The essay will focus on the role and responsibilities of Registered Nurse (RN) by considering the model of Roper, Logan, and Tierney (RLT). And will incorporate with a case of history chosen patient with Long term condition. Experiencing from placement. The purpose is to explain the impact of LTC type 2 diabetes to consider the effect of treatment and the psychological influence with respect to the concerned patient’s life and family. The placement was a diabetic clinic nurse. The NMC Code of Professional Conduct Guidance has been kept throughout this essay and all the names have been changed for confidentiality and anonymity.
Because of the nurse, the ethical legitimate and the professional concern here is the patient’s sovereignty. Autonomy is considered as the most authoritative phase of an ethical outline of nearly throughout the nationwide. ‘Autonomy is such a notion that is originated in moral, political, and bioethical philosophy” (Vancampfort et al., 2016). The theory of ethics is grounded in 4 moral principles that are autonomy, justice, beneficence, and non-maleficence (Williams, 2015). Ethical principles should be highlighted while providing care towards patients in determining how to handle them. Professionals must respect sovereignty in a sense to give priority to patient’s decisions and choices (Holloway et al., 2016). According to this situation, by conferring to the right of autonomy, nurses have to admire the decisions of the patient. Ethical issues and alterations in society are accountable for the nurse-client relationship. Confidentiality is sharing information in a group.
Diabetes mellitus is a group of disorders that are caused by an improper function of insulin, which is a hormone formed by the pancreas. And insulin is responsible for helping to control blood sugar, in the blood. There are two types of diabetes type one and type two. Approximately 90% of the population who are suffering from diabetes have type 2 (De Moura et al., 2015). Type two diabetes is a very serious condition where the insulin your pancreas makes cant’s work correctly, or their pancreas can’t make enough insulin (Diabetes UK,2019).
Hypoglycemia attacks such as Mr. Med can occur in both type one and type two diabetes. Hypoglycemia or low blood sugar level is one of the commonly found condition in people with diabetes. Hypoglycemia can be defined as a blood sugar level below 70mg/Dl (Diabetes UK, 2019). The most common causes for hypoglycemia are not eating enough food after insulin-like Mr. Med t didn’t eat properly and he skips the meal and his dietary consumption has become reduced.
Currently, in the UK there are over 15.5 million people who have a long-term condition (king’sfund, 2019). Such as Diabetes, chronic obstructive pulmonary disease, hypertension, and arthritis, (King’sfund, 2019). Worldwide long-term conditions, over 36 million deaths each year, with the earliest deaths happening in small and middle-income countries (Nicol, 2015). In the UK,, people in the low socioeconomic groups have a 60% higher incidence of LTCs than those in the higher groups (Nicol, 2015). Worldwide cardiac disease, cancers, respiratory diseases, and diabetes account for 80% of deaths and between them, they share the following risk factors tobacco use, physical inactivity, hurtful alcohol use and unhealthy diets (Nicol, 2015).
In the year of 2009, the World Health Organisation (WHO) bring into being that over thousands of population who are residing in the UK are suffering from diabetes (Snelling, 2016). As discussed earlier, over 80% of people with type 2 diabetes are the victims of overweight (Turner et al., 2015). Controlling diabetes in the initial stage by doing exercising and consuming a healthy diet is dominant. Health care experts could give suggestion on this and there are so many health creativities run all the way through the state to help. The role of the nurse working with a team is very essential and could not give emphasis to enough as they can enable person’s all-inclusive care and be the main point surrounded by the health care team to comfort
A seventy-year-old patient is being described who is living resides in a flat. Mr. Med has been suffering from type two diabetes for the past 15 years, which is getting more severe day by day and it not managed by diet, medication. Mr. Med and his wife live alone and do not have family, and they are lonely. Mr. Med’s diabetes has now is getting worse and he has started a therapy plan of self-managed insulin. Mr. Med’s wife is taking care of her husband and he is also getting himself registered with the nursing community. Mr. Med also consults with his local general medical practitioner, and he visits a diabetic clinic daily. Currently, he has diagnosed a hypoglycaemic attack on a shopping trip, and when he rushed to the hospital and received treatment accordingly.
Persons with a condition such as diabetes type two are two to three more likely to grow depression than normal people who are in a good health (Nicole and hollowood, 2019). A person living with diabetes type 2, feeling pain and reduced ability to handle their medication, has an increased risk of developing depression and which may turn in, increase their pain and distress, creating a cycle of signs. There is evidence that depression can increase the likelihood of a person developing a condition like a type two diabetes (Nicole and hollowood, 2019).
The activity of living is resulting from the Roper, Logan, and Tierney model of nursing that comprises of several activities (King, 2017). et al., 2016). The nurse practices the model to evaluate the patient’s relative independence and potential for independence in the activities of daily living. Its help the nurse to decide what involvements will lead to increased independence and what continuing support is needed to balance any dependency that still exists (Nursing-theory, 2019).
Communication
Mr. Med faces difficulties day by day when communicating with other people. Though there are a number of aspects which have worsened his communication in the course of the hypoglycaemic attack and for the duration of his stay in hospital. Ineffectual communication can be a result of the hypoglycaemic attack and caused the neuroglycopenic symptoms of slurred speech and tingling around the lips (Bali et al., 2016).
Eating and Drinking
Eating and drinking, as with breathing are important to maintain the body’s homeostasis, and we need to eat the correct food and drinking the correct waters that to ensure the correct balance (Roper, et.al2008). So Mr. Med had been managed by medication and diet, though as this was no longer providing adequate control Mr. Med was started on insulin. He further said that because of the skipping meals, his dietary consumption has become reduced, this was determined as his origin of the hypoglycaemic attack. Nursing staff approved the analysis of blood sugar and identified a low blood sugar level and after that directed a quick acting carbohydrate (Barber, 2016). The nurse has a role to ensuring Mr. Med’s dietary needs are met and being involved in health education programs. the nurse is accountable for assessing the nutritional needs Mr. Med, to ensuring that Mr. Med received the correct food, and encouraging Mr. Med to eat or drink or dealing artificial feeding regimes.
Nurses should act in the agreement with the 6cs of nursing (Compassion in practice, 2012). The role the nurse relating to Mr. Med case concerns all aspects of care. Educating Mr. Med and his wife is important to ensuring the prevention and management of his diabetes. Nursing is centred on individual nursing. In the past, several tasks were assigned to nurses, apart from caring for the patient. Now, the significance of patient-centred care is acknowledged, and registered nurses are assigned patients rather than jobs (Epstein et al., 2015). The whole of nursing is consisting of four interactive stages. To get access is the first stage, which is carried out at the initial stage of treatments but is vital to remember continuity in the evaluation as the treatment or disease may progress. Nurse’s duty is to keep the patient’s autonomy, keep up and recover health and encourage a professional relationship of trust (Murdaugh et al., 2018). Mr. Med was offered with education about diabetes and its management by the team on the following understanding what diabetes is, dietary advice, exercise, and glucose monitoring
The physiology of diabetes was discussed with Mr. Med and written information was offer and advice to on how to contact help and support. According to Diabetes UK, know that providing good quality information at the of diagnosis and offer advice of how to help guidance and assistance in the future like future is important to people with diabetes dealing their diabetes (Diabetes UK,2019). According to NHS, the NHS’s nutritional advice for people diabetes is usually to follow the dietary guideline that recommends to everyone in the UK (NHS Diet Advice for Diabetes,2019). People with diabetes advise to eat 5 portions of fruit or vegetables per day, have some dairy or dairy alternative (like soya drink), eat starchy carbohydrate food with each meal, drink plenty of water. Cut down on alcohol, cut down on sugar, cut down on sugar, and eat fish regularly. Mr. med’s body index mass (BMI) was 24.9 so he is in a healthy weight range. So Mr. med must keep on eye his healthy weight and have try to stay in a healthy weight. Mr. med’s weight was 78kg and height was 177cm.
Mr. Med doesn’t work, and he stayed at home, doesn’t go out of the house. However, the activity is significant to the factor of his treatment plan and, it’s important to have a healthy meal plan and to keep his blood sugar level through medicating or insulin. Exercise has a plentiful aid, but the main one is that it makes easier to control their blood sugar level. People with type two diabetes have too much glucose in their blood, moreover because their body didn’t produce enough insulin to process it, or because of their body didn’t produce enough insulin to process it, or because of their body didn’t use insulin correctly (Lisa M. Leontis,2019). The blood sugar is important in diagnosing and monitoring the continuing treatment of diabetes. People by diabetes are incapable to process sugar properly in their bodies due to a lack of the hormone insulin (RNC,2019). NICE mention that people by diabetes assume nine annual health checks. The nine annual health check for diabetes are blood test ,smoking status , blood pressure , urinary albumin test , weight and body index mass, eyes check, feet check and cholesterol levels (RNI,2019). Mr. med was made conscious of these target ranges, however, was relieved not to expect these results originally till treatment was recognised, and routine and dietary changes had been adapted.
After 6 month the nurse visit to Mr. med house and the nurse review to see him , the nurse saw his improvement about his lifestyle and his dietary since she advise him to follow the instructuion nurse gave him. He is getting much better than before.
By concluding this essay, it is analysed that nursing plays an important role in terms of patient medical care. However, after the core analysis of patient’s journey with respect to every single phase in terms of LTC, it is evident that LTC is considered as a life-changing factor when a person is diagnosed with it. This study targeted the ethics and responsibilities of Registered Nurse by focusing on the above-mentioned factors with the help of Roper, Logan, and Tierney’s model. this essay, I will use the Gibbs Reflective Cycle to reflect my personal professional practice that needs improvement in some areas concerning the role of me as a Registered Nurse (RN).
I felt that I should assist the medical caretaker in order to make the patient, Mr. Med, comfortable since I analysed that this must be considered high priority by means of evaluating the drugs. Though, I was only obsessed with the comfort level of the patient and realized that I might not do just with the patient by leaving him in such a critical condition. However, being a nurse, I believe that such decisions are supposed to make for the sake of the patient’s health.
I learned how to use glucose monitoring and I really enjoyed the placement. However, I decided to support the assistance of health care to assure that the patient was comfortable, as this was the precedence of time. Though, on account of the NMC code of conducts, one should take care of individual by means of your priority and ensure their autonomy and dignity as well, which I already did. Moreover, as an RN, I must be able to differentiate the uses of drugs with respect to their purposes.
