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An analysis of patient care on an acute medical ward

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  1. Introduction
  2. The primary nursing framework
  3. Chronic inflammatory conditions
  4. Pain assessment
  5. Identification of the problem
  6. Assessing the nursing care
  7. The philosophy of care
  8. Conclusion
  9. References

The aim of this patient care study is to discuss the care and nursing interventions that a particular patient received whilst staying on acute medical ward. Clause five of the Nursing and Midwifery Council's Code of Professional Conduct (2002) states that ?as a registered nurse or midwife you must protect confidential information? and if information is to be revealed the patient's consent must be sought. The patient's permission was obtained after an explanation of the purpose and proposed content of the care study, with a staff nurse present. For reasons of confidentiality, the patient will be referred to under the pseudonym of Kirsty. Kirsty is a seventeen-year-old young lady who was diagnosed with Crohn's Disease when she was thirteen years old. She lives in a terraced house with her mother and is a hairdressing student. She was admitted to the ward from the Children's Outpatient Department following a routine check-up, where she presented with right-sided abdominal pain and loose stools. She was diagnosed with a flare-up of Crohn's Disease. Kirsty was chosen for the purpose of this care study because her strength of character was admired and a good relationship was established.

Kirsty was admitted to a twenty-six bedded acute medical ward, which is primarily gastrointestinal conditions, however medical outliers are admitted. There are three bays: one male, and two female, one called the Day Room (as it used to be the patient's day room, but was opened as a bay as there was a bed shortage) and the second is called the Female Bay.

[...] The scoring system on the chart is on a scale of 0 being no pain; 1 being mild (no pain at rest but mild pain on movement); 2 is moderate (intermittent pain at rest, moderate pain on movement); and 3 severe (continuous pain at rest, severe pain on movement). If the chart was used as it was intended, Kirsty's occurrence and severity of pain and the effects of analgesia could be monitored and assessed four hourly (or as necessary) more effectively. [...]

[...] (2000). Nursing Models and Nursing Practice. 2nd Edition. London: Macmillan Press Ltd. Archibold, G. (2000). A post-modern nursing model. Nursing Standard. 14(34), 40-42. Cunningham, J. (2001). A Palliative Approach to Pain Management. Nurse 2 Nurse. 1(12) Freeman, L. (2002). Food record charts. Nursing Times, 98(34), 53-54. Harris, G. and Bond, P. (2002). Nutritional care for adults in hospital. [...]

[...] The model of nursing used on the ward is an adaptation of the Roper, Logan and Tierney Activities of Living Model. The focal point of this model involves twelve activities of living: maintaining a safe environment; communicating; breathing; eating and drinking; eliminating; personal cleansing and dressing; controlling body temperature; mobilizing; working and playing; expressing sexuality; sleeping; and dying (Aggleton and Chalmers, 2000). The model on the ward incorporated communication, diet, and sleep, mobility, hygiene, toilet, occupation and a section for activities of daily living prior to admission on the admission form. [...]

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