Patient Centred Care: Clinical Reasoning Cycle Framework

Running head: HEALTH CARE
Health care
Name of the student:
Name of the University:
Author’s note

1HEALTH CARE
Introduction:
Person centred approach to nursing focus on consideration of patient’s personal needs,
desires and goal while implementing care to patient. This is based on components like being
responsive, fostering trusting relationship with patient, promoting physical and emotional
comfort and providing meaningful care (Ulin et al., 2016). Clinical reasoning skills enable
nurse to implement patient centred care. This paper utilizes the clinical reasoning cycle
framework to demonstrate patient centred care by analyzing the case study of Mr. Jim Gray.
It will process the health related information of the Mr, Jim, establish goals and nursing care
and evaluate the effectiveness of the nursing care strategies. A reflection on the patient’s
outcome will be provided too.
Consider the person’s situation:
Mr. Jim Gray is a 28 year old male admitted to the Mental Health unit 5 days ago
after a failed suicidal attempt. She has been diagnosed with major depressive disorder
(MDD). He is the son of a grazier and the family is suffering from financial crisis because of
longstanding drought conditions in the district.
Processing information
To assess and identify key problems in patient, it will be necessary to consider
subjective and objective information of Mr. Jim. The handover information of Mr. Jim
suggested that he was reluctant to have lunch and ate almost nothing. He returned to bed
immediately. The occupational therapist reported no interest of Jim in taking part in any
small group games. Based on this information, it can be interpreted that key symptoms of Jim
includes suicide ideation, low appetite, social isolation, little interest in activities. These
symptoms are similar to that of major depressive disorder (Draper & Tetley, 2013). However,

2HEALTH CARE
the duration or persistence of these symptoms is not known. In addition, the vital signs of Jim
include blood pressure 125/75 (normal BP 120/80), temperature 36. 3 degree Celsius (normal
37.4) , pulse 66 bpm (60 to 100 bpm) and respiratory rate 18/min (normal 12 to 20 breaths
per minute). All the vital signs are within normal limit expect body temperature which is
lower than expected.
On assessment of the body, burn mark has been found on his neck due to breaking of
the rope during suicide attempt. Minor bruising and broken skin on arms and leg from fall has
been found too. These forms of self inflicted injuries are common during failed suicide
attempt such as strangulation and jump from a height. Hence, injury patterns must be
assessed to promote full recovery of patient (Siegl et al., 2017). The review of current
behaviour of Mr. Jim shows that he is not willing to talk with anyone. Currently he is turning
face towards the fall and stating that he just wants to die. This is high risk behaviour as he is
still having suicidal thoughts and it can increase suicide attempts in the future too. Interacting
with such patients can be challenging for nursing staffs too. Hence, nursing staffs must be
skilled in therapeutic interactions to effectively deal with patients who are suicidal (Awenat
et al., 2017).
Three nursing problem or issues:
Based on collection and processing of subjective and objective information of patient,
three major problems have been identified for patient. Based on the analysis of symptoms of
Jim during afternoon shift, one nursing problem identified is risk of suicidal thoughts or
suicide ideation. Suicide ideation includes thought about killing oneself or making plans to
end life. This is evidenced from the mark in the neck which is a sign of failed suicide
attempts and patient’s verbal expression of willing to die. Hence, addressing suicide ideation
is a major problem that needs to be prioritized by nurse as it can lead to future risk of self