Unit III Thoughtful practice and the process of care
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vital signs and nutritional status assessed. Discuss with
each other the truth or falsity of the claim, ‘Who the
nurse is, is as important as, and sometimes more impor-
tant than, what the nurse does’.
2.
Receive the same clinical assignment as another
student, and independently outline your care priorities,
specifying what you plan to accomplish during each of
your clinical hours. Talk with the other student about the
differences in what you both hope to accomplish and
how you would do this. Try to imagine what these dif-
ferences would mean to the person.
3.
You are the only registered nurse (RN) on a 50-bed
wing in a long-term care facility. You have one enrolled
nurse (EN) working with you and two assistants in
nursing (AINs). Each of the 50 residents requires assis-
tance with activities of daily living, all take at least some
medications and most require monitoring for multiple
chronic (and sometimes acute) illnesses. When the nursing
home is short-staffed, you are sometimes the only RN
covering two 50-bed units. How will you decide which
interventions to delegate?
4.
Describe how you would probably respond, and how
you would like to respond (if these are different), to
hearing another nurse in the shift report that one of the
people you are assigned to was a real ‘PIB’ (pain in the
butt) all day and ‘just impossible’ to care for. Reflect on
the importance of the language we use to report on a
person to one another.
BOX 18-3 Organising student clinical responsibilities
To organise clinical responsibilities, check:
1. The person’s notes and history
2. The name by which the person wishes to be addressed
3. The person’s chief complaint and reason for admission
4. The person’s current health status
•
Note any physical or emotional changes indicating the need to modify the plan of care.
5. Routine assistance the person needs to meet basic human needs
6. Priorities for care:
•
Priorities identified by the person as most important. The student might state: ‘I’ll be your nurse or midwife until
3 p.m., and I’m interested in learning what you would most like to accomplish today.’
•
Identified health problems, goals for the person and related nursing/midwifery interventions
•
Medical orders that need to be implemented
•
Interdependent or collaborative nursing/midwifery responsibilities
7. Special ‘events’ of the day that may require special observation of the person, teaching, preparation or aftercare:
•
Diagnostic tests
•
Consultations with specialists
•
New therapies (physiotherapy, medications, surgery, radiotherapy, etc.)
8. Special teaching, counselling or advocacy needs
9. Special needs of the family
Developing knowledge skills
In this chapter you have been learning about implementing
care as part of the process of person-centred care. Once you
have had the opportunity to practise and carry out imple-
menting care you will be more confident to practise these
identified skills and procedures.
What have you learnt?
•
Basic knowledge of how to implement person-centred care
•
Ability to collect the appropriate data to implement
appropriate care
•
Knowledge of what constitutes accurate and appropriate
data for the implementation of person-centred care
•
Ability to understand and interpret the meaning of the
collated data
•
How to recognise actual and potential barriers to
collecting accurate and appropriate data for the
implementation of care.
To enhance your learning and facilitate further
understanding of this chapter, refer to thePoint
and LNPS online resources.
Developing critical thinking skills
1.
Team up with another student and take turns role-playing
a nurse visiting a homebound older man who needs his