The aim of this essay is a reflective account in which I will describe a newly acquired skill that I have learned and been able to implement within my role as a trainee assistant practitioner. (T.A.P.) for Foundation for Practice. I have chosen to reflect upon neurological observations on patients that will be at risk of neurological deterioration. Before I begin any care or assessments, I should have a good theoretical underpinned knowledge, of the skill that I am about to put into practice, and have a good understanding of anatomy and physiology, in order to make an accurate assessment of a patients neurological status. I will be making a correct and relevant assessment to identify any needs or concerns to establish the patient’s individualized care, and make observations to determine an appropriate clinical judgement.
I will be using the Gibbs, G. (1988) model of reflection to reflect upon for this essay, as this six stage cycle will guide me through the process of description to the action plan, as I find myself to be an active/reflective learner and feel that I can relate to, and learn something that is of value to my practice, and future career and lifelong learning skills through this model of reflection. Throughout this reflective account I will refer to the patient as Mr X, in order to respect confidentiality and maintain his anonymity (NMC) (2008), and local trust policies and guidelines (2009).
Gibb’s model (1988) first describes the event, so my description of the event is: Mr X was admitted to the medical assessment unit (MAU) from the A+E (accident and emergency) department, with a preliminary diagnosis of a T.I.A. (transient ischemic attack) and dysphasia. Ross and Wilson (1996) describe this as, caused by small...
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...the patient’s family more within the assessment after obtaining the patients consent, but my main aim in this case was to concentrate the assessment, solely on the patient, with little information from the family/loved ones. This is a vital skill to remember as patients family/loved ones can often feel unimportant and distant toward nursing staff, and no one knows the patient better than they do, and can tell you vital information. Therefore involvement of family/ carers or loved ones is sometimes crucial to patient’s further treatment and outcomes.
For the final stage of Gibbs’ (1988), my action plan would be, to involve the family more, and to work within my skills log book to increase my competency level and to gain knowledge through literature, the internet, and my mentors and future modules and to keep my knowledge and skill up-to-date.
Consent is necessary from everyone, not only those who can verbalise his or her needs. It is important to find out the persons communication needs so that they can be involved in discussions around their needs and preferences. My duty of care is to ensure that choices are given, and that appropriate support is obtained where there is lack of capacity is the decision is complex and the individual cannot consent. This may be from families or next of kin or using advocates to ensure that the client’s best interests are maintained. There may be past events or requests that could indicate the client’s preferences, and these must be considered when choices have to be made by others. Any preferences should be recorded on care plans and shared with relevant others to be able to determine the best interests of the person. Decisions should also be put off until the client is able to make their own choices where possible and not taken on their behalf through assuming we know
I intend to explore the effects of a parietal brain injury from the perspective of a neuropsychologist; ranging from types of tests that are employed when trying to determine the extent of the damage, to gaining an understanding of how this damage will affect the rest of the brain and/or the body. I will also explore the effects of a brain injury from the perspective of the family members, and their experiences with the changes that occur during the rehabilitation process. According to The Neuropsychology Center, “neuropsychological assessment is a systematic clinical diagnostic procedure used to determine the extent of any possible behavioral deficits following diagnosed or suspected brain injury”(www.neuropsych.com). As mentioned previously, a brain injury can be the result of many types of injuries or disorders, thus a broad range of assessment procedures have been developed to encompass these possibilities.
It is also placed for diagnostic evaluation of idiopathic normal pressure hydrocephalus according to Marmarou (2005). Hydrocephalus as defined by Sheppard & Wright (2006) is an abnormal increase in the volume of CSF within the brain. LDD placement is also used to reduce intracranial pressure (ICP) during craniotomy according to Grady et al (1999) and Samadani et al (2003) and as adjuvant therapy in the management of traumatically brain-injured patients added by Munch et al (2001). The knowledge gained from reading books and articles and the skills acquired and enhanced during the process of mentoring developed the confidence of the learner in looking after particular patient. To complete competency in this area and to advance knowledge and skills, it was suggested that learner have to increase exposure to particular patient group. This is experiential learning (learning by doing) recommended by Kolb (1984) where through repeated encounters thoughts are framed and modified. This support the advancement of the learner from ‘novice to expert’ (Benner, 1984) that occur as part of professional development.
The object of this essay is to discuss the role of the Assistant Practitioner. How it has emerged; how it fits into the structure and skill mix of the NHS workforce and the effect it has had on that structure. It will also outline the principles of accountability and statutory regulations that govern the day to day practice of the role.
The nurse needs to describe what focused health assessments they think would best suit the patient. The nurse needs to work out a way in which we can help decrease Alice’s heart rate and blood pressure. To do this the nurse would perform a neurological assessment and a head to toe assessment. These two assessments will give the nurse more information about Alice’s nervous system, if she is in any pain and what further assessments and treatment need to be completed. A neurological assessment is a technique of gaining specific data in relation to the role of a patient’s nervous system (Ruben Restrepo).
As a neurologist I am a medical doctor with specialized training in diagnosing, treating, and managing disorders of the brain and nervous system, including diagnosis of brain tumors. As a professional I act as the primary care provider for patients with chronic neurological problems and as a consultant to other physicians who have clients suspected of having a condition involving the nervous system (Life NPH, n.d.). A neurological examination allows me to effectively diagnose the condition of the patient and suggest appropriate treatment options. I first review the patient's health history with special attention to the current condition.
Interaction with their patient on a regular basis is also a crucial aspect of a neurosurgeon’s career. Supporting the patient in medical decisions and informing the patient of all possible risks, effects, delays, results, and outcomes of his or hers surgery is conceivably the most imperative obligation a neurosurgeon can carry out. The physician must be able to clearly and precisely discuss they patient’s course of action with whom they are comfortable with to ensure the best recovery.
The purpose of the paper is to discuss the activities involved during the evaluation of a patient. Evaluation of a patient can be seen as the process of examining a patient critically. It comprises of gathering and analyzing data about a patient and the illness (Allan, 2012). The core reason is to make judgment about the disease one is suffering from. Such judgment will guarantee proper treatment and diagnosis. Typically, gathering of information from the patient is the role of nurses while making judgment and prescription is the doctor’s role (Jacques, 1988). In any case all practitioners are required to know how to evaluate a patient.
(patient) and the Clinical Nurse Manager both parties agreed that the author could proceed. All information will be kept confidential and no names will appear on this assignment that could be traced back to the client or hospital. As a student nurse this will comply with the guidelines set out by An Bord Altranais (2009). All nurses should be able to account for the care they give, why they give the care and also an evaluation of the care they have given. Barett et al (2009) maintain that this is a core part of care planning.The Department of Health and Children (2001) has shown its commitment to organising care plans and the importance of them as was evident in the 'Primary Care A new Direction' health strategy.This identified the importance of discharge planning and and the development of individualised care plans following discharge. This assignment will cover a full assessment of a person whose care the author has managed in the clinical setting. Based on this assessment the author will compile a care plan focusing on two key nursing diagnoses derived from the nursing assessment. The author will list all nursing diagnosis related to this patient and give a rationale for each.
This essay will explore the authors meaning of reflection, how various reflective styles can benefit the practitioners within their settings, and how important reflection is within Early Years Practice. According to Appleby (2010, p.10), reflection is a generic term which describes various behaviours involving feelings, and thinking about thoughts and experiences, in order to examine issues and develop, new understandings and insights. Reflection within practice allows the practitioner to develop a sense of awareness around their daily activities, and helps them to evaluate how they could evolve these activities further, if the given opportunity was to arise again. Similarly, keeping a reflective journal
I will be using the What? Model of Structured reflection suggested by Driscoll (2000), a recognised framework for reflection to demonstrate my ability to reflect on a clinical skill with the professional value of privacy and dignity.
Reflective practice is a process of thinking and critically analysing one’s experience to improve professional practice. Reflection on nursing situations not only promote the nurse’s professional development but also improve the quality of nursing care to patients (Gustafsson & Fagerberg 2004). According to Dolphin (2013), reflection process consists of systematic appraisal of events and examination of its each component to learn from the experience to influence the future practice. Though there are many models available to structure the reflection, I have chosen Gibbs model (1988) as it follows specific steps in a systematic way in reflection process. And also, this model emphasises the role of emotions and acknowledges the importance of emotions in the reflection process. This is a simple framework and this assignment will follow the headings as per this model. The incident I will be reflecting
Reflection has its importance in clinical practice; we always seek to be successful and that can be achieved by learning every day of our life through experiences we encounter. In that way we can reconsider and rethink our previous knowledge and add new learning to our knowledge base so as to inform our practice. Learning new skills does not stop upon qualifying; this should become second nature to thinking professionals as they continue their professional development throughout their careers (Jasper, 2006). According to Rolfe et al. (2001), reflection does not merely add to our knowledge, it also challenges the concepts and theories by which we try to make sense of that knowledge. Acquiring knowledge through reflection is modern way of learning from practice that can be traced back at least to the 1930s and the work of John Dewey, an American philosopher and educator who was the instigator of what might be called ''discovery learning'' or learning from experience. He claimed that we learn by doing and that appreciating what results from what we do leads to a process of developing knowledge, the nature and importance of which then we must seek to interpret (Rolfe et al., 2001).
This assignment focuses on an incident which was experienced during a community placement. The patient suffered from bowel cancer, my mentor and I were visiting her to change her dressing. The names of people have been changed to ensure confidentiality Nursing and Midwifery Council (NMC, 2008). Gibbs (1988) cited in Jasper (2013) will be used as the reflective model because it is simple and, easy to understand. Through the model’s six key stages I will describe my experience and how I maintained dignity while giving personal care to patients in the community. Writing a reflective account makes one relive their thoughts and, feelings and make appropriate changes when required (Howaston-Jones, 2013).
In health care, there are many different approaches throughout the field of nursing. When considering the field of family nursing, there are four different approaches to caring for patients. This paper will discuss the different approaches along with a scenario that covers that approach. The approaches that will be discussed include family as a context, family as a client, family as a system, and family as a component to society. Each of these scenarios are approach differently within the field of nursing.