Essay for Nursing PDF

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I got a B for this essay as they said I did not make enough comparisons between the domains. ...

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Introduction: In this essay, the role of a nurse in maintaining health and wellbeing in individuals and whanau is going to be explained, the holistic health model and health literacy concept is also going to be discussed and related to the wellness check, and my role as a student nurse. The patient assessed in the wellness check is a middle-aged Caucasian female who identifies with the holistic health model, with a high level of health literacy. For the sake of maintaining the patient’s anonymity, I gave the patient a random name (Sarah), to be used throughout this essay. According to The World Health Organization (WHO) holistic health is defined as the body being in a state of complete mental, social, and physical wellbeing, rather than just without illness (Clendon & Munns, as cited in WHO 1974). Typically, nurses take more of a holistic approach to health (Clendon & Munns, 2019), this means that they will include holistic health principles in their practise. However, the wellness check includes few questions regarding mental and social wellbeing, and instead follows more of a biomedical model which focuses on the physical and biological conditions of health (Australian Institute of Health and Welfare, 2018). Generalised role of a nurse: A nurse’s role in maintaining health and wellbeing amongst individuals and whanau’s is similar in community work, which is different to working one-on-one in an institution where the nurse focuses on the biomedical aspects of health. Nurses who maintain community health (individual and whanau) focus on illness prevention, and if an individual is ill, then the focus is on rehabilitation and recovery (Clendon et al, 2019). As a student nurse I knew the importance of being aware of individuals perspectives and ideas of health in order to provide the best healthcare, as according to the Nursing Council New Zealand (2012), for a nurse to be able to maintain health and wellbeing amongst individuals and whanau’s, they must first be aware of and prioritise other patients views on health and treat accordingly, so before beginning with the wellness check questionnaire I first asked Sarah what her view on health was. Health literacy: Health literacy is defined as the ability to find, understand, and facilitate information regarding health and its services, in order to be able to make knowledgeable and relevant health decisions (Ministry of Health, 2015). (Health Navigator, 2018) In New Zealand, the healthcare system has high health literacy demands – this comes with complications as over 50% of the adult population struggles with health literacy, and 80% of Maori men as well as 75% Maori women have poor health literacy skills, these factors all contribute to health related complications such as: Wrongly-advised care to patients, due to patients inability to explain preferences or understand care advise, ability to give informed consent, health inequality, inability to understand instructions on prescription medication, and access to healthcare. Unfortunately, it is very common for individuals with low health literacy skills to conceal their lack of understanding due to embarrassment, and this can also contribute to the negative health impacts mentioned earlier (Health Navigator, 2018). According to the New Zealand Nurses Organization (n.d.), it is a nurse’s responsibility to improve health literacy among individuals, family and whanau, by first assessing one’s level of health literacy, and when necessary using strategies to educate.

My role as a student nurse, and the wellness check: According to Crisp, Douglas, Ribeiro, and Waters (as cited in Kitson & Muntlin Athlin, 2013) the fundamentals of care framework for nurses, consists of three aspects: First creating a professional relationship with the individual, acknowledging and incorporating the individuals essential care needs, and a dedication to be responsive to these tasks. Of these three aspects, the core element is building a relationship with the patient before any other aspects of the framework can be delivered. There are five steps to building a relationship with a patient, this consists of first establishing trust, uninterrupted focus on the patient, anticipating their worries or requirements, recognizing them individually and being able to act accordingly, and lastly assessing the relationship at hand. It is vital for nurses to be trusted by their patients in order to build a successful professional relationship (Crisp et al, as cited in Kitson et al, 2013). As a student nurse, I made sure to integrate the fundamentals of care framework by building rapport and giving Sarah my undivided attention, genuine empathy for her situation, and throughout the wellness check I evaluated her body language and tone of voice to assess her level of comfort or stress. Through my evaluation I observed that Sarah was very open and answered all the questions with detail, showing me that a trusting relationship was built. The importance and benefit of having adequate health literacy can be seen in the wellness check I performed on Sarah, who at 41 has normal vital signs (Blood pressure of 120/80 mmhg, temperature of 37 degrees Celsius tympanic, a consistent strong radial pulse of 75bpm, and an effortless consistent respiratory rate of 15 rpm) as well as no cardiovascular risks presented in the cardiovascular risk factors questionnaire sheet in the wellness check, despite being diagnosed with lupus, arthritis, and epilepsy at the age of 31. Sarah informed me during the wellness cck that she successfully manages her health due to a great understanding of her body and healthl, she runs 4 kilometres a day 5 times a week. She does not drink any alcohol or smoke cigarettes. Her diet consists of adequate fluid intake, 2-3 servings of fruit and vegetables (using the palm of her hand as an idea of serving size) for her daily intake of carbohydrates, fibre, minerals and vitamins. For protein and calcium, she has yogurt, and lastly, she has one serving a day of lean meat and occasionally liver for iron, folic acid, and vitamin b12 as she says she tends to get anaemic. Sarah is following an accurate diet plan, as according to the NZ Nutrition Foundation (2018), an adults daily dietary intake should consist of 2-3 servings of fruit and vegetables (serving size roughly size of palm), 2-3 servings of milk products (serving size example, 1 pottle of yogurt), 1 or more servings a day of lean meat, and approximately 6 servings of grain foods. Sarah says that when she was diagnosed with lupus, arthritis, and epilepsy 10 years ago, it sparked her deep interest in health and began educating herself online through documentaries, books, and peer reviewed medical journals as she wanted to understand her disease and how to manage it. Because of this, Sarah understands what her body needs in order to be healthy and now lives a very active, nutrient-rich, pain-free lifestyle. She has not seen a doctor in 5 years as she states she hasn’t had the need. This is an example of high health literacy, Sarah can research, extract, and apply accurate information regarding her health and in return does not suffer many symptoms of her diseases and is able to maintain and know the importance of an active healthy lifestyle. In the wellness check, Sarah answered in response to a question regarding her sleeping pattern that she struggles to maintain a regular adequate sleeping pattern, as she averages 6-8 hours of broken sleep at 2-3 hours at a time due to her baby waking her up during the night. Knowing that Sarah identifies with the holistic health approach, I asked Sarah how this impacts her emotional and social wellbeing, Sarah informed me that it occasionally makes her stressed and that it impacts her ability to socialise with friends. I then asked how she manages her stress levels due to lack of sleep, and

what support system she relies on, she informed me that going for her runs and reading books in the sun helps her relax on a spiritual and emotional level, and for a social support system she relies on her partner, this shows her holistic approach to health. Knowing the importance of maintaining family wellbeing, I asked how Sarah’s partner manages emotionally during her times of stress, as I was concerned about a possible negative impact on Sarah’s emotional wellbeing if her partner (support system) becomes unavailable to support her, due to his own emotional stress. Sarah informed me that her partner manages emotionally by regularly seeing his friends and family, and maintains a health diet, active lifestyle, and sleep pattern. From this, I knew that she had a healthy long-term support system. Conclusion: In summary, it is apparent the importance of acknowledging patients varying views of health in order to provide the best healthcare as a nurse. It is also shown how beneficial it is to have a high level of health literacy, for healthcare practise and patients themselves. Sarah has an unfortunate health history consisting of an auto-immune disease called lupus, arthritis, and epilepsy – but due to her high level of health literacy, she is able to understand her illnesses and health, and is also able to research, understand, and apply health knowledge. Prior to the wellness check I made sure to build a trusting relationship with Sarah, and in return I was able to have a complex one-on-one conversation regarding her health, allowing me to provide her with appropriate healthcare. Post wellness check, I learned about Sarah’s health history, how she manages her emotional, social, physical, and spiritual health and the effects on her support system, I also assessed her vitals and informed her she was all in normal range. I recommended that Sarah should seek advice from a doctor to assess her severity of arthritis, and to get further advice on how to manage her sleep, as I was concerned that she may have underlying health issues she is not aware of, considering she has not had a review on her illness from a doctor or health professional in 5 years.

References

Crisp, J., Douglas, C., Ribeiro, G., & Waters, D. (2016) Potter & Perry's Fundamentals of Nursing ANZ Version. 5th ed. Philadelphia: Elsevier

Kitson and Muntlin Athlin, 2013. Development and preliminary testing of a framework to evaluate patients’ experiences of the fundamentals of care: a secondary analysis of three stroke survivor narratives. Nursing Research and Practice 2013; undefined:

Clendon, J., Munns, A. (2019) Community Health and Wellness: Primary Health Care in Practise. 6th ed. Australia: Elsevier

World Health Organization, 1974. World Health Organization (WHO): Basic documents. Geneva: WHO, 1974.

Australian Institute of Health and Welfare. 2018. Australia’s health 2018. Australia’s health series no. 16. AUS 221. Canberra: AIHW.

New Zealand Nutrition Foundation, 2018. Adults. Retrieved from: https://nutritionfoundation.org.nz/healthy-eating/adults...