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NRS 221 The Assessment ASET Nursing For Cultural Differences

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  • Course Code: NRS 221
  • University: California State University
  • Country: United States

Questions:

Question 1: Person-centred communication with an older person
 
In the video, Max identifies some challenges he has with communication. How have physiological age related changes impacted on Max and his ability to communicate effectively? Discuss the extent the ASET Nurse uses person-centred communication strategies to overcome these challenges.
 
Question 2: The process of assessment of the older man in the video
 
In the video, the ASET Nurse conducts a short assessment of the older man. Based on current evidence of the assessment of older people and what you have learnt about Max through the video, identify four (4) areas of assessment that were not included or inadequately assessed in the video. Discuss the assessments and assessment tools relevant to each of the four areas you have identified and explain why they are relevant to Max’s case.
 
Question 3: Strengths based assessment
 
In the video, Max reveals some of his health concerns. Critically analyse the ASET Nurse’s use of the principles of strengths-based nursing to address Max’s concerns and to what extent is it effective in supporting Max to take a problem solving approach to his own care process?

 

Answer:

The Aged Care Services in Emergency Teams (ASET) operate within the healthcare departments offer quality and professional health care to aged people. Their aim includes extending improved healthcare outcomes for old people. Healthcare departments that deal with aged people face difficulties. Staff, ASET nurses, and other healthcare providers involved in taking care of the aged have communication barriers caused by various reasons (Christenbery, 2018). Effective nursing communication is important in the accurate assessment and diagnosis of clients as well as the planning of nursing interventions (Melynk and Fineout-Overholt, 2011). That has since changes because nurses are now viewed as collaborators in patient care together with doctors and other members of the healthcare team (Ellis, 2016). The nursing profession is now highly specialized to include various cadres and sub-specialties for nurses.  

Among factors contributing to communication, barriers include physical and cognitive impairment, cultural differences, poor hearing, limited health literacy, poor vision, and generational beliefs (Ruoff and Hoffman, 2016). However, healthcare service providers and other staff members have strategies for improving communication among aged patients. ASET nurse is responsible for delivering quality services to older people. Their role includes offering appropriate and well-coordinated assessments and care planning to the aged (Ni, 2014). They also conduct consultation services for including offering health education as well as evaluation of patient conditions. The operations involve monitoring patient progress and observing her status from time to time while maintaining social relations by communicating (Ni, 2014).  

 

Challenges Facing Max in Communication

Max has difficulties hearing. He is slow in responding to some questions. Max decides to keep quiet in some instances especially when he fails to figure out what Robyn asked. Hearing problem made the client experience difficulties in understanding. The second challenge is facing Max background distractions such as noise. There distracting noise coming from next rooms. The sounds are hindering communication as well as making it difficult for max to comprehend the communication. The third problem is inadequate literacy in medical terms. He does not know specific names for equipment used in assisting him to walk. Technical language is a challenge and has little understanding of common medical conditions.

The relationship between Physiological age and communication

Older people need special clinical care due to issues associated with the functional decline of body organs, none- acute care needs, and complex comorbidities. Age affects cognitive abilities thus making their bodies less sensitive and less active. Most studies have revealed that most of the cognitive capabilities decrease with age. Hearing and vision deficiencies increase with age thus making old people develop physical deficiencies (Ruoff and Hoffman, 2016). Old people have various complications associated with aging such as including but not limited to fear, emotions, anger, anxiety, apathy, and uncertainty. Aged people have a perception that other people are after controlling and managing their lives. The condescending and patronizing issues increases as one get aged.  

 

Person-Centred Communication Strategies used by ASET Nurse

ASET Nurse applied a straight and involving introduction session and initiated a dialogue by asking open-ended questions (Ruoff and Hoffman, 2016). She actively employed good communication skills through listening and gauging patient preferences. ASET Nurse applied several techniques to deal with Max’s hearing problem. The first approach was the use of a clear voice (Ruoff and Hoffman, 2016). She was calm and smooth in communicating. She was not rushing what she intended to say. ASET Nurse always maintained eye contact with Max while speaking to ensure that he could see her mouth moving and clearly understand. She applied none verbal cues such as hand gestures and facial expressions to explain and elaborate to Max. ASET nurse was capable of discovering various emotional responses from Max. She responded to emotional reactions with much understanding. ASET nurse tried to use clear descriptions on various medical terms. During their conversation, Robyn gave the patient an opportunity to explain some of the information in their own words to integrate their knowledge and understanding in the interview.  

Assessment Process of Old People

The first step is considering the patient situations by giving patient attention, such as welcoming tone, guidance to the right waiting for the section, offering first aid services as well as determining if the patient can follow queue or require getting taken to an emergency room (Levett-Jones, 2013). The second step includes the process of collecting cues and information through various medical skills such as observation, asking questions, intermediaries assistance or through machine analysis (Levett-Jones, 2013). The session involves obtaining essential information that provides patient’s detailed data and information to assist in the evaluation of patient’s conditions. The third step consists in processing the data and information provided to attain an understanding and meaning that can get explained to a specific individual (Levett-Jones, 2013). Processing step should integrate all relevant data and information essential for helping the physician to analyze the physiological, psychological, and social functionality of old person.

The fourth step involves identifying problems and issues as indicated by the information gathered (Levett-Jones, 2013). The session includes evaluating risk as well as the nature of the issues. The session involves comparing various possible dangers with specific tools to acquire the most appropriate possible results. The step provides determining conditions that cause particular symptoms as well as detecting and quantifying the sensed conditions.  The fifth step involves establishing goals and appropriate actions taken (Levett-Jones, 2013). Physicians provide a plan that should guide in treatment, or therapy process with specified goals for each therapy, medical procedures or other conditions.

The session involves prescriptions, medical review process as well as nutrition plans among other detailed purposes. The sixth process consists in taking appropriate action for isolating, preventing, or suppressing diseases (Levett-Jones, 2013). It is the actual implementation of planned treatment procedures. The process involves implementing psychosocial treatment through the admission of medication for active recovery such as harnessing personal and social connections. It is essential for considering linking the patient to supportive care meaningful for a quick recovery. The strategies obtained include preventive measures for permanent recovering from the ailing complications.

The action taken depends on prescribed plans for effective and efficient treatment procedures. The seventh step involves evaluating the outcomes of actions taken (Levett-Jones, 2013). The physician evaluates if the activities implemented have achieved the targeted goal. They determine if the patient the progress of a patient after each action and the impact of actions taken. The process helps in determining if the patient requires other assessments or not. The session involves reporting various outcomes for effective and efficient follow-up of procedures applied. The final step consists in reflecting on processes and new learning from the results (Levett-Jones, 2013). The session is documenting detailed methods used for the specific condition identified in the assessment process.

 

The Four Areas of Assessment Inadequately assessed in the Video

The assessment process involving ASET nurse and Max involves little time of assessment process. ASET nurse ignored some of the essential steps in assessment due to limited time. Among the skipped steps included establishing goals for the actions required. She did not develop any purposes such as short-term expectations for implementing the various identified problems and issues worth solutions identified. Establishing goals could help Max in determining the expected outcomes that could solve his depressions, and problems associated with the movement. The most appropriate tool in the stage is the InterRAI Comprehensive Assessment Tool used for encompassing a broader focus on various outcomes beyond a specific issue,

The second steps skipped by ASET nurse during the assessment process are the taking actions. In the assessment process, no responses were associated with the assessed complication. The nurse did not take any activities related to treatments, care and preventive measures for the patient. The essential actions could help Max in hastening the recovering process as well as giving him hope for recovering. The tool appropriate for the stage is the Intervention for Seniors At Risk tools for monitoring the elderly patient during the treatment process.

The assessment process also failed to implement an essential method such as evaluating the outcomes. As a result of ASET nurse overlooking previous steps, it was difficult to obtain results that could get applied to assess the consequences of procedures. The evaluation process is essential in Max life for effective and efficient analysis of his holistic health status. The assessment tool appropriates during this stage is the Systematic Evaluation tool for further information about care plan and appropriate interventions for restoring health and wellbeing.

The fourth process that was not involved in the process was a reflection on actions taken during the process. The nurse could not have any new learning because the treatment and outcome of the actions taken never had enough time to bring results (Dang, 2018). No documentation on impacts of medications that could get achieved. The skipped processes affected other findings in the process. The stage is essential for making inferences conclusion as well as learning new information regarding treatment procedures. The primary tool is the final set of draft standard tool that summarizes screening as well as assessment outcomes.

The principles of Strengths-based Nursing in Address Max’s Concerns

Strengths-based Nursing helps in promoting family and person-cantered care. The principles applied in practice helps in making healthcare more responsive as well as relevant based on patient lifestyle (Gottlieb, 2014). It incorporates a sense of developing essential attributes to patients such as skills for empowering patients, imparting self-efficacy, and giving hope of recovering to patients (Gottlieb, 2014). Among the principles and values applied in nursing include establishing relationships with patients because they are the critical measures towards healthy functioning and hastens the process of healing. They have the right to retain their healthcare information or share it. Although the informed consent was communicated through a humble request via word of mouth, Robyn applied ethical standards such as informed consent by explaining the right to reveal personal information. She asked moral principles on honouring Max’s personality when she requested him if she could allow her to engage in a conversation.  

The principles of empowering personal and family setup promote self-acceptance and boldness in appreciating what life offers (Gottlieb, 2014). The principal encourages the development of healthcare and nursing practitioners who can empower patients. Robyn has applied such strength-based paradigms to promote health behaviours and hope for Max. She offered Max essential guidelines to take control of her health conditions by changing his health and promote fast healing. He acquired self-control measures to cope with stress and anxiety.

Nurses acquire principles such as self-efficacy and develop policies of enabling patients to achieve the strong desire of accomplishing and meeting personal goals (Gottlieb, 2014). Robyn applied self-efficacy skills to kelp Max deal with complex, challenging situations such as social relations, behaviours and, feelings. Through directives provided by Robyn based on future-oriented perception have the potential of helping him in dealing with social problems and other challenges in Max’s life. The strengths such as self-efficacy directly helps Max in concentrating personal energy towards productive projects or areas that promote self-healing and positive coping (Gottlieb, 2014). Nursing professions have strength based principles of hope. Robyn has given Max a positive event will occur in future and makes patient anticipate for better options in the future.  

 

Conclusion

The goal of communication in health is collecting, sharing, and transmitting critical information that can assist in good health. However, the communication process is prone to oversight, glitches, and errors. Poor communication has adverse effects on patients’ safety due to risks such as malpractices, lack of patient safety. Communication is a challenge in various healthcare departments ranging from small medical practices to large healthcare operations. Strengths-based nursing (SBN) is another essential principle that applies the use of core values that guide staffs in providing quality nursing action thus encouraging self-efficacy, hope, and empowerment. It is necessary for guaranteeing adequate care to families and personal patients. The strategies help physicians in focusing on inner and outer strengths-that essential for assisting patients and families in dealing with problems while minimizing deficits. SBN guarantee promotion of health through facilitating effective healing, as well as alleviating suffering by creating environments that work well with patients.

 

References

Christenbery, T. L. (2018). Evidence-based practice in nursing: Foundations, skills, and roles. New York, NY : Springer Publishing Company

Dang, D., In Dearholt, S., Sigma Theta Tau International., & Johns Hopkins University. (2018). Johns Hopkins nursing evidence-based practice: Model and guidelines.

Ellis, P. (2016). Evidence-based practice in nursing. Thousand Oaks, California : SAGE Publications ; London : Leaning Matters

Gottlieb, L. N. (2014). CE: Srengths-Based Nursing.  Strengths-Based Nursing: A holistic approach to care, grounded in eight core values. American Journal of Nursing, 114(8), 24-32. doi: 10.1097/01.NAJ.0000453039.70629.e2

Levett-Jones, T. (2013). Clinical Reasoning: Learning to think like a nurse. Frenchs Forest: Pearson Australia

Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare: A guide to best practice. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.

Ni, P. (2014). How to communicate effectively with older adults. Psychology Today. Retrieved from www.psychologytoday.com/blog/communication-success/201411/how-communicate-effectively-older-adults;

 Ruoff, G., and Hoffman, J., (2016). Malpractice risks in communication failures: 2015 annual benchmarking report. Cambridge, MA: CRICO Strategies.

Gottlieb. L. N., & Benner, P. (November 2013). Strengths-Based Nursing: Moving beyond deficits in nursing practice and nursing education. Educating Nurses Newsletter. Retrieved from https://www.educatingnurses.com/articles/strengths-based-nursing-moving-beyond-deficits-in-nursing-practice-and-nursing-education/

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