Introduction of the Patient
Matthew Wilkins is a 60year old retired person who lives in his home alone. His wife died two years back and his only son lives out of state with his wife and two kids. He was a teacher at a school for the last 21 years. He is no more in touch with his son and his family. Previous family records suggest that he had been verbally and psychologically abused by his son and daughter-in-law. Hence they left him alone, leaving him devastated. Living alone, mentally affected him for years (Liu, Mumford and Taylor 2018).
Some individuals believe that after retirement, they must simply relax at residence and take responsibility for their wellbeing, but for Matthew, retirement is only the beginning of a new chapter. As a result, he wishes to spend his retirement time with a variety of valuable experiences and objects. He spends his time gardening and reading books. He feels the satisfaction of sowing a seedling and enjoying it blooming. He has got some friends in his neighborhoods and the NGOs he is involved with. He loves spending time with them and discusses various topics. Often he spends his afternoon birdwatching, which is a great opportunity to contemplate or helps him to just tune off and think relaxing thoughts.
Recently he contacted a healthcare service organization to hire a nurse. Hence I was asked to look after him at his residence and help him with his daily needs. He has got arthritis and neuropathy which left him with muscle weakness and pain in the affected area. He went through many pain management sessions and physiotherapies but the pain he suffers from is incurable. Pain management lessens his pain temporarily and minimizes the anxiety caused by disease-causing effects (Fillingim 2017).
Mr. Matthew would rather stay in their comfortable surroundings than live in an institution. It is critical to provide a safe and nurturing setting for the elderly to reduce falls, especially for those who reside alone and with little monitoring from relatives. He is still regularly participating in a variety of social events. He continues to live freely and rely on public services, especially commuting, in his everyday life. It is assumed that he can use the telephone and radio.
On a physiological basis, aging causes a steady decline in physical and cognitive function, an increase in the chance of illnesses, and, eventually, mortality (Tough, Siegrist and Fekete 2017). These alterations are neither progressive nor constant, and they are only tangentially related to an individual's chronological age. Hearing impairment, glaucoma and vision impairment, back and shoulder discomfort and rheumatism, respiratory problems, obesity, anxiety, and memory loss are all common illnesses among the elderly. Older people are more prone to suffer from many illnesses simultaneously.
The ideal formula that Mr. Matthew follows for physical well-being and wellness is to balance physical exercise and a nutritious diet. He set a target of being constantly engaged for at least half an hour each day, sometimes split down into three 10-minute periods each day. Consuming a range of meals from all dietary categories benefits him get the nutrition he requires as he gets older. He consumes fruits and veggies and increases his protein intake by eating more seafood, chickpeas, and lentils.
Research shows that the share of life spent in a healthy lifestyle has stayed about consistent, meaning that the extra years are spent in bad conditions (Knox and Muros 2017). People's capacity to perform the activities they love would be little altered from that of a child if they can enjoy these additional days of existence in a healthy lifestyle and a nurturing atmosphere. Physical care is an essential everyday requirement for an older individual. He requires help with showering, clothing, and hygiene.
The importance he puts on himself, his high self-image, and his feeling of self-worth are all examples of his self-esteem. Individuals with strong self-esteem often have a positive attitude and are usually content with themselves. The death of a partner is an incredibly traumatic experience. Everybody needs to find strategies to cope with and adapt to the alterations brought about by these occurrences. When individuals are dissatisfied, they either absorb or visualize their feelings. Sickness, pain, and other physiological issues have led to poor psychological health for him. More typically, poor physiological conditions can have an impact on an individual's self-esteem and capacity to achieve their aspirations, leading to discontent or even despair. Obtaining the finest available therapy for both the physiological condition and the subsequent mental effects is critical in such circumstances for maximum return to excellent emotional stability (Tandberg et al. 2019).
Healing from maltreatment requires respect for others as well as emotions of safety and support. For Mr. Matthew support is essential, and expert assistance will be necessary at times. Abusive behavior can sometimes result in emotions of poor self-esteem, loss of respect, sadness, loneliness, and rage. He also used proactive coping strategies. These intervention actions educated him not just for particular stresses, but also for many that are expected to occur in everyday life. Cultivating and developing these abilities is part of proactive responding (from pragmatic and scholastic information, encounters, and a significant quantity and variety of interpersonal interactions) (Naef et al. 2021). Furthermore, similar strategies entail developing skills and capacities to more precisely analyze the dynamic landscape, from signals of a potentially stressful event to suitable techniques and material utilization to reporting on a particular circumstance. Connecting with acquaintances, on the other hand, is expected to add the advantage of social assistance to his worry, which is effective. Aside from that, he sought positive reinforcement, looked toward spirituality, employs laughter, and expresses his feelings.
He suffers from being emotionally alienated if he does not become conscious of, cultivate, and maintain his social well-being. Separation from social interactions creates a self-perpetuating cycle since solitude causes a lot of sentiments of dread and danger, which in turn contributes to further isolating behaviors. Expressing his sentiments to people in a non-blaming manner may also improve his psychological well-being while encouraging people to communicate their emotions to him. Forming significant connections, on the other hand, tends to help him look happier and is an excellent motivation for controlling his feelings. Feeling as though he can have a positive effect on the individuals and environment around him boosts his thinking of well-being (Ibiam, Bekomson and Angioha 2020).
Participating in civic development efforts nearly always necessitated his collaboration with individuals who reside locally. For instance, if a neighborhood gathers to repair a public playground, individuals of various ages may discover themselves working beside each other in an observation center or scooping soil over the period of several weekends. A good and enduring connection is marked by positive, peaceful conversations in which he feels listened to and cherished. If anything bothers him, he addresses it freely with the other individual.
Becoming involved in the social environment and contributing encourages socialization. Furthermore, he participates in volunteer opportunities which results in him having a shorter duration of anxiety. Volunteering stimulates his mind, which benefits his psychological health (den Dulk and Swanberg 2021). Relevant and constructive hobbies might make him feel optimistic and more optimistic about life. Volunteering is an excellent opportunity to reconnect with old friends and establish bonds. Collectively, he may discover, assist others, and create lasting experiences to cherish with his friends. He imparts vital valuable experiences to new generations by connecting with them. The youth of today, on the other side, sometimes educates him with fresh perspectives on life. Tediousness may make existence a little boring on the occasion. If he feels lonely or has overly much time to spare, volunteering could be precisely what he wants to liven matters up. Many service opportunities enable him to explore different items and develop new abilities.
Mr. Matthew says faith is the most essential component in his ability to cope with physiological wellness issues and life difficulties. When dealing with physical issues and challenging social conditions, he depended on religion to some extent. Individuals with mobility issues who have a cheerful, optimistic outlook on the future are more likely to heal. Religious ideas and behaviors frequently promote the formation of communities and large interpersonal supportive structures. Because individuals of their group engage with the elderly and engage them with concerns about their wellbeing and professional care, more interpersonal interaction for aged persons enhances the possibility that diseases will be diagnosed earlier and that elderly adults will cooperate with therapeutic programs (Meuleman and Billiet 2018). Since Mr.Matthew has such social connections, he is less prone to ignore himself.
Collecting a religious background demonstrates to elderly clients that the healthcare professional is open to discussing religious issues. Clients may be asked if their religious convictions are an essential aspect of their lives, how these convictions affect how they manage themselves if they're a member of a spiritual or cultural group, and whether they will like the medical insurance provider to address their psychological issues. Psychological qualities including negative affectivity, psychological disease, and extreme trauma inhibit beneficial emotional transformations for Mr. Matthew. Normal aging-related reductions are mild and largely impair cognitive ability and executive function. His empathy is commonly related to emotional intelligence since it includes him linking his life anecdotes with that of others.
He gets more pleasant as a result of his personality. Medical concerns, including pain or illness, can sometimes cause behavioral changes. Noise, discussion, people, and movement sometimes all be disturbances that occur and are hard to digest or comprehend. Infectious diseases, constipation, and lack of rest are all diseases that induce abrupt modifications in his behavior. Furthermore, certain drugs also alter his behavior (Hosseini, Chaurasia and Oremus 2019).
Mr. Matthew was just brought to the medical facility owing to pain. My employment was at a hospital frailty unit, which cares for the aged who are facing an abrupt start of discomfort. I will focus on how I gave care and support to Mr. Matthew through his final days in the department, which led me to choose this perspective because of the various parts of care that I learned whilst he was in the hospital, which will then be discussed in the essay. For this perspective, I will use the Gibbs reflective cycle as a model.
Description: Autonomy is defined in healthcare ethics as a nurse's obligation to support a patient's ability to make judgments, even if such judgments are not in the client's best interests (Dima et al. 2017). Mr. Matthew shouted out to me as I was responding to other clients on the unit, under the observation of my supervisor, saying she was in serious agony after she had been hospitalized with lower back discomfort. As a nurse, it is necessary to utilize essential thinking to address challenges connected to primary client treatment, and as a nursing student, I requested extra assistance since I had no idea what else was going on with Mr. Matthew, who stated that he was weary. Compassion is key to the treatment we give, and we react to each person's suffering, discomfort, fear, or necessity with empathy and respect. The doctor summoned the intensive care appeal team to administer the control, but Mr. Matthew was exhausted. However, one of the caregivers demonstrated her bravery and devotion to clinical outcomes by stating to the doctor that it was not acceptable to prolong the control owing to Mr. Matthew's weariness and inadequate progress. The doctor attended to the caregivers' concerns and subsequently requested persistent progressive airway support, which is employed to cure disruptive sleep disorders. Mr. Matthew had the ability, so the physicians and experts revealed to him and his friends that parts of his systems were ceasing to work, and one of a physician's tasks is to retain confidence by remaining transparent, upfront, and acting with honesty (Yu et al. 2017).
Mr. Matthew was subsequently moved to the End of Life unit with his approval, transported to a private ward, and assigned to the hospice department. A nurse is supposed to offer ethical and professional care to avoid bodily, mental, or spiritual damage to him. Patients nearing the edge of their lives require high-quality therapy and attention to enable them to survive as well as feasible until death, and to depart with respect (Myatt 2015). He had difficulties eating as a client towards the end of his days, and the physicians and caregivers decided to transfer him to pressurized breathing for ease. Mr. Matthew was sweating and fatigued while being on pressurized breathing when I and one of the caregivers changed him. The nurses then informed the friends that he was becoming weary and that they must refrain from making him speak.
Feeling: Severe pain that persists after treatment measures such as pharmaceuticals, palliative care, physiotherapy, and vocational therapy is referred to as persistent pain, which Mr. Matthew was suffering (Relji?, Pajnkihar and Fekonja 2019). Culture, past pain history, emotion, capacity to deal with it, and even ideology may all impact pain, and people must be medicated accordingly. When I saw him within the ward, I felt sorrow for him, and throughout our conversation, he stated his desire to give up and finish it all. I felt much worse because I knew he didn't have any family to call. Staring at Mr. Matthew, I felt a combination of feelings, but I could see why he wanted to quit, and the sole justification was the agony he was beginning to feel all over his body, not just his shoulders. I was pretty competent in decision making, but there was a time when I was presented with a circumstance in which I could recognize the issue but was unable to draw out a remedy owing to a dearth of expertise in client end-of-life care. In retrospect, it was a wonderful lesson since it enabled me to understand how patients deal with fatal illnesses individually, as well as the effect it has on caregivers (Hariyati and Ungsianik 2018).
Evaluation: As this was my first interaction with a patient suffering from extreme pain and end-of-life care, I learned a lot and gained a lot of knowledge, particularly regarding acute pain treatment, by asking multiple inquiries and establishing a strong patient-nurse connection. Throughout this journey, the nursing staff developed a positive professional connection with the client. Competence is defined by people of an activity who embrace similar ideals and expertise adopting independent evidence-based decisions. Professionalism in nursing and midwifery is achieved via intentional partnerships and is supported by circumstances that promote expert performance (Contreras et al. 2020). Responsibility is demonstrated and embraced by professional nursing and midwifery. I advised him that he would require an evaluation by the hospice group before changing her pain reliever or increasing the amount and that the physician had been aware of this. This appeared to settle him down a bit as I spoke and empathise responded with him. Healthcare is the act of caregiving, and nurses must interpersonally respond to what treatment workers and clients want to provide the treatment they need.
Analysis: Mr. Matthew possessed capability, and the healthcare professionals ensured that he was actively engaged in his care. Clients may stipulate that they want life-sustaining initiatives, such as diagnosis, revoked, however, there is no moral or lawful difference between taking away or disengaging therapies, and it is generally more difficult for medical practitioners to remove therapies than to determine not to start it in the first place. Nurses, as the main providers, must guarantee that attentive attention and consolation methods are provided as the patient's disease develops. The Nursing and Midwifery Council Code (2015) emphasizes the importance of utilizing a variety of verbal and nonverbal interaction strategies, as well as taking customs and culture into account, to effectively interpret and react to an individual's emotional and medical requirements. As a recently assigned nurse, I am committed to devoting my responsibilities to all clients and their relatives or caregivers, showing compassion and courtesy at all times while providing the finest treatment possible while taking the collaborative endeavor into account (Li et al. 2022).
Conclusion: To think and feel for Mr. Matthew, I was provided the chance to participate in a conference with the hospital's healthcare professional, which reinforced the significance of decent effective communication and precise record maintenance to ensure that all attendees in Mr. Matthew's unit were aware of what was going on. In regards to communication, I thought I was developing assurance because I had established a connection that was both proficient and pleasant, and trustworthy.
Action Plan: The Action Plan outlines the top priorities for improving accessibility to and awareness of best practices in pain treatment. Pain is an important factor to address to guarantee that individuals live better lives via efficient treatment and integrated care of chronic illnesses, which are the primary source of sickness, impairment, and mortality. To acknowledge the intricacy and pervasiveness of suffering in our society and decrease its effect, we need strategic and sustained public intervention. Vertically connected communication approaches are being used to provide comprehensive and diversified communications across multiple multimedia channels such as Television, the internet, social networking sites, newspapers, and clinic-based newspapers to communicate ideas and connect to a large local population. Give customers access to appropriate services that allow them to discuss and negotiate their pain experience among health professionals, workplaces, caregivers, or family members to minimize prejudice, the necessity to reiterate their narrative, and improve self-management of pain. Create an overall educational plan to encourage scientific pain management training throughout all healthcare professional fields, including undergraduate, postgraduate, occupational, and academic development. This must involve, among other things, uniformity of pain control education curriculum across institutions, and an emphasis on valuation treatment and the optimal employment of non-pharmacological methods to pain treatment such as fitness, nutrition, and so on (Yamada et al. 2018).
While patients seldom, if it ever does, indicate that their pain has been removed as a result of a pain management program, they frequently notice a decrease in the severity of their pain. Usually, clients begin a pain management course due to chronic pain, but they quickly discover that pain eradication should not be their main focus. Rather, students are taught to concentrate on more feasible objectives. Clients are urged to engage in group-based pain treatment programs frequently (containing flexibility, aerobic fitness, and weightlifting) and to enhance their activities under monitoring. The objective is to progressively enhance functionality without surpassing pain and suffering thresholds (Pagulayan, Eltair and Faber 2018). Most people can take conventional pain killers safely with training and frequent supervision. Patients are requested to track their prescription for a month before starting a pain control program and to submit their regular medication after the course. Many individuals who suffer from chronic pain describe being melancholy and experiencing difficulty connecting to others. Most group-based pain regimens result in reduced anxiety, lower mental anguish, and greater self-esteem in clients. Clients who establish an aim of returning to work are more likely to succeed. According to follow-up relevance assessments, clients who have a favorable encounter in a pain control course are more likely to resume work and continue an energetic, professional lifestyle (Amer-Cuenca et al. 2020).
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