Reflective essay relating to a patient with COPD

Reflective essay relating to a patient with COPD INTRODUCTION: The purpose of this essay is to adopt Rolfe, Freshwater and Jasper (2001) model of reflection in reflecting upon my experience in practice placement while caring for a patient with a long term condition. This model will help to identify the learning needs and how it may be achieved. To maintain confidentiality in this essay with respect to the NMC code of conduct, I will be keeping the patient’s information anonymous, thus will be referred to as Elizabeth. Reflection is an important element of learning (Arbel, 2009). John and Freshwater (2005) defined reflection as assessing previous experience to develop tacit and intuitive knowledge. Rolfe et al (2001) model of reflection propose a framework that uses Borton’s (1970) developmental model. Pryce (2002) explains that, this model is a simplistic cycle that is based upon three sample questions to reflect on a situation: What? So what? Now what? Hence, it is vital that student nurses reflect regularly so as to improve their practice, knowledge, skills and behaviour to care for their patients to the best of their ability. Ultimately, Botten (2012) stresses the importance of reflection for student nurses, as it enriches their clinical learning, enabling them to learn more about themselves and the way they practice. WHAT I met Elizabeth during my previous practice placement at the surgical ward, she is 70 years old and was diagnosed with severe chronic bronchitis approximately 8 years ago. She was admitted to the ward due to acute exacerbation of chronic obstructive pulmonary disease (COPD). According to Kauffman (2014), bronchitis is the Inflammation of the bronchi associated with partial obstruction of the bronchi by secretions or constriction. Chronic bronchitis is also included under the umbrella of COPD (Jindal Vijayan, 2011). In regards to NICE (2010), about 3 million people have COPD in the UK, 900,000 have diagnosed COPD and an estimated 2 million people have COPD which remains undiagnosed. Also, according to department of health (2010) COPD mainly affect people aged over 45 with a history of smoking. SO WHAT Elizabeth stated that she was experiencing progressive dyspnea and increased cough. McCann (2007) stated, with chronic bronchitis, increased accessory use of muscles may be chronic and is preceded by a productive cough, sputum production and shortness of breath. At the time of assessment during admission, Elizabeth reported that she has been unable to care for herself and has difficulty managing her daily activities as she lives alone. Elizabeth’s personal hygiene appeared to have deteriorated and she was only able to speak in short sentences. Elizabeth’s personal hygiene was deteriorating as a result of her inability to self-care. According to Field Smith (2008), hygiene is fundamental for all people. The nurses used Roper et al (2001) and Orem (1991) nursing models in meeting Elizabeth hygiene needs. In addition to Field Smith (2008), it is stated that, this nursing models helps patients to achieve the activities associated with their daily life independently. Following the care plan, the nurse assessed Elizabeth’s hygiene needs, taking into consideration any deficit that may affect her ability to care for herself. The nurse made sure that appropriate personal hygiene care including washing, oral care, hair care, mouth care and nail care was provided and this was discussed with Elizabeth in order to ensure her needs are fully met by protecting her right to privacy and personal choice. DOH (2003), states that personal hygiene is the physical act of cleansing the body to ensure that the skin, hair and nails are maintained in optimum condition. Dingwall (2010) also suggested that assisting patient in meeting their hygiene needs as well as helping them can develop a nurse-patient relationship and allow a skilled practitioner to assess how the patient is improving mentally and physically. Due to the exacerbations, she had problems eating and swallowing, hence, simple routine nutritional screening was performed using a validated nutritional screening tool such as Malnutrition universal screening tool (MUST). According to Rice (2006) nutritional support is a vital part of nursing care because many patients with COPD are malnourished. This nutrition screening was carried out so that changes in her weight can be identified immediately and dietary changes can be started to improve her nutritional status as soon as possible. Specific dietary advice and support as well as general advice for meal planning were reinforced. Nazarko (2002) emphasised that, nutritional status is crucial to patient’s state of health. Referral to dietician and speech and language therapists was made to optimise her nutritional status, and assess and treat her swallowing difficulties. According Evans (2012), swallowing difficulties can make patient’s eating and drinking difficult and c an often result in patients losing weight if no adequate support is given. Hence, Adjustment of food flavour, texture, density and temperature was made to help minimize dysphasia. Any liquid given such as water or ensure was thickened as they are difficult for the tongue to control and can easily splash into the trachea (Weetch, 2001). Due to concerns regarding Elizabeth inability to carry out daily activities safely without risk of falls or accidents, which may result detrimental effect upon her health and quality of life, referral to the following members of multi-disciplinary team was made for further assessment to assist with her daily activities of living that may enable her to continue to live within her home safely. These members of multi-disciplinary team included; social services, physiotherapist, occupational therapist, social workers and age concern. According to Karen Aidin (2011), Dyspnea causes many patients with COPD to withdraw from day-to-day activities and hobbies. Referral to rehabilitation services was considered to improve her breathing, oxygenation and endurance (NICE, 2006). Home care aide services were considered to assist Elizabeth with her activities of daily living care. Rice (2006) suggested, in planning care, it will be crucial to determine what activities of daily living the patient c an perform. NOW WHAT In becoming an efficient nurse, there are some areas of improvement that needs to be considered for future practice such as; understanding more about activities of daily living for COPD patients, having more knowledge on assessment discharge, how they are done, package of care for COPD patients. These learning needs will be achieved through working closely within the multi-disciplinary team. According to Nehring Lashley (2010), working within multi-disciplinary will give the student opportunity to enhance their professional skills and knowledge of patient’s care. Also, reading more about COPD exacerbation will enable the student to recognise a patient having exacerbation if it re-occurs in future practice, knowing how to manage their condition effectively, hence, providing high quality care. CONCLUSION COPD is a debilitating illness which causes patient’s emotional, social, psychological and physical distress due to the impact on daily living. This reflective essay has helped the student acknowledge the importance of reflection within practice as it allows professionals to convey thoughts of how they can improve on their practice to enhance effective delivery of care.

Ethical Decisions

Chapter 6 Ethics Issue Brenton T. Percell BUS323 Commercial Law Salem University In your opinion, was it ethical for Mr. Trump to broadcast this type of information to the public? When making an ethical decision, the following questions should be asked is it a utilitarian decision approach, deontological approach or virtue ethical approach. The utilitarian decision meaning was the firing for the greater good for the mass of people? No. Was it a deontological decision based on, treat others how one would want to be treated, No. The last philosophical reasoning being virtue decision. Virtue decisions are defined to be genuine and honest and should be handled in that manner is a public relation leader. When decisions are made with virtue in mind, all decisions should be made ethically to ensure honesty is conserved. (Bennett-Alexander & Harrison, 2012, pg16-18) (Media, 2018) With the above steps in understanding an ethics decision defined in my opinion the manner that Mr. Trump chose to terminate his employment with Mrs. Carolyn Kepcher, publicly on his BLOG, stating,† She loved her fame, and she loved celebrity Apprentice, and it was affecting her work.† was unethical. If this was the case was it any progressive action to make Mrs. Kepcher aware of her performance or was she just terminated? These are grounds of termination depending on a contract agreement, state laws (at- will). The action that makes this judgment unethical is the hiring of his daughter proceeding after the termination of Mrs. Carolyn Kepcher. (Bennett-Alexander & Harrison, 2012, Pg154) In your opinion, where should we, as a society, draw our (1) legal and (2) ethical lines regarding the type of information shared in this context? [Please keep in mind, for a variety of reasons, an ethical behavior may require more restrictions and restraint on actors than one would want to codify in law.] The legal implication in this situation cannot be made soundly due to the unknown variables such as contract, state that contract was signed legally no laws were broken, Mr. Trump was on his account that solely reflects on himself and his brand. Which is within his right, freedom of speech. The reasoning for the termination may not be the best or ethically sound but it is a reason. In my opinion, it is more of an ethical/ moral issue rather than a legal issue. No-one rights were violated during the firing of Mrs, Kepcher. ReferencesBennett. (2012). The Legal, Ethical & Regulatory Enviorn of Business in a Diverse Society. [VitalSource]. Retrieved from https://online.vitalsource.com/#/books/1259582132/Media, W. (2018). Ethical Theories. Retrieved from https://pagecentertraining.psu.edu/public-relations-ethics/introduction-to-public-relations-ethics/lesson-1/ethical-theories/

The Alchemist Mood

Besides language, techniques to convey purpose in the alchemis: Through concrete diction and imagery, Paulo Coelho exhibits his purpose in writing the Alchemist and supplies an ambience in which the readers are prompted to learn and evaluate their own relationships, dreams, feel hope and ambition. Since the novel has a very serene tone, Coelho uses dictation to add interest to the novel. When a reader can visualize a situation, they can more easily relate to it by connecting memories that they have to those Santiago is experiencing in the novel.Coelho uses concrete dictation by showing a situation instead of just telling it to the readers. In order to do this he has to use very descriptive language. Once the reader can picture Santiago’s emotions, they are free to interpret the lessons taught into their own circumstances. In Coelho’s novel, the setting has a lot to do with the emotions and lessons learned. Santiago achieves his personal legend of discovering who he is t hrough the desert and acceptance of his conditions.The way that Coelho teaches his lessons to Santiago and the readers is by connecting them to forces of nature. â€Å"Treasure is uncovered by the force of flowing water, and it is buried by the same currents. †(p. 24). The readers are comfortable with the thought of nature and can connect the lessons by picturing something that they are familiar with. Imagery and symbolism are highly connected in the Alchemist. Coelho uses a desert to represent the mind of Santiago.On his travels through the desert, he is given peace and quiet to think about his own life; to meditate. As the readers progress in his adventure with him, they learn things about Santiago as he learns them. This is because Coelho uses dictation and imagery to help the readers and Santiago visualize themselves in relatable situations and uses the techniques to create a tranquil mood in his book, The Alchemist.

A Report On The Seminar On Reading And Writing Is Made Me...

The Blugold Seminar in Critial Reading and Writing has made me a better writer, and reader for that matter, without question. At the beginning of the year, I was not very excited about taking this class. I had written many papers in high school, why do I need a specific class for doing the exact same thing; however, I could not have been more wrong. This class has taught me many writing skills, as well as enhanced my current writing skills, that I will be able to continue to use throughout my writing life. The first skill that was brought to my attention that I was able to refocus on was the ability to participate ethically and responsibly in the inquiry and research process. Begin able to research an argument, claim, or fact ethically and responsible was somewhat of a â€Å"shock† for me. One of our first assignments of the year, â€Å"The Milwaukee Experiment† tackled the issue of unethical labels used in today’s society. The reason that I started off strugglin g with this concept was because I grew up in a small town, went to a small high school, and did not really experience much diversity there. I would say that ninety-nine percent of the population was Caucasian throughout my town, and because of that we didn’t have to â€Å"worry about† being politically correct in racial, cultural, or sexual terms. â€Å"The Milwaukee Experiment† taught quickly to be politically correct when in reference to someone’s race, especially in an academic setting. The main example for this would be me usingShow MoreRelatedMy First Year Seminar ( Wifys )900 Words   |  4 Pagesgrade school teachers made me write about my day to day life and learn small grammar like the period, comma and how to spell words correctly while in high school being taught stronger links in writing for example run on and fragments. 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