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Patient With Decreased Mobility And Collapsing Shows Nursing Essay

This report will analyse and discuss the treatment plan of an seniors patient. Furthermore, it will determine the patient's physiological, subconscious and sociological needs. The survey will look at the individual as an individual and will give a alternative view of the patient. Relevant legislation will be associated and reviewed as well as teamwork and the role of a student nurse.

Due to confidentiality in compliance with NMC and Data Coverage Action 1998, the patient's name will be altered (http://www. opsi. gov. uk).


Mr. Brown is an 81 calendar year old Asian gentleman, who was admitted to crash and crisis (A&E) with reduced freedom and collapsing episodes. The A&E office did the entire blood display, ECG and torso X-ray. The personnel nurses Founded his notes and documented all patient's data including earlier medical history and current medical problems. The medical personnel decided to provide him to 1 of the wards in a healthcare facility. Mr. Dark brown was transferred to the ward where he was assessed by using Roper, Logan and Tierny medical model which is discussed within the next chapters.


Roper, Logan and Tierny is a model of nursing which combine a life time strategy considering patients' needs regarding previous development, current degree of development, and likely future development (Safarino 1990).

This model comprises in twelve activities of everyday living which are applied on a person whether he's in condition or not. The actions are following:

Maintaining a safe environment




Eating and drinking


Personal cleansing and dressing

Maintaining body temperature

Working and playing


Expressing sexuality



Mr. Brown was accepted to A&E with collapsing episodes, pain and lowered mobility. Mr. Dark brown had been accepted with comparable symptoms before. In addition to the above mentioned problems, Mr. Brown had had a history of Parkinsonism, degenerative vertebral disease scheduled to osteoporosis and depressive disorder. Mr. Dark brown said he had been suffering from a strong pain in his back, decreased freedom and movement disorders. Mr. Brown was also complaining about dizziness when he stood up.

Recorded measurements of Mr. Brown's postural and resting blood stresses were carried out to learn if his blood pressure drops when he was standing up. In healthy people there is certainly hardly any difference between blood circulation pressure in the resting and standing up position. However, in elderly people or people that have diabetes, a significant drop of blood pressure might occur when they operate (http://www. nursingtimes. net).

Nevertheless, Mr. Brown's blood circulation pressure were within the standard level which is under 120/80 mmHg in both readings (http://www. bpassoc. org. uk).

The nurses realised that Mr. Brown was cured with Fentanyl patches which are an opiate analgesic for his pain and one of the medial side results can be dizziness (http://www. drugs. com). Mr. Dark brown was described the Pain Relief Team who could determine him properly because they're people specially trained because of this particular process (NMC 2008).

Mr. Brown was complaining about intolerable pain that was spreading throughout his rear. The TREATMENT Team assessed him to find the best possible treatment. They discovered that the pain was triggered by osteoporosis and Parkinsonism; however they said that these diseases could not give the patient "unbearable movable" pain as Mr. Dark brown was talking about.

The Pain Relief Team has so far tried a variety of analgesic types, but none of them seem to be to be working effectively as the patient has not ended complaining about his pain so far.


Degenerative Spinal Disease is a process where pathological changes in the tissue and composition of the spine take place (http://www. backcare. org. uk). It really is a normal procedure for deteriorating vertebral discs which progresses with era and spinal disc degeneration (http://spinwarp. ucsd. edu). Ageing is a standard process in the human body, however, when the vertebral discs degenerate rapidly, it can result in again pain as the vertebral discs start shedding inflammatory proteins and this can distress (Appendix 1). Treatment for degenerative vertebral disease involves medication, exercise, manipulative treatment and physiotherapy (http://www. globalspine. net).


Parkinsonism is an illness with symptoms nearly the same as Parkinson's disease. The symptoms are tremor, rigidity, hypokinesia, low blood circulation pressure, athrophia and urinary problems (http://www. parkinsons. org. uk). In contrary with Parkinson's disease where the human body suffers from a low level of dopamine, patients with Parkinsonism have normal dopamine levels (http://www. merck. com).

Mr. Brown experienced previously had two MRI and CT scans, and the results for Parkinson's disease were negative as his dopamine was of standard levels, therefore, Mr. Brown was identified as having Parkinsonism.

Mr. Dark brown was commenced on medication for his disease and was referred to a physiotherapist and a treatment team. When Mr. Dark brown was admitted to medical ward, he was totally mobile, and handling to walk along with his keep. When he was used in the geriatric section for treatment, he was given physiotherapy to improve his mobility that could affect the grade of his life. The physiotherapist was exercising with Mr. Dark brown but his family started complaining that the physiotherapist was cruel and forcing him to walk. The family explained that their father was elderly and should be treated with more compassion as he didn't feel able to adhere to physiotherapy. The Code (NMC 2008) says that people must value patient's and client's choices and protection under the law. The physiotherapist therefore quit attending Mr. Dark brown which made him and his family happy, however, Mr. Brown's range of motion deteriorated rapidly more than a couple of months to the stage where Mr. Brown ceased walking and mobilising completely and required assistance with simple duties such as dressing or transferring from the couch to the foundation and Mr. Dark brown started asking for a wheelchair to copy to and from the toilet. It was told Mr Brown that was unacceptable as he previously been completely mobile on entrance to hospital. The nursing personnel explained to Mr. Brown and his family about the importance of maintaining earlier levels of function and Mr. Brown's family decided to continue with physiotherapy which could help along with his mobilisation. Mr. Dark brown started gradually to cooperate with exercises, mobilising and now Mr. Brown is able to walk to the bathroom but still requests a transfer back again to his room using a wheelchair. The physiotherapist found Mr. Brown's gait a little unsteady in order a professionally trained health care worker he chosen that Mr. Dark brown would start utilizing a zimmer frame in order to provide better stability and avoid falls (http://www. hse. gov. uk).


Another very important aspect of any good standard of living is adequate oral intake and nourishment (http://ezinearticles. com). Mr. Dark brown started reducing your weight over his long stay in medical center as he didn't like the hospital's food. He lost weight and started feeling very vulnerable, which discouraged him to move and continue his flexibility levels. This contributed to further problems such as eradication. Mr. Brown began to become constipated and suffered from frequent stomach pains. He was prescribed Lactulose and described a dietician. Mr. Brown was assessed as an individual with poor dental intake, lack of vitamins and minerals. Therefore, he was advised to begin taking Fortisip as a complementary product to his diet. Fortisip is a dietary proteins drink enriched with minerals and vitamins (http://www. epgonline. org). This food dietary supplement helps to provide the body with absent calorific consumption, however, Mr. Dark brown didn't like its flavor despite Fortisip being available in a number of flavours. To be able to provide Mr. Dark brown with a good dental intake, the nursing staff arranged along with his family that they might start having Mr. Brownish food he liked. This effectively managed and retained Mr. Browns weight.


Mr. Brown can be an Asian man and was created and raised in a Muslim family. He arrived to the UK in his early forties. Mr. Brown has four children and six grandchildren. When he was admitted to the ward he was offered lady chaplaincy service which he refused. As Mr. Brown said himself, he had greatly designed to local culture.

Before he was admitted to the hospitals, where he has spent nearly 10 months, he had been staying with his partner and children and grandchildren in a large house. He i did so gardening and savored playing board game titles along with his grandchildren. All these activities which he savored have been deprived in the hospital environment. Mr. Brown started becoming stressed out because he spent days and times in one room and he discontinued enjoying life. Along with his Parkinsonism disease which also contains symptoms of despair, Mr. Brown became lethargic without real interest in life. Mr. Dark brown was offered to start taking skill classes that are taken twice each week within one of a healthcare facility dayrooms. It's been proved that fine art therapy helps ill patients to relax, improve mental poison and improve standard of living (http://findarticles. com). Sadly Mr. Brown refused art therapy.

One of the participants of nursing staff tried to persuade him for taking the possibility to socialise by firmly taking part in the art work classes as she sensed this might help Mr. Brown's socialisation. This was a personal feeling of the member of nursing personnel, however, Mr. Brown did not hold the same view and he thought she was forcing him to do something that he didn't wish to accomplish. The nurse was looking to do the best in order to increase the patient's standard of living and meet the patient's needs but she was reminded that her personal thoughts and prices might vary from person to person. This may be classified as an individual and professional value issue. This occurs when personal feelings become better than professional status and can eventually lead to issue. (http://www. cliffsnotes. com). The nursing staff told Mr. Brown that all actions taken have been done limited to his advantage. Mr. Brown accepted this and he began to talk to the staff more. This may also be seen as a benefit as although a conflict happened, it helped bring better communication and co-operation between personnel and patient (http://work911. com).

Mr. Dark brown refused to use art classes, which means nursing staff decided to send him to the occupational therapist who attempted to find a suitable way to help Mr. Dark brown socialise more. The occupational therapist found that Mr. Dark brown was used to sticking to his family and nothing could swap his family life. As Mr. Brown's family said, family life is one of the most crucial areas of life in the area of the world where Mr. Brown comes from, which was afflicted by his admission to clinic. The family have been arriving to go to Mr. Dark brown every day approximately the visiting hours allowed. In addition they explained to nursing personnel why these were not happy with physiotherapy remedy which was seeking to encourage Mr. Brown to walk and keep maintaining his flexibility. They explained that in their culture nursing personnel and family take care of the patient and family members, whereas nursing staff in UK nursing homes encourage the patient's freedom. From their point of view elderly people are entitled to respect and should have their desires fulfilled, whereas Western culture is based on encouraging patients freedom in order to increase and develop skills regardless of the patient being elderly. In Islamic countries, long term wards or assisted living facilities are exceptional, as they think that it's the family who should take care of their comparative, it is their duty and honour (http://www. islam-guide. com). This point of view have been talked about with the family and nursing personnel and a bargain was come to, for example, motivating the individual to walk to the bathroom but wheeling him again. This worked efficiently as both factors were satisfied. The family found an effort from nursing personnel to fulfill Mr. Brown's culture values and nursing personnel were happy to perform the best practice, retaining Mr. Brown's ability to move while also respecting patient's rights and selections (NMC 2008).

After almost eight weeks in the good care of older people device, Mr. Brown's condition allowed him to be discharged back again to his home, however, his family are refusing this because they're worried they cannot cope. It had been advised that Mr Brown should be looked after within a medical home, which his family also refused as it was unacceptable from their ethnic values. Mr. Brown's family feels that their dad is seriously sick. They assume that their daddy has Parkinson's disease. If the first check of Mr. Brown's dopamine levels was done and did not prove the existence of Parkinson's disease, these were disappointed because they presumed that their father presents with Parkinson's disease symptoms so therefore must have the disease. They asked for another judgment from another type of consultant that was finished with the same final result. Mr. Brown was diagnosed with Parkinsonism. His family still will not agree and hasn't accepted the result or diagnosis and still maintain their daddy has Parkinson's disease. The family thinks that there has been one in diagnosis plus they have lost rely upon the medical and medical personnel, choosing to isolate themselves from staff. Effective communication and trust between patients, their family members and nursing staff is really important to be able to cooperate and offer best quality care (http://www. bt. com. bn).


As mentioned recently, Mr. Dark brown has spent a long time in medical center and has been deprived of each day family life. The good care of older people ward and everything members of the multidisciplinary team are aware of this fact, therefore they make an effort to address each patient separately (NMC 2008). The hospital where Mr. Brown is accommodated co-operate with the neighborhood WRVS. WRVS is an organisation compromising of people who voluntarily help seniors. The WRVS team comes to the ward weekly and sells magazines and groceries to the patients in order to permit patients some independence for their needs and also operate a tea bar in the foyer that allows patients and their family to enjoy a short period away from the ward environment. (http://www. wrvs. org. uk).

Another voluntary team that attends to patients in this ward are students from the all natural therapy course. These folks come regularly, and offer the patients a broad spectrum of massages that assist the patients to relax and take their imagination off their problems (http://www. healthk. co. uk).


Mr. Brown was presented to the ward Objective Statement. He is aware that all the multidisciplinary team members are working at a higher level of scientific skills and knowledge. Mr. Dark brown has been in the ward for some time and now has learned all the customers of staff which helps him to incorporate into the complete framework of the ward's team and daily habit. All staff work in conformity with NMC The Code, respecting patient's rights and selections, equality and diversity, dignity, privacy, safe practices, confidentiality and anti-discrimination practice (NMC 2008). Mr. Brown originates from a culture where in fact the patients are attended by a healthcare professional who is the same gender because they are (http://books. google. co. uk) and one of his wishes is usually to be attended by the male nurse. The ward personnel continuously tries to fulfil Mr. Dark brown wishes however, there is not always adequate staff or a man nurse in the ward anticipated to shortness of staff in NHS (http://www. nursingadvocacy. org). Mr. Brown was familiar with this fact and now he understands the circumstances and understands that his privileges and selections are respected and if it's possible, he gets the attendance of the men nurse.

Mr. Dark brown was diagnosed with Parkinsonism. Depressive disorder is one of the syndromes of the disease so mental needs have been known as well as the physiological symptoms of this disease. Mr. Brown was seldom happy and nobody has really seen him happy or smiling. Mr. Brown has been encouraged by his family to always seek the help of personnel, undermining his self-reliance. It has not helped him to keep and improve his health as Mr. Dark brown seems to enjoy "the sick and tired role".

Mr. Brown has been complaining about pain. The TREATMENT Team has assessed him but however without success. The Pain Relief Team hasn't learned why Mr. Brown's pain was moving to different places of his back again so together with other health care participants of multi disciplinary team, they decided to refer him to a psychiatrist to evaluate his psychological talk about and needs. The psychiatrist evaluated Mr. Dark brown and diagnosed him as a patient with psycho-somatic disease. Psycho-somatic disorders can greatly impact the human body and affect the real somatic disease and its own effect on patient's head. Physical disease can also deteriorate by mental factor (http://www. patient. co. uk).


Mr. Dark brown has been included and included within a sizable MDT and he has been given the best healthcare. The multi disciplinary team including nurses, doctors, physiotherapist, occupational therapists, psychiatrist, and scholar nurses who've all been collaborating with him and communicating among the other person as a team to be able to provide high quality treatment. Team work is vital in healthcare. The multi disciplinary team have been synchronised and linked together in order to connect each member's action to get the best results for the individual. The team is a group of people with a goal who interact (http://www. team-wise. co. uk). Working as a good team is really important in health sector as health care staff is dealing with lives. John Adair's theory of team work suggests that team work should achieve the prepared goal and improve learning new knowledge by cooperating with other users of the multi disciplinary team by learning from each other (http://www. teambuilding. co. uk).

Belbin Team Role Theory proposes that every member of multi disciplinary team has certain strengths but also weaknesses. Dr Meredith Belbin also proposes that everyone included in multi disciplinary team should discover his advantages and weaknesses and cooperate with other folks in order to build up his skills and therefore donate to better quality work (http://www. belbin. com).

Good team in health care area must have grounds to work together, respect one another and essentially make team conferences in order to determine how effective teamwork inside the team functions. The team meetings helps interior communication in the team, steering clear of mistakes, despatch insufficient communication and helps to develop each participants of multidisciplinary team's skills (http://www. scotland. gov. uk).


The role of a student nurse is very important. Each student nurse who is involved in the team work of an ward should have theoretical knowledge to execute the skills, biological, mental and sociological aspects, honest and legal perspectives Impact of Substance of Treatment and/or National Benchmarks (http://www. health. heacademy. ac. uk). University student nurses must be familiar with the law and legislation and its own function. Among the main is The Health insurance and Safety at the job Function 1974 which really helps to learn how to work safely to be able not to damage themselves or others. Other similarly important acts are the Data Protection Act 1998 and Legislation of Care Take action 2001. All pupil nurses should be familiar with Human Rights Act 1998. Learner nurses working in mental health sector should know Mental Health Care and Treatment Action 2003.


This survey has effectively analysed a care and attention plan of elderly patient. Specific chapters provided the patients needs including the physiological, internal and sociological aspects. As well to be analysed generally, these factors were also related towards the average person patient. Furthermore, the article included the relevant legislation that is essential for health care professions. Besides health care programs and legislation, effective teamwork was reviewed highlighting the benefits it has for health care personnel and patients. The reported also shown a brief advantages to the role of a student nurse and their function to become an effective member of the multidisciplinary team.

Conclusion reset

Mr. Brown was admitted to the hospital with a collapse. He was Carried out in a health care process and plan to recover and be able to manage daily LIVE activities. Alas Mr. Brown began losing his ability to move and also eat disorder happened. All health care professionals involved with Mr. Brown's circumstance have been looking to provide best care quality to FULFIL, IMPROVE, DEVELOPE his physiological, subconscious and sociological needs. Mr. Brown continues to be accommodated in the ward and hopefully he will retrieve soon.

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