ANP8011 Clinical Leadership in Contemporary Health Care Practice

Introduction:

Emma Gee is a sports enthusiast and was a therapist by profession who has been in the gruesome struggle of surviving a condition that can lead to hemorrhagic stroke, at the tender age of 24. The recovery process of the patients suffering from hemorrhagic stroke is critical and time taking. Caregiving is an integral part of the recuperation process of such patients (Krafft et al 2012). Emma had to undergo a long journey for recovering from the acute condition. The journey was a difficult one as she had several other physical complications that she suffered to, as a result of the severe condition. The physical challenges that she faced, made her mentally weak. Caregiving was hence more challenging. The inculcation of certain strategies to ensure steady recovery was also important as she was critically ill (Sura et al 2017).

The discussion elaborates the case study of Emma Gee. The discussion also includes the process by which the person can be taken care of based on the evidences available about the suffering.

The discussion also puts an emphasis on the holistic approaches that can be taken in the case of Emma Gee for her resilience (Aggarwal et al 2012). The implementation of Strength-based Nursing is also considered under the analytical discussion.

The sufferings of Emma Gee:

Emma was suffering from arteriovenous malfunctioning (AVM) that needed an intricate surgery to be done on the brain to remove the swelling that occurs as a consequence of AVM (Grace and Wolfenden 2017). The incident changed Emma’s life as it had an immense effect on her regular life. In a day of time Emma became a powerless woman from a fulltime therapist. The symptoms that Emma had, led to the diagnosis of the condition. The movement of the body was very strained and the process needed a lot of energy consumption. There was a problem of judging distance between varied objects. These uncomfortable situations made Emma to visit a doctor and as a result, the condition of AVM was found to be the reason of such abnormalities.

The procedure that Emma had to be under, before the finalization of surgery was in itself a challenge to bare. Several sessions with doctors of different genres were organized for addressing to Emma’s condition. The first being

Strengths-based nursing:

The strength based nursing of any patient, basically requires the caregiver to promote the patient’s self-efficacy by empowering the patient and the family and friends of the patient. The procedure also requires a professional from healthcare department, to mobilize, develop and capitalize the patient’s strength in a way that promotes proper health (Gottlieb 2012). The nurses need to focus and enhance the strengths of the patient, be it inner or outer strength. The nursing based on strengths also needs the nurse to consider all the primary needs of the patient and implement the procedure in accordance with the necessity (Caeiro, Fero and Costa 2013). the application of such procedure increases outcome and decreases the time taken for recovery. The goals of such processes if followed properly, even facilitates healing of the patients in the critical care unit quickly (Abbott, Mc Sherry and Simmons 2013).

Principles of strength based nursing that should be inculcated for Emma Gee:

The process of strengthening the patients requires the primary implementation of a few points. The first and the most crucial point that should be compulsorily under consideration is that the perspective of the caregiving should be person or family oriented. The nurses should evaluate the patient and analyze the cultural and individual needs of the patients and plan the care procedure in cooperation to it (Mannix, Wilkes and Daly 2013). The process should also be influencing the patients, it should be able to empower the patient, the family and relatives, it eliminates the problem associated to the absence of communication with the people associated in the case. The process should be approaching a person’s improvement as a whole, it should also be holistic in nature. The analysis should also be evidence based, the history of the cases that the caregivers are handling provides a proper understanding of the concepts that it deals with. The process also considers the participation of the patients in the process of rehabilitation, it decreases the work of the caregiver in addition to enhancement of the treatment procedure. The involvement of the patient in the procedure increases the effectivity as self-care decreases the problem of negligence by the patient. The process should have the presence of both the patient and the caregiver in a collaborative manner. (Parahoo 2014).

Strengths-based nursing procedure implemented on Emma Gee:

Emma had been through several phases of treatment to attain minimum recovery. The process was no less than a roller-coaster ride. The medical assistant that Emma got from the caregivers was more on a professional level rather personal. The care process was more influenced on healing the physical suffering of the patient rather than focusing on both physical and mental well -being. The interaction that the caregivers had with Emma was very minimalistic. The moral support that Emma needed while trying to regain her communication skills that speech and limb movements, needed the assistance of a professional who can take care of the patient as a family, but such initiatives were only taken by the family members and relatives. The family tried to communicate with her using a pen. However, failing to do so, they used a red magnetic letter board that would enable Emma to communicate. This would help to reduce her frustration of not being able to communicate. The family was always supportive and travelled to the hospital to visit her. They would sing to her in order to reduce her stress. They would give her gifts and flowers that made her feel comfortable and happy. The family made regular visits to the hospital. The caregivers are supposed to provide assistance to the patients in such a way that they find it comfortable to communicate in whatever manner they can.

The inculcation of the primary goals of nursing based on strengths is to make the communication process with the patient as well as the family members as simple as possible. In case of Emma, the communication was almost nil. The recovery process was mainly assisted by the medical practitioners who were treating Emma. The procedure implemented by the nurses for assisting Emma, did not enhance the care giving procedure, it only helped her recover physically. Strengths based nursing is a vast term to implement in a scenario, analyzing and examining the scenario is a crucial task of nurses. The nurses should work on giving mental support to the patient and their family as well, this reduces the discrepancies associated with dealing with the patients and strengthens the morals of the family and relatives.

Transition points in the recovery process of Emma and implementation of strengths based nursing process for her resilience:

The care based on strengths in the field of nursing, for post surgeries are critical to be implemented on the family and relatives rather than the patient. The patient in surgical cases are generally unconscious, they do not require the support of a care giver for mental strengthening purpose immediately. The family and friends are the ones who are vulnerable to mental weaknesses which can lead to several physique harming consequences, hence it is crucial to take care of the relative and give them the necessary support (Mckie 2012). The nurses need to be benevolent to the people associated with the patient to ensure them about the smooth recovery of their patient.

For assisting Emma based on strengths initiates as soon as she regains consciousness. The struggle that the patients like Emma have after undergoing surgery is unbearable, the excruciating pain that the patients deal with, makes the patient feel mentally extremely low. The task of the caregiver is of major importance in such scenarios. The implementation of the principles of nursing based on strengths is of major effectiveness, it increases the morals of the patients to work on their own recovery process (Mackenzie and Greenwood 2012). The patients get hope to get back to normal life and work on it. The health care of such patients needs the incorporation of strength based nursing effectively as the process of recuperation is intricate and strenuous to achieve.

Rehabilitation of the patients of critical care unit like Emma, needs more support of the caregivers than the others. The procedure in case of patients with neuro surgeries requires prolonged period of time to be fit to move and communicate independently (Foley et al 2012). The assistance in such cases has to be at a very personal level because the patient requires to stay at the center for longer than general patients. The motivation that such patients needs, should be learned and understood by all the health professionals as they are the ones who spend more time with the patients than the members of the families. Emma needs assistance in carrying out communication as the cranial nerves that are responsible for facial sensations and facial movements were majorly affected due to AVM (Carr 2014). The nerves of Emma’s limbs were also effected as a result she had to use a wheelchair for movement, the nurses should do a proper study of the ailments associated with the surgery and act accordingly. The caregiver should encourage such patients as the recovery process of such patients is very difficult to attend. Continuous encouragement and support act as key tools in to mediate the process.

Care Plan

Nursing care of patients suffering from AVM, begins in the intensive care unit, where it requires accurate reporting of events and baseline neurological activities of the patient. Monitoring of the neurologic changes should include timely and successive neurologic assessments. Symptom management like blood pressure control and hemorrhage prevention are the main criteria of nursing care for patients suffering from AVM. Seizure control, hypertension prevention and lifestyle modifications are some of the interventions needed to be included in the nursing plan. Antihypertensives that help to control systolic and arterial pressure can be used (Zacharia et al. 2012). Following surgery, a phenomenon may arise called “normal pressure perfusion breakthrough”. This causes postoperative hemorrhage or swelling as a result of changes in the blood flow and pressure. Such situations can be handled by the administration of narcotics or any alternative treatments. It is necessary to include the family and other healthcare members in the nursing plan in order to ensure that the patient does not suffer from any stress or is not subjected to any stressful situation that would cause changes in blood pressure and subsequent hemorrhages. If seizures are observed, ant seizure prophylactic medications can be administered. The patient and also her family members have to ensure that proper lifestyle changes are carried out. The most important lifestyle modifications being cessation of smoking and limiting exertions. It is also necessary for the family to observe the patient frequently and identify any medical complications in the patient that needs immediate intervention. Moreover apart from Emma, the family members also require counseling in order to enable them to overcome such stressful situations. Other healthcare professionals who can be included in the nursing care plan are neurologists, neurosurgeons, general practitioners, speech and mobility experts.

Holistic approach in Emma’s recovery process:

Holistic approach in the field of care giving requires the caregiver to analyze the situation of a patient and design a care procedure based on the recovery of a person as a whole (Morton et al 2017). The approach needs the nurse to study and examine the condition of a person carefully to achieve complete the healing procedure in totality (Dossey et al 2012). Licensed caregivers who provide care by approaching the body, mind, emotion, spirit and environment of a patient are known as holistic nurses.

Emma needs a holistic approach for her healing procedure as the condition has effected the body as a whole. For strengthening Emma’s impulses, the mental health should be taken care of in the right way (Fontaine 2013). The holistic approach in case of Emma also requires the participation and assistance of clinicians like doctors, physiotherapists and holistic nurses as it is a major case to resolve and rehabilitation is difficult to achieve. Approach should be in a way that influences the patient to take part in the procedure of recuperation and act patiently with the professionals (Papathanasiou, Sklavou and Kourkouta 2013). The approach also undermines the possibility of negligence to a particular aspect of the case as it considers the whole body under the planning of the treatment.

Healthcare given to Emma and implementation of nursing based on strengths in the case:

The process in which Emma was taken care of was absolutely on the professional levels. The purpose of proper care giving was not accomplished in Emma’s case as it had not considered the other aspect of a survivor that need to be inspected and taken care of. Interaction of the caregivers with Emma was almost negligible. The nurses only considered following the treatment procedure prescribed by the doctors, they had no interest in communicating with Emma. The process was monotonous and made Emma mentally weak and the procedure of recovery was initially not assisted by the patient as the mental preparedness that the patient needed to have was not considered by the caregivers. The family and the relatives were the only ones, who worked on strengthening Emma mentally. Emma is close to her twin sister Bec, her mom and dad have a great influence in her life, assisting them for giving her the necessary care was important. The nurses only worked on providing the steps necessary for betterment of the physique of Emma, that is, the evidence based practice was the only step that was implemented by the nurses in the caregiving process.

Several steps that are present in the principle of caregiving to the patients for strengthening purpose were deviated in the case of Emma. The process did not work on strengthening Emma, rather was very superficial, just to attend to the primary needs of the patient. The first and foremost step that should be considered by the caregivers, that is to give person centred care to the patient was not achieved. In Emma’s case, mental support was highly required as the body was partially devoid of impulses, it required the assistance of a nurse to empower Emma and make her believe that recovery in totality was possible in her case (Zorowitz, Gillard and Brainin 2013). The nurse did not provide mental support to the family . The family also requires mental support in such situations, they are also vulnerable to physical and mental ailment due to the stresses they go through. Counselling the family members is also of major importance, it builds up then strength of the scenario in totality (Forster et al 2012).

The hospitals and nursing homes of several countries, including Australia, that have incorporated the steps included in the principles of strengths based nursing, they have had a tremendous positive change in the scenario (Beckett et al 2013). The empowerment process has been noted to be highly effective as it reduces the time taken by the patient’s to get back to their normal life. The process not only increased patient outcome but also has managed to improve the working environment for the professionals in the field. The constituents of the mentioned principle have even encouraged people to take up nursing as a profession, as the principles include the healthy participation of the caregiver in collaboration with the others in the same profession.

Conclusion:

Therefore, from the above discussion it can be concluded that the necessity of incorporating the principles of strengths based nursing is of major significance in the cases like that of Emma. The process is also known to enhance and increase patient outcome. The process also helps in creating an understanding between the caregiver and the patient in consideration. The case of Emma Gee is an example of how the recovery can be affected by not implementing the steps to strengthen patients in the field of nursing. Emma’s journey was a long and difficult one. Introduction of effective nursing plan can significantly improve her condition. The necessity to implement such principles is of high significance as it facilitates health promotion and empowerment irrespective of the differences. The family members of Emma are seen to be highly motivating, making them understand the ideologies associated with strength based nursing can drastically increase the chances of recovery as they are the ones who stay with Emma for a longer time than the caregivers. Post –surgery, Emma should be given counselling sessions for improvement of her mental condition. Collaboration of the care givers with the family members of Emma will decrease the discrepancies that arise due to lack of communication between the patient’s family members and the nurses.

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