Nursing Care Plan- Discusses Roper, Logan And Tierney Model Of Nursing
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Update Date : 2012-06-30
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Upload Date : 2012-06-11
Short Description :
This essay discusses Roper, Logan and Tierney Model of Nursing. The model identifies 12 nursing activities of daily life that are related to basic human needs. They argue a ôsafe environment, communicating, breathing, eating and drinking, eliminating, personal hygiene, controlling body temperature, mobilising, working and playing, expressing sexuality, sleeping and dying
Detailed Essay :
Nursing Care Plan
Roper, Logan and Tierney Model of Nursing
Originally designed for the model of care, more nurses are aware of the Roper in 1976, has been updated and added to 1981.1980 and 1983 Roper, Logan and Tierney (Tierney and Roper, 2000). This form was used in a wide range of care settings. The model identifies 12 nursing activities of daily life that are related to basic human needs. They argue a “safe environment, communicating, breathing, eating and drinking, eliminating, personal hygiene, controlling body temperature, mobilising, working and playing, expressing sexuality, sleeping and dying” (Siviter 2002).
The nurse will need to be able to assess where there are problems of continuing a sufficient quality and quantity of self-care activity for the patient's health and well-being. The care is delivered to meet the requirements of the patient by means of a care plan “that is put into place on admission.” In the process of care and structure of the individualization of care exists. Care plan should also include the client, but very confused with the client, it may be beyond the capabilities of (Siviter 2008).
Issue and Goal
In this article I am going to discuss how to nurse and develop a plan of care in connection with 12 activities of daily living, with “Maintaining a Safe Environment, Communication, Eating and Drinking and Working and Playing” as its main aims. Our patient of nursing care plan is Jake, age 4 years having 95 cm height and 13 Kg weight. On examination we found that Jake is normal in every physical manner but the problems areas we found are he is not social even he is anti social we must say, he is shy and feeling insecure as he was sitting very close to his mother, he lacks communication and above all he needs nutritious food and good eating habit.
Jake’s mother informs that the preschool teachers are concerned about his diet as he often refuses to eat his lunch. When we asked Jake about what he likes to eat, he says "McDonald’s". On further questioning, we find he generally has cereal for breakfast and Sally stated they eat a lot of take away food as she gets frustrated when she cooks a meal and he will not eat it. She knows he’ll eat the take away food. Even then he doesn’t eat much.
Nursing Care Plan
Maintaining a Safe Environment
This complex and multi-dimensional AL describes the importance safety plays throughout the life course. ‘Environment’ refers to the internal (maintained by homeostasis against diseases causing physiological and psychological disturbances) and external influences (everything outside the body influencing health, including accident prevention). It requires a range of external and internal factors (such as level of consciousness, sensory impairments, disability and confusion) to be considered, assessed and planned for (Roper & Tierney 2000).
In Jake’s case we need to make him realize that the environment around him is safe and secure. So that he could left his fears and shyness. We need to make him feel easy without forcing to speak or play or study etc.
The nurse assesses the patient’s normal ability, language barriers and changes (Roper & Tierney 2000). Jake’s first language was English, and was free of sensory impairments preventing effective communication.
I was conscious not to make him feel disturbed and his ability to communicate based on his school performance and everything.
I tailored my communication style to his anxiety. He displayed this through body language and very little speaking or answering only ‘yes’ or ‘no’.
He was not feeling comfortable in making eye contact so I made my conversation looking here and there as if I was not paying so much attention to him. Then I realized he was looking at me and slowly he started feeling relaxed. Even sometimes she smiled at me with a tinge of shyness and as soon as I look at him he stops smiling and start looking at the ground.
I used techniques to encourage Jake to explore his anxiety; including paraphrasing, reflecting and clarifying, and avoided leading questions.
Eating and Drinking
Eating and drinking form important social activities, and a patient’s social, economic and political influences impact on the ability to eat a balanced diet (Roper & Tierney 2000).
Though Jake has almost normal body mass index but if he continues his eating habit then he must be overweighed due to junk and take away food. Or else he can be suffering from any type of deficiency as well. Similarly he can also get some disease.
Jake did not have any food allergies or feeding process and had been referred to a dietician who prescribed a dietary supplement.
Elimination relates to the biological necessity for living organisms to eliminate waste products via the renal and digestive systems. Jake did not have any deficits in this area.
We need to plan his diet and encouraging him to have healthy meal. He needs motivation and slowly we will be adding more food variety to his diet. Initially we need to consider his likes and choices. We cannot suddenly eliminate take away food from his diet as he is a 4 year old child; he cannot understand the importance of health and healthy food. We need to develop his taste to different variety of cereals, fruits, fresh juices, vegetables and meat.
For this we need his mother’s help as well; she also needs to understand the importance of healthy food as healthy food is equally important for children and adults as well.
Working and Playing
Working and playing is also very important for Jake. As his mother and teachers complained Jake does not involved in playing and other physical activities with other children.
Playing is a good exercise for children’s growth and development. Physical activity is not only necessary for physical development but for mental development as well.
In the beginning we were told by Jake’s mother that Jake loves watching TV and of course he most of the time sitting and watching TV. Which is why he is getting lazy and his mind and brain are also getting passive. His level of physical and mental response can be weaker with the passage of time and as he grows up he would be putting on more weight.
We need to show him how playing interesting can be. We need to make him involved in physical activities like cleaning up his room or cleaning up the backyard on weekends and on return he will be given any reward. This type of activities should also be formulated in schools as well. In this way Jake and other students having such problems can be used to of doing activities and love playing.
A Nursing Model is thus a set of concepts systematically constructed, scientifically based, and logically related identifying essential nursing practice. These concepts link theory with practice and offer the nurse an exploration of the necessary values required for effective practice.
Nurses aid the assessment, planning, and implementation of patient care by providing a framework within which nurses’ work and aim to achieve uniform seamless care. I believe this Model offers an efficient framework. However its success depends on the nurse’s ability to accurately see the patient in a holistic sense. Without an accurate Assessment all stages of the nursing process falter.
Also it is vital that a clear, succulent, and accurate handover is provided to ensure Jake’s nursing care plan is successful. When the doctor and evolve a remedy design, and you should habitually have a decisive aim in brain and address all facets of everyday life and how to request them to the persevering separately. This double-checks that the care of the persevering as a entire on the cornerstone of one-by-one desires him / her. This doctor should confirm that the persevering is to consider and care design is revised on a normal basis.
In Jake’s case the success of the pre-procedure interventions are measured against the successful conclusion of his care plan. Roper, Logan and Tierney's model was used because it encourages minimal disturbance of the individuals normal pattern of living, (Siviter 2002) this model is also seen as being broad and flexible and nursing care can be given in accordance to the patients circumstances and it is easy to follow. “The factors influencing the activities of living are: biological, psychological, sociocultural, and environmental and politico economic” (Siviter 2008). Psychological factors influencing the activities of living include intellectual development and emotional development.
Roper N., Logan W.W. & Tierney A.J. (2000). The Roper-Logan-Tierney Model of Nursing: Based on Activities of Living. Edinburgh: Elsevier Health Sciences. ISBN 0443063737.
Siviter, B. (2008) Student Nurse Handbook: a survivial guide 2nd edition, Edinburgh: Balliere Tindall for Elsevier ISBN 978-0702029462
Siviter, Bethann (2002) Personal interview of Nancy Roper at RCN Congress, Association of Nursing Students, reported in Fall 2002 edition "The ANSwer" (RCN)
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