Perception of Clinical Reasoning Competence †MyAssignmenthelp.com

Question: Discuss about the Perception of Clinical Reasoning Competence. Answer: Introduction: This assignment will deal with gauging the capability of a nurse in prioritising the most significant nursing care matters for a service user. For the convenience of the understanding the assignment two theoretical frameworks namely Millers Functional Consequences Theory and Levett-Jones Clinical Reasoning Cycle is taken. This two theories underpin the nursing practice and used as a tool to initiate the practice of identification and assessment, implementation and evaluation of care service (Castles et al. 2013, p.45). The total assignment is divided in to two parts namely Part A and Part B. In the beginning of the assignment the identification of the three nursing care priorities by Millers Functional Consequences Theory is proffered as part A. This portion specifies the Age related changes; associated risk factor, negative functional consequence as well as positives functional consequence are identified and addressed. In the next stage the identification of all the nursing care pri orities in accordance with the 8 steps in the Levett-Jones Clinical Reasoning Cycle is done. The Levett-Jones Clinical Reasoning Cycle is comprised of Consideration of the patient situation; collection of the cues or information; processing of the information; identification of the problems or issues; establishment of the desired goals; taking action for changing the situation; evaluation of the outcomes by showing the expected outcomes and reflection (Reuter Lorenz and Park, 2014, p.355). Age related changes: When people getting old, several inconvenience may developed. This inconvenience can range from the physiological implication to psychological problem. After evaluating the entire case study it has been seen that the contextual person Mr Ratin Bhai who is 87 year old is diagnosed with Parkinsons disease accompanied by hypothyroidism from past four years. He also lost his wife in eh past year. His medical condition is now controlled with the help of medication namely Thyroxine 100 micrograms daily; Carbidopa or Levodopa 25/100 q8h and Entacapone 200 mg q8h. As he does not have any immediate family member looking after him at such old age is problematic (Childs et al. 2015, p.1424). Risk factor: Age is accompanied by many health implications. It is also important to be mentioned here that people like Mr Ratin Bhai is at risk of suffering injury due to fall. It has been seen that people above the age of 87 more prone to suffer fall due to lack of orientation (Currais and Maher, 2013, p.813). Furthermore, as the contextual person is diagnosed with Parkinsons disease, his daily work habit is hampered which can in turn affects the wellbeing of the contextual person. Dependency on other person can cause low self-esteem in the contextual person who is in need of support (Dijkstra, 2017, p.54). These low self-esteem and lack of motivation for living can affects the mental makeup of the contextual person. Negative functional consequence: There are many negative functional consequence of aging, the primary implication is loss of health and physical vigour and thus to work. In the given case it is also observed that the financial condition of the contextual person is not that much sound. Furthermore, he also has no immediate family member to look after him (Hunter, 2012). Positives functional consequence: Without any medical interventions, the functional consequences of the age are always negative. However, with proper intervention plan the functional consequences can be turn as positive (Eliopoulos, 2013, p.67). With proper medication and care the age related risk can be diminished. This also helps in the improvement of the quality of life among the older adults. Appropriate intervention in proper time helps the contextual person to face the age related implications and prepare for good (Dalton et al. 2015 p.29). Identification of the three nursing care priorities using the first four steps of the Levett Jones Clinical Reasoning Cycle Consider the patient - The present client is 87 years old widower namely Mr Ratin Bhai who has been diagnosed with Parkinson disease traced four years back and also has been suffering from hyperthyroidism. His hyperthyroidism also has been diagnosed four years back and currently it has been controlled by medication (Hunter and Arthur, 2016, p.73). Mr Ratin has been suffering from slight tremor in both hands which is worsening day by day and the basic house hold jobs such as cooking; making tea etcetera has become critical for him (Liou et al. 2016, p.707). Mr Ratin has developed a thought about the present worsening health condition and getting worried about the insecurity of the coming future. Collect cues or information - Mr Ratin has been suffering from Parkinson disease for last four years along with the hyperthyroidism about the same period of time. Both the diseases have been accumulated by the time of the visit and many symptoms has been escalated during this period (Mather et al. 2015, p.625). There has been tremor in both hands of Mr Ratin which makes the situation worse for him as he is unable to perform day to day basis domestic jobs such as making tea, cooking etcetera (Castles et al. 2013, p.45). Mr. Ratin also have developed psychological discomfort due to the worsening physical condition. Altogether Mr. Ratin developed a critical condition physiologically as well as psychologically (Reuter Lorenz and Park, 2014, p.355). Process information - Parkinson disease: Mr. Ratin is a widower residing in a two story home and staying almost alone although he has brother and his wife staying close to him. He has no children to look after (Childs et al. 2015, p.1424). Parkinson disease is a genetically developed condition which has been diagnosed four years back and it has been getting day by day. Hyperthyroidism: apart from Parkinson disease Mr. Ratin also has been developed hyperthyroidism which makes the situation worse for him (Currais and Maher, 2013, p.813). There are many symptoms that has been developed due to the worsening physical condition of Mr. Ratin such as tremor in legs and hands which hindered for his daily basis house hold jobs (Dalton et al. 2015 p.29). Identify problems or issues - The patient has developed Parkinson decease along with hyperthyroidism which has been developed four years back. Mr. Ratin has been migrated in 1946 and currently staying alone in two story home after his wifes demise. Financial along with psychological issues has been developed alongside the diseases (Hunter and Arthur, 2016, p.73). The persisting effect of both Parkinsons and hyperthyroidism have induces multiple complications such has tremor in hand and legs and partial disability of performing house hold jobs. Therefore a psychological setback also has been developed due to his worsening condition and uncertain future (Liou et al. 2016, p.707). Having identified all of the nursing care priorities, choose the top priority of care and then discuss using the remaining 4 steps in the Levett Jones Clinical Reasoning Cycle Establish goals - In accordance with the SMART objectives the specific goals has been set such as Specific - ensuring the wellbeing of Mr. Ratin as he is staying alone in his two story hose after the demise of his wife. The first specific goal is to transfer him to a medical centre for ensuring the safety and wellbeing apart from medical attention through professional help (Mather et al. 2015, p.625). Measureable - The tremor and worsening condition could be improved through timely medication and professional attention (Castles et al. 2013, p.45). Achievable - total wellbeing of Mr. Ratin in the medical centre through professional help and timely medication and care (Reuter Lorenz and Park, 2014, p.355). Realistic - assessment of the Parkinson disease and hyperthyroidism and preparation of action plan in accordance with the outcome (Childs et al. 2015, p.1424). Timely - overall wellbeing of the Mr. Ratin in comparison with the present situation is restored within next 1 month (Currais and Maher, 2013, p.813). Shifting Mr. Ratin to the medical centre for care and professional assistance for the assessment of the present condition and preparing a treatment plan accordingly (Levett-Jones, 2013). Regular medication and exercise has been incorporated for the improvement of hand and leg tremor (Hunter and Arthur, 2016, p.73). Immediate preparation of treatment plan has been taken place for hyperthyroidism and diet chart for the maintaining and improvement from the present condition (Liou et al. 2016, p.707). Psychological counselling need to be arranged for the understanding of the present situation and also has been preparing him for the future to cope with the present condition (Mather et al. 2015, p.625). Evaluate outcomes showing the expected outcomes - The present assessment of the hyperthyroidism shows the condition has been improved from the last condition. Mr. Ratin able to do all house holds jobs of his own and the effect of Parkinson also diminished from the last assessment (Reuter Lorenz and Park, 2014, p.355). Regular medication and physical exercise helped him to perform some of his daily activities and some degree of normalcy also has been restored The tremor has been showing signs of improvement and holistic wellbeing of Mr Ratin has been developed as the effect of the Parkinson and hyperthyroidism has been showed down (Levett-Jones, 2013). The psychological wellbeing also has been restored due to the physical development. Reflection - Next time I would do an assessment for the determination of exact physiological and psychological situation of the patient for the understanding of the immediate course of action regarding the treatment. I should have proper medical professional help for the proper and timely treatment of the patient. If, I have the proper understanding of the background of the patient; it will help me to evaluate the present condition and reason of the condition. I now understand the exact procedure of the development of the action plan for the patient and timeframe in which the patient could restore from the last physiological condition. Conclusion: It can be concluded from the above assignment that the ageing is an inevitable and it is accompanied by much negative consequence. The first foremost consequence is a loss of a companion and physical ability to work and earn the livelihood. In the initial portion of the assignment, the age related implications are discussed with the help of Millers Functional Consequences Theory. As the assignment precedes the problem that is associated with the ageing are identified and address. Levett Jones Clinical Reasoning Cycle is applied to understand the modes of intervention. In the first 4 steps of this theory helps the contextual health and social care personnel to understand the entire situation for planning intervention. In the final 4 step, the established goal in accordance with the SMART category is set along with taking the appropriate action and evaluation of the plan. In the concluding portion, a reflective note is also shared including the experience of the person who plans the in tervention. Reference List: Castles, S., De Haas, H. and Miller, M.J., 2013.The age of migration: International population movements in the modern world. Palgrave Macmillan. Childs, B.G., Durik, M., Baker, D.J. and Van Deursen, J.M., 2015. 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(2013). Clinical reasoning: Learning to think like a nurse. Frenchs Forest, NSW: Pearson. Liou, S.R., Liu, H.C., Tsai, H.M., Tsai, Y.H., Lin, Y.C., Chang, C.H. and Cheng, C.Y., 2016. The development and psychometric testing of a theory?based instrument to evaluate nurses perception of clinical reasoning competence.Journal of advanced nursing,72(3), pp.707-717. Mather, C.A., McKay, A. and Allen, P., 2015. Clinical supervisors' perspectives on delivering work integrated learning: A survey study.Nurse education today,35(4), pp.625-631. Reuter-Lorenz, P.A. and Park, D.C., 2014. How does it STAC up? Revisiting the scaffolding theory of ageing and cognition.Neuropsychology Review,24(3), pp.355-370.