B741 : Nursing and Healthcare : General Practice Nurse

GPN Health Assessment 

With the increase in number of cases of dependent aged people turning to full time help in the final years of their life, GPN or General Practice Nurse are the nurses who are there to help these people by taking care of them in a simple yet helpful manner. These people give the best possible services to the patients in need and ensure that they are always taken care of, 24X7 without any fail or as per their schedule requirement (QNI, 2017)

GPN or General Practice Nurse is a widely recognised concept now and many nursing professionals are now turning towards it.

These General Practice Nurses are an integral part of the team of the doctors treating the patient, and are sometimes involved from the very starting of the patient’s treatment so as to be aware of their history, so that later on they can work for them exclusively as their medical help. These nurses take care of everything for these people; their bathes, food, regular check-up, exercise, checking their blood pressure, regular doctoral visits etc. These nurses being associated to the practising doctors, are all the more experienced and deal exclusively with the patient, one case at a time. These nurses should not only be well in handling typical medical emergencies, but should also know how to deal with issues relating to mental health, learning disability and child care too, since they are not limited to just taking care of old people (Health Careers , 2016).

The MBS and 707 healthcare schedule is devised by the government of Australia to ensure that elderly population has full access to quality healthcare treatment and they are never deprived of any of their medical needs. These provisions are made keeping in mind the requirements of all these people, and how the country’s medical team wishes to achieve it. It’s aim is to ensure that all the elderly population of Australia remains fit and healthy, fit easy access to healthcare whenever and wherever they want, with complete support and minimum disturbance and inconvenience possible. Services like these are extremely important in every country so that the elderly population gets proper treatment and lives better (Australia Health Governemnt , 2018)

In Mr. Pitman’s case, the situation hasn’t worsened yet but has to be controlled as soon as possible. Currently, he is just finding trouble coping with his daily to day tasks like cooking, reheating food, getting dressed but these are signs that his body is no longer supporting his will and that he now needs a person to constantly take care of him. Lack of proper diet is what has resulted in this situation, which then turns towards taking a told on his mental fitness as well. Thus, it is essential to understand that this situation is to be taken seriously, and this is not something which can be postponed or delayed for even a single day now. As per the suggestions of his doctors, he should go for hiring a GPN as soon as possible.

Activity of Daily Living 

Australia has a wide population base which falls in the age bracket of 60 years and above. These are the people who are in need of extreme medical attention because of obvious complications that happen in their lives because of reasons best pertaining to their age and to their medical history.

What is quite surprising is that often times these issues result in so much of escalation, that it becomes almost immediate for them to get medical attention which might not come with the convenience of waiting and taking it slow.

Of these medical cases, majority are attributed to physical injuries that they sustain majority because of the fall they encounter (Stenhagen, 2013).

A fall is too far reached and describing it in one definition or giving it a scope is a little difficult. However, according to WHO (2007) falls are defined in two ways: the elderly define it as loss of balance and falling down physically while the medical professionals define it as any event which leads to an injury or decline in medical condition. When we talk of statistics, as many as 25% of elderly are affected by it worldwide and this percentage simply keeps growing over time, and does not seem to go down or stagnate.

The frequency in the fall increase with age, frailty and the inability to handle themselves. According to Olas et. all (2015) This is a matter of leading concern among healthcare professionals, as these cases are being reported more than ever now

The rate of hospital admission due to falls for people at the age of 60 and older in Australia, Canada and the United Kingdom of Great Britain and Northern Ireland (UK) range from 1.6 to 3.0 per 10 000 population (WHO, 2007).

While people do not take this matter seriously, and believe it be just another accident happening this is not the case with it. It should be noted that falls can be merely an accident for a person who is young, as much as 40 years of age. However, for anyone who is elder than 60 years in age fall is a serious issue and results in serious health conditions like slip disc, hip dislocation, osteoporosis and so much more. The after effects of it are simply not worth the pain.

These situation further add to the trouble of these people, which is undesirable by everyone including the doctors as well as their families too (Krishnaswamy, 2016).

In case of Mr. Pittman, similar was the situation where in he suffered bad because of his apparent “fall”. Mr Harry Pitman, an 83 year old veteran, tripped on a mat at home going to the toilet and fractured his left Neck of Femur. He was admitted to hospital for a TOTAL HIP REPLACEMENT.  

Following are some of the cases/illustrations which he suffered because of his fall, and how it impacted his daily routine:

• He has problem in walking and care barely go out to take his dog Ruby for a walk. Since he has pain while walking he has completely refrained from walking out now.  Staying at home all the time and not meeting people, constantly watching TV can have an adverse effect on his mental health as he might start withdrawing from the world a little too early in age. This is not an ideal situation.
• He is constantly taking painkiller via pills or via injections to ease the pain around the affected area. This is not recommended because his body is too weak to completely digest these strong medication, and will eventually affect his liver and then kidney. Consumption for a long time can lead him towards multiple organ failure and his untimely demise too, again this over dependency on pain killers is to be avoided at all times and it is important to see how other alternatives like osteopathy and physiotherapy can help relieve Mr Pittman’s pain. ‘
• Even though he gets cooked food, he is almost never able to reheat it and thus, ends up eating cold food. Often times, the food keeps sitting out and might get spoilt as well, still he ends up eating it. Because of this he often experiences constipation and his bowel movements are almost never in an ideal state, thus further harming him. These issue can have an effect on his kidney, as it is also mentioned that often times he is not able to use the washroom in the middle of the night and ends up going and reliving himself in the morning only. Kidneys are the most important organ, and the most prone to failure in old age as well. This then leads to the patient going on for painful dialysis which is never something which is looked forward too for anyone so far.
• He is now completely dependent on his close people to help him change and get ready as he is barely able to move so much so that he can have a bath and change. This situation will soon jam his entire body and might lead him in a state of induced paralysis which he brings upon himself and not because of some issues in his motor nerves. For him to constantly be well, it is important for him to keep moving and being less dependent on together for his menial chores, yet important ones like bathing, getting dressed and other things too.

The Roper Logan Theory model can be well implemented here in this situation. This theory is based on nursing and health care and how patients, such as the cases of Mr Pittman. The theory focuses on defining living for an individual and how he or she can attain it with certain goals and commitments that can be undertaken in order to uplift their current state of life as well.

Roper calls for taking these activities of the day not as checklist or to-dos but “as a cognitive approach to the assessment and care of the patient, not on paper as a list of boxes, but in the nurse's approach to and organization of her care," (Williams, 2015).

Here this model can be applied to see how Mr Pittman can divide his daily activities and plan to achieve them in a manner best suited to him, without much stress.

Thus, having done this he can easily pass some of his most dreaded moments in ease and bliss.

Nursing Care Recommendations 

Mr Pittman’s situation is not hitting the rocks right now, however surrently, he is just finding trouble coping with his daily to day tasks like cooking, reheating food, getting dressed but these are signs that his body is no longer supporting his will and that he now needs a person to constantly take care of him. Lack of proper diet is what has resulted in this situation, which then turns towards taking a told on his mental fitness as well.

Following are some of the recommendations for Mr Pittman that his GPN can provide him:

• He can either move into a day care or medical care centre and live their permanently and take all his needs to be taken care of, or hire a full time nurse who will live with him or be with him 24X7. This will ensure that he does not fall back on anything like food, bath, recreation etc.
• He should rely less on painkillers and should find other methods to ease his pain. These painkillers aren’t good for him. His body is too weak to completely digest these strong medication, and will eventually affect his liver and then kidney. Consumption for a long time can lead him towards multiple organ failure and his untimely demise too.
• it is important for him to keep moving and being less dependent on together for his menial chores, yet important ones like bathing, getting dressed and other things too, hence he should take up some easy exercises as well to make sure he doesn’t jam himself at all
• He also has to get himself checked every now and then. In this pursuit, he has to be totally honest with his doctor/GP and allow him the liberty to run on him some tests which he feels are necessary or would be in the coming future. This will ensure that he is always on the grid, and that he does not fall back anywhere at all, under any circumstance whatsoever.

Bibliography:

Health Careers . (2016). General practice nurse. Retrieved from https://www.healthcareers.nhs.uk/explore-roles/nursing/roles-nursing/general-practice-nurse

QNI. (2017). Transition to General Practice Nursing . The Queen's Nursing Institute .

Australia Health Governemnt . (2018). MBS Primary Care . Retrieved from https://www.health.gov.au/internet/main/publishing.nsf/Content/mbsprimarycare_mbsitem_75andolder

Stenhagen, M. (2013). Falls in the general elderly population: a 3- and 6- year prospective study of risk factors using data from the longitudinal population study ‘Good ageing in Skane. PMCID , 13(81).

WHO. (2007). WHO Global Report on Falls Prevention in Older Age. United Nations . UN WHO.

Krishnaswamy, D. B. (2016). FALLS IN OLDER PEOPLE . Madras Medical College and Government General Hospital .

Williams, B. C. (2015). The Roper-Logan-Tierney model of nursing: A framework to complement the nursing process. Wolters Kluwer Health, 45(3).

Rita Drummond Olans, P. K. (2015). Defining a Role for Nursing Education in Staff Nurse Participation in Antimicrobial Stewardship. The Journal of Continuing Education in Nursing., 46(7).