlessness and also inability to speak properly, During this stage the nurse Chorinda was screaming and discussing with the fellow nurse, that the problem of the patient is weight, she is overweight and she needs to reduce it to the minimum level. The patient is by background, aged 38-year-old a Samoan woman who is working in the textile factory in Dandenong, and weighs approximately 114kg and recording the height of 160cm, with the BMI: 44.5 and also has hypertension. The patient is currently having the medication of the Irbesartan 150mg PO daily. The patient was getting multidisciplinary assistance from the respiratory consultant, a Physiotherapist, a social worker, and a respiratory CNC. She was further given a quick clinical examination and further recommended to get assistance for adult-onset asthma, which was controlled through the Salbutamol and Seretide inhalers. The patient apart from experiencing the dyspnoea also showed the symptoms of Asthma. The nurse Cholrinda while handling the said overweight is all about the cultural things and Kate while dropping to lower and patient health.

Feeling: Gibbs Cycle- Person-Centered Care

When screening the patient's condition, I could see she has had an increased wheezing sound, having a high respiratory rate. I felt bad when I saw how the two nurses were discussing the case, especially Cholrinda, where she mentioned how the patient is overweight and it is due to the cultural aspect. The nurses were insensitive and the way, they were handling the case, out of the chaos, further questions the nurse's Integrity and the professional behavior (Code of Ethics, 2018). The patient's dignity and respect were also outraged when the overweight issue was being questioned and discussed related to the patient's cultural aspects. In my opinion, the principles of justice, fairness, beneficence, nonmaleficence along the nursing code of accountability, fidelity, and autonomy, can help to improve the condition(NMBA, 2018). As the patient was feeling inconvenient, and there was an inability to discuss her health condition, further lead to an inability of the multi-disciplinary team to be informed.

The nurses were feeling incapable to communicate the multidisciplinary team. The nurses were just following the doctor's directions of giving adequate medication and even providing a better way as they lacked 6C's compassion, conscience, and were insensitive to the patient dignity and respect. Further, the patient even pushed Clorinda, leading to the chaos and the conflicting situation. Chlorine was unable to handle the situation and only enacted with professional care. As per the PCC it is important to have therapeutic care and it is important to form a bonding with the patient, but in the case, it is evident, Chlorinda fails to bond with the patient, while nurse Kate was able to resolve the case effectively with the compassion. The nurses also have to report all the information to the multidisciplinary team and for this nurse was able to enact with the collaboration and the competence practice, while the same was not followed by the Chlorinda, who fail to report the matter to the multidisciplinary team. The nurses should have abided by the Integrity, Objectivity, Professional competence, and also to follow the Confidentiality clause along with professional behavior.

Evaluation: Gibbs Cycle- Person-Centered Care

The patient care could have provided better care, through effective communication, and bonding can be formed. The therapeutic relationship can be maintained through the consistent communication, understanding the gaps and even working collaboratively to have better care and better ways to handle the sensitivity to the issue (Hossain, 2019)., As per the PCC practices, it is important to be responsive to the patient needs, important to understand the patient situation, preferences and the ways the situation can be handled. Through effective communication, the patient's wants can be handled by collaborating timely reporting the information and even enacted in the best interest care of the patient (Sinclair, 2020). Nurse Chlorinda also caused the problem of dignity, integrity, and respect for the patient (Code of Ethics, 2018). The patient needs to be provided care with the principles of Non-maleficence, Beneficence., providing a better way of health maximization and also ensure an efficient way to handle the case (NMBA, 2018).

A patient had an inflamed airway, the nurses apart from administering the medication should have also provided with the best care to the patients (Fedoruk 2012).

Analysis: Gibbs Cycle- Person-Centered Care

As per the case, the patient could have been provided with a better care framework, if the medical condition could have been improved focusing on the need, want, and care(deKay, 2020). The patient's condition could have improved, by providing adequate medication, care, and even the corrective steps to improve the condition (Esteban, 2020). The patient could have been educated on how to maintain long term care along with overcoming the situation by consistently working on it (Eassey, 2020). The patient could also be provided with the causes to overcome the airways and how to improve the inflammation of the airways which ahs eventually become narrow, swollen, filled with mucus, and has caused the problem of the irritants e.g. dust mites, pollen, etc.

Conclusion on Gibbs Cycle- Person-Centered Care

To conclude, the patient is experiencing the wheezing condition, and the patient is continuously explaining the problem of the respiratory disorder, facing the problem of the blocked nasals, having high hypertension, problem and also further deteriorating medical condition. The patient also has a high pitched whistling sound and is unable to inhale the fresh air. The nurses can provide relief, by providing a quickly aided condition, but the nurse Chlorinda is unable to provide the competent, compassionate, and caring help, while the nurse Kate is being able to handle the condition, with the better steps. The inflammation has even caused a blockage in the throat and the airways along with facing infection, experiencing the allergic reaction or physical obstruction due to the foreign object. The patient is facing a lack of care and the nurses need to support by providing the social, mental, and physical labor.

Action Plan: Gibbs Cycle- Person-Centered Care

The action plan in the case is to provide consistent care to the patient by educating the patient for the long term consequences of such conditions, ways to handle it, self-medication, and how to correct the condition (Stridsman, 2020). The patent should also discuss the warning signs, such as the wheezing sound, any sort of fever, cough and even experiencing some sort of the inflammation in the airways (Patel, 2020). The patient can also be guided through the diet plans and providing help in the proper exercise regime which can help to lose weight. It would help to improve the condition and even provide better care in maintaining the healthy lifestyles, that can handle the emotionally and mentally stress-free (Li, 2020). The patient-centered care would be how to improve the condition through communicating, focusing on the regular doses of medication, and even consistently providing better care plans (Stern, 2020). The patient can also be guided by how in such a situation, the consistent liquid diet, precautionary ways of overcoming pollutants, dirt, and any sort of the care. The relationship can be improved through therapeutic care and forming a bond with the patient, focusing on proper care, and taking adequate steps. (Danek, et al, 2020).

References for Gibbs Cycle- Person-Centered Care

Danek, C. J., Biggs, M., Loomas, B. E., Laufer, M. D., Kaplan, G. S., Shriner, K. M., & Wizeman, W. (2020). U.S. Patent No. 10,561,458. Washington, DC: U.S. Patent and Trademark Office.

deKay, K. (2020). Clinical Issues—March 2020. AORN Journal, 111(3), 358-365.

Eassey, D. (2020). Living with Severe Asthma: A Self-Determination Theory Perspective.

Esteban, I., Stein, R. T., & Polack, F. P. (2020). A Durable Relationship: Respiratory Syncytial Virus Bronchiolitis and Asthma past Their Golden Anniversary. Vaccines, 8(2), 201.

Hossain, S., & Morshed, M. R. (2019) Childhood pneumonia in the devel diagnosis and management strategy.

Li, Y., Chen, W., Liu, C., & Deng, M. (2020). Nurses’ Psychological Feelings About the Application of Gibbs Reflective Cycle of Adverse Events. American Journal of Nursing, 9(2), 74-78.

NMBA (2018). A way forward for nursing. Journal of advanced nursing, 76(1), 4-6.

Patel, K. (2020). High-Risk Prescriptions for Aging Patients. In Geriatric Practice (pp. 177-184). Springer, Cham.

Sinclair, C. (2020). Developing and revising the Canadian Code of Ethics for Psychologists: key differences from the American Psychological Association code. Ethics & Behavior, 1-15.

Stern, J., Pier, J., & Litonjua, A. A. (2020, February). Asthma epidemiology and risk factors. In Seminars in Immunopathology (pp. 1-11). Springer Berlin Heidelberg.

Stridsman, C., Axelsson, M., Warm, K., & Backman, H. (2020). Uncontrolled asthma occurs in all GINA treatment steps and is associated with worse physical health–A report from the OLIN adult asthma cohort. Journal of Asthma, (just-accepted), 1-16.

Tark, A., Estrada, L. V., Tresgallo, M. E., Quigley, D. D., Stone, P. W., & Agarwal, M. (2020). Palliative care and infection management at end of life in nursing homes: A descriptive survey. Palliative Medicine, 0269216320902672.

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