Reference no: EM133792595

Problem

Part I

Include a description of the selected date's field activity with distinct details of the interactions with the preceptor that demonstrate the nurse's role in promoting the sphere of care (i.e., education, collaboration, communication, referrals, resource allocation, services)

I got the opportunity to shadow an admission hospice nurse for three patients, all of whom were 70 years of age or older, during my observational experience with an RN BSN.

Patient number one was a 72-year-old patient presenting with coffee ground emesis, a hallucination of seeing bugs in bed. Ineffective haldol, due to increase emesis. I observed the nurse discussing concerns with the doctor, new order was obtained for suppository compazine. The nurse noticed that a lot of family and kids were visiting, increasing noise, patient got more restless, also the family was relucting about using Morphine. The RN educated the patient on the importance of having a quiet environment when visiting to keep the patient calm. She provided family education on the use of Morphine and explained that it helps with shortness of breath as well as pain. The family appreciated education. A '' quiet environment'' sign was applied to the outside door. Later on, the family rang the bell requesting pain medication for their loved one. The nurse's intervention helps to support the patient end of end-of-life comfort measures.

The second patient was 75 patients with Liver cell Cancer, s/p liver transplant, unfortunately, his cancer returned and metastasized. admitted for respite care, the wife is the main caregiver. Plan to discharge patient home with his wife today. The nurse utilized teach-back methods, wife was able to demonstrate how to properly transfer the patient to the bathroom and wheelchair, allowing him to do as much for himself. The nurse also sat down with the wife and provided emotional support, hugged her, and reinforced that if she needed extra support, the hospice team was there to help her navigate through the process.

The third 77-year-old patient was diagnosed with Supranuclear Ophthalmoplegia. The patient seized every 30 min, lasting about 45 seconds. The nurse and doctor collaborated with medication on board, and seizures were under control. The nurse ensured that the patient was turned and repositioned, and medication was administered. The nurse provided family updates.

Two patients passed away on the unit, I observed the RN providing emotional support for the family, Allowing the family to stay in the room as much as they wanted. I helped the RN get the body ready for the funeral services.

Part II

Include a description with specific details of the rationale for how the activities of the nurse are related to the documented sphere of care.