In this essay I will be exploring the relationship between nursing theory and practice in patient assessment. I will analyse the activities of daily living section (Appendix 1) of the combined nursing assessment tool and look at how it facilitates patient centred care. I decided to focus my essay on this after working on a ward on placement where it was routine to complete a Combined Nursing Assessment within four hours of any patient arriving onto the ward. For this essay I will be using the Gibbs (1998) cycle of reflection. In accordance with the Nursing and Midwifery Council (2008) I will use the pseudonym Patient A, to protect the identity and confidentiality of the patient.
What were you thinking and feeling?
I was pleased to see how much input and care all the staff were providing for the patient as being in hospital must have been very frightening for him. His parents and carers were a great source of information and were able to tell me everything about Patient A that he could not, which allowed me to compile information for the nurses to use to implement a plan of care. After spending time with Patient A, talking to him during the assessment and reassuring him, I felt as though the assessment had opened up communication with patient A and his carers. I was happy that the patient appeared to become more settled as we went through the questions and talked. By completing this document I felt as though I was able to see a bigger picture of the patient and his needs and preferences.
What was good and bad about the experience?
The planned procedure would bring relief to the patient after being unable to verbalise his discomfort to anyone. It felt rewarding being able to work with the patient and his carers and by doing the assessment, the patient received an excellent care package. The assessment tool enabled the staff to provide care tailored to his needs. This included knowing what types of noises he doesn’t like, privacy by keeping his curtains nearly closed but open enough so he could see what was going on around him. Knowing that when he returns from theatre he may have had an opposite response to the sedation, which could mean that he would feel agitated and confrontational and that his eating was very limited so even if he refused food he would have some of his favourite biscuits once he was able to eat.
What sense can you make of the situation?
The Department of Health (2009) states that healthcare workers who work providing mainstream healthcare services do not always know the best way to treat people with learning disabilities (2009). The Department of Health’s strategy (2010), following the Autism Act (2009), thus includes the implementation of a framework to increase awareness and understanding of autism among frontline professionals. Autism is a neurodevelopmental condition which presents as a combination of communication difficulties, impaired social interaction, and repetitive behaviours (Venkat, 2012). The spectrum part of the diagnosis of autism means that people with autism may share specific challenges but every person with autism is affected in a different way (Oxford University Press, 2013).
Patient A’s autism has heavily impacted upon his life, most of which has been spent living in a care home for adults with autism. A stay in hospital may be challenging for a person with autism, and as such the activities of daily living (ADL) nursing assessment was used to determine Patient A’s physiological and emotional needs and to build an appropriate care and treatment plan to facilitate the goals of the patient, his carers and the health professionals treating him. This could only be achieved...