224
Unit 3
Applying concepts from the nursing process
are taught how to use equipment and are given a copy of the
equipment manufacturer’s instruction booklet, the names of
resource people, lists of equipment-related supplies, and loca
tions where they may be obtained.
In the written summary of the care plan, the patient
and family members are reminded about the importance of
routine health screening and other health promotion strat
egies. A network of support services and communication
systems may be required to enhance opportunities for indepen
dent living. The nurse uses collaborative, administrative skills
to coordinate these activities and pull together the network of
care. The nurse also provides skilled care, initiates additional
referrals when indicated, and serves as a patient advocate and
counsellor when obstacles are encountered.
The nurse continues to reinforce prior teaching and helps
the patient to set and achieve attainable goals. The degree
to which the patient adapts to the home and community
environment depends on the confidence and self-esteem
developed during the rehabilitation process and on the accep
tance, support and reactions of family members, employers and
community members.
There is a growing trend towards independent living by
people with severe disabilities, either alone or in groups that
share resources. Preparation for independent living should
include training in managing a household and working with
personal care attendants as well as training in mobility. The
goal is integration into the community—living and working in
the community with accessible housing, employment, public
buildings, transportation and recreation. State rehabilitation
administration agencies provide services to assist people with
disabilities in obtaining the help they need to engage in gainful
employment. These services include diagnostic, medical and
mental health services. Counselling, training, placement and
follow-up services are available to help people with disabilities
select and obtain jobs.
If the patient is transferred to a long-term care facility,
the transition is planned to promote continued progress.
Independence gained continues to be supported, and progress
is fostered. Adjustment to the facility is promoted through
communication. Family members are encouraged to visit, to
be involved and to take the patient home on weekends and
on holidays.
CLINICAL REASONING EXERCISES
1
A 25-year-old graduate student is diagnosed with fibro
myalgia after several years of visiting doctors and being told
that his symptoms were ‘all in your mind’. Due to chronic
fatigue and pain, he often missed days from university and
eventually withdrew from university. His wife is not very
supportive because she too thinks the illness is ‘in his head’.
How would you help this man learn to cope with his con
dition and the damage to his self-esteem? How would you
involve his wife in the process?
2
A 43-year-old Indigenous Australian woman tells you
she is always tired and thirsty and has frequent yeast infec
tions. She also tells you that she has not had a Pap test or
any kind of physical examination since her last child was
born 8 years ago because she does not have access to trans
port and lacks the money to pay for a taxi service. What
would you tell this woman? How would you advise her to
find the resources to obtain healthcare?
ONLINE RESOURCES
A wide range of additional
resources to enhance teaching and learning and
to facilitate understanding of this chapter may be found
online at
, including videos,
animations, journal articles, review questions, quizzes
and the e-book. Subscribers may also access Lippincott’s
extensive online point-of-care procedure guide LNPS,
which provides a wealth of evidence-based, reliable
information.
REFERENCES AND SELECTED READINGS
Books
**Double asterisk indicates classic reference.
Boogaerts, M. & Merritt, A. (2008). Psychosocial care. In Chang, E. &
Johnston, A. (Eds),
Chronic illness and disability: Principles for nursing practice
.
Sydney: Elsevier.
PATIENT EDUCATION
Learning to cope with disabilities
Take control of your life
• Face the reality of your disability.
• Emphasise areas of strength.
• Remain outward looking.
• Seek inventive ways to tackle problems.
• Share concerns and frustrations.
• Maintain and improve general health.
• Plan for recreation.
Have well-defined goals and priorities
• Keep priorities in order; eliminate nonessential activities.
• Plan and pace your activities.
Organise your life
• Plan each day.
• Organise work.
• Perform tasks in steps.
• Distribute heavy work throughout the day or week.
Conserve energy
• Rest before undertaking difficult tasks.
• Stop the activity before fatigue occurs.
• Continue with an exercise conditioning program to
strengthen muscles.
Control your environment
• Try to be well organised.
• Keep possessions in the same place, so that they can be
found with a minimum of effort.
• Store equipment (personal care, crafts, work) in a box or
basket.
• Use energy-conservation and work-simplification techniques.
• Keep work within easy reach and in front of you.
• Use adaptive equipment, self-help aids, and labour-saving
devices.
• Recruit assistance from others; delegate when necessary.
• Take safety precautions.
CHART
10-8
