The focus of the examination is to evaluate a service user who has been admitted onto a ward in which a learner was present and plan care, predicated on their needs which were outlined in the holistic assessment process. The evaluation will include the original assessment and the complete care and attention plan as an appendix (appendix 1) in which a model of medical will be utilized as a framework. The model preferred was the Roper, Logan and Tierney activities of everyday living (2000). This assessment will then discuss the student nurses judgements and decisions about the service users' needs and why and how these were made. This will be recognized by theory which in-turn underpins the decision-making and analysis processes. The setting up of which this task uses was the following; a service end user had been admitted through automobile accident and disaster to a medical ward, with acute stomach pain and nausea. To do something relative to the NMC code of conduct (2008) private will be managed, and consent was obtained from all involved in the delivery of treatment and the service user, subsequently any titles mentioned will maintain no relationship to genuine brands and places.
The service individual 'anna' possessed a previous health background (PMH) including irritable bowel symptoms (IBS) tonsillectomy (2009) and was an insulin handled diabetic, and it was clear at present to the scholar nurse and the ward sister that the Anna was in pain.
As previously mentioned the use of your model of medical was used to construct a good care plan, the model used was Roper Logan and Tierney's activities of everyday living. This model was chosen as it was the model of nursing, in which the scholar nurse was on location as it addresses a holistic health care analysis. This therefore means that the model may be used to create a care and attention plan surrounding the service user that may take into consideration many needs including communal, emotional, mental health and physical problems and needs. The style of medical was also chosen because of the regimented daily living activities which evidently outlined relevant needs for the Anna. They are as follows; to permit the Anna the perfect time to communicate her concerns, to control pain and to successfully manage the feeling Of nausea whilst providing reassurance through communication.
The holistic good care plan that had been completed prioritised nausea and pain control as the Anna's needs. These aspects were identified as being main concern after initial evaluation had taken place (appendix 1) in which many decisions were made, however only two of the will be talked about, these are as follows; to regulate the Anna's pain, and the decision to reassure the Anna.
The decision of giving the Anna reassurance was made before any initial analysis had took place. This decision was made as it was clear to the college student nurse that she was worried and the diagnosis was made because of past experience with service users who have endured similar pain with health issues. Matching to Taylor (2005, p. 46) nursing knowledge is a crucial part of the decision making process. Aswell is connecting with the service user to reassure them and present the service consumer knowledge about their possible reason behind their current starting point of pain. Information was also gained from the Anna's mother about her normal behaviour which helped verify why the patient is worried, as there had been a quick change. Kaplow (2007) suggest members of the family can reassure worried patients. Mallik et al (2004) suggests that the communication is important in the decision-making process, this is noticeable from the care plan that can communication and data collection from both Anna and her mother was gained.
Hilgard et al (1994) suggests that pain is controlled in lots of ways, and that levels of pain are dependant on patient's perceptions of pain. It had been clear that Anna was at pain as observation of body language and also through communication with her and her morther. Therefore analgesia was given as prescribed and administered by the nurse not the university student. To help examine the pain degrees of Anna's a pain graph was used (appendix 2). The usage of the nursing process empowered a methodical approach to recognise that Anna acquired a problem and helped in the health care planning process after conversing with Anna a diagnosis of pain was made and the pupil was able to decide to teach Anna with having relevant knowledge through books of positions that may help relieve pain.
It shows up that the medical process is an enormous amount of making decisions for service customer care. Knowledge of anatomy and physiology also play a part in the decision-making process alongside, past encounters with earlier service users with the same problem help to make decisions. After much reading it is apparent that there is much research on experienced nurses making decisions but only a limited amount on university student nurse decision-making. Thompson et al (2004) talked about cognitive continuum theory; this explains how decisions are created by data collection and interpretation as well as intuition. Nurses have always was required to make decisions in practice about services users worry but now they can be increasingly more accountable for decisions that they are making.
Benner's (1987) theory of newbie to expert, talks about five different steps from newbie to expert this suggests that it takes time and experience to be an expert and nurses must move through each step to travel to the next step. This is apparent from this assignment that the student made decisions predicated on several different factors and use of different information therefore working through the periods of amateur to expert.
In realization it is visible that decision-making is complex and considers a vast amount of aspects to deliver best look after the service customer, these aspects include data based practice, previous experience and knowledge, codes of conduct, federal policies and types of procedures, examination tools, information seeking and interpretation, and the service users tastes. Furthermore decision-making has been a difficult area to research from students nurse point of view as there is a limited research and literature for university student nurses and decision-making, this advises there is need for further education for college student nurses.