Nursing Exemplar The nursing process Essay What Is Nursing? Essay Bortons Reflective Model Essay on Nursing Care Plan

1. Nursing Exemplar
Katherine Gallagher NU 310 Exemplar 2/21/2012 I arrived to work well rested and ready to start
the day. I had just returned after a two week long vacation. Because of the time off, I arrived to 7
East to find that the assortment of patients was not familiar at all. As I began getting reports on
my patients, one in particular I started to feel a little anxious and stressed. At first glance I could
tell I would be busy for the next twelve hours. Lynda was a 45 year old woman that was admitted
almost a week ago after having an emergent tracheostomy placed. Lynda was newly diagnosed with
laryngeal cancer with already having several other diagnoses including: seizure disorders, mild
mental retardation, behavioral issues, and was legally...show more content...
The look on Lynda's face was that of incredible confidence, I was truly impressed with her. By the
end of our second twelve hour shift, Lynda had learned how to suction herself. It was passed
along in report to simply encourage her independence in suctioning herself. Day three, my
mission was to teach Lynda the proper care of her PEG tube, and to continue with the
encouragement of her suctioning herself. After walking her though a bolus feeding in the
morning, she agreed to do the next one. Lunch time came around and sure enough, she was able
to complete the bolus feeding with minimum assistance. By the time came for the next feeding
she was going to get the can of food to do it herself when I had walked in the room. She laughed
and told me I was right that the PEG tube was a lot easier than suctioning. At this point in Lynda's
stay I knew that she would be going home soon. Later that evening, while discussing Lynda's
progress over the last few days with the physicians I asked them what the plan was and instructed
them that we needed to get nutrition, social work, and case management involved so that she could
go home. The physicians stated that they would place the consults that I requested but as for
discharge they were unsure about when this would happen because Lynda's brother doesn't think she
can care for herself on her own. I was shocked to hear this, the brother who I had not
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2. The nursing process Essay
The standards of practice describe a competent level of nursing care as exhibited by the critical
thinking model known as the nursing process. This practice includes the areas of assessment,
diagnosis, outcome identification, planning, implementation, and evaluation. The nursing process
includes significant actions taken by registered nurses (RN) and forms the foundation of the nurse's
decision–making ("American Nurses Association," 2010). Assessment is the accurate collection of
comprehensive data pertinent to the patient's health or the situation ("American Nurses Association,"
2010). Assessment is the first step in the nursing process and the most important. Assessment is the
accurate collection of the patient's health date...show more content...
It is during the second phase that the nurse must establish a nursing diagnosis. Only diagnosis
approved and listed through The North American Nursing Diagnosis Association (NANDA) may be
used. Ineffective airway clearance, risk for impaired skin integrity, risk for infection and ineffective
coping are just a few examples of NANDA approved diagnosis. A nursing diagnosis is a clinical
judgment about actual or potential individual, family, or community experiences/responses to health
problems/life processes. A nursing diagnosis provides the basis for selection of nursing interventions
to achieve outcomes for which the nurse has accountability (Defining the Knowledge," 2012). The
third standard of practice is outcomes identification. During this phase, the registered nurse identifies
expected outcomes for a plan individualized to the patient or the situation ("American Nurses
Association," 2010). During this step outcomes must be derived from the nursing diagnosis and must
be measurable, realistic and attainable by the patient. The registered nurse involves the patient,
family, heath care providers, and others in formulating expected outcomes when possible and
appropriate. The registered nurse must also consider associated risks, benefits, costs, current
scientific evidence, expected trajectory of the condition, and clinical expertise when formulating
outcomes ("American Nurses Association," 2010). Example of an
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3. What Is Nursing? Essay
Nursing is universal in the sense that nurses can be found almost in all countries around the world
(Henderson, 1978). They are in the hospitals, in school clinics, in the community centres, residential
homes and even play major roles in some of the popular soap operas in television. There are even
television shows that mainly revolve around nurses and which chronicles what they do at work –
both the positive and the negative. It is one of the most visible and easily identifiable occupations as
compared for example to other occupations such as engineers, managers or even pharmacists,
medical technologists and other health related occupations. This is partly because of what nurses do
and most especially how nurses look – with some still...show more content...
The salient point in Henderson's definition is describing the duty of a nurse as one that cares or
assists an individual whether sick or well in obtaining a state of health in order to live an
independent lifestyle (paraphrased). Henderson also described the independent and dependent role
of nurses and the importance of a collaborative work with the other members of the
multi–disciplinary health care team especially the doctors (Henderson, 1966). The Royal College
of Nursing, on the other hand, described nursing as the utilization of clinical judgement in
extending the care necessary for the people to maintain and achieve an optimum state of life
throughout their lifetime (RCN, 2003). Other significant definitions of nursing were those given
by the World Health Organization (WHO) and the American Nurses Association (ANA). The
roles and functions of nurses have a very fascinating history and have evolved since the 19th
century. Landale (1895), in her letter to the editor of the Nursing Record and Hospital World
gave us a glimpse of what a nurse should be during that period. Referring to a nurse as a woman
in uniform, it gave us an idea that nursing was a female dominated vocation and not to be treated
as an economical occupation for financial gain. Landale (1895) placed an emphasis on the
characteristic of being a servant and being devoted to service in order to be a nurse who was worthy
of the uniform. The
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4. Borton's Reflective Model
In this assignment, the author has chose to critically analyse a situation where a second year nursing
student Catherine, who is on a 7 week clinical placement is having an issue when communicating
with patients at times.
Using Borton's reflective model, the author identifies appropriate teaching and learning strategies to
improve Catherine's communication skills. This model has been chosen to discuss the assignment
as it is relatively basic models that suits junior practitioner however it can be used at different
stages as learner improve their reflecting skills as according to Jasper (2013). Due to the
simplicity of the model, there is an increased in utilization of Borton's reflective model by the
healthcare professional (Jasper, 2013). Borton's framework asks the practitioner to reflect using
three types of questions: 'What?', 'So what?' and 'Now what?' . The last stage heads professionals to
create or change their practice as an outcome of reflection. Reflection is the self recognition...show
more content...
Issues such as staff shortage, increased workload, staff feeling threatened by the student nurses, and
poor teaching skills can contribute to students not feeling supported (Burns and Paterson, 2005).
Nursing students had identified that anxiety as their main concern in the research done by Masoumi
and Sharif (2005). The unfamiliarity of tending for patients and worrying of making mistakes during
the clinical attachment are the factors that students feel anxious. Mentor can diminish anxiety by
utilizing simulation, where genuine case studies and scenarios are being simulated and roles and
responsibilities of student nurse are being discussed (Burns and Paterson, 2005).Gradual
encouragement in helping student nurse to gain control over their own learning may aid to construct
their confidence which will reduce their
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5. Essay on Nursing Care Plan
Introduction: A nursing diagnosis identifies an actual or potential response of a patient to a health
problem (Jones 2009). Nursing diagnoses are important because they provide the foundation for the
selection of nursing interventions (Walton 2008). This care plan is the concluding half to the initial
care plan that identified nursing diagnoses and goals with the aim of promoting the holistic
wellbeing, mental health, and independence of a 68 year old Mr. Bertoli who has returned home
from hospital after experiencing a stroke. Particular emphasis will be placed on proposed
interventions to achieve Mr. Bertoli's healthcare goals and the provision of rationales. This is
important to justify the significance of the interventions and indicate...show more content...
However collaboration between a professional interpreter and a family member can be beneficial
when dealing with the older person. This is because family member can assist in the provision of
physician–to–patient information after the conclusion of the encounter (Rosenberg, Seller & Leanza
2008). Intervention 1b: The provision of written information in the patient's primary language
containing the purpose and side effects of the patient's medications (Aboul–Enein & Ahmed 2006).
Rationale 1b: The provision of written medication information given to the patient helps significantly
in cases of medication non compliance (McGraw & Drennan 2004). This is because it aids in
memory retention and presents patients with access to a reliable source of concise medication
information, particularly if the patient needs to be reminded of certain aspects (Gorgos 2006). These
written medication information sheets need to be provided in the patients primary, dominant
language because it reduces the difficulty and limits barriers to patient understanding (Gorgos
2006).This is important because this intervention aims to increase a patient's understanding of their
medications, and when a patient feels more competent with the use of their medications, reduced
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