Sunday, August 11, 2019

Palliative Care for Urinary Tract Infections in Elderly Patients Essay

Palliative Care for Urinary Tract Infections in Elderly Patients - Essay Example By an extension, the principles of a model of medical reflection also provide a cyclical model which will enable me to reflect upon this problem and subsequently examine my nursing practice as a founding point for further development and improvement in the nursing profession. Description In this paper I will be reflecting on an experience with a patient who was suffering from urinary tract infection, dehydration and dementia, whom I encountered during my community placement. This patient was suffering from Urinary tract infection and dehydration and had been transferred to the ward from Emergency Medical Unit (EMU). The patient was also suffering from dementia and during the handover it was mentioned that she could be both verbally and physically aggressive. It was also handed over that she had intravenous (IV) fluids prescribed and needed a cannula insertion as she had removed the one previously in place. This involved a patient who will be referred to as Mrs P, in order to maintain confidentiality and anonymity (NMC 2008). Mrs P was an elderly 79-year old woman who was suffering from dehydration and urinary tract infection. Mrs P had also been diagnosed with dementia, and was reported as being aggressive both physically and verbally. Feelings Initially when we opted to insert the cannula into the patient initially she agreed to our intentions only to turn aggressive and unmanageable, later my mentor advised the matron to insert the cannula, which she did though without the patient’s consent, as the patient shouted and almost made the whole process impossible. I was disturbed by these two related events, first, the patient’s aggressiveness and two, our forceful way to inserting the cannula into the patient. Thus these situations brought in me a need to find out more about the patient and their condition, and the consequences of the matron’s decision. When I met the patient I felt sympathetic towards her and her insistence to refusing the c annula insertion given her general condition. A mixture of thoughts crossed my mind, although I could understand why she did not want to undergo the process, but this thought was not conclusive for me as a medical student. On reflection it seemed a positive experience as it allowed me to see how people cope differently with medical conditions, and the impact it has on the patient and the entire therapeutic process. Evaluation During this experience I thought that the nursing team had built a good professional relationship with the patient and therapeutic process. The patient had plenty of time to discuss any concerns or issues that she had and any of her reasons for refusal the cannula insertion. In my mind, I had theorized that the issues that had been discussed or ought to be discussed included issues such as symptom management; how the patient is feeling is important and needs to be taken into consideration. This would also need to be discussed with her partner alone, to find out how she is feeling and to find the best medical alternative for her treatment. This is why the Visual Analogue Scale could have been helpful for monitoring the progression of the patient’s condition (Crichton 2001). Since I have used the tool before, I find it to be beneficial for effective monitoring of patient’s condition because it was a good indicator as to when we would need to adjust her analgesia using the World Health Organization (WHO)Â  analgesic ladder (WHO, 2005).

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