Care Planning for Adolescent Patient

AC 1.1   Explain the job role in relation to your patient. What exactly will they do and why?

Tanisha, Tanisha, 16, has been waiting with a friend to be seen. She hurt her wrist at the local skate park practicing on the ramps and also has a cut to her left leg. The triage nurse is trying to persuade her to give the contact details for her parents.

Charlie Rutter, the Children’s Nurse is called to assess Tanisha. The patient is 16 years old, which means that she is grown-up enough to give consent to her own treatment. “Like adults, young people (aged 16 or 17) are presumed to have sufficient capacity to decide on their own medical treatment, unless there’s significant evidence to suggest otherwise” (NHS, 2019). However, the Children’s Nurse plays an important role in trying to encourage the teen patient to involve the parents in their decision. If, despite the encouragement, Tanisha refuses to share information with her parents, her wish must be taken into consideration by a healthcare professional (Great Britain, Department of Health, 2001). Nurses must comply with the NMC Code which clearly states that all nurses ‘’owe a duty of confidentiality to all those who are receiving care. This includes making sure that (…) information about them is shared appropriately’’ (NMC Code, 2015).

Charlie will provide Tanisha with all the information about the treatment that can be offered. Firstly, the Children’s Nurse will do the observations, such as taking the pulse, respiration, saturation, blood pressure, temperature, weight, and height. She will prepare and make up a folder with patient’s notes and details such as GP address, patient’s address and any kind of allergies. She will check if the patient is wearing an appropriate wristband and also classify the pain score of the patient. As the patient has a cut in her left leg, the Nurse must assure that the patient is not bleeding any further and then attend to the wound. After this intervention, Charlie will pass over all the information about Tanisha to the Junior Doctor who will follow up the patient. Afterwards, if any surgical procedure is necessary, the Children’s Nurse will be responsible for monitoring and administering medications and intravenous infusions.

The competent Nurse must have the ability to deal with various challenges, thinking critically and being able to apply her knowledge and skills into her practice as well as work within a multidisciplinary team (Storey, Gillies and Howard, 2002). Additionally, according to Bowcott (2009), the basics of nursing care encompass dignity, compassion and, above all, safety.

(306 words)

AC 1.2

Choose at least two other practitioners from the case study who will be involved with your patient and analyse the similarities and differences between their job roles and that of your chosen practitioner. Include at least one non-professional role from those listed over page.

Two other practitioners who will be involved in Tanisha’s case are Dr Dan Foster (Junior Doctor) and Sunni Hasan (Health Care Assistant). In the same way as nurses, they are committed to deliver a positive experience of care to Tanisha, ensuring she will have the competent staff with the right skills working towards her well-being.

Communication is also important when treating a child or dealing with parents. Nurses, Doctors, and Health Care Assistants need to make sure that their communication is understandable and clear. All of these professionals must use the 6Cs values which are: care, compassion, competence, communication, courage, and commitment (Bennett, 2013).

On the other hand, they have specifics roles to be played when it comes to looking after a patient. Tanisha will be assessed and supported by her Children’s Nurse Charlie, who is regulated by the NMC. She is specialized in the Paediatric field and trained to perform a complex variety of clinical tasks. She is responsible for caring and supporting the patient’s needs before and after the surgical procedures and administrating medications. Some experienced nurses who have completed a Prescribing Course might even prescribe the medications (Dowden, 2016).

Doctors are also registered and regulated professionals. Compared to nurses, their roles include much more decision-making especially when it comes to diagnosing and treatment. Nurses do not decide which treatment the patient will receive but they deliver care and carry out interventions ordered by doctors.

Similarly to Nurses, HCAs also give care to the patients, such as feeding, washing and monitoring, however, their job is non-professional. They are not regulated and do not have a professional register. HCAs cannot administer drugs and they perform tasks delegated by nurses within their level of competence. Sunni Hasan, the HCA, will assist Charlie Rutter, the paediatric nurse, giving the necessary care and support within her limitations as HCA. She must also encompass the 6Cs values in her practice (Bennet, 2013).

(319 words)

AC 2.1

Analyse at least 4 important professional qualities/values (not skills) which your chosen professional should demonstrate with your chosen patient (what, why, how?)

Skills, abilities and knowledge can be developed, but qualities and values are built at home within family and/or social environment. Some values can be considered intrinsic such as solidarity, compassion, tolerance, respect for others and responsibility. In 2012, the Department of Health published the document “Compassion in Practice” which sets out six keys values for healthcare professionals: care, compassion, competence, commitment, communication and courage.

Tanisha, is a 16-year old child, in the emergency department, scared, with pain in her wrist and with a cut in her left leg. Surely, she is afraid of both her pain and her parents’ reaction. Having Charlie as her Children’s Nurse will help her to calm down and make her feel safe. The nurse must show compassion which requires empathy, respect and dignity. Charlie must demonstrate solidarity, tolerance, and respect as her patient does not agree to contact her parents.

Junior Doctor Dan Foster has the responsibility to diagnose accurately the patient’s wrist. He needs to make the decision whether he is sending Tanisha home with any prescribed medications or whether the patient needs more investigations like an X-ray. He will precisely make use of the competence value.

When it comes to Sunni Hassan, she will follow the instructions from the Nurse Charlie and Doctor Dan. She needs to be a good listener. Effective communication which is one of the 6Cs values, is essential to effective team working (Great Britain, Department of Health, 2012).

(239 words)

AC 3.2 

Evaluate the importance of supervision and teamwork for the professionals caring for your patient.

The teamwork in the healthcare field is essential for the quality of care delivered. It is a process that involves a group of professionals and non-professionals working towards a common and shared objective: the patient’s wellbeing. The team needs to know and understand the roles of the particular team members in order to work efficiently.

To deliver efficient and high quality care, it is crucial to understand the roles. In Tanisha’s case, these roles are performed by Children’s Nurse, Healthcare Assistant and Junior Doctor. They all have different responsibilities and they will participate in Tanisha’s care. They will make some of the decisions jointly as the care is made up of a collaboration of all members. Poor communication or conflicts between the team members may result in less efficient patient care.

Another important aspect improving the quality and communication among professionals is the supervision (The NMC Code, 2015). The appropriate delegation of responsibilities and tasks considering the team members’ knowledge and capabilities is imperative. The team is supervised by a leader who delegates, guides and motivates the members. Charlie will supervise HCA to make sure she performs her tasks accordingly.

(190 words)

Reference

• https://www.nhs.uk/conditions/consent-to-treatment/children/
• https://www.nhs.uk/nhsengland/aboutnhsservices/documents/consent_%20aguideforparentsdh_4117353.pdf
• Storey, L., Gillies, A. and Howard, J. (2002). Competency in healthcare. Oxon: Radcliffe, pp.2-14.
• Bowcott O. (2009) All new nurses to have degrees from 2013. The Guardian. 12th November
• Bennett, V. (2013). ‘All of us need to embed the 6Cs in everything we do’. Nursing Times, 109 (1/2), p. 11.
• https://www.england.nhs.uk/wp-content/uploads/2012/12/compassion-in-practice.pdf
• https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf

Bibliography

• Bennett, V. (2013). ‘All of us need to embed the 6Cs in everything we do’. Nursing Times, 109 (1/2), p. 11.
•   Bowcott O. (2009) All new nurses to have degrees from 2013. The Guardian. 12th November
• Dowden, A. (2016). ‘The expanding role of nurse prescribers’. Prescriber, 27(6), pp. 24-27.
• Great Britain National Health Service (2019). Children and young people consent to treatment. Available at: https://www.nhs.uk/conditions/consent-to-treatment/children/ [Accessed: 07 October 2019]
• Great Britain. National Health Service (2012). Compassion in Practice. Available at: https://www.england.nhs.uk/wp-content/uploads/2012/12/compassion-in-practice.pdf [Accessed: 07 October 2019]
• Great Britain. National Health Service (2001). Consent – what you have a right to expect A guide for parents. Available at: https://www.nhs.uk/nhsengland/aboutnhsservices/documents/consent_%20aguideforparentsdh_4117353.pdf [Accessed: 07 October 2019]
• NMC. (2015) The Code Professional standards of practice and behaviour for nurses, midwives and nursing associates. Available at:
• https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf [Accessed: 07 October 2019]
• Storey, L., Gillies, A. and Howard, J. (2002). Competency in healthcare. Oxon: Radcliffe, pp.2-14.