This work is a reflective commentary on the factors that influence an individual's health from the poster developed for Health, life, and social science unit by analyzing the presentation. The Gibbs reflective cycle will be used as this is a popular model of reflection for describing, and identifying feelings that could have influenced my practice, identifying strengths, and weaknesses of my performance as well as creating an action plan (Gibbs, 1988). For the purpose of this assignment a pseudonym, Jason Tots will be used to protect patient confidentiality, Amelia as the Health Care Assistant, and Janet as my mentor (Nurse in charge) in accordance with the Nursing and Midwifery Council (2018).
I was among the team members that received handover at the beginning of a morning shift under the supervision of Janet where I and Amelia were placed in a ward of four patients to monitor. Upon handover, Mr. Tots appeared to be confused, incontinent, sad, and sometimes agitated. Mr. Tots is a 75-year-old man who was among the four patients in the ward I was placed. He is a retired bank manager who has lived alone with his dog as he is divorced for a very long time. He had a son who is out of the country and calls him almost every day. The past medical record of Mr. Tots states that he has Type I diabetes mellitus as well as a History of Dementia in his family and High blood pressure. Mr. Tots is diagnosed with Dementia which is a syndrome that is usually of a chronic or progressive nature that leads to deterioration in cognitive function beyond what might be expected from the usual consequences of biological aging (Ballard et al., 2011; WHO, 2017). To ensure all staff and nurses are aware of Tot's condition, the 'Butterfly Scheme' was used whereby the logo was placed at the top of his bed station to identify he had Dementia, circular red logo was implemented to show that he is also diabetic and also yellow triangular sign was used to show he is at risk of falling. Old age is a common risk factor for dementia according to Raphael Wittenberg et al., 2019 'Projections of older people with dementia and costs of dementia care (2019-2040)', it was estimated that almost 885,000 older people had dementia in 2019 (Raphael et al., 2019). Vascular risk factors such as Hypertension, Diabetes mellitus, smoking, and heart disease have been associated with Dementia (Breteler, 2000). Smoking, physical inactivity, diabetes, and air pollution have been identified as potentially modifiable late-life dementia risk factors (Livingston et al., 2020). According to research conducted by Cacioppo in 2011 on the 'effects of social isolation', it was observed that Depression and social isolation are associated with accelerated brain and cardiovascular aging (Cacioppo et al., 2011).
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I was worried witnessing how confused and agitated Mr. Tots was because that was my first time caring for a dementia patient. He wanted to come off the bed knowing that he was at risk of failure, I and Amelia were trying to communicate to calm him down but it seems not working out so she told me to call Janet (The nurse in charge) as Amelia could not leave because it was a cohort bay. Janet was able to understand him and I was amazed by Janet's calm approach toward Mr. Tots, I felt confident and determined that I could learn from Janet to meet the needs of Mr. Tots.
The incident was challenging at first because I and Amelia were trying to communicate with Mr Tots and it was not working out as I don't have enough experience on how to communicate and care for a dementia patient. The strength of this incident was that Janet had a lot of experience caring for a dementia patient who I was able to learn about and was able to meet the needs of Mr Tots afterward. Also, a strength of this incident was that all staff were made aware of the Butterfly symbol which was in accordance with the National Health Service improvement guidelines for Dementia (NHS, 2017), and also placed the symbol on the wall at the top of his bed to identify she has dementia.
According to the Nursing and Midwifery Council (2018), good communication helps to build therapeutic relationships and aids better understanding of people's health needs which is important to nursing. The Egan 'SOLER' principles proved to be effective when trying to communicate with Mr. Tots as it supports the warm approach used by Janet to calm him down (Egan, 1975) and a therapeutic touch to enhance trust as he lies down on the bed (Stonehouse, 2017). Therefore, as a student nurse caring for Mr. Tots under the supervision of Janet, learning the effective way of communicating is important to build a therapeutic relationship.
From this experience, I can understand how effective communication is a core principle of nursing. I can also understand how important a warm approach and the use of therapeutic touch are when the patient is not calm. Also, adapting communication to suit patients' needs is a crucial part of person-centered care.
I aim to learn more about understanding dementia, methods of communicating, and also developing more skills on how to approach and care for dementia patients.
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