Bed Bathing a Patient Essay Example for Free

Bed Bathing a Patient Essay Introduction In this assignment I will be exploring the legal, professional and ethical issues involved in bed bathing a patient/client in a hospital setting. I will be reflecting on a personal experience, experience during a seven week placement on a diabetic ward. I have decided to use a reflective cycle which is an adaptation from Gibbs (1988) model.This reflection has provided a systematic approach to my learning and to my nursing practice. Within this essay I intend to discuss approaches to assessing, planning, implementing and evaluating care. Heron (1977) refers to the process of reflecting as a conscious use of the self. Once one becomes consciously aware of their actions, it is easer to recognise the reason for doing them in the first instance. The first stage of this process is to acknowledge our actions by reflecting we reveal to our selves how we act, such actions are spontaneous and without forethought attention. To maintain my clients autonomy I am unable to disclose any client information, accordingly I have given my client the name Mrs Jones this is to protect and respect my clients confidentiality as stated by the NMC Code of Professional Conduct. Gibbs model of reflection (1988)DescriptionDuring any clients admission stage an assessment on the clients skin care regime is made, this takes into account the clients personal preferences, the level of function the client may have to provide self-care and the amount of assistance required to promote optimal hygiene procedures in the form of bed baths, in respect of encouraging independence. The reason why we bed bath clients is to promote personal hygiene and to give them a sense of well-being it also maintain intact skin i.e. prevention of pressure sours. Bed bathing allows the caregivers to monitor changes in the clients skin condition. (Staff Nurse, during placement)It was approximately 07:45 Friday morning of mid June, three weeks into my placement. After handover I was given the task of bed bathing a female client. Mrs Jones, what I learned about Mrs Jones in handover was very brief. She was admitted to hospital as she was suffering shortness of breath, she had been suffering from Parkinsons disease for ten  years, she also had a catheter instituted, she had very little control of the lower half of her body, her right shoulder was dislocated and she was MRSA+. Mrs Jones took part in a trial drug many years ago this was to help her control her Parkinsons disease coming off the drug became impossible and as a result Mr Jones is reliant on this drug, this drug was referred to as apple morphine on the ward. The basic bed bathing equipment I required was one bath towel, one hand towel, several disposable swipes, clean bed linen, (2 x sheets) laundry bags, (in this case red bags as the client is MRSA+) a slide sheet, small yellow bag for clinical waste, pad and incontinence sheet, bowl of warm water and a set of pyjamas and or gown all provided by the hospital. The client had acquired her own personal toiletries before admission this consisted of a bar of soap, shower gel, talcum powder, perfume, two flannels, (one for the upper part of the torso and the other for the lower half) moisturiser, a comb, dentures pot, tooth brush and tooth past. In addition to this the client required saline solution, disposable wipes, new dressing cut to size and tape and a yellow clinical waste bag for the disposal of old dressings. Myself and Claire the Auxiliary Nurse who I was paired with to work alongside put on our protective disposable gloves and red aprons on after collection the supplies from the linen room. I greeted Mrs Jones and introduced myself and Claire. Morning Mrs Jones, how are you this morning? She replied Oh, hello, I could be better I continued my name is Sharon (as this was easier for people to pronounce, after consulting Sister) Im a student nurse and Im going to be looking after you today, and Im Claire, and Im also going to be looking after you today too. I continued can we help you to get ready for breakfast? Yes please, Replied Mrs Jones. Before we began we asked if Mrs Jones if she had any objections to either me or Claire giving her a bed bath, as she looked apprehensive, she replied that this would be fine. We also asked if she had any pain and how her night was, she stated that she was in pain quite a bit but that it was normal for her at this time in the morning. She also stated that her night was awful, as patients in the  next bay kept her awake most of the night. Myself and Claire consulted the staff nurse about Mrs Jones pain, the staff nurse spoke to Mrs Jones about her medication and said that it was not due until 8:30 and so we were asked to continue as long as the Mrs Jones was happy for us to do so. Mrs Jones replied if that was the case there was nothing she could do other than for me and Claire to continue. We explained the procedure to Mrs Jones and gain her consent she allowed us to obtain any necessary toiletries from her draws whilst I did this Claire prepared a bowl of warm water. I removed Mrs Joness personal belongings from the table and placed them in the draws for safe keeping. I wipe over the table with an alcohol wipe to sanitize the surface and place on there the necessary items we would need to give Mrs Jones a bed bath. We draw the curtains closed to maintain Mrs Joness privacy and dignity at all times. Before we began I asked Mrs Jones if she would like to use a bed pan before we continued any further. She informed us that it was probably too late and she felt she had already made a mess. We reassured her that everything was alright and we would help to get her cleaned up as quickly as possible. Mrs Jones apologised a number of time and started to get upset. We again tried to reassure her again and clam her down, we in forced the reason that we were there and that was to help her in any way to see that she is alright. She agreed with us and asked us to continue. We raised the bed to the appropriate height to avoid putting undue strain on our backs, whilst I did this Claire emptied Mr Jones Catheter and placed the bag on the bed. We decided to place a sliding sheet under the client to assist us in rolling the client. I took the liberty of explaining the procedure to Mr Jones as we carried out the task. I asked if it was possible for her to roll on her right side as I was aware the Mrs Jones right shoulder was dislocated, she insisted that this was fine as it had been seen by the doctors and nothing could be done about it and insisted that she had rolled on it sever times before. We assisted Mrs Jones in removing her night gown, we freed her left arm first then her over her head and then gently freeing her right arm avoiding injuring her arm any further, to maintain Mrs Jones dignity we placed a large bath towel over her covering her private  areas. I helped Mrs Jones to bend her left leg and asked her to hold on to the cot side with her lef t hand. I placed my right hand on the left side of Mrs Joness waist and my arm across her left leg to provide added support. I placed my left hand on her left upper back. Claire had prepared the slide sheet, clean linen sheet and an incontinence sheet to go under her. On the instruction ready steady (then the manoeuvre intended, in this case it was) roll, we all assisted in rolling. Claire placed one of her hands on Mrs Joness back to provide added support and prevent her from rolling back. Claire folded the old linen in to its self, to as far as it would go until it reached Mrs Jones. Claire placed the clean slide sheet, linen sheet and incontinence sheet already folded in preparation under the old linen sheet. On Claire say so we rolled Mrs Jones on to her back, Claire were rolling you over a slight bump now, ready steady roll. To roll Mrs Jones on to her other side me and Claire switched roles and this time Mrs Jones was holding on to right side of the cot side but with her left hand. I removed the old linen and placed it inside the red linen bags. I took the liberty of cleaning Mrs Jones with her permission. I used a damp disposable wipe which Clair handed over to me and wiped away from the genital area, I placed the soiled wipe on the soiled incontinence sheet I continued doing this until the are was clean, once this was clean I washed the area with soap and water. I folded the soiled incontinence sheet into its self and disposed of it in the yellow clinical waste bag. I took this opportunity to wash Mr Joness back, neck and the backs of her legs with soap and water, I then wash off the soap and dried. I straightened out the clean slide sheet, linen sheet and the incontinence sheet and then Mrs Jones lied on her back. After a few minute, I placed the hand towel over the clients chest and with her permission began to wash her face at the clients request I used water only on the face. I used separate wipes for each eye to prevent any cross contamination and a separate wipe for the rest of the face and then dried. Whilst I was doing this Claire began to wash Mrs Joness hands with soup and water after gaining permission to do so, Claire continued down the arms and rinsed off, whilst I dried the hands and arms Claire continued to wash the clients chest. Claire removed the dressing from around the tube of the catheter and disposed of it and her gloves in the clinical waste bag, she  then went to wash her hands. When Claire retuned she had a fresh pair of gloves on she began to cleanse the skin from the tube outwards and then dried the area, she decided not to reapply another dressing as she felt it was not required but did tape down the tube to Mrs Joness stomach to prevent it from dislodging. Claire carried on washing and rinsing Mrs Jones (Underarms, stomach, waste, genital area, (working outward to prevent infection) legs and feet) and I dried following Claire as she washed. The water that we used was kept clean at all times, as the used deposable wipes were not re-entered into the bowl. Whilst carrying out the bed bath myself and Claire assessed the Mrs Joness skin condition for any sours or broken skin. We applied talc to those areas Mrs Jones requested and then helped her to dress. We put the right arm in the nightgown first as this was her bad arm then subsequently her neck and left arm, there was no need to lower the nightgown much as this was a hospital nightgown with an open lower half, we then placed a linen sheet and blanket over her to keep her warm at Mrs Joness request. We raised the head of the bed to a seated position so that Mrs Jones was sitting upright. As I attended to Mrs Joness oral hygiene Claire combed Mr Jones hear to her particular style. I then started to tidy and clean the area and Claire began to document and update the care plan. Once I had cleaned and sanitised the table I replace Mrs Joness belonging on the table and placed the table close to her so everything she may need was of reach. FeelingsIn reflection to the incident at the time I felt as though everything went fine, but as I have had the opportunity to reflect on my experience in much more depth and detail I in writing this essay I felt as though I took the lead but only because I was given the opportunity to do so. Claire was fairly new to working as an Auxiliary Nurse and was somewhat inexperienced as this was the only ward she had worked on she had more knowledge of the ward setting and the type of conditions people are admitted with on the ward. I was quite confident in assisting in a bed bath of a client as I have worked in providing personal care to all type of client for a good few years now and believe that my experience as a Health Care Assistance helped me immensely. My uncertainty was of the clients abilities and reactions to what we were actually doing it, thats when I decided to talk to the client  and guild her through what we were doing. The thoughts in my head at the time were that the client may not have experience the type of bed bath that we were performing and may have not been something she was used to. I felt calm but a little apprehensive due to this but could find the words at the time to ask her if this was the way her carers would normally perform a bed bath. It is important to remain professional at all times and make sure the client didnt feel too uncomfortable. I remember feeling somewhat responsible for the client as I was looking after her. I believe I acted in the best interest of my client and have acted in such a manner set out by the NMC Code of Professional Conduct. I felt that it would have been better for the staff nurse on duty to explain to the client in much more depth, why it was not possible to administer the drugs at the time of the clients request rather than just to say its not the right time and the drug round starts at 8:30. Although my client had told me the truth about her dislocated shoulder had been seen by the doctors and that it was safe to manoeuvre on as long as it was comfortable it was my responsibility to seek professional advice because of my uncertainty at the time. If for any reason had this not have been the truth there may have been serious repercussions. I dont think I would have known what to do if her condition had worsened due to the manoeuvre. The steps forward build on the steps backwards or sideways. They are also the steps necessary for self-reflecting from this statement emphasised by Tschudin (1999) I able to understand that confidence in the self is quite an important quality to be have in order to acknowledge setbacks and mistakes, your should be able to learn from them and even see them as part of the overall picture. EvaluationI have grater knowledge of such issues that can arise if set guideline, policies and procedures are not followed. There are very few bad points that had taken place during this reflective experience. I believe it is important to involve the client in decision making which I failed to illustrate wherever possible this was when we redressed the client after bed bathing without involving the client and allowing the client to choose. We  all have a professional responsibility to provide care to all patients/clients to the highest possible standards of care that will not be compromised by infections standard set out by the NMC Code of Professional Conduct. I acknowledged limitations set out by the NMC Code of Professional Conduct, in that my knowledge and experience of the drugs on the ward was very limited and therefore I acquired help from a qualified member of staff. You must behave in a way that upholds the reputation of the professions outlined by the NMC Code of Professional Conduct this was maintain throughout the whole experience as I never spoke over the client nor did I ignore the client I showed the client up most respect. I was able to build a level of trust with theMy experience of working as a Health Care Assistance for and agency has enabled me to perform better in such conditions. By planning and discussing with the care team during handover and then with the patient about what our intentions are, what we are going to do and why, I was able to identify and minimise risks to the client. Seeing the way in which others behave or make mistakes allowed me to reflect on the point of view of others and to learn form them help me build on my knowledge. AnalysisI chose this experience as it is a procedure that I am quite confident with performing. Thiroux (1995) created his own set of principles of ethics, which can be applied to any situation. 1) The value of life, 2) Goodness or rightness, 3) Justice or fairness, 4) truth telling or honesty and 5) individual freedom. Ethical acts are executed in every day life even if we acknowledge it or not, the way we greet colleagues and clients even in the way in which we say good morning. Tschudin (1999) p175. As a training professional we are accountable for our actions and therefore must be able to backup any decision making with evidence I could see from my  clients facial expressions that she was uncomfortable and was experiencing some sort of upset, during which in actual fact she was in a fair amount of pain. ConclusionI felt that the approach I took was in the right way and with the right intentions set out by the NMC Code of Professional Conduct. My reflective experience was very basic I felt and did not allow for much discussion, although a lot of the experience was preparation, planning and assessing which prevented the experience to go bad in anyway. I feel that as I am a first year nursing student I am very limited in what I can do and because of this little opportunity is given to me to experience other than what I have preformed as a Health Care Assistant. I felt that myself and the Auxiliary Nurse worked well together and were able to share the responsibility equally. Overall I found reflection on my experience interesting as it allowed me to look at legal, ethical and professional issues surrounding nursing practice. Action PlanIf a situation like this was to arise again I think I would like to try to take out more time to talk to the client about how they are feeling, at time I felt like I was prying too much as I felt like I was doing most of the talking. I also feel that it is important for me to work along side more experienced members of staff or qualified member of staff to be able to learn more whilst on my placements. Although I experienced in providing personal care to client I am not too familiar with ward setting. I do not think I have learnt an awful lot on the practical side of my experience but by reflecting on my experience in this assignment has allowed me to understand professional, legal and ethical issues of providing care and the dilemmas surrounding health care professionals. In the future I would not always go on the clients say so and seek professional advice and not just take the patient word. Bibliography Bartter. K, (2001) Ethical Issues in Advanced Nursing Practice. London: Reed Elsevier Plc GroupBurnard. P, Chapman. C, (2004) Professional  and Ethical Issues in Nursing. 3rd Edition. London: Elsevier LimitedGlasper. A, Grandis. S, Jackson. P, and Long. G, (2003) Foundation Studies for Nurses: using Enquiry Based Learning. New York: Palgrave MacmillamThe NMC Code of Professional Conduct Standards for Conduct, Performance and Ethics. Standards 07-04. London: Nursing Midwifery CouncilTschudin. V, (1999) Nurses Matter: Reclaiming Our Professional Identity. London:Macmillan

Extinct Animals Research: Woolly Mammoth :: essays research papers fc

Extinct Animals Research: Woolly Mammoth   Ã‚  Ã‚  Ã‚  Ã‚  We have learned much about the Woolly Mammoth almost more than any other dinosaur that has been identified. Due to the fact that the Woolly Mammoth so closely resembles today's elephants, care for them would most probably require most of the same factors to keep it alive. Since the Woolly Mammoth has been extinct for 4000 years, it is difficult to tell exactly what they lived on, but we can hypothesize.   Ã‚  Ã‚  Ã‚  Ã‚  The Woolly Mammoth lived during the Ice Age, so if alive today, it must be kept in a tundra environment. For food, only basic tundra vegetation is necessary. Due to the thick pelt that the Woolly Mammoth has, any known Ice Age temperatures would suffice since the thick fur protects the animal in any extreme temperatures.   Ã‚  Ã‚  Ã‚  Ã‚  Large enclosures would not be needed as they would be for a normal elephant since the Woolly Mammoth is only three meters high. The huge tusks would allow it to scavenge for its own food, so no special feedings would be necessary. Feedings would also be needed on a less frequent basis since the Woolly Mammoth, much like today's camels, keeps under its sloping back a thick layer of blubber as nutrition when food was not needed.   Ã‚  Ã‚  Ã‚  Ã‚  The problem in keeping a creature such as the Woolly Mammoth in a zoo- like surrounding would be poachers. Due to the endangerment of such a magnificent species, poachers of pelts and ivory would most certainly be after it's huge tusks and thick furs, so it would be necessary to post guards around it's cage at all times.   Ã‚  Ã‚  Ã‚  Ã‚  A large-scale habitat would be constructed for this creature since, during the period it lived, the Pleistocene, there were no restrictions on the places it could roam to. There was nothing stopping this beast from stomping along to wherever it wanted to go. A Woolly Mammoth might find it peculiar to be stuck in a twenty foot ice field with no predators or other animals whatsoever.

Opposition Speech Against House Resolution 3243 Essay

Poverty indeed has many faces. But its indelible mark of pain and misery is unmistakable in the nameless faces and faceless names of those who suffer from it. The destitute who are living on a perilous edge. The lowly who are struggling to hang on amidst hard choices between hunger, housing, health care and education for their families. Yet, our government is still on an ambiguous trail towards resolving the poverty problem. The legislature is still groping in the dark as to how poverty should be measured and determined. For this reason, I am opposed to the enactment into law of House Resolution 3243, otherwise known as the Poverty Measurement Improvement Act. It does not make any important or meaningful improvement on how poverty and poverty thresholds are to be gauged. Proponents of H. R. 3243 profess that it would improve understanding of the effectiveness of government programs to combat poverty and would more accurately determine the real extent of poverty. They insist that official poverty statistics overestimate poverty. (Ways and Means Republicans, 2007) Yet it will fail as it fails to address the crux of the matter: What really is poverty and who really are poor in America? H. R. 3243 misses the point completely. What it does certainly is not measuring but underestimating poverty. A new measure should instead be endorsed, one that would more accurately define the poor population. While the proposed bill would now consider previously unaccounted data like non-cash benefits such as medicare, housing assistance, food stamps, and the Earned Income Tax Credit (EITC) as forms of income, I do not however agree with its underlying principle. Proponents assert that to continue to ignore the value of anti-poverty benefits is misleading, and that if introduced to the matrix, the number of people living under the poverty line would decrease. They contend that by counting benefits earned, many people will no longer be considered poor. (Ways and Means Republicans, 2007). I find this idea a little absurd. The poverty line to be determined does not consider the significant factors that should be included in the equation. To reduce the number of people living below this poverty line that is deceptive would delude us that poverty has been and is being alleviated. H. R. 3243 fails to substantially capture the gamut of the multidimensional qualities of poverty. And this has been one of our biggest problems all along. Our equation is flawed. The equation that H. R. 3243 proposes is still wrong. The proponents claim that ignoring anti-poverty benefits escalates poverty rates, intensifies appeals for additional benefits, multiplies government spending, and increases taxes which all impact ultimately on the people (Ways and Means Republicans, 2007). This circuitous argument is again misleading. In fact, the cost of providing benefits would be considerably higher if only the government recognizes the true number of people who are poor. Poverty has to be scrutinized on its multifarious dimensions and gauged through a variety of indicators — levels of income and consumption, social indicators, and indicators of vulnerability to risks such as age and gender and of socio-political access across groups and geographical settings (Citro & Michael; 1995, 2). Factoring these aspects in the poverty count, would in fact significantly increase the total number of poor (Willis, 2000). This complex dynamics includes changing access to employment and increases in non-food items such as housing, education, transportation, and health care, among others (Van Hook, 2003). A case in point: In this era of skyrocketing healthcare and insurance costs, because of differences in health status and insurance coverage, different population groups face significant variations in medical care costs, but the proposed measure would not take account of them (Citro & Michael, 1995). The average family spent one-third of its budget on food based on the poverty measure developed in 1964, but today, the figure is closer to one-sixth (Catholic Campaign for Human Development). It is proposed that actual costs for food, clothing, and shelter, rather than a budget for food, be used to determine the poverty level (Institute for Research on Poverty (IRP), 2004). Other factors to be integrated in the proposed poverty matrix should include adjustment of the poverty level for family size and of housing costs based on geographical differences; deduction of mandatory expenses such as taxes, work expenses, child care costs, child support payments, and out-of-pocket medical care costs from family income before comparing income to the poverty level; and the use of Survey of Income and Program Participation as an alternative Census survey (Citro & Michael, 1995; as cited in IRP, 2004) The IRP underscores some difficulties on how to incorporate the proposed changes. However, as current research trends indicate, there are no limits to technical and scientific knowhow that would preclude us from formulating a blueprint to address those problems. The dilemma that poverty creates amongst millions of Americans should be reason enough to inspire and propel scientific and research efforts. Having examined all sides of this issue I am convinced that H. R. 3243 should not be passed. It is lame legislation under the pretense of promoting public welfare. It is weak. It is inadequate. It is deceptive. Please stand up for the millions of faceless and nameless Americans who are wallowing in the morass of destitution. Poverty is a call to action. When you join the fight against poverty and misery, these millions of poor Americans will thank you with their votes and ongoing support. While there is no panacea to poverty, we can all work together to alleviate it. It is time we make the necessary changes in our laws to help our countrymen.

Examples Of Office Administration - 1061 Words

Experience Office Aid Lakota High School Office: Kansas, Ohio 2016-2017 †¢ I was the third arm of the office team at my high school. †¢ I answered the phone, took messages, made copies, distributed mail, watched the office, ran errands, and did any of the oddball jobs that the full-time secretaries did not have time for. †¢ I ultimately was a person who tried to help to calm the delightfully hectic world of a high school office. Library Aid Lakota Local School’s Media Center: Kansas, Ohio 2015-2016 †¢ Acting in similar duties as I did in the office, I helped to catalogue/check out books and do what I could make the lives of the full-time staff easier. Skills Organization †¢ I find organization to be the most important skill of all to be†¦show more content†¦Everyone that walks by that desk has a fascinating story with all kinds of different twists and turns that will better educate myself in my journey. This job, in my opinion, seems like the best way to connect with other people living in Morrison Tower. By becoming an office assistant, I hope to make a small part of their day just a little bit better. This position is very customer service orientated. What is your definition of good service? My definition of good service is simple; residents should leave the front desk happier than when they arrived. Good service doesn’t always stem from big picture concepts but from minute details that make the resident’s experience enjoyable. From smiling and saying â€Å"Hello† to being prepared for almost any question that can be asked to wishing them a great day. Most importantly, never to utter the phrase â€Å"I don’t know.† I’m a firm believer that the more appropriate phrase is along the lines of â€Å"let me find that out for you.† All in all, being carefully considerate to project kindness, confidence, and knowledge is my definition of good service. 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Per Webster’s Dictionary, ergonomics is, â€Å"A science that deals with designing and arranging things so that people can use them easily and safely† (Webster’s Dictionary, n.d.). Office ergonomics is essentially the science