A person centred care of plan is an approach which ensures that the client is the central concern for the nursing care and treatment given to them. The provision of an effective plan of care along with a discharge system is pivotal for care and support for patient. A proper provision of care responsive to the personal preference is important alongside the values, needs as well as an assurance that all clinical decisions comply by the values and ethics of their clients providing care, comfort, safety and assurance. The primary aims of a person centred care is provision of quality, healthcare safety, co-ordination along with the quality of life which are also the primary principles for nursing effective in providing an effective care and support for their patients (American Geriatrics Society Expert Panel on Person Centred Care et al., 2016). Thus, nursing principles encourage the development of a stable therapeutic relationship by following a holistic approach which helps in implementing an effective plan of care and support towards a patient considered above all medical proceedings thus enhancing a person centred plan of care. Discharge co-ordination as well as planning forms an important plan in making the home to hospital effective simultaneously enhancing the process of an effective person centred plan of care. Since the discharge process requires a multidisciplinary collaboration, patients should have the primary care and support and be active during the process. According to the person centred plan of care implemented by Gothenburg, the model helps in the provision of a structured approach where patients are treated as persons first and should be considered with care and not reduced for consideration only associated with their disease (Ulin et al 2016). The given case study revolves around the life of Mr Simons who is a retired army officer and has the habit of excessive smoking. As far as his medical conditions are concerned he has often suffered from post-traumatic stress disorder (PTSD) along with symptoms pertaining to back pain. However, he and his family members have not been seen to suffer from bowel movements. His results of colonoscopy has revealed a lesion indicating symptoms of cancer and a provisional diagnosis revealing rectal cancer. His chemotherapy as well as radio therapy results have specified the symptoms of the cancer. The upcoming paragraphs will encompass the various sequential process used for nursing and the subsequent nursing diagnoses used. They will also highlight the logical as well as ethical standards which are required for providing a rationale for the care and support provided. Further all the medications as well as the discharge planning, involvement of Multi-Disciplinary teams (MDT) and provision of an effective plan of care is also discussed.
The nursing process involves the five steps of sequential processes like diagnosing after assessing the symptoms, then planning the treatment process simultaneously followed by implementation and evaluation of the whole process. Assessment involves systematic as well as dynamic ways of collection and analysis of data about the patients. Diagnosis involves the clinical judgement inclusive of the response regarding potential and actual needs as well as requirements of the situation. Planning involves post diagnosis and assessment period where measurable as well as achievable long range or short range goals for the clients. Implementation includes the changes which are made according to the plan of care improvised for the patient which involves continuous care for patients which is done during hospilization as well as preparation for the needs of the discharge plan which needs assurance. Evaluation is the final step involving the continuous scrutiny as well as examination of the results and regular improvisation done according to the plan of care (Feo et al., 2017).
The two basic diagnosis processes accentuated by the nurse are provision of care for colonoscopy and the related surgical processes as well as care formulated for processes post colorectal surgery. After being reviewed by panel of doctors and related health care professionals he shows development of colorectal cancer which has to be diagnosed in order to be understood for proper treatment procedures.
Plan of care for trauma and stress – Being a senior army personnel Mr Simons has been suffering from disorders related to trauma and depression. Hence a proper plan of care has to be implemented for Mr Simons. Nurses have come to the solution through the formulation of assessment tool including formation of manually created questionnaires. SPAN and SPRINT has been used as effective assessment tool for their determination of the mental illness suffered by Mr Simons (Kane, 2015).
Plan of care after Colonoscopy- Simon have been advised to under annual colonoscopies for the next a span of 5years as a part of the surveillance post diagnosis of colorectal cancer. He has undergone his colonoscopy under mild sedation and mild dose of anaesthetics. Colonoscopy studies have revealed he has a lesion which is low in his bowel and according to the biopsy, colonoscopy studies will assist I the determination of the kind of lesion. According to the experiences Mr Simon had shown a positive attitude during the whole colonoscopy, he had apprehended to be worse than the present treatment. He had felt no pain during the process and a proper plan of care along with treatment has been formulated. A continuous plan of care should be implemented according to the kind of feedback received from Mr Simons post-surgery which would be of primary importance for the role of a nurse. According to screening tests for colorectal cancer, the numbers have declined however there has been an increase in the screening rates of colorectal cancer thus proving the seriousness of the disease (Wharam et al.,2016).
Plan of care post Radiology and Chemotherapy- After the studies of colonoscopy, he has been advised to undergo chemotherapy and radiotherapy to reveal more information about the kind of cancer he has been suffering from. According to the health care professional assisting him in the process, he would need chemotherapy for assisting the reduction of the type of cancer which would reoccur in the future. His CT scans however do not reveal any signs of metastasis however his MRI studies reveal presence of nodes in the fats which are surrounding his rectum thus needing the emergency of adominoperineal resection(APR) (Uyl-de Groot et al., 2014).
From the results of the rapid detection as well as response adult observation charts, which has been received twice it can be seen that his respiratory rates have fluctuated and is very much similar from the rates shown in the earlier graphs while his oxygen rates are stable and in good condition above 98% which has not changed even in the earlier case (Howarth, Warne & Haigh 2014). Moreover, his blood pressures have fluctuated with highest values at 130/70 which has been almost the same and far more stable in his second report which has been taken earlier than the first one. His pulse rates also have sown fluctuations than the previous ones which has been very stable with occasional peaks in the second report with stability in between .His temperature has been lower than the normal levels in both the reports and his pain scores have increased during the first and middle days of his treatment process which has been lower than the results of the first report.
For the treatment processes involving colonoscopy and radiotherapy which are important for healing and identification of the various stages of colorectal cancer, his multi-disciplinary team would primarily consist of pathologists, radiologists, colorectal surgeons, oncologists and Clinical Support Nurses (CSN) who are specialized for provision of care in the specific department and provide care and support towards the patients depending on the seriousness of the situation. They would be helping in providing the much needed care and support and also help in proper diagnosis of the growing symptoms of colorectal cancer. Such teams along with specialised nurses contribute by undertaking target assessments as well as functional or capacity based assessments and thus is an important component inclusive of care referring to various disciplines according to their availability (Wallace et al., 2014). Since he undergoes an operation regarding his colorectal ailment and even undergoes the treatment process of chemotherapy as well as physic-therapy, surgeons would be helpful in the treatment procedure enhancing the rate of discovery. Provision of an interdisciplinary integrated care is often central according to the contemporary policies of health. The main aim of hospitals in introducing multidisciplinary teams would be digressed from the functional components of organisation of care but be focussed on specialisation which is mainly discipline based (Liberati, Gorli 7 Scratti, 2016). From studies conducted on cancer patients it has been found that Multi-disciplinary teams or MDTs are an essential instrument for the care policies involving patients suffering from cancer and their continued development is important as well as crucial for the provision of care to the patients which they need as well as deserve. In comparision to health care systems around the world, European systems have an effective set of professionals who benefit by having a proper basis for effective model for cooperation for the multidisciplinary teams. Such policies intend to refer the healthcare systems and policymakers in improvement of the services which are currently provided inclusive of the care provided to the patients whose lives mainly depend on the kind of action taken by them (Borras et al., 2014).
The need for ethical as well as legal proceedings for the care requirements is crucial as many social problems have come up which involves strict monitoring. Various ethics committees have been formed for enhancement of understanding about medical issues related to biomedical research. Such committees are formed mainly for consideration, submission communication as well as evaluation. Research protocol, information leaflets are often required along with consent forms which are reviewed properly for the reduction of crimes related to such issues (Guraya, London & Guraya, 2014). Medical malpractice is a term against which strict laws and regulations should be formed as it involves the improper as well as negligent treatment given to a patient resulting in damage loss or injury (Howarth et al. 2014). Moreover, disputes have been found regarding improper care given to the patient which is according to the standards of care usually given. Health Quality Indicator’s project have been approved regarding the laws against medical malpractice as promulgated by the agency for Healthcare Research and Quality (AHRQ). State level laws have been implemented which change the rules which compel the physicians to follow rules and practice according to the national care standards (Freks & Jena, 2016).As far as other healthcare systems are concerned around the world, various revised structures have been formulated regarding the mental health care delivery by the United States which includes a recovery oriented, person centred as well as assessment as well as treatment of the disease. Moreover extensive training process has been implemented for nurses for provision of an effective plan of care (Kane, 2015). Thus proper healthcare delivery systems are required where cancer are is one of the topmost priorities regarding effectively, safety as well as personalised which is done through the implementation of a diagnostic test (Oil de grout et al .,2014).
Nurses play an important role in the provision of care and creation of an environment which promotes values, customs, and spiritual beliefs as well as human rights where there is active participation of the individual community as well as family members (Wharam et al. 2016). Furthermore, sharing of society and Advocation for equity as well as social justice is important aspects of nursing principles especially those for vulnerable populations. Implementation of policies regarding nursing and healthcare are mainly focused on fundamental care and person centred care which enhances the nurse-patient relationship. Moreover, a holistic interpretive synthesis (HIS) is often implemented for interpretation of the research findings for creation of an effective practice relevant recommendations mainly for nurses (Rebecca et al., 2016). Enhancement of values involving compassion, trustworthiness as well as integrity are important parts of nursing. Thus these factors formulate the basic applications regarding legalisation and ethics related to the given case study and provision of care with respect to colorectal cancer and medical processes continued further.
Conclusion
Thus from the following paragraphs it can be concluded that an effective plan of person centred care along with an effective discharge plan often helps the patient in coming out of the traumatic experiences. In the given case study, Mr Simons have been suffering from colorectal cancer which has been identified through various processes like colonoscopy followed by chemotherapy, radiotherapy for treatment. The patient has also undergone surgery involving adominoperineal resection (APR) (Liberati, Gorli & Scaratti, 2016). Being a nurse, an effective plan of care has been made which has been improvised with the ongoing process of the surgery and related processes. His professional experiences and their influence on him causing post traumatic disorders has also been kept in mind, formulating an effective plan of care through the successful implementation of assessment tools. Thus, with all the principles kept in mind, such care plans and implementation of successful discharge plans would enhance his health and cause a speedy recovery for Mr Simons and his family.
References
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