Question

Foundations of Nursing: Scenario This clinical scenario relates to a life experience of a 53 year old male client, who was admitted to one of the Medical ward which I was assigned to. Upon entering the ward, a smell was evident. I desperately searched the area for its origin. When I entered the latter area of the cubicle, the scent grew and to my surprise, there was a man lying in semi-supine position on a filthy bed, linens soiled and a bed pan by his side. I inquired from his relative who verbalized that client whose name is Mr. J was bought to ward four (4) days ago with a history of diabetic foot ulcers. Upon observation, both feet were swollen and oozing; and client appeared to be in pain. I was informed that Blood investigations were done and sent to the lab for various test to be performed. Further assessing Mr. J’s surroundings, he had dirty tissues and utensils at his bed side trolley along with other edible foods. I realized that the windows around that side of the cubicle were non-functional due to its dilapidated condition. The nurse in charge verbalized that they are short staffed hence the reason for the unkempt area. I further reviewed the situation bought before me and decided to assist the Mr. J by cleaning the area; removing the residue of spoilt foods, changing his linens and carrying out of soiled bed pans. Client was advised to use a wheelchair as an assistance to the bathroom. Within the next few days, Mr. J’s relatives, namely his children were educated on the management of proper “Foot Care” and how he can reduce the risk of further complications.

Review the scenario above and indicate the shortcomings as it relates to patient care and a hospital environment and how using the Florence nightingale environmental theory could better or alleviate some of these shortcomings.(1000 words)

Answer 1

Shortcomings

1. There was a shortage in nursing staff - New nurses needed to be hired
2. Maintenance of premises neglected leading to jammed windows and dilapidation
3. Support staff's attitude casual towards a patient's condition even ignored and worked in stinking environment
4. Support staff did not escalate to management the deficiencies in the hsopital
5. Basic hygiene ignored by the nurse

As per Florence Nightingle "nursing is an act of utilizing the environment of patient to assist him in recovery". The foundation of her theory is the environment all external conditions and forces influence the life and development of organisms. According to her external influences can prevent, suppress or contribute to disease or death. Her goal was to help the patient keep his own vitality by meeting his basic needs through control of environment.

Hence - by keeping patient's room clean and changing his linen nurses could have reduced the patients stress level and stopped his condition from deteriorating.

Nurses should have been concerned about the noxious smell in the air which came from patients excrement

Nurses should have tried to open the window to let fresh air & sunlight come in the room as per Florence Nightingle light was very important for patient's quick recovery

Thus these few corrective actions from nurses would have alleviated patient's condition.