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Nurses and Reflection

Discuss about the Reflective Cycle for Social Determinants of Health.

Reflection is the art of trying to disseminate information, decisions or actions about phenomena. Nurses offer holistic care to the patients in any health institution and therefore reflection is an important part of progress and development in the nursing practice. Reflection of health care systems, human biology, environment and lifestyle. Its inevitable that in the course of his / her career, a nurse will face different scenarios depending on the kind of environment she is in and the kind of influencing factors management. (WHO, 2002).

A 2-year-old child is admitted to the hospital with symptoms such as fever, moderate shaking chills, sweating. She vomits and the mother reports that she has been experiencing diarrhea for since the night before. She has also complained of a headache. From the active physical signs, the nurse can tell that the little girl has active malaria symptoms and therefore recommends that they check her vitals. The child cries a lot as she is scared of treatment and her pain as can be seen from her dilated eyes is quite advanced. She needs treatment soon but treatment can’t be diagnosed without proper diagnosis. The nurse needs to take her vitals so as to send a report to the doctor together with the recorded notes of what the mother has reported for advanced checkups.

As a nurse, one is always aware at the back of one's mind that events such as these are bound to happen since it's a health institution, and different clients check in with different illnesses and conditions. Some suffer biologically, others mentally and others psychologically. The nurse can’t help but feel sympathetic towards the little girl and the mother as the little girl is in severe pain but her pain won’t let her get the help she needs. More to that, the mother seems torn between allowing the nurse to check the child by whatsoever means and making sure that the baby feels protected from her fears. As a nurse, I cannot help but remember a time in my younger age when I was in the little girl’s shoes and needed treatment for Malaria but was too afraid of syringes and any other sharp objects that I just wouldn’t allow the doctor to check up on me or administer treatment. To me, the doctor was much worse than the illness I was suffering from as he gave me bitter oils and one to two shots of painful medication through a syringe (Ghanim, 2005).

Case Study - Diagnosis and Treatment for a 2-year-old Child

The nurse takes time to explain to the mother the necessary procedures to be taken in order to treat the little girls condition as she hands over the girl a little paly color puzzle. The little girl seems to lighten up and now looks at the nurse as a friend. Being that the little one has to be treated in order to feel better. Th ensure takes a soft approach to address the big elephant in the little girl’s eye. Her temperature needs to be checked as well as her blood pressure, weight and a blood work analysis. She decided from the simple tasks to the more complicated tasks so as to build up the little girl’s confidence. She Explains that she will just take a peek into her ear to check for a bad person that may be whispering in her year. She is able to record her body temperature. She also checks for her body weight by placing her on a weighing balance as she plays around with the thermometer. She then places the little girl on the seat and explains to her that they need to look for any bad friend that may be in her body and so they have to press on the hand a little bit to see if the bad person is there. The child is able to remain calm. As she checks for the blood pressure, she talks to the kid about playing and who her friends are and what cartoon she likes to watch. She records her blood pressure (Bortz, 2004).

She is aware that the last procedure will be one she will not like but it has to be done and thus she first sends her and her mom to the doctor to get a confirmation if the procedure is necessary. The doctor’s office is full of art and color which diverts the girl’s attention to all the lovely art on the wall. From her symptoms and the high temperature of 39oc, the doctor is almost sure of her condition but still blood analysis test to be done to ascertain the condition. The nurse comes in and tells the little one that she needs to close her eyes and imagine a place where she plays a lot and tell her what she likes. As she talks, she prepares the syringe and asks the mother to hold on to the hand as the prick will sting. Slowly the nurse inserts the syringe into the blood stream and draws out blood. The patient cries for a minute or so and then becomes happy again as she is given a loll. The child is able to enjoy the playroom as they await the blood test results.

Conclusion

The blood tests take 15 minutes to produce results. The test results show a prevalence of the plasmodium vivax virus in her blood stream. Therefore, she needs chloroquine as it effective for emergent use and also provides high resistance to the parasite. From the years the nurse has been exposed to, she was able to identify that the situation demanded a positive attitude in order to achieve a common goal of holistic patient care. By creating a calm, fun situation, she is able to calm the fear in the child and make the health institution be a place she could like for the little while she had to be in the hospital as her condition gets diagnosed and a treatment method established. The benefits to this is that the child is able to get the treatment she deserved but the downside to it is that the interaction time is limited and the nurse may not be able to get the child to trust in her that easily and build up on her trust in time to diagnose her condition and may be have time to attend to the other patients as well (Holland, 2008).

Conclusion

A nurse’s role is quite diverse and there is an expectation to face new scenarios on a daily basis where there is no similarity of events management. This enables the buildup of confidence in the field through experience and improvement of skills overtime. The nurse is able to execute her roles successfully in ensuring that the patient is at most comfort as she can in the hospital as she undergoes assessment of her condition and the best form of treatment to her illness is established. The child is shown to be fearful of the hospital and the procedures at the hospital and therefore proves stubborn and defiant at first to getting her condition diagnosed and treated. But through the nurse’s application of holistic care they’re towards the patient where she integrates care and compassion, she is able to build the patient’s trust in her enough t let her take assessments checks from physical to tests to blood tests. This makes it easier for the doctor to establish the cause of her discomfort, state of well-being being and her symptoms more understandable. If the nurse lacked experience in dealing with pediatric care, then the process may have been harder or even rare to be carried out. More to that, the diagnosis and treatment process would have been hard to execute. Her experience in nursing as well as understanding the child’s mind makes it easy to treat the little girl.

Even though the process was successful, its still evident that more can be done to ensure the patient get quality care at the health institution. Through evaluation and study of the hospitals policies, it would be easy to evaluate patients who come in the hospital with more critical conditions to get services much faster and not have to wait in queues which can worsen their present illnesses. More to that, formulation of better coordination between the administration and nurses can improve service delivery.  Advocate to the parent for necessary tools like mosquito nets, living around clean dry places, use of mosquito repellants. As a nurse I can also take the time to reward the child with a little present for cooperating during diagnosis and treatment. This can be informed of a lollipop and other child friendly options. More ro that, through enhancement of studies in the field and attendance of seminars, workshops and undertaking training programs, I can improve in nursing techniques and assessment of patient’s conditions. There can also be involvement of administration and other health officials in the institution to provide more services with lasting solution and quality ones too.

References

Bortz, W., 2005. ‘Biological basis of Determinants of Health, American journal of public health, vol.95, No.3, pp. 390-392.

Ghanim, S. A, 2004, ‘Factors influencing the utilization of public and private primary health services in Riyadh city,’ JKAU: Econ. & Adm, vol. 19 No. 1, pp 3-37.

Glouberman, S., & Millar, J. 2003, ‘Evolution of the Determinants of Health, Health policy and Health information in Canada,’ American Journal of Public Health, Vol. 93, No.3, pp. 388-391.

Holland, K., Jenkins, J., Whittam, S. (2en Ed.)2008, Applying the Roper-Logan-Tierney Model in Practice, Churchill Livingstone Elsevier.

Kuczmarski, R.J., Flegal. K.M. (2000) ‘Criteria for definition of overweight in transition: background and recommendations for the United States’. American Journal of Clinical Nutrition 72, pp.1074–81.

McCeney, M & Krantz, D, 2005. ‘Effects of psychological and social factors on organic disease: A critical assessment of research on coronary heart disease, Annu.Re.Psychol, Vol. 53, No 341-369.

 McEwen, B.S., 2001, ‘The neurobiology of stress; from serendipity to clinical relevance, Brain res, Vol.886, pp 172-189.

Merton, M. 2005, ‘Social Determinants of health,’ Lancet, vol.365, pp1099-1104.

Ocampo, J. M, 2010 ‘Self rated health: Importance of use in elderly adults,’ Colombia medica. Vol. 41, no.3 pp277-285.

Owens, D. 2007, ‘Physical psychological and social…..the challenge of general practices’, The Honkong college of general practitioners pp.49-50.

Roux, A. V., 2007, ‘Integrating Social and Biological factors in health research a System Review: AEP, vol. 17, No.7, pp. 569-574.

Steinberg, A. M. 2006, ‘Factors affecting health poverty and environment, World Health Organization 2006- commission on social Determinants of health.

Stroebe, W. 2000, ‘Social psychology and health (2end.), Open University press, Celtic court 22 Ballmoor, Buckingham MK18 1XW

WHO, 2002,’Reducing risks promoting healthy life: World Health Organization report 2002, Geneva.

Yearwood, E. L., 2010, ‘The Social Determinants of Health and Mental health: Global Foundations for Improving Child and Family Mental Health’ Journal of Child and Adolescent psychiatric Nursing, Vol. 23, No. 3, pp196- 197.

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