This writes up will be based on reflection of my placement at the Frail Elderly Ward. The reflection will focus on one of the elderly patients whom I encountered during my placement at frail elderly. I was able to assist in giving medication to Mr. Andrew. Although the reflection will focus on Andrew’s case, there were other several elderly patients whom I cared for at the ward. Mr. Andrew is an 84 old man who has had dementia for the past five years. Apart from dementia, he was unable to swallow food nor drink due to an obstruction in his esophagus. Consequently, he was receiving both food and medication via tubes. This condition had made him isolate from other people in the elderly care units. The isolation is attributed to the fear of people to see how he was feeding. The patient was mostly agitated by the presence of tubes and the plastic feedbags. The tubes had made him extremely isolated himself. There was hence ended of improving his mental state.
It is clear that Andrew was suffering from multiple health complications. This implies the need for the utilisation of multidisciplinary approach to achieve the best outcome (Mudge et al., 2016). The interdisciplinary team also included his family members. After a consultative meeting between the relatives and family doctor. It was agreed that he should be referred to Psychiatrist to help in stabilising his mental condition (Fava, 2014). The Psychiatrist prescribed antidepressant medications to help in controlling of his condition. The treatment did not only aim at improving his mental states but also improving his quality of life. The quality of life was improved by gradually introducing him to other patients in the ward. He was also slowly involved in the social activities within the hospital setting.
After few days of Psychiatrist medication, Andrews’s depression level increased. The depression level made him more communicative. For instance, in one of the occasion, he refused to take medication that I took to him. He even threatens to sue me if I force him to take the medication. Apart from the medication issue, he talked to me about football and other general issues. This gave an opportunity to introduce him to other elderly patients in the TV lounge. I also involved him in card playing. The positive progress marked with a reduction in the isolation impressed his relatives. Despite the progress, Andrew was still against the medication. According to the conversation I had with Andrew, it was clear that he understood the aim of the medication. He was however not willing to take the medication because he believed he was okay. I was forced to consult the qualified nurse in charge. The nurse intern talked to his relatives because without the medication his condition would deteriorate.
The family members requested if we could administer the medication to Andrew via the tubes without his knowledge. I, however, explained to them that it was unethical to give any patients medication without their consent (McCarthy & Gastmans, 2015). This hence implies that it would be an offence to give Andrew medication without his knowledge. The qualified nurse in charge also seconded my thoughts. On the contrary, the relatives said that we were abusing their patient since failure to take the medication was going to worsen the condition. The nurse decided to refer him to the local adult safeguarding team. The hospital manager also insisted that the medication should be administered conversely since he did not want the safeguarding team to investigate more complains in his hospital. The manager insisted that he is also a doctor and that I should follow his instructions since I was only but a student nurse. The threats did not change my mind because I believed Andrew could make independent decisions (Meier & Ong, 2015). This implies that the medication could only be given after the psychiatric team reviews the case. The nurse in charge also explained to the manager that we could not follow his instructions because he was not Andrew’s private doctor and neither was the Psychiatrist. The manager went as far as threatening to suspend my placement.
Despite the challenges, I was glad that my patient was improving and was more communicative. His medical refusal may have been an indicator that he was actively taking part in his medication. The relative’s reaction was also understandable because they were concerned with Andrew’s condition. In their view, our action was a hindrance to Andrew’s progress. I was however disappointed with the manager because he seemed to more worried about the social services than the wellbeing of the patient. Being health care practitioners, I expected him to be supportive of the decision. This implies that the hospital was not performing as expected. If the medical staff were doing, their job well then there would be no need of being afraid of the reviews. Reviews are not only meant to criticise the organization, but they also help in improving the reputation of the organization (Wooten & Hoffman, 2016). For example, after reviewing Andrew’s situation may be the team would recommend some changes in the organization culture concerning the elder people. I was however glad that despite the threats I managed to maintain my stand that was based on my professional values and believes. In my view, I behaved ethically by respecting Andrew’s interest.
A nurse should always ensure that his values and professional ethics are observed to the later. According to Makaroff, Storch, Pauly, & Newton, (2014), treating the patients and colleagues ethically implies doing well, being harmless, respecting other people’s choice and being fair at all times. There are also other legal frameworks that protect the adults who lack the mental ability to make decisions for themselves as a result of health conditions (Chadwick & Gallagher, 2016). Every adult has the right to make decisions unless proved otherwise. In the case of Andrew, I felt it was good to involve the Psychiatric team because they would help Andrew make the right choice concerning his medication. However, I did not see the need of support from specialized individuals. Being registered nurses are obliged to adhere the professional code of practice (Winland-Brown, Lachman, & Swanson, 2015). The code or practice stipulates that every nurse have a professional duty of care. The care comprises of protection and advocacy of the vulnerable patients under my care (Johnstone, 2015, Krautscheid, 2014). This hence implies that I was right to decline the manager direction of giving Andrew medication against his will without considering the advice of the specialist groups.
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