Doris is 60 years old, and has a history of diabetes which is managed by oral hypoglycaemic medication. Since her husband died two years ago she lives alone with her two cats and has been treated for depression, after falling in her kitchen she was unable to get off the floor, and was found by a neighbour some hours later. After assessment in the emergency department Doris was admitted on to the ward following a discovery of an ulcer that developed on the heel due to a combination of poor circulation and unrelieved pressure, after been reviewed by the multidisciplinary team a decision had been made to amputate the lower leg and foot.
During the hand over I was informed by my mentor that Doris had been admitted onto the ward for elective surgery. According to Kozier et el (2008) pre operative care is the psychological and physical preparation of the patient for surgery and involves a number of nursing interventions. Once handover was finished I was asked by my mentor to go through a preoperative assessment with Doris. I went over to Doris and introduced myself, I closed the curtains to maintain privacy and dignity and started to ask questions, I concentrated on my body language and the tone of my voice speaking softly and clearly and maintained eye contact, Arnold and Boggs (2007) suggests that there are different types of communication styles such as verbal style includes pitch, tone and frequency. Non verbal style includes speech accompanied by posture and movement, eye contact closeness to or distance from the other person. Sharpening observational skills to gather data needed for nursing assessments, diagnosis and intervention is of special value to the nurse planning care for patients.
I instantly noticed from Doris’s facial expression that she was looking anxious and nervous Baillie, L (2009) states in answer to the first question patients facial expression, restlessness, wringing hands and profuse sweating are indicators of anxiety due to a feeling of impending doom. Whilst assessing Doris i asked her to relax and take deep breaths in order to calm her down as Arnold and Boggs (2007) suggest careful assessment of the patient should be carried out including observation and assessment and the development of trust in relationships can enable nurses to accurately identify the causes of anxiety, Breathing control and relaxation therapy are skills used by professionals to reduce anxiety.
Roach (2002) identifies caring both as a natural attribute of being human and as the core of nursing. B jork (2000) presents a model of practical skill performance which includes aspects such as sequence and fluency, but also includes caring comportment explained as being how the nurse creates a respectful, accepting and encouraging atmosphere which includes concern for the whole person. After completing the assessment my mentor came by Doris’s bed and told me to go for a tea break, just before I left I informed Doris that I was about to leave and asked if there was anything I could do for her, she replied ‘I think I need to use the bed pan and any chance I could get a news paper’. I helped her with the bed pan and brought a newspaper for her.
According to Dallas and Sully (2005) by listening attentively we shut out extraneous noise and distractions, put aside our own perceptions and thus demonstrate acceptance and respect for those we are with. Doris was going to be reviewed by the general anaesthetic doctor I asked for Doris’s permission to stay in and listen to what was going to be said which Doris was happy…