Reflection-Person Centred Care (PCC)

Description

In the case, when Tula was admitted to the hospital,  I could see that she was persistently having a dry cough a condition of the paroxysmal expiratory wheeze, as she has developed acute dyspnoea after her 12-hour factory shift.  As in the third week of the reflection, I was able to learn the  Person-Centered Care (PCC), Clinical Reasoning Cycle (CRC) and in sync with the Gibbs reflection cycle. In the tutorial class, the focus was on the Tula case. As a background, Tula is a 38-year-old Samoan woman who is working in the textile factory in Dandenong, Melbourne, she weighs 114kg has a height of the 160cm, having a BMI: 44.5 and has hypertension problem. As observed in the case, nurse Chlorinda was screaming, and discussing how the patient is overweight is due to the cultural problem. In the .case nurse, Kate was also observed to be leaning below and checking the patient's health by asking her. A person-centered would obligate to take care of the person's safety, comfort and also focus on the well-being uppermost, to ensure the people's safety, and also promote patient safety. For example, in the case, the patient is experiencing difficulty in breathing would also show, some signs of fever, sore throat, rapid breathing, etc. The signs and the symptoms are the patient's discomfort, feeling unconsciousness, and even showing a stressed respiratory rate. The patient even takes the current medication of the  Irbesartan 150mg PO daily. I could see that due to her inpatient problem, Tula was taken care of by the coordinated nurses along with the respiratory consultant, a Physiotherapist, a social worker, and a respiratory CNC. 

Feeling

When screening the patient's condition, I could see how both the nurses Clorinda and Kate were being insensitive to the condition.  Firstly the Cholrinda nurse mentioned how the patient is overweight and it's due to her cultural fault. As per the Code of Ethics (2018), the nurses should abide by the clause of integrity and professional behavior and needs to respect, care, and understand the patient's condition. The patient was also showing the keenness to be taken care of by the Chorinda, however, the nurse was acting professionally and only provided the obligated care, which was directed by the doctors. Kate's nurse, on the other hand, could hear her wheezing sound but was not thought to provide quick relief to the patient such as providing an overall emotional and mental well being. Not only she was gasping for the breath, but due to her blocked airways, I could see she was not able to talk, was feeling helpless and her condition was deteriorating further, had the multi-disciplinary team would have not enacted properly and timely. As per the PCC care, the nurses are supposed to provide therapeutic care and also should form a bond with the patient.  Her condition was monitored continually and I could see how her condition was checked, monitored, and even evaluated by the uses, respiratory consultant, physiotherapist, and the social worker to check the vital signs. I was feeling bad to see, how the Chlorinda nurse handle the case while in comparison kate was compassionate, caring and also foster a collaborative approach to take care of the patient., she was even showing the stressful condition of high hypertension and had a pain in the ulna. 

Evaluation

The nurses could have formed a bond with the patient through the effective communication (Fedoruk 2012), In my view, the  Just like Kate, if the Chlorinda could have been more reciprocal of the patient feels, the therapeutic relationship could have maintained  (Daly, 2017). The patient-centric care would be to continuously monitor the patient's wellbeing socially and emotionally along with spiritual wellbeing. The related beliefs and practices:  that can further improve the patient's condition. Due to this, her current condition, if not treated well the nurses are just violating he patient dignity, respect, and care. The nurses should follow the obligation to take care of the patient with the competence, confidence, conscience, commitment, and comportment.during the patient critical stages (Stridsman, 2020). 

Analysis

The patient had inflamed airways and showed she was continuously monitored, for the condition of inflammation of the airways (bronchioles) that has become narrow, swollen, filled with mucus, and also has caused due to the various irritants e.g. dust mites, pollen, etc. The patient-centric approach would be to check for the vital signs past repeated encounters and the diagnosis of the medical records.  The patient would be checked and monitored by the team of experts for the recurrent cough and wheeze for one year that has the nocturnal and exercise-induced cough which is shown in between the episodes. Wheezing heard when examined and reoccurring instance of the  3, shows eczema and so far, with the combination of drugs and care has shown improved health in the last 6 weeks Patel (2020), Busman, (2013) &  Levett-Jones, (2018). Further, she was given the two-drug combination of the Sere tide which is the two drugs combined and also the other one drug to reduce the inflammation and the other was used to dilate the airways (Willis, 2020). 

Conclusion

To conclude, the expiratory wheezing also means how the wheeze, happens when the patient is exhaling that can lead to the exhale of breath. The nurse Chlorinda was insensitive while taking care of the patient and similarly Kate showed compassion towards the patient. The patient showing the wheezing sound is further showing the high-pitched whistling sound which has also made her inability to breathe. The inflammation has further caused the blockage in the throat and the airways, the common causes have even caused infection and also the possible allergic reaction or physical obstruction, that has caused the problem of the foreign object.  the nurse should educate, provide long term care of how to maintain hygiene, and ensure a pollution-free environment. The patient is a low waged worker and her unction can be corrected with the combined efforts of social, mental, and physical labor. 

Action plan

The action plan to correct her current condition is to keep a check on her blood pressure. The diet plans and the exercise regime would help her to lose some weight and improve her condition (Holland (2019) & Esteban (2020). Further. The patient needs to adopt healthy lifestyles, which is emotionally and mentally stress-free (Willis, 2020). Apart from eating healthy she also needs to follow some moderate level of the exercises, to keep a check on weight. Her weight and combined with the good eating plans can help to overcome the PCOS problem (Holland, 2019).  The other actionable plans are to stay away from the dust, pollutants, mage a home free dust environment, and further, a liquid diet has to be given Stern (2020), Stridsman & Backman (2020) & Backman et al (2019). Regular doses of the medicine and the inhalers, apart from this, she could also be given a hot lemon, ginger and honey water to open her blockages and complete rest to improve her condition. In case, the condition does not get corrected within the 7 days, she needs to visit the hospital again (Backman 2019).

Consequently steps to make the patient’s knowledge and skills and help them access the health information at an appropriate literacy level, to develop self-management skills, and also seek the patient’s ability ways for active care. To have a safe, sound, and effective patient monitoring case in the healthcare delivery systems – and integrating the patient’s environment (e.g. home, workplace, school) that can ensure the well being of the patient (Chang, 2019).