Theories of Nursing Paper Research Example | Topics and Well Written Essays - 1000 words

Theories of Nursing - Research Paper Example One of the central tenets of Benner’s work is the idea that care forms the central aspect of nursing, that it allows a nurse to better connect to a patient, to better administer care, and to better see possible problems and situations before they arise (Alligood, 2002, 157). Though I agree to a certain extent with the primacy of care to any practical nursing environment, I believe that care can only be of actual use to a nurse if he or she has the advantage of experience to guide them in how to best support their patients. Much of my recent practice has been as a primary triage nurse for an (unfortunately) over-crowded emergency room. This emergency department has fifty-three adult patient beds and it is up to me to decide how they are best used in most situations, only changing significantly when patients develop new symptoms or problems become apparent after the triage process has already begun. In a recent experience I had fifty-two beds filled with extremely high priority patients, something of a nightmare, and nearly simultaneously had six patients presenting the extremely distressing symptom of chest pains, all describing them in nearly identical ways. I obviously had only one bed to give until other beds cleared from patients being released or transferred, and had to make one of the most difficult decisions I ever had to make as a triage nurse. I realize in retrospect that I naturally applied many of Benner’s theories of Person, Environment, Health and Nursing to the situation at hand without necessarily realizing it at the time. Obviously, in a triage situation, two of the aspects of this theory most directly applied to what I was doing in practice – Health and Nursing. In a triage setting two things are important: identifying the patient most in need of care (or in extreme triage situations, the person to whom care will be most useful) and as a nurse finding the best and most efficient way to identify the best and most effective me thods of allowing them to receive that care. So I had to identify which of these people was the most unwell, and how I could best act to make them better, whilst simultaneously trying to get the other five the care they needed as fast as humanly possible. My education certainly played a significant role in my decision. In nursing school, I learned how to differentiate between a wide variety of chest pains, to use specialized language (such as throbbing, stabbing, dull, sharp and so on) to help weed out the possible causes of a wide variety of pains, and thus by knowing their causes apply the best care to the group of six as possible, which in this case meant getting the most serious case a bed as soon as possible. Likewise, I had an academic knowledge of how to use pain scales to help identify patients based on their level of pain from one to ten, with one being nearly nothing and ten being the worst level of pain possible. Using this academic knowledge I was able to quickly dismiss two of the cases as most likely being caused by acid reflux (burning pain high in the esophagus with relatively moderate pain scale) and patients who were, though taking a good precaution by seeking medical care, probably not in need of emergency services in an urgent fashion. Following this, however, the situation became much more difficult. Two of the people I

Parkinson's disease Essay Example | Topics and Well Written Essays - 1000 words

Parkinson's disease - Essay Example Damaging approximately 60% to 80% of the cells producing dopamine would cause its deficiency and consequently lead to the appearance of PD motor symptoms. The National Institute of Neurological Disorders and Stroke, NINDS (2013) refers to this brain cells impairment process as neurodegeneration. Prevalence and Incidence About 1 million people in the US suffer from PD with between 50,000 to 60,000 new cases being diagnosed annually. Worldwide, between 4 million and 6 million people suffer from PD (National Parkinson Foundation, 2013). It has been particularly noted to set in at age 50 to 65 with a lower incidence in African Americans as compared to the Caucasians and 3:2 for male to female ratio incidence (Talan, 2011). Motor Manifestation Years before the motor manifestation, people with PD experience non-motor symptoms including sleep disorders, loss of smell, hyposmia and constipation. The Braak’s hypothesis cited by the NPF (2013) observes its earliest signs in the medulla, particularly the olfactory bulb which controls the sense of smell. It would then gradually progress to the cortex and substantia. Notwithstanding, the four motor symptoms cited by NFP (2013) are cardinal in PD: postural instability, slowness of movement, rigidity and tremor. The well-known symptom of tremor has been referred to as rest tremor by NINDS (2013) as it becomes maximal on rested limbs and disappears with sleep or voluntary movement. It begins with a single leg or arm and later becomes bilateral. The tremors have a frequency of between 4 and 6 Hz. Secondly, the slowness of movement referred to as bradykinesia by NFP (2013) relates to difficulties in the whole movement process: planning, initiation and execution. This early manifestation hinders simultaneous and sequential movement performance indicated by problems related with performance of fine motor controlled tasks like sewing, writing and dressing up. The magnitude would be determined by one’s emotional state or activity. Rigidity would be manifested by stiffness of the limb and resistance to movement due to excessive continuous muscle contraction or muscle tone. This could be uniform or ratchet referred to as lead-pipe and cogwheel rigidity respectively. It could be accompanied by pain. Whereas in the early stages it affects the shoulder and neck muscles, it later progresses to the whole body. Finally, the late stages of the disease exhibits impaired balance causing frequent falls and bone fractures due to postural instability. It would be experienced by 40% of the patients. Talan (2011) adds posture and gait disturbances like festination to the list of these motor manifestations. Diagnosis and Detection Initial diagnosis requires the identification of at least two of these four motor manifestations (NPF, 2013). Bedside examination by a neurologist remains the most basic diagnostic tool for suspect patients. To aid this diagnosis, emergent imaging modalities including PET and DAT scans would be performed by a neuroimaging expert with DATscan playing a critical role of differentiating PD from other essential tremors but cannot indicate the PD subtype. Also to aid in accurate diagnosis would be the need for information on physical and medical examination and also medication history to ascertain the absence of medication that causes symptoms similar to those of PD. The