NUR1201- William Taylor Case Study

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NUR1201- William Taylor Case Study

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NUR1201- William Taylor Case Study

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Course Code: NUR1201
University: University Of Southern Queensland

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Country: Australia

Background Information
Reflection is a way of thinking and working for Registered Nurses and is useful in raising our conscious awareness of aspects of care that may or may not be hidden from our view. This raised awareness about these aspects of care improves our understanding as nurses and assist us in directing action strategies that can improve both the patient and their family’s experience and the ‘partnering in care’ strategies that we utilise. Improving the ‘patient care experience and partnering in care’ and using Gibbs Reflective cycle (1988) as a framework in combination with drawing upon relevant theory provides a foundation for nurses to operate from and as such is required for task 2.
 
 
Instructions:

View the Case Scenario – Recording ‘The Age 75 Recording’

This Recording is located at the top of this study desk page within the white ribbon, under useful links: course recordings

After viewing the ‘patient experience and partnering in care’ case scenario recording – ‘The Age 75 Patient Experience and Partnering in Care’, write a 1300 word reflectionusing Gibbs Reflective Cycle (1988) as the framework, in an essay style.   

Within your reflection aim to draw upon relevant literature/theory to help you analyse this patient experience with the goal to improve the care experience of patients and their families.

Drawing upon relevant literature (theory) will support and strengthen your reflection.
Examples of relevant literature you could draw from would include: 

Theory taught this semester. For example the weekly NUR1201 topics such as nursing governances and nursing philosophies that guide the application of nursing care practice, and other related theory such as the National Safety and Quality Health Service Standards and partnering in care ‘action’ strategies. Aim to also include relevant theory linking to this patient experience topic – Preventing falls and harm from falls and My health record(e-health record).
Other relevant literature (peer reviewed journal articles) you have researched, using the USQ library data bases. 

 
Answer:

 Taylor will be analyzed. In the case study, the patient had provided information about the different negative and positive experiences that he had gone through while seeking for services from different healthcare professionals. This assignment will shed light on the different aspects of the experiences of the patient. It will cover important aspects like person-centered care, effective therapeutic communication, and development of bonds with patients, active participation in decision-making sessions, high quality care and many others.
Mr. William Taylor is a 75 year aged man who lives with his wife. He had received poor quality care from the professionals in the public hospital where he had gone when he was suffering from pain due to stones in the kidney. This had created apathy in him towards professionals in public hospitals. He is also highly vulnerable towards fall and had gone through several episodes of fall recently. Although he had suffered from bruises, cuts and skin tears, he had not gone to the hospitals. Rather he had gone to his GP who referred him to a surgeon. The surgeon had communicated with him insensitively that affected his dignity and self-esteem. His father was also provided inappropriate care where the doctor had conducted surgery of leg amputation without discussing and asking for informed consent from his father. However, the professionals who had cared for him for his diabetes issues and iron-deficiency issues had partnered with him regarding preparation of his care plans and had educated him well. The care that he received was compassionate that made him feel cared for by the professionals. This had positive impacts on his health and hence the disorders were properly managed.   
I was quite disheartened at the insensitive comments of the surgeon who was to care for the wounds developed by William after fall. It not only had hurt his dignity but might have also made him feel powerless, as he was getting old. The neglect that he had faced at the public hospital from the healthcare professionals also made me quite upset. The nurses had entirely breached the principles of effective care to patients as they have neglected the patients entirely when he was suffering from pain. No one came to attend him and ask him about his health. Such poor services have severe negative aspects both on the mental and physical health of patients (Gorgos et al., 2018, pp: 353). However, I was quite mesmerized at the high quality care that was provided by the gastroenterologist. Not only did he make the patient an active participant in his own care but also discussed the intervention procedure with him in such details, that William was highly confident about the action of pill-cam. Moreover, the professionals caring for his diabetes issues had also given him appropriate care and educated him well about medication regime. The confidence with which he handled the medication part made me understand the importance of effective patient education and collaboration.
The most important values that had been instilled by my parents from early childhood are being responsible and accountable about every actions and decisions that I take not only in my everyday life but also in my life decisions. I believe that these two values and beliefs are also extremely important in the nursing profession, as this would help me to be answerable about my actions and take effective responsibility of care for my patients. The professional who attended the father of the patient as well as those professionals of the public hospital were neither accountable about their actions. They were seen to be negligent and did not act as responsible individuals who were assigned with the duty of ensuring best quality life of the patient. I also harbor the values of empathy, compassion, kindness and sensitive approach as my father had always made me understand the importance of these attributes. The patient was suffering from pain from the skin tears but the professional showed an unkind approach and made insensitive comments about his old age. This might have affected his dignity and have made him powerless. Therefore, I will try my best to ensure that I follow my values and beliefs when I provide care to patients in order to make them satisfied and help them lead quality lives.
 
Through the analysis of the case study, different aspects of inadequate care were observed. One of the most important aspects was the lack of empathy and compassion in the care provided by the surgeon to William. Empathy and compassion are two important attributes of non-verbal communication (Hoos et al., 2015, pp: 930). Researchers are of the opinion that these two attributes have the ability to develop therapeutic relationship with the patients. When patients see that professionals are feeling the pain and suffering that they are going through, they can overcome stress and anxiety.  They feel that the professionals genuinely want to care for him and this helps in development of relationships based on trust and mutual respect. These aspects have positive outcomes on health of the patients (Newell & Jordan, 2015, pp: 76). The surgeon failed entirely to provide this form of care and in turn affected his dignity and self-esteem. He did not allocate nurses for fall risk management of the patient. Researchers are of the opinion that environmental modifications where the patients reside are also important for fall prevention of patients. Moreover, he was also not educated about proper ways o prevent risks of falls (Edvardsson et al., 2017,pp: 220). Another aspect of inadequate care was also noted through the negligent care provided by the professionals of the public hospital. The duty of the professionals is to ensure that they maintain beneficence principle and non-maleficence principles that are important ethics in nursing governance. Beneficence ensures providing best, safest and high quality evidence based care to patients that ensure high quality care to patients. Non-maleficence ensures that the care should be such that it would not cause any suffering or harm to patients (Lizarondo et al., 2016, pp: 44). Although, William was suffering from immense pain due to the stones in the kidney and waited for intervention, no professionals cam e to ask about his health or provide care or attend to his concerns. 
Adequate care was given to the patient by the gastroenterologist as well as the other healthcare professionals who cared for his iron deficiency issues and diabetes. They had involved him in active decision-making sessions by effectively partnering with him in his own care. The nurses were constantly by his side during his iron-infusion intervention and showed empathy and compassion and attended to his needs in a dedicating manner. The National Safety and Quality health standards have advised the healthcare professionals to partner with consumers and enable shared decision making with the patients to provide care that aligns with their needs and expectations (Lowell et al., 2014, pp: 255). Effective partnering with patients require a person centered approach where patients are requested to participate and provide their suggestions and feedbacks in their own care plans. This makes the patients feel empowered and gives them the confident to take responsibility of their own health management actions. Therefore, William was seen to manage the disorders efficiently.
One of the most important negative indicators for poor quality care is the lack of empathy and compassion during communication with the patient. The surgeon was unkind to the patient and this affected his dignity and self-esteem. In order to provide patient satisfaction, it is important to develop therapeutic relationship with patients where empathy and compassion are important components (Hinchcliff et al., 2016, pp: 561). I would ensure that I develop the skills effectively to provide high quality care. Another negative indicator is the negligent care that had been provided to William by the professionals of the public hospital. Nursing governance is an important aspect of healthcare that every professionals need to be careful about. Nurses are the main frontline health workers where they are highly qualified to access and decide the care needs of the patients (Rance & Treolar, 2015, pp: 35). They need to ensure that every patient are able to receive sage and quality care that ensure better quality lives for them. Accordingly, they also need to advocate any major issues faced by patients so that expectations and needs of the patients are met in all aspects. However, the nurses did not even attend William when he was suffering from pain and were busy with other patients. This made him feel less important and disrespected. Hence, I would make sure that I ensure nursing governance in the patients.
One positive indicator of good care to patients was successful partnering of the patient in decision making and developing of care plans. The professionals handling his iron deficiency and diabetes issues had made him participate in his decision-making; such actions empower them and make them feel responsible about their own healthcare. These make them more complaint with medication regime (Biggar et al., 2015, pp: 21). Therefore, William was found to highly confident in maintaining his medications and hence the symptoms and signs were under control. Another positive indicator was the development of health literacy among the patient. The professionals had ensured educating the patients about his disorders, the rationale of using the medication and even the ways the technology of how pill-cam is used. All these had helped him to understand the need for the interventions and helped him to understand the risks that might arise if he did not take them properly. Effective health education helps patient to be more complaint with the interventions advised by professionals and makes them confident (Boyd & Sheen, 2014, pp: 35). I would also ensure following this attributes in my practice as well.  
I need to develop my communication skills so that I can develop therapeutic relationship with the patients. Therefore, I would be joining workshop to develop my communication skills on the weekends. The mentor would guide me to develop both verbal and non-verbal communications so that I can effectively interact with patients and develop good bonds necessary for patient satisfaction. I will also conduct evidence-based studies by which I can develop the skills required for person-centered care and involve patients in effective partnerships. The recommendations given by researchers in the journal papers will act as guidelines that will help me to achieve my goals.  
From the entire discussion, it can be seen that partnering with patients in their own care not only satisfied the patient but also brings out positive impact on the health of the patients. Ineffective communication that lacks empathy and compassion can prevent the development of effective relationships between professionals and patients. Moreover, it is also important for professionals to ensure that they are involving patients in decision making and educating them about the disorders and the importance of definite interventions in details. This helps in reduction of anxiety and stress and in place makes patients more compliant with the care. This also helps in developing confidence among patients and this has positive outcomes on health of patients. 
 
References:
Biggar, S., Dawson, M. T., & Lim, E. (2015). Reflections on the consumer participation movement through Health Issues articles. Health Issues, (114), 21. https://search.informit.com.au/documentSummary;dn=507230874006451;res=IELHEA
Boyd, L., & Sheen, J. (2014). The national safety and quality health service standards requirements for orientation and induction within Australian Healthcare: A review of the literature. Asia Pacific journal of health management, 9(3), 31-37. https://dro.deakin.edu.au/view/DU:30069760
Edvardsson, D., Watt, E., & Pearce, F. (2017). Patient experiences of caring and person?centredness are associated with perceived nursing care quality. Journal of advanced nursing, 73(1), 217-227. https://doi.org/10.1111/jan.13105
Gorgos, A., Ghosh, S., & Payot, A. (2018). A shared vision of quality of life: partnering in decision-making to understand families’ realities. Paediatric Respiratory Reviews. https://doi.org/10.1016/j.prrv.2018.09.003
Hinchcliff, R., Greenfield, D., Hogden, A., Sarrami-Foroushani, P., Travaglia, J., & Braithwaite, J. (2016). Levers for change: an investigation of how accreditation programmes can promote consumer engagement in healthcare. International Journal for Quality in Health Care, 28(5), 561-565. https://doi.org/10.1093/intqhc/mzw074
Hoos, A., Anderson, J., Boutin, M., Dewulf, L., Geissler, J., Johnston, G., … & Schneider, R. F. (2015). Partnering with patients in the development and lifecycle of medicines: a call for action. Therapeutic innovation & regulatory science, 49(6), 929-939. https://doi.org/10.1177/2168479015580384
Lizarondo, L., Kennedy, K., & Kay, D. (2016). Development of a consumer engagement framework. Asia Pacific Journal of Health Management, 11(1), 44. https://search.informit.com.au/documentSummary;dn=035680584185050;res=IELHEA
Lowell, A., Schmitt, D., Ah Chin, W., & Connors, C. (2014). Provider Health Literacy, cultural and communication competence: towards an integrated approach in the Northern Territory. https://digitallibrary.health.nt.gov.au/prodjspui/handle/10137/885
Newell, S., & Jordan, Z. (2015). The patient experience of patient-centered communication with nurses in the hospital setting: a qualitative systematic review protocol. JBI database of systematic reviews and implementation reports, 13(1), 76-87. doi: 10.11124/jbisrir-2015-1072
Rance, J., & Treloar, C. (2015). “We are people too”: Consumer participation and the potential transformation of therapeutic relations within drug treatment. International Journal of Drug Policy, 26(1), 30-36. https://doi.org/10.1016/j.drugpo.2014.05.002

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