Nursing Care Study Essay

The aim of this nursing care study is to demonstrate that, as a student nurse, the writer is capable of developing and delivering the skills needed for assessing and addressing each individual patient’s care needs. Included in these set of skills, is the ability to develop critical thinking, decisive decision making and the ability to reflect on events so as to become a better health care provider. The patient in which the writer will discuss was based upon an eighty three year old man, pseudonym Mr.

Scott who was admitted into accident and emergency via a referral from his general practitioner presenting with exacerbation chronic obstructive pulmonary disease (COPD) with a history of congestive cardiac failure (CCF). On admission to accident and emergency Mr. Scotts’ team took arterial blood gases, ordered a pulmonary function tests and a chest X-ray.

Prior to the exacerbation of Mr. Scotts’ condition he regularly attended a cardiac clinic due to being a long term sufferer of congestive cardiac failure and also attended pulmonary function clinic for tests (pulmonary function tests).

Through these clinics Mr. Scott was educated on his medications and current condition. On admission of Mr. Scott, the writer decided to use the frameworks Roper Logan and Tierney (2000); Orem’s Self Care Framework (1995) and Gibbs (1988); which incorporates each tool of assessment known as, plan, implementation, evaluation, educate and reflection. Using the above frameworks, an improvement of Mr. Scotts’ current exacerbation of chronic obstructive pulmonary disease (COPD) was seen to have been resolved and a new evaluation of Mr. Scotts’ care was developed.

The chosen tool of reflection used is known as the Gibbs cycle of reflection. The writer applied this tool in order to evaluate the patient care. The rationale behind this was to attempt to fully understand reflection so as to apply this to everyday practice, thus improving as a student nurse. The Gibbs cycle involves a description of the incident, feelings and thoughts experienced plus the evaluation and analysis of the incident, conclusions and action plan (Gibbs, 1988). According to Barnett (2005) using a tool of reflection, to give an account of experiences in the clinical setting can aid the nurse to analyse and explore their feelings regarding patient care.

Main body

Eighty three year old Mr. Scott was admitted to accident and emergency with a referral from his general practitioner, presenting with a recurrent upper respiratory tract infection and a history of exacerbation of chronic obstructive pulmonary disease (COPD) and congestive cardiac disease. Due to his history of chronic obstructive pulmonary disease (COPD), Mr. Scott was sent for a chest x ray to assess the deterioration of his lungs due to his condition. (Alexander et al. 2009) Post admission into accident and emergency, Mr. Scott was sent to St. Pat, Thomas, Johns’ ward where the writer was working at the time as a student nurse.

The writer found, when assessing Mr. Scott, that he lived alone, locally, was a widower of ten years and had two daughters who also lived near by. Although Mr. Scott had many concerns, he also had a good social network such as the support of family and a home help package of six hours a week, which included meals on wheels. The local public health nurse also called to see Mr Scott on a social capacity. Presently the main health concerns which faced both Mr. Scott and his family were; the deterioration of his dyspnoea, related to his chronic obstructive pulmonary disease; pressure ulcers, due to developing pressure ulcers while in hospital in previous years and anxiety from both Mr. Scott and his family due to the unknown. Reassurance was given and they were explained what care he was to receive.

Issue # 1 Breathing.

The key feature of chronic obstructive pulmonary disease (Barnett, 2009) is that of experiencing breathlessness. Being breathless for most patients can be both a stressful and frightening experience, which can raise anxiety levels. In past studies, men predominantly more than women were found to be affected by chronic obstructive pulmonary disease (COPD); but in a recent study carried out by Meilan et al. (2007); research has found that cases of chronic obstructive pulmonary disease (COPD) are increasing in women world wide. The care Mr. Scott received was split in two, short term and long term care; both of which were constantly re-evaluated to maximise efficiency and quality of care.

As part of the short term care plan the writer ensured that the bedside was set up with suctioning equipment help prepared for potential complications. To avoid complications, for example tachypnoea (rapid breathing) which is found to be an early indication of respiratory distress (Jevon and Evens 2001); the golden rule of thumb, depth and rate of breathing was monitored and recorded accurately (Jevon, 2010). Further reducing the risk of complications occurring, Mr. Scott was encouraged to sit up in a semi fowler position while enduring deep breathing exercises enabling him to breathe with greater ease and comfort. The rationale behind this was supported by a study carried out by Duggan et al. (2005).

The long term goal was to ensure that an oxygen saturation level between 88%-94% is maintained (Alexander et al 2009). To monitor oxygen saturations levels, a pulse oximeter was place on Mr. Scott’s finger. The rationale for this is to detect oxygen absorption of haemoglobin (Plaice &Graham, 2000). A study carried out by Groeben (2003) shows that administering high concentrations of oxygen to patients with chronic obstructive pulmonary disease (COPD) will reduce the respiratory drive, resulting in respiratory depression. This finding gives rationale to why a low flow of oxygen therapy is given to patients with chronic obstructive pulmonary disease (COPD). Humidification was added to Mr. Scotts’ oxygen therapy to warm and moisten the gas (Jevon and Ewens 2001) promoting secretions while enhancing patient comfort (Woodrow 2005).The rationale for this is that oxygen is known to dehydrate exposed membranes in the upper respiratory tract.

Issue #2 Pressure ulcers.

According to Lawrence et al (2010), every individual’s skin changes with time, this is a normal process of ageing. With this change comes a decrease in its elasticity and turgor, therefore with age one has to ensure that vital care of skin is given in an attempt to avoid skin breakdown. Due to Mr. Scott being an elderly man of eighty three, the writer was concerned about skin integrity. A tool known as the water low score was used in order to assess the likelihood of Mr. Scott developing any pressure ulcers during his stay in the hospital (Whiteing 2009). As Mr. Scott had developed pressure ulcers in a past experience, he would have an increased chance of a re-occurrence. In an attempt to prevent this situation the writer requested that Mr.Scott be nursed on an air mattress. (Stafford and Brower 2009). Issue #3 safety and delerium

Anxiety is an emotional state influenced by past experience, which exists at a given point in time with a level of intensity related to an upcoming perceived threat (Passer and Smith 2007) The provision of information is extremely important to the patient as studies from, Biswajit et al. (2009) has shown that an informed patient with a good understanding of their condition reduces anxiety. Harvey (2002), recommend shared control in patient-practitioner interactions in that patients effectively participate in controlling important events. After liaising with Mr Scott’s’ medical team regarding his anxiety, a low dose of Alprazolam brand name Xanax 5mg, was charted and given in an attempt to relieve his anxiety. Alprazolam reduces anxiety within patients (De Witte, et al 2002).

Medical care administered

On admission to the ward Mr. Scotts’ medical team ordered pulmonary function tests. These tests determine what type and extent of restriction the patient is experiencing (Alexander et al 2009); furthermore indicating any increase/decrease in their condition (Daly 2009). Arterial blood gasses were checked in order to determine the amount of O2 to be administered reducing the risk of hypoxia. The rationale for taking arterial blood gases was to determine the bloods Ph and the O2 levels circulating within the blood. (Alexander et al 2009). A sputum sample was also attained from Mr Scott and sent to the lab for culture and sensitivity testing to trace which bacteria is present in the sputum so as to treat the infection (Gray et al 2008). Through reflection the writer recalled that oedema may be present in the lower extremities secondary to Mr. Scotts history of congestive cardiac failure and chronic obstructive pulmonary disease (COPD) and recorded the findings.

The rationale for this was that, Mr. Scott suffered with congestive cardiac failure which increased the risk of developing oedema while in juxtaposition, putting increased pressure on functioning internal organs (Morley et al. 2009). During the writers assessment of Mr. Scott it appeared that he was suffering from a sudden onset of dyspnoea, (laboured breathing). Using critical thinking, the writer administered oxygen therapy at maximum of twenty four percent and immediately informed Mr. Scotts’ team on his condition. The rationale behind administering low dose O2 is due to the fact that the hypoxic drive can be decreased by administering a large dose of O2 leading to respiratory failure and the worsening condition of the patient, (Simmons et al. 2004). Using the Gibbs reflection cycle, the writer believes students should be under constant supervision in order to attain the knowledge of administering O2 to patients diagnosed with chronic obstructive pulmonary disease.

The medical team looking after Mr. Scott prescribed an antibiotic called Tazocin (4.5grams three times a day) to be given intravenously. The rationale for administering this antibiotic was to attempt to fight any infection that the patient may have developed. Also prescribed for Mr. Scott was a steroid and bronchodilator. The rationale for charting a steroid and bronchodilator was that, they are found to decrease inflammation in the air way and also to open up the airway (Greenstein et al 2009). Due to Mr. Scotts’ condition he was a long term user of oral Corticosteroids. Studies (Walters et al. 2008) have shown that, corticosteroids reduce the need for additional medical therapy while, also shorting hospital stay.

On previous reflection (Gibbs 1988) as a student nurse, the writers’ knowledge developed due to reflection from previous patient care. The writer knew that due to Mr. Scott being on steroids, his blood sugar levels needed to be checked once a day as to ensure it stayed within the normal range. The rationale behind monitoring Mr. Scott’s’ blood sugar once a day was due to the side effects that are directly related to the administration of corticosteroids. Such side effects are as mouth ulcers, weight gain and increased skin thinning ( The writer encouraged Mr. Scott to rinse his mouth out with water post administration of oral steroids to reduce the development of oral ulcers or a candida infection of the mouth, (Greenstein et al 2009).

The Roper, Logan, Tierney (RLT) 2000 nursing framework aided the writer in focusing upon the care study. This model encompasses key factors such as social status, environmental factors as well as the physical/ psychological factors which influence people in their daily lives (Roper et al 1991; 2003, Newton 1991). This model is designed to be adaptable to any patient and not for the patient to adapt towards the model of nursing; therefore it allows the nurse to care for each patient on an individual level (Roper et al 2000).

Nursing can therefore be defined through this model in terms of helping people to prevent, alleviate, solve or cope with problems (actual or potential) when relating to the activities of daily living, (Roper et al. 1990).


Although the Roper Logan and Tierney’s’ model of nursing covers a holistic view, a model known as the Orem’s Self Care Framework according to Fawcett (1995) concentrates on the individuals’ self maintenance and regulation through a type of action known as self-care. This model could be seen as beneficial to Mr.Scott as a patient whom has been diagnosed with chronic obstructive pulmonary disease as a main part in maintaining good health is a good understanding/ communication, knowledge and education of how to care for ones’ self (Eva et al. 2009).

The aim of this piece of work was to assemble while using tools of assessment an individual care plan. This was to be drawn up together with the patient and the writer so the system of care would be of an individual status. The writer also aimed to demonstrate that with critical thinking and decisive decision making the patient involved received intervention when needed.

As the writer worked on the ward mentioned a strong therapeutic relationship had been built between patient and student nurse, this allowed the patient to feel at ease when asking questions regarding his condition enabling the writer to educate the patient at a higher understanding. Upon Mr. Scott’s discharge he expressed a better understanding of his knowledge about his condition, he also felt that if or when he experienced another exacerbation he would not feel as anxious and be better able to cope with it. Hearing this as a student nurse the writer felt that it had enhanced professional development for further nursing practice.

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Nursing Home Abuse Essay

Approximately 1.4 million elderly people reside in long term care facilities, such as nursing homes. The families that admit their loved ones to these long term care facilities believe that excellent care is being provided to them. Many of the residents in nursing home settings receive adequate health care, but a numerous amount of other residents are subjected to abuse and neglect. It is believed that nearly one-third of all nursing homes have residents that are subjected to abuse either by staff or other residents (Masters in Health Care).

Definitions of elder abuse vary. It is difficult to pinpoint exactly what actions or inactions constitute abuse. Besides a variety of definitions, the major types of abuse that occur in nursing homes are categorized into physical abuse, sexual abuse, emotional or psychological abuse, neglect, abandonment, financial or material exploitation. The solution to such nursing home abuse is rather simple. To prevent the inhumane treatment of the elderly in nursing homes, the nursing shortage needs to be addressed.

The scandal of elder abuse in nursing homes appears to be new phenomena, but in reality this god forsaken crime has occurred for decades. Due to an elder’s physical and cognitive make up, they are not able to defend themselves from the heinous acts of abuse by their caregivers. Abuse in nursing homes is mainly thought of as physical aggression, but the elderly are subjected to psychological abuse also. One would think that no man or woman could commit abuse onto a helpless individual; however the issue of elderly abuse in nursing homes has been a growing problem. In 2003, there were 20,673 complaints of abuse, gross neglect, and exploitation on behalf of nursing home and “board and care” residents (American Association for Justice). By 2010 the number of elderly abuse complaints rose to a number between one million and two million (National Center on Elder Abuse).

A study prepared by the staff of the Special Investigations Division of the House Government Reform Committee found that thirty percent of nursing homes in the United States (5,283 facilities) were cited for almost nine-thousand instances of abuse over a recent two year period. The common problems of the study included untreated bedsores, inadequate medical care, malnutrition, dehydration, preventable accidents, and inadequate sanitation and hygiene. These common problems can be categorized into the major types of elder abuse in nursing homes. Physical abuse, sexual abuse, psychological abuse, neglect, abandonment, and financial exploitation are considered the major types of such abuse.

Physical abuse is defined by the use of physical force that may result in bodily injury, physical pain, or impairment. Physical abuse may include but is not limited to such acts of violence as striking (with or without an object), hitting, beating, pushing, shoving, shaking, slapping, kicking, pinching, and burning. In addition, inappropriate use of drugs and physical restraints, force-feeding, and physical punishment of any kind also are examples of physical abuse (National Center on Elder Abuse). Nearly sixteen-percent of nursing home abuse cases involve physical abuse (Brent & Adams). An article published by ABC news interviewed Helen Love, a 75 year-old grandmother of three that was a victim of nursing home abuse. Helen told ABC, “He choked me and he went and broke my neck.

He broke my wrist bones, in my hand. He put his hand over my mouth.” Two days after the interview, Helen Love died. Nursing home officials did not report her beating to a state official who was at the nursing home at the time. Ultimately, though, Love’s attacker served a year in prison. An investigation revealed that he had been fired by two previous nursing homes for aggressive behavior. A report by the Senate Select Committee on Aging found that many nursing home abuse cases are not immediately reported to law enforcement official (Robinson). In fact, a recent report indicated that one in fourteen incidents of elder abuse where not reported to the authorities (American Association of Justice).

Emotional or psychological abuse is defined as the infliction of anguish, pain, or distress through verbal or nonverbal acts. Emotional/psychological abuse includes but is not limited to verbal assaults, insults, threats, intimidation, humiliation, and harassment. In addition, treating an older person like an infant; isolating an elderly person from his/her family, friends, or regular activities; giving an older person the “silent treatment” and enforced social isolation are examples of emotional/psychological abuse (National Center on Elder Abuse). Almost twenty percent of reported elder abuse cases involve emotional abuse (Brent & Adams). With emotional abuse being the most abundant, it is also the most difficult to define. Emotional abuse is purely subjective which therefore is difficult to reprimand nurses against these crimes. The other major crimes however are objective, and are more easy to identify, such as neglect.

Neglect is defined as the refusal or failure to fulfill any part of a person’s obligations or duties to an elder. Neglect may also include failure of a person who has fiduciary responsibilities to provide care for an elder (e.g., pay for necessary home care services) or the failure on the part of an in-home service provider to provide necessary care (National Center on Elder Abuse). According to Brent & Adams, twelve percent of abuse cases involve caretaker neglect.

Neglect typically means the refusal or failure to provide an elderly person with such life necessities as food, water, clothing, shelter, personal hygiene, medicine, comfort, personal safety, and other essentials included in an implied or agreed-upon responsibility to an elder (National Center on Elder Abuse). The Federal Bureau of Investigation published an article in May of 2012 about a case of nursing home neglect. The owner of three Georgia nursing homes, George Dayln Houser, was convicted in Atlanta of defrauding Medicare and Medicaid for $32.9 million dollars.

To receive Medicare and Medicaid payments, Houser agreed to provide his residents with a safe and clean physical environment, nutritional meals, medical care, and other assistance. Houser not only failed to maintain a nursing staff sufficient to take proper care of the residents but did not pay food suppliers or providers of pharmacy and clinical laboratory services, medical waste disposal, trash disposal, and nursing supplies (FBI). Neglect, alongside physical abuse, are the most detrimental to a residents health. Not only do caregivers subject their residents to the atrocious crimes of neglect, but they also exploit them financially and materially.

Financial or material exploitation is defined as the illegal or improper use of an elder’s funds, property, or assets. Examples include, but are not limited to, cashing an elderly person’s checks without authorization or permission; forging an older person’s signature; misusing or stealing an older person’s money or possessions; coercing or deceiving an older person into signing any document; and the improper use of conservatorship, guardianship, or power of attorney (National Center on Elder Abuse). In 2009, a Chicago nursing home worker faced financial exploitation and aggravated identification theft charges for allegedly stealing $4,008 from a Illinois nursing home. The criminal remained free on bail and was fired from the Illinois nursing home. Authorities acknowledge that the criminal had a previous criminal conviction for forgery (Nursing Home Blog).

The major types of nursing home abuse have a direct correlation to inadequate staffing levels. A recent statistic by the American Association for Justice, found that ninety-percent of United States nursing homes had staffing levels too low to provide sufficient care. Residents of those nursing homes falling below minimal staffing standards are much more likely to develop bedsores and experience excessive weight loss than those in other nursing homes. This is because enough staff must be available so that all residents who cannot eat by themselves receive help. Also, unless immobile elderly residents are repositioned frequently, they may develop bedsores. To add to the problem, understaffing contributes to low morale and frustration among employees, decreasing their ability to deal with residents patiently and respectfully.

According to the American Association for Justice, a series of reports revealed that many nursing homes do not have enough staff to meet the levels recommended by federal officials (3.45 nursing hours per patient daily) and nursing home experts (4.55 nursing hours per patient). Insufficient hours per patient hosts all sorts of potential problems for nursing care, the most problematic being neglect.

Many nursing home residents need constant nursing attention to ensure that they do not develop medical problems. In many cases, residents need to be turned, moved, or given skin assessments to avoid developing pressure ulcers or from forming deadly blood clots. John A. Fisher, Ph. D, said there have been an alarming amount of recent cases in which New York nursing homes have been found liable for elder abuse after a resident died or was injured due to inadequate care. In every case, inadequate staffing was named as a contributing factor to the cause of the abuse. With inadequate staffing being the undeniable cause of nursing home abuse, how does the projected nursing shortage effect this issue?

The projected nursing shortage in the United States is expected to intensify as baby boomers age and the need for health care grows. “In the July/August 2009 Health Affairs, Dr. Peter Buerhaus and coauthors found that despite the current easing of the nursing shortage due to the recession, the U.S. nursing shortage is projected to grow to 260,000 registered nurses by 2025. A shortage of this magnitude would be twice as large as any nursing shortage experienced in this country since the mid-1960s. In the article titled The Recent Surge In Nurse Employment: Causes And Implications, the researchers point to a rapidly aging workforce as a primary contributor to the projected shortage (American Association of Colleges of Nursing).”

In some instances today, nurses are forced to attend to 20 patients at a time, and that is at the lower part on the nurse- patient spectrum. Federal law requires Medicare and Medicaid certified nursing homes to have an registered nurse (RN) director of nursing (DON); an RN on duty at least 8 hours a day, 7 days a week; and a licensed nurse (RN or LPN) on duty the rest of the time. However, there are no minimum staffing levels for nurse’s aides, who provide most of the day-to-day care. Instead, nursing homes are required “to provide sufficient staff and services to attain or maintain the highest possible level of physical, mental, and psychosocial well-being of each resident. (Elder Law Answers)” If a nursing home met only the federal nurse staffing requirements described above, a resident would receive 20 minutes of nurse time per day.

In 2000, the Centers for Medicare and Medicaid Services (CMS) reported that the preferred minimum staffing level was when nursing home residents received three hours of total staff time per day — two hours of nursing assistant time and one hour of licensed nurse time. The optimum staffing level, according to the CMS, is one hour of licensed nurse time and three hours of nursing assistant time (Elder Law Answers).

Most states have standards that are higher than the federal requirements, but still fall short of the levels recommended by the CMS. According to a recent study, the key to improving nursing home staffing levels is increasing state standards. The study by Charlene Harrington, a UCSF School of Nursing professor, found that states with the highest standards for nursing staff levels are the only states where nursing homes have enough staff to prevent serious safety violations. According to the study, the act of raising the state minimum staffing ratio has a direct impact on the quality of care nursing home residents receive. With such an impact that state and federal standards have on quality of care, how can the state enforce nursing homes to follow such mandates?

According to an article published by nursing home reality endorsed by Aaron Delurey, the best way to ensure that residents are receiving an ample amount of care is for state officials to introduce these three procedures: Have each state mandate an increase in the percentage of surprise inspections that must take place outside of regular business hours on weekdays. Second, require management personnel to work staggered shits all the time, not just when the state is in their building. Why require this change?

When the management is out of the building the quality of care given often suffers. Third and foremost, when the state shows up for an any kind of inspection, the inspectors should immediately seize the payroll data to verify staffing levels for the 14 continuous days immediately prior to the inspection. The inspectors should also insist that while they are in the building that no additional staff can be called in. These procedures would ultimately address the nursing shortage, therefore depleting the abuse within nursing homes.

Pros and Cons of Sending Parents to Elderly Nursing Homes Essay

Many adults have elderly parents who could benefit from living in a retirement home. However, it’s hard to decide to send an elderly parent to a retirement home because there are several other care options available. Furthermore, this decision can be made more challenging because most retirement homes have several pros and cons that should be fully considered beforehand. Here is a brief look at some of the most important pros and cons to consider before finding an elderly parent the right retirement home.

Perhaps it can help you make a more informed decision about entering a retirement home.

On one hand, sending an elderly parent to a retirement home provides elderly people and their families several benefits that are hard to overlook. Many people think it’s a good idea to enter a retirement home because most retirement homes provide many benefits that are hard to pass-up. For example, the biggest benefits that retirement homes provide to residents include around the clock supervision, expert on-site medical care, and individualized help with daily needs.

At first glance, these benefits can make a huge difference in the lives of elderly people because they can make their lives more enjoyable.

However, many people tend to forget that retirement homes also offer other benefits that are often overlooked by people. Here are some of the most common benefits that retirement homes provide to residents and their loved ones. One of the most overlooked benefits retirement homes provide to residents is a structured environment. Elderly people often need a more structured environment as they grow older. This is especially true if they are mentally or physically disabled because it helps them lead a more normal and happy life.

Furthermore, elderly people also tend to be more distracted by changes to their environment. Most retirement homes understand this. That’s why they try to set up a daily schedule that helps their residents lead a normal life. This structured schedule includes set meal times, scheduled activity times and other repetitive activities. Another overlooked benefit of retirement homes is a chance to remain as independent as possible. This benefit will be especially important to Baby Boomers because it will help them still lead the independent life style that their generation is so used to enjoying.

This will help them still enjoy living to its fullest because it will allow them still do most of the things they enjoy doing. Finally, many people also tend to forget that retirement homes also help elderly people’s families deal with the logistics of caring with an elderly loved one. Many of us have elderly loved ones that need more help than what we can provide by ourselves. This is true because many of us have jobs and other responsibilities that make it difficult for people to take care of an elderly loved one who needs help with daily activities.

As a result, retirement homes also provide several care options for families who need extra help helping their elderly loved ones. On the other hand, sending an elderly parent to a retirement home also poses several potential problems that also need to be considered. Here are some of the most common problems that people encounter: Paying for a retirement home’s services can be difficult for many people because most insurance policies and Medicare coverage plans generally deny covering the cost of living in a retirement home.

This can make it difficult for many people to afford a retirement home’s services because many retirement homes charge high monthly fees to residents. In fact, many retirement homes charge “A la Carte” rates that tend to be expensive because they give consumers more freedom to buy only the services they need. These pricing plans are convenient. However, they also make it more difficult to afford living in a retirement home because many people cannot afford to play for services using these pricing plans.

Many elderly people and their families also have problems finding retirement homes that provide top quality care because many retirement homes have difficulty finding qualified staff who can work with elderly people. Furthermore, many elderly people’s families have also had difficulty with staff members who are unwilling to work with clients’ families to resolve concerns. These problems can make it very frustrating to find the appropriate retirement home because it can be difficult to find a retirement home that has a staff that is willing to answer consumer’s questions about their services.

Finally, many people also forget that some elderly people have trouble living in a retirement home. This is true for many reasons. For example, some elderly people are so independent that they have a hard time accepting help from others. Other elderly people have problems living in a retirement home because they have a hard time getting along with certain staff members because of personality differences. These problems can make it difficult for many elderly people to live in a retirement home because their personalities make it hard for them to live in some living situations.

As you can see, there are many pros and cons to consider before entering a retirement home. This makes it important to research all of your care options before selecting the right option for your elderly loved one. Doing this will not only help you make a more informed decision for your loved one, it can also make a real difference in your elderly loved one’s overall quality of life. As a result, be sure to explore the pros of cons of entering a retirement home to see if retirement homes are your elderly loved one’s best care option.

Pediatric Nursing Essay

A pediatric nurse must offer the proper maintenance care to a child. Depending on the specific pediatrics office or environment that they work, most accurately define the roles that they are to assume. In pediatrics nursing, the nurse is responsible for the developmental screenings. Part of this aspect includes measuring the height, weight, and other preliminary measures that mark a child’s growth and development. Nurses in pediatrics are often responsible for collecting laboratory samples.

A pediatric nurse will also perform further routine tests and screenings such as checking a child’s temperature, heart rate, blood pressure levels, and respiratory rates.

He or she may be responsible for conducting the more basic eye exams, as well. A pediatric nurse is also in direct contact with the parents, so they are to offer the parents the support that they need. In pediatrics nursing, a pediatric nurse may be instructed to interpret laboratory results. Those nurses that work in acute care pediatrics may also conduct in depth physical assessments of any given child.

There are several ways become a pediatric nurse.

You can become a LPN, an RN, or obtain your Bachelor’s in Nursing. A Licensed Practical Nurse (LPN) takes approximately one year. Your scope of practice varies with the state that you live in. In my state, Indiana LPNs cannot start IVs, but can give medications, with the exception of a few specific medications. While the track to becoming an LPN is the shortest, your opportunities are also limited. For example a lot of hospitals are not hiring LPNs so they are limited to nursing homes. A Registered Nurse (RN) is the next type of nurse that you can become. Typically, this takes approximately two years to achieve.

Nurses who go through a RN program receive either a nursing certificate or an associate’s degree in nursing (ADN or ASN). Registered nurses can work in many areas and have a wide range of privileges. RNs are the most flexible when it comes to areas in which you can work. Another option is to complete a four-year program in nursing which gives you a bachelor’s Degree in Nursing in addition to an RN license. More and more facilities prefer nurses with their BSN. To obtain your BSN you can either go to a four-year college or you can obtain your RN and then go to a bridge program and obtain your BSN.

After obtaining the option of nursing you desire the next step is becoming a pediatric nurse. One of the easiest ways to become a pediatric nurse is to apply to work in a site that serves pediatric patients and receive your specialized training there where you work.

The hospital where I hope to work offers a 3 month intern program for new nursing graduates that include both classrooms and clinical training specifically in pediatrics. Becoming a Certified Pediatric Nurse (CPN) once you have graduated, you can also take an exam to become a Certified Pediatric Nurse. There are also special classes that address Pediatrics. These include Pediatric Advanced Life Support (PALS) through the American Heart Association, the Emergency Nurse Pediatric Course through the Emergency Nurses Association (see: www. ena. org), and Emergency Medical Services for Children.

An Exploration of a Needs Orientated Approach to Care Planning Essay

The purpose of this assignment is to explore a needs orientated approach to care planning, through the use of a problem solving approach to care, and a nursing model. It aims to show an understanding of what both a problem solving approach to care, and a nursing model are; and to establish how various key elements of both are implemented in practice.

The following citation by the Department of Health (DH) (2009) identifies what is intended by the process of care planning; Personalised care planning is essentially about addressing an individual’s full range of needs, taking into account their health, personal, social, economic, educational, mental health, ethnic and cultural background and circumstances.

In order for the care planning process to be effective the need for both a problem solving approach to care and a nursing model is fundamental.

The problem solving approach which will be discussed within this assignment follows the format of Assess, Plan, Implementation and Evaluation (often referred to as APIE) developed by theorists; Yura and Walsh in 1967.

APIE offers a structured, systematic approach to nursing practice through the use of the methodical care planning stages highlighted above (Barrett et al, 2009).

Nevertheless, broad literature research suggests that this process lacked effectiveness in meeting the holistic needs of the individual and so, the process was adapted to include two further stages known as; Systematic Nursing Diagnosis and Recheck to produce the acronym ASPIRE (REF). However, these amended stages will not be discussed widely within this assignment, and so the process of APIE will be referred to throughout. The nursing model developed by Roper, Logan and Tierney (RLT) in 2000, is one of several extensively criticised models commonly used in practice; to enable the facilitation of a holistic approach to care.

The purpose of a nursing model is defined by Barrett et al as; Models give direction to the nurse about the patients and their needs and define nursing roles derived from the views, beliefs and values about people, health, the environment and nursing (Barrett et al, 2009 p. 42). As previously identified, RLT are keen to adopt an holistic approach to care as oppose to other models which only take into account a patients needs from a medical perspective.

The RLT model has been acknowledged to reflect the current realities of healthcare within the United Kingdom (Barrett et al, 2009), consisting of five underlying concepts; Activities of Living, Lifespan, Independence-dependence continuum, factors influencing AL’s and individuality which (Roper et al, 2000) clearly state are interrelated with one another to emphasise the importance of holism. Pearson et al, along with many other nursing authors, highlight the significance of agreeing on a nursing model to be used together with the problem solving approach to develop an individualised care plan efficiently.

Pearson et al (2005 p. 84) indefinitely state; ‘the ‘process’ cannot happen without an agreement on nursing’ as, whilst APIE provides the systematic framework as to how the care plan should be devised, the nursing model effectively identifies what should be considered at each individual stage (REF). The Royal College of Nursing (RCN) also supports the utilisation of a nursing model alongside a problem solving approach, in identifying that; It facilitates consistent, evidenced-based nursing care, and necessitates accurate, up-to-date care documentation (RCN, 2011).

This assignment will also discuss how the RLT model and the problem solving approach are used to meet the biopsyhosocial needs of an individual, and also the strengths and limitations of using RLT’s model and a problem solving approach in relation to developing a care plan. An exploration of how the implementation of the RLT model and a problem solving approach allows the multidisciplinary teams (MDT) to use the approach to meet public health needs, will also be explored within this assignment.

To support such discussions, a range of knowledge gained throughout this module and previous programme themes, as well as a formative care plan developed for a fictional patient known as Mabel Dunn (see appendix A); will be utilised effectually. Through the exploration of each stage of the problem solving approach in turn, and how RLT is utilised alongside this process, enables an extensive in depth analysis to take place whilst using the formative care plan as reflective material to support the discussion. Assessment is the initial stage of the nursing process.

Roper et al consistently use the term ‘assessing’ to signify that it is an on-going process, and highlights its continuity throughout the patient’s episode of care (Aggleton & Chalmers, 2000). It is divided into two stages to allow for a holistic representation of the patient to be established (Barrett et al, 2009). Effective assessment allows the prompt identification of any changes in a patient’s health status, and if necessary; allows any action to be carried out immediately supporting the delivery of safe, effective care DH ().

The formulation of an accurate assessment is a fundamental skill for a student nurse as outlined by the NMC (2004), and so it is important that a holistic approach is adopted for this skill to be achieved. An holistic approach supports the consideration of…….. needs,(THEME? ) which Pearson et al (2005) accentuates that without the holistic consideration of a patient’s needs; it could lead to an inaccurate representation of the individual.

RLT portrayed their understanding of a holistic approach through the use of the 12 Activities of Daily Living (ADL’s); as they believe a patient is best understood in terms of how they carry out the ADL’s (Holland et al, 2003). The 12 actvities (AL) of daily living act as a framework in the assessment process by providing a means of categorising the information in a systematic format (ppt presentation). Barrett et al (2009, p. 45) clarifies; Each activity represents a particular type of behaviour that all of us carry out on a day to day basis, whilst interacting with each other and our environment.

The idea surrounding the ADL’s was derived from the Human Hierarchy of Needs developed by psychologist Abraham Maslow in (), by offering a representation of the common elements of everyday living that ensure human survival, and also quality of life (Barrett et al, 2009/pearson?? ). Despite the main focus of RLT’s model been holism, it has been extensively criticised in meeting the holistic needs of patients in the past, as practitioners have used the ADL’s in a checklist format (Barrett et al, 2009) even though the use of the ADL’s has been stressed to be used in a broad format, to enable a comprehensive assessment to be sought effectively.

This could potentially cause further complications…. It is for this reason as to why the proficient skill of assessment is fundamental before becoming a competent practitioner as, without a comprehensive assessment the patients’ needs will not be considered from a holistic perspective, and consequently the model will not be used for its principal purpose. Holland et al (2003) highlight that the 12 ADL’s can interrelate in many different ways and therefore potentially impact on one another encouraging an holistic account of an individual’s needs.

As a practitioner it is important to understand that the ADL’s can interrelate with one another and therefore influence on each other http://www. dh. gov. uk/en/Healthcare/Longtermconditions/DH_093359 (DOH, 2009) . A holistic approach supports that only taking into consideration the individuals physical needs during assessment as oppose to the human being as a whole; could potentially lead to an inaccurate representation of the individual and therefore lead to difficulties in meeting the patients’ needs effectively (Pearson et al, 2005).

The quality of assessment will be greatly enhanced by the participation of the client and carers to the assessment process ensuring that the client’s wishes are foremost and, wherever possible, the client’s own words are used to reflect their needs RCN It also decreases the potential for, or the severity of, chronic conditions and helps the individual to gain control over their health through self-care.

RCN The Nursing and Midwifery Council (NMC) emphasise the importance of the ability to effectively assess, plan, implement and evaluate care, forming the basis for the standards of proficiency as a student nurse (NMC, 2004). The concept of individuality is constantly emphasised by theorists as been crucial in the implementation of holistic care, and therefore stress the importance of taking a patient centred approach to care planning which will be discussed at a later stage within this assignment.

Nurses have a major role in promoting health and well-being, as well as preventing disease and Roper et al see this as been an essential factor in the model for nursing (Roper et al 2000, p. 102) cited in (Holland et al, 2003) As previously stated, the stages of APIE interrelate in a cyclical context to allow for the establishment of a holistic, needs orientated approach to care delivery. The next stage known as Systematic Nursing Diagnosis was adapted due to criticisms of the approach lacking the concept of holism; one of the main focuses of the RLT model of nursing.

Barrett et al (2009) accentuate how a nursing diagnosis differs from that of a medical diagnosis by establishing that; it places emphasis on a patients holistic needs, and so takes into consideration the physical, psychological, social and spiritual inferences of having a specific medical diagnosis. Hesook (2010, p. 200) also supports this statement in that; ‘health problems that are the referents of nursing diagnosis have been conceptualised from nursing perspectives in a variety of ways. Systematic nursing diagnosis can therefore be used resourcefully with RLT’s nursing model by allowing the nurse to reflect on the assessment stage formerly carried out, before beginning the planning stage to clarify the problems highlighted within the previous stage.

Hogston & Marjoram (2006) acknowledged the fact that the original nursing process; APIE discussed in this assignment lacks this stage, arguing that the nurse does not have time to reflect on the assessment stage of the problem solving approach which affects the thoroughness of the care planning approach which could potentially lead to…. ??? look at a limitation of SND… ADD example of Mabel Dunn… Planning Planning is the second stage of APIE and is also a multistage process which Barrett et al (2009) consider to involve the development of the care plan itself; based on information gathered within the former two stages. According to Within this stage, the nurse is accountable for setting appropriate goals and prescribing the relevant care to a patient to meet their holistic needs.

Nursing Exemplar Essay

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 blind. Lynda also lived in an apartment for assisted living, and her only support that was occasional present was her brother, Steven. That first day I have Lynda, she was started on a full liquid diet. It quickly became clear that she was aspirating food.

She was very angry with me after I took away her first real meal she was having in 5 days.

After the physicians came to see Lynda and she had a swallow evaluation preformed it was decided that the best option for Lynda would be to have a percutaneous endoscopic gastrostomy (PEG) tube placed, for feedings. Lynda was added to the schedule and had her PEG tube placed that day. She was not happy with me and blamed me. I explained to Lynda why she needed to have the PEG tube, she told me that she understood why, but just wanted to go home. I told her that we just had to look at this as another path she had to take in order to get home.

I told her that if she was able to care for her tracheostomy that a PEG tube would be nothing. It was at about this point I learned that even though, she had already been on our floor for almost a week with what would be a permanent tracheostomy no one had yet taught her to suction herself. As they were calling for her to go downstairs for the PEG tube placement, I assured Lynda that she was strong and that she would be able to do this. I told her that I would be there when she came back, and I would be there all week to teach her. With that Lynda felt confident and off she went.

As Lynda was having her PEG tube I was thinking about all the questions I had about Lynda. I started reading her history and physicals, and the clinic reports. The first clinic appointment she had was when she came in almost one week ago. At this visit she was told that she was not breathing adequately enough and it was because she had a large tumor that was starting to block off her airway. She was told that she need to have a tracheostomy and soon before it would close off her airway, and then she had two options radiation so see if it would shrink the tumor or surgery to remove the tumor.

She agreed to have the tracheostomy and planed to have surgery as it was explained to be her best option. It really didn’t say if Lynda understood the full extent of the surgery she would have, she just saw it as something she had to do and then she could go home. While waiting for Lynda to come back I met her friend Sister Mary. Sister Mary told me all about Lynda, about how she has known her since she was a teenager and all the hardships that Lynda has gone though.

Of the many things I learned about Lynda from Sister Mary was that Lynda was a trooper and she would be able to care for her tracheostomy and PEG tube. As my shift came to an end, and Lynda was still in recovery. I decided to write Lynda a note that state for her to get some rest because we had a busy day ahead of us tomorrow. Day two, my mission was to teach Lynda the basics of self suctioning. As I walked into her room this morning she was all smiles and told me she was ready to learn. We started with the basics showing and explaining her tracheostomy tube and the suction catheters to her.

I then gave her a dummy doll we teach patients how to suction on, and she was able to show all the correct steps that I have taught her on the dummy. At this point in the day after lots of practicing Lynda was able to remove the inner cannula tube of her tracheostomy and clean it. 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 seen in the last three days, and from what I heard hadn’t even come to visit Lynda at all. I voiced my concerns with this to the physicians, and told them she has shown myself and other nurses her ability to care for herself, and maybe they should suggest that her brother come in and see her care for herself. I had their attention, and they called the brother to tell him all that she has done and suggested that he come in to see her new abilities because they would like to send her home.

Before I left that evening I told Lynda about what the physicians had said and about her brother’s fears. I told her that it was now her time to shine if she wanted to go home and that I believed in her. After being off for two days, I was so delighted to hear that Lynda was going to go home that day. Lynda requested to have me be her nurse that day, from what I gathered she had been asking where I was. Her discharge went off like a breeze, everything fell right into place. Lynda told me that she was going to miss me, and I told her she would see me soon enough. She was coming back for her surgery in two weeks.

When Lynda came back for her surgery, she had wrote me a letter, telling me that I was more that her nurse, I was her friend and that she was grateful I believed in her. Lynda had become a more difficult patient to have after her surgery, and she would need frequent encouragement to perform the tasks that we already knew she could do. It took Lynda a period of time to realize that all the nurse’s and not just I knew that she could do all these things. Once Lynda realized that it was her choice and responsibility, she started suctioning and feeding herself again.

Even to this day Lynda comes to visit me on the floor when she comes in for her clinic visits. I always get a big hug and smile from her. She reminds me that the things I do every day as a nurse make such a positive impact on my patients. This experience taught to trust my instincts and to believe in my patients. I am no longer afraid to speak up with it comes to advocating for my patients. My role as an advocate for Lynda helped her to obtain her main goal of going home. I was able to offer support, guidance, and knowledge to help ensure that she would be able to care for herself in a safe manner.

Competency in Information and Technology Literacy Essay

The dynamic changes in information technology has advocated for nurses highly qualified in nursing informatics. This paper discusses some barricades allied to the employment of essential Nursing Informatics competencies into undergraduate nursing websites. Introduction Information Literacy is the set of skills needed to discover, repossess, evaluate, and use information. The Changes in information technology have led to new changes in the way nurses operate on patients. These nurses have to undergo various competencies. This paper discusses the changes and the required competencies.

Discussion Information literacy is important in the nursing researches and practical working with the nursing informatics equipment. It is not just for students to learn but for practicing nurses and other healthcare practitioners as well. The practice of nursing in which the nurse makes medical decisions based on the best existing research proof, his or her own clinical expertise, and the needs and inclinations of the patient is referred to as evident based nursing. The nurses should learn to practice Information system to design and maintain their healthcare information.

For instance, PDAs (Personal Digital Assistant or Patient Data) could allow nursing scholars to access various decision support systems that would offer them with professional guidance relating to specific care and treatment matters at their patient’s bedsides. There are various sources where one can learn about information literacy and find ideas about relationship between them. These include the website, libraries, journals, electronic full-text for nursing, that is, books, journals, virtual libraries, other articles and databases.

To evaluating a website containing medical records, determine the website goal; discover the website objectives; website content description, evaluation questions, sources of evaluation data, methods of data collection. The steps performed are performed systematically. First and foremost, find out if the results have been reproduced in other research laboratory or by other scholars. Next step involves an attempt to conclude the study’s credibility.

Look keenly at the material of study that is, if investigators essentially compare two sets of topics or did they just make bservations? If a control was used were the group results comparable? Evaluate the criteria used to conclude this study. Consider the modification and duration of the study. The next step is to look at the conclusions. Consider if they are warranted by the evidence. If one can’t find useful solutions in the website, then it is time to address some questions like: does one have to take illegalized results? How does one know that the product in question is the right one? If the product is or could be the right one, then, what guarantees this?

Moreover one must to know more information on the product. Any information that is relevant should be taken into account. If the person still decides to take the product, he or she should be sure to tell the doctor who can make observation on the side effect about the product. Conclusion Nursing informatics is very important in today’s dynamic technological application. It is very important for nursing professionals to have the knowledge of nursing informatics as this will help them to participate fully in the technology enabled nursing.

First Lady of Nursing: Virginia Henderson Essay


Virginia Henderson has made an everlasting imprint on society. With her various degrees and teaching settings, Virginia was a very knowledgeable nurse who helped other young nurses into their roles in the health care industry. She was not only a teacher and student, but also a researcher. Because of her many roles in nursing, the books she has written and revised cover a wide span of information. Although this may intimidate some, Virginia wrote for a general audience so that all could learn how to take care of a sick loved one.

She defined nursing, so that the whole population could have a universal definition. She pushed for the roles of nurses to be clearly defined so that hospitals would be able to see all a nurse could or could not do, making a safer environment for the patient. Because of all her work, Virginia Henderson is one of the most well-known nurses in history.

Key Words: Virginia Henderson, Need Theory, Definition of Nursing

A look Inside the First Lady of Nursing: Virginia Henderson

After a long hospital stay a patient hopes to go home and care for themselves; this was not always the case until Virginia Henderson revolutionized the nursing industry.

Virginia grew up with a great education and went to school for many years, giving her an extensive span of knowledge that allowed her to make her mark on nursing. Although nursing is a forever changing occupation with new innovative technology always arising, Virginia Henderson has made a lasting mark on nursing with her “Need Theory” and her many books, teaching nurses worldwide the concepts of health promotion and disease prevention.

Henderson began her life in Kansas City, but she was only there for a short four years. Born on November 30, 1897 Henderson became the fifth child of what would be eight. Her parents, Lucy Abbot Henderson and Daniel B. Henderson, came from a background of educators and scholars. In 1901, at the age of four, the Henderson’s relocated to Virginia, where Virginia would finish her maturing (Halloran, 2007).

Through a developed impulse to help the sick and wounded military personnel, Henderson began her journey of nursing. Beginning her education at a young age of four under William Richardson Abbot, a figure named “grandfather”, Virginia Henderson grew to be a well-informed individual as she continued her schooling. Although she attended school, Virginia’s education did not produce a diploma, which hindered her entrance into nursing school (Halloran, 2007). In 1921, Virginia graduated the Army School of Nursing, located in Washington D.C and continued her journey as a nurse by accepting a position as a staff nurse at the Henry Street Visiting Nurse Service. After briefly working here, Henderson began her role as a teacher. Working back to her roots, she taught at Norfolk Protestant Hospital in Virginia (Anderson, 1999, p. 9). Here, Virginia was the first and only teacher in the school of nursing (Halloran, 2007).

Although she was not done with her role as teacher, she decided to let another do the teaching when she went back to school at Columbia University Teachers College to complete her Baccalaureate and Masters degree in nursing. After accomplishing these goals in her career she again went back to educating young nurses at the Teachers College from 1930 to 1948 (Herrmann, 1996, p. 19). Throughout her role as an educator, Henderson saw the need to teach young nurses not only clinical skills, but also analytical skills to help them succeed as nurses (Anderson, 1999, p. 9).

As her years of teaching came to an end, Henderson took on the role of researcher associate at Yale University in 1953 (Herrmann, 1996, p. 19). The research, named the National Survey of Nursing, conducted was “designed to survey and assess the status of nursing research in the United States” (Halloran, 2007). Later on in life, after the completion of her Nursing Studies Index, Virginia began to see the world as she “embarked on an international schedule of consultation” (Herrmann, 1996, p.22). With all this knowledge she was able to write and revise many books that would keep her name alive even today.

Another major part in Virginia Henderson’s career is the work that will survive forever, her books. While teaching at Columbia, “she revised Bertha Harmer’s Textbook of the Principles and Practice of Nursing, which was published in 1939” (Halloran, 2007). Starting in 1948, she began to revise the fourth edition of the Principles and Practice of Nursing, which took her five years to write. Although the title may fool the reader that this book was not meant only for nurses, “it is written for anyone who is faced with the prospect of caring for another human being”. Her earlier works were greatly influenced by all she had gained as an instructor of clinical nursing (Halloran, 1996, p. 20). Creating the first annotated index of nursing research, Henderson began her four volume Nursing Studies Index in 1959 and completed it after twelve years (Halloran, 2007).

This volume was “an analytical and historical review of nursing literature from 1900 to 1959” (Tlou, 2001, p. 241). Henderson continued to write as she progressed in years. She wrote Basic Principles of Nursing Care in 1960, Nursing Research: A Survey and Assessment in 1964, and the Nature of Nursing in 1966 (Herrmann, 1996, p.21). The beginning of her sixth edition of the Principles and Practice of Nursing started when Virginia was seventy- five, in the year 1972. In the book she argues that “health care will be reformed by the individual nurses who will enable their patients to be independent in health care matters when patients are both educated and encouraged to care for themselves” (Halloran, 2007). Although her books have a great influence on us, the thing that makes her most well-known is her definition of nursing and the Need Theory.

With her contribution of her Need Theory, Henderson taught other nurses what she believed was the true meaning of nursing: to assist an individual to become more independent on the road to health. Henderson defined nursing as “helping people, sick or well in the performance of those activities contributing to health or its recovery, or to a peaceful death, that they would perform unaided if they had the necessary strength, will, or knowledge” (Halloran, 1996, p. 23). In her basic needs theory Henderson defines the roles of a nurse by explaining that a nurse should help or provide conditions under which the patient can do the following unaided: 1. Breathe normally.

2. Eat and drink adequately. 3. Eliminate body wastes. 4. Move and maintain desirable position.5. Sleep and rest. 6. Select suitable clothes – dress and undress. 7. Maintain body temperatures within normal range by adjusting clothing and modifying environment. 8. Keep the body clean and well groomed and protect the integument. 9. Avoid dangers in the environment and avoid injuring others. 10. Communicate with others in expressing emotions, needs, fears, or opinions.11. Worship according to one’s faith.

12. Work in such a way that there is a sense of accomplishment. 13. Play or participate in various forms of recreation. 14. Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities. Henderson wanted to define nursing because she feared that some states didn’t have a true definition of nursing, which could lead to an unsafe environment for patients. In order to solve this issue she believed that nursing should be defined in the Nurse Practice Acts that would clearly state a nurses roles (Anderson, 1999, p. 10). Even though she defined nursing as this, she still saw acknowledged that nurses were given a stereotype.

Virginia Henderson had an ideal of what nursing should be and who they were. She believed that nurses during her time were not able to give the care that they thought would help the patient (Henderson, 2006). Virginia believed that because nurses came from all classes in society that the public had a confused definition of what a nurse was. She saw that the image of a nurse was influenced by the fact that most were women, who were not well educated from a privileged social class.

Virginia Henderson saw nurses as the ones who provided the most intimate and comforting service as they are the ones who are continuously with the patient, because of this she saw nurses as independent practitioners. She identified a nurse as someone who would have to be able to work with all ages of people in order to provide for their needs and help them live a life as normally as possible (Henderson, 2006). In order to fix the stereotype and lead members of society to truly see how important nurses were, Henderson thought nurses should be educated in a certain way.

Henderson also believed that nurses should be prepared in national, provincial or state systems of higher education (Henderson, 2006, p. 25). She thought that nursing students should work with other people in the health fields in order to create an interdisciplinary learning environment. She also believed that nurses needed an understanding of government and economics (Henderson, 2006, p. 26). She thought that nursing students should be assigned to practitioners, where they would first observe and then participate until they can function independently.

She thought nursing should be taught in stages. The first stage would be geared toward studying the basic human needs or functions and helping patients with daily activities. The second stage would be devoted to helping patients with common dysfunctions. The third stage would be studying the different stages of life and the specific help that is needed for a particular disease. She also thought that nursing students should be taught in a multitude of settings (Henderson, 2006, p. 30). If each of these principles were followed Virginia believed nurses would get the education they needed and be respected.

Without the ground-breaking research and ideas contributed by Virginia Henderson, nurses today would not be taking care of patients in a style allowing them to succeed after recovery from the hospital. Virginia passed away on March 19, 1996. Although she may be gone from this world she is still with us through her books and her theories.

Anderson, M. (1999). Virginia avenel henderson: A modern legend. Wyoming Nurse, 12(1), 9-10. Halloran, E. J. (1996). Virginia henderson and her timeless writings. Journal of Advanced Nursing, 23(1), 17-24. doi: Halloran, E. J. (2007). Virginia henderson 1897- 1996. Retrieved January/31, 2013, from Henderson, V. (2006). The concept of nursing. 1977. Journal of Advanced Nursing, 53(1), 21-31;
discussion 32-4. doi: 10.1111/j.1365-2648.2006.03660.x Henderson, V. (2006). Some observations on health care by health services or health industries. 1986. Journal of Advanced Nursing, 54(1), 1-2; discussion 2-4. doi: 10.1111/j.1365-2648.2006.03829_1.x Herrmann, E. K. (1996). Virginia henderson: Signature for nursing. Connecticut Nursing News, 69(5), 1. Tlou, S. D. (2001). Nursing: A new era for action. A virginia henderson memorial lecture. Nursing Inquiry, 8(4), 240-245.

The Difference Between an Licensed Practical Nurs and Registered Nurse Essay

It takes a lot of courage to let go of what is known, familiar, and comfortable. Change is a driving force in everyone. Like a butterfly, individuals in the nursing field may go through similar stages of metamorphosis, which is a process of growth, change, and development, (Wikipedia Foundation, 2006). Nurses have a vast amount of opportunity for growth and change in the healthcare field. The nursing profession has often been viewed as target of change rather than a force that proposes, leads, and implements change”(Habel,2005).

Many individuals are choosing to evolve and expand their careers and obtain their bachelor’s degree in nursing. While the Licensed Practical Nurse (LPN) performs much of the same skills, the student professional nurse must refine his or her skills in clinical judgment, collaboration, leadership, and delegation to effectively care for their patients as a professional nurse.

The many comparisons and contrasts to the role of a Registered Nurse (RN) to an LPN can vary by their credentials.

However, there are differences and similarities in pay, education, training, abilities, and their qualifications that are required for them to practice safely, and legally. While it is true that both are ultimately charged with providing quality patient care, the differences are vast and the careers of the two are usually very different.

When comparing the differences in opportunities between a RN and LPN, one must first understand the abilities and skills sets of each. This paper will highlight some of the differences between and LPN and RN. Difference between an LPN and RN According to the Florida Nurse Practice Act, a “Registered Nurse” means any person licensed in this state to practice professional nursing and a “Licensed Practical Nurse” means any person licensed in this state to practice practical nursing. Practice of professional nursing” means the performance of those acts requiring substantial specialized knowledge, judgment, and nursing skill based upon applied principles of psychological, biological, physical, and social sciences which shall include, but not be limited to the observation, assessment, nursing diagnosis, planning, intervention, and evaluation of care; health teaching and counseling of the ill, injured, or infirm; and the promotion of wellness, maintenance of health, and prevention of illness of others.

The administration of medications and treatments as prescribed or authorized by a duly licensed practitioner authorized by the laws of this state to prescribe such medications and treatments. The supervision and teaching of other personnel in the theory and performance of any of the above acts. Practice of practical nursing” means the performance of selected acts, including the administration of treatments and medications, in the care of the ill, injured, or infirm and the promotion of wellness, maintenance of health, and prevention of illness of others under the direction of a registered nurse, a licensed physician, a licensed osteopathic physician, a licensed podiatric physician, or a licensed dentist.

The professional nurse and the practical nurse shall be responsible and accountable for making decisions that are based upon the individual’s educational preparation and experience in nursing. As an LPN, in the setting where I work, I must admit that some of my roles differ significantly from that of an RN for example there are some medications that I have to administer under the direction of an RN such as IV pushes also it is not within my scope to do an initial admission assessment, whereas the RN is allowed to do those duties.

An Rn can make a decision that a client will require a peripherally inserted central catheter (PICC line) for the administration of fluids and/or medications and so can call a doctor for such an order. Thinking about the positive role models around me, I have to admit that the person I admire most is Florence Nightingale, who has been a pioneer in nursing. Her lasting contribution has been her role in founding the modern nursing profession, which has opened the doors of nursing for me.

She has set an example of compassion, commitment to patient care, and diligent and thoughtful hospital administration, which I have been using and will always be apart of who I am, not only as a nurse but as a person. I endeavor just as Nightingale to leave an indelible mark in the field of nursing. My personal philosophy of nursing is that one must contemplate the qualities of the endeavors to which a nurse obligates their heart and soul to.

A nurse commits to being the embodiment of altruism, charisma, empathy, and knowledge applied to the enterprise of protection, promotion, and enhancement of the holistic health states of all persons. This includes, and is not limited to a nurse’s practice in the professional arena, but also a nurse takes this way of thinking outside the workplace to uphold these ideals. So too should nurses reflect on their own knowledge base and strive to be always yearning for new experiences and understanding to elevate the level of professionalism inherent in their application of nursing.

Furthermore, I believe nurses are obligated to their fellow professionals, as an integral part of the health care team, to aid and improve the ability of their peers. This collegiality is essential to the upkeep of the trusted image a nurse has among their colleagues and the public. Additionally, this allows for greater cohesion between health care workers and provides the patients with requisite care that espouses the statement of nursing above. Finally, a nurse must always remember to whom they are ultimately accountable; their patient.

This accountability is first and foremost in upholding the principles a nurse represents. A nurse should constantly be asking themselves whether or not the care they are providing is exceeding the expectations of their patients and bestowing health advancement to preserve the patient’s health integrity. Moreover, a nurse must remain vigilant of the duty to themselves in the same regard by being able to self-evaluate: “Am I providing the exceptional, empathic, and optimal holistic care that my patient deserves and that I can be proud of? ”

Critique of Jean Watson’s Theory Essay

The Theory of Human Caring was written by Jean Watson. This model consists of ten carative factors to assist nurses with caring for their patients. Dr. Watson calls this a transpersonal relationship. Watson defines transpersonal care ‘as the capacity of one human being to receive another human being’s expression of feelings and to experience those feelings for oneself’ (Walker, 1996, p. 992). It is much more than a scripted therapeutic response, it is a moral duty that rises from within the nurse, and Watson identifies nursing as both an art and a science.

The first premise of this theory is that the more individual the feelings are, that the nurse transmits, the more strongly does the caring process affect the recipient (Walker, 1996). The two persons in a caring transaction are both in the process of being and becoming.

The moment of coming together in an actual caring occasion presents the opportunity for each person to learn from the other, how to be human.

Watson implies more than a mere mergence of experiences; she suggests a spiritual union of souls (Watson, 2008; Walker, 1996, p. 92). This writing will evaluate Watson’s theory and critique using Chinn and Kramer’s model of evaluation using description, clarity, simplicity, generalizability, accessibility, and importance (Meleis, 2012, p. 184). Clarity Watson precisely defines the concepts and sub concepts central to this theory. Watson explains abstract phenomena by using ordinary language in extraordinary ways, and uses nontechnical, sophisticated, fluid, and evolutionary language to artfully describe concepts.

Watson’s propensity toward metaphorical expression adds urgency to her moral message for nursing (Alligood & Tomey, 2010). At times, lengthy phrases and sentences must be read more than once to convey meaning. The increasing inclusion of metaphors, personal reflections, artwork, and poetry make her complex concepts more tangible and more aesthetically appealing (Walker, 1996). According to Watson, ‘A model of caring science that goes beyond an intellectualization of the topic invites us into a timeless yet timely space to revisit this perennial phenomenon of the human condition (Watson, 2008, p. 8).

Critics of Watson’s work have concentrated on the use of undefined or changing/shifting definitions and terms and her focus on the psychosocial rather than the pathophysiological aspects of nursing (Alligood & Tomey, 2010, p. 101). Watson tends to explain abstract phenomena by using ordinary language in extraordinary ways. Watson’s propensity toward metaphorical expression adds urgency to her moral message for nursing (Walker, 1996). Simplicity Watson draws on a number of disciplines to formulate her theory.

To understand the theory as it is presented, the reader does best by being familiar with the broad subject matter. The theory is more about being than about doing, and it must be internalized thoroughly by the nurse if it is to be actualized in practice. Health as harmonious unity of mind-body-soul recapitulates emphasis on human idealism inspires nurses to readopt or realign themselves with a commitment to care (Walker, 1996). Basic concepts and premises appeal to nurses trying to ‘carve out’ a caring practice in the context of contemporary health care. Generalizability

Watson’s theory seeks to provide a moral and philosophical basis for nursing. The scope of the framework encompasses all aspects of the health illness phenomenon. In addition the theory addresses aspects of preventing illness and experiencing a peaceful death, thereby increasing its generality (Alligood & Tomey, 2010). The carative factors that Watson described provide important guidelines for nurse patient interaction; however, some critics have stated that their generality is limited by the emphasis placed on psychosocial rather than physiological aspects of care (Alligood & Tomey, 2010).

Transpersonal relationships can put the patient at ease, trust increases, and this is an exceptional environment for healing to take place. Watson explains that concepts, defined as building blocks of theory, bring new meaning to the paradigm of nursing and were derived from clinically inducted, empirical experiences, combined with philosophical, intellectual and experiential background; thus her early work emerged from her own values, beliefs, and perceptions about personhood, life, health, and healing (Alligood & Tomey, 2010).

Accessibility Another characteristic of the theory is that it does not furnish explicit directions about what to do to achieve authentic caring healing relationship. Nurses who want concrete guidelines may not feel secure when trying to rely on the theory alone. Some suggest it would take too long to incorporate the caritas into practice, and others state that the emphasis on Watson’s personal growth gives her latest book an idiosyncratic quality that while appealing to some may not appeal to others (Alligood & Tomey, 2010).

This theory does not lend itself easily to research conducted through traditional scientific methods (Walker, 1996). Some critics have stated that generality is limited by the emphasis placed on psychosocial rather than physiological aspects of caring (Alligood & Tomey, 2010). Watson continues to state how the transpersonal relationship is the foundation of her theory, she calls this a special kind of human care relationship, a union with another person-high regard for the whole person and their being in the world (Alligood & Tomey, 2010).