The Episode of Care
Schizophrenia patients experience a lot of health-related and non-related problems. My patient was not an exception, as he had a heart problem. His deafness was a barrier I had to counter by using writing pads as a way of communicating with the patient. I kept him busy to ensure he did not have hallucinations and delusions, which ordinarily made him resentful and uneasy. His children’s absence made him feel unwanted, but I ensured that he would always have me around to avoid such thoughts. An irregular heartbeat threatens his life, and a pacemaker was installed to rectify this problem. He self-neglects hygiene and relies on the healthcare staff for cleanliness.
The patient relied on medications I was charged with administering to relieve him of his heart complications. Regular check-ups for the issue and proper diet were prioritized to guarantee the patient improved daily. Involving him in activities that made him excessively joyous or excessively fearful was avoided. Encouraging him about how his life would be better and his health challenge countered was the therapy I used. The episode of care was often faced by rejection and presentism, but eventually, the best way was used for recovery.
The NMC Code Application
The Nursing and Midwifery Council’s (NMC) Code provides an extensive description of the four principles that ensure that patients receive the highest possible quality of care. For this case, I have continuously assessed my actions and followed the NMC Code as closely as possible. I believe that the principle of effective practice was applied most extensively throughout my interactions with the patient and the personnel. My time in this healthcare facility introduced numerous factors that required me to constantly research and develop the most efficient ways to deal with specific problems.
First, I had to familiarize myself with the latest evidence in communicating with patients suffering from severe mental illnesses with significant crippling co-morbidities. It was necessary to understand the impact of all existing conditions, select the best methods of their alleviation, and remain within the boundaries of one’s cultural sensitivities (Nursing and Midwifery Council, 2018). This analysis brought into light the possible communication, medication, and cooperation issues between personnel, for which I had to prepare carefully. The NMC guidelines were clear regarding the knowledge base required for achieving a positive outcome and gave me a clear path forward.
Based on the collected evidence, I prepared myself to develop a plan, communicating it with my partners and the patient, and then proceed with following it. While I focused more on the patient, I understood the necessity of putting teamwork on top of the priorities list. Informative and efficient communications with personnel are crucial to achieving mutual understanding, timely assistance, and respect for the team efforts (Nursing and Midwifery Council, 2018). The patient was never left behind during my decisions, yet I had to ensure that my colleagues’ effectiveness never dropped. By identifying and sharing any information relevant to the patient’s case, I believe that our team preserved a high standard of care quality.
Adjusting my strategy was also a difficult task throughout the treatment process. Any decisions must be based on the most recent information from all possible sources and approved by supervisors (Leigh and Roberts, 2021). While receiving feedback from the patient was challenging, I had many opportunities to improve my approach through comments provided by other nurses, especially through the records I have been keeping for clarity. By reflecting on their input, I was able to further enhance my efforts in ensuring the patient’s successful recovery. In fact, I was eager to receive opinions from professionals to improve my competence and confidence.
However, there was an issue stemming from the lack of clear communication with the patient, which indicated a missing requirement from the NMC Code. I understood that there are severe issues with communication stemming from the unique needs and mental handicaps of the patient. When he was having delusions, I ensured that I was physically present and provided the necessary medications and supportive care until he fully recovered. In order to minimize the possibility of losing this opportunity to calm a patient, a multimodal approach to communication was required. To follow the NMC Code, I had to assess the most efficient way of communication, test several possible solutions, and compare the retainment for each method (Rees, Forrest, and Rees, 2018). There are significant chances of relapse and non-adherence to treatment among patients with schizophrenia, especially in cases with paranoia (Singh, Karmacharya, and Khadka, 2019). It was possible to avoid this pitfall only due to my efforts to establish clear communication with the patient. In order to overcome the patient’s paranoia-induced suspicions, I had to keep my speech clear of any jargon, ambiguous phrases, or trigger words that I learned from my colleagues, the patient’s file, and evidence.
During this practice, I had to improve my attitude toward keeping patients’ files. The principle of “practice effectively” requires a nurse to keep their records as extensive, clear, and concise as possible (Nursing and Midwifery Council, 2018). I was able to achieve this goal by using evidence as to the most efficient way of keeping records. Not only did I write all the procedures and events, but I also included my thoughts on possible developments in this case, which are supported by the existing evidence to remain factual and relevant (Brooks, 2021). I also invited a co-worker to assess my initial plan for filling the patient’s information in order to guarantee its sufficient readability and clarity of thoughts.
While the patient was not in my personal care, I made sure that I was available to other nurses when their health tasks were assigned to them. Delegating an activity that is outside of an assistant’s scope of competence or to a person unable to provide the compassion necessary for the task is strictly prohibited by the Code (Nursing and Midwifery Council, 2018). During periods when my patient became loud and uncontrollable, I made personal initiatives to calm him and ensure the environment was conducive for other people. Any observations on the most efficient approaches to appeasing or persuading the patient were thoroughly documented by me in the hospital’s records, allowing others to use them with great success eventually. Lastly, after reading the guidelines, I immediately re-checked the validity and appropriateness of my indemnity at the hospital to conclude that my practice was as effective as possible.
Findings and Improvement Suggestions
From the evidence and personal experiences, I have learned that one of the best therapies for patients with schizophrenia is to guarantee they have closer relationships with their relatives and friends. If not available, the second-best option is to provide a secure environment that nurtures communication between nursing personnel and a patient. Trust is paramount for such situations, as it reduces anxiety and paranoia in patients with severe mental illnesses.
I have learned a great deal about assisting older patients with mental illnesses and the need to understand each individual’s situation. Establishing a close connection with a patient is a critical step inefficient practice, and it is especially vital when dealing with a person with severe paranoia. Only through a mindful approach that was guided by evidence was I able to provide sufficient help to the patient. Cooperation is impossible without understanding one’s knowledge, skills, and time boundaries. My records and expertise in dealing with that specific patient had to be as accessible as possible to my colleagues. Accountability for personal duties promotes cooperation and warrants one to be informed on what they should know and do. Whenever it is necessary to delegate my tasks to other nurses, I will ensure that their understanding of the situation is close to mine, as it is my responsibility for the patient to keep their safety on top.
For future development, I will continue adopting the most accurate and efficient methods from the latest sources of evidence. The NMC guidelines give excellent recommendations on mindful nursing practice and ensure that the highest standards of care will be upheld. I will always assess my actions with the four principles provided by the NMC and strive to expand my knowledge and skills to assist patients to the best of my abilities.
Reference List
Brooks, N. (2021) ‘How to undertake effective record-keeping and documentation’, Nursing Standard, 36(4).
Leigh, J. and Roberts, D. (2021) Supervising and assessing student nurses and midwives in clinical practice: A practical guide. Banbury, UK: Lantern Publishing Ltd.
Nursing and Midwifery Council (2018) The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates. London, UK: Nursing and Midwifery Council.
Rees, H., Forrest, C. and Rees, G. (2018) ‘Assessing and managing communication needs in people with serious mental illness’, Nursing Standard, 33(4), pp. 51–58.
Singh, P.M., Karmacharya, S. and Khadka, S. (2019) ‘Severity Of Relapse And Medication Adherence In-Patient Of Schizophrenia: A Study From Nepal’, Journal of Psychiatrists’ Association of Nepal, 8(2), pp. 54–58.