PATIENT NEEDS AND EFFECTIVE NURSING COMMUNICATION

Running head: PATIENT NEEDS AND EFFECTIVE NURSING COMMUNICATION
PATIENT NEEDS AND EFFECTIVE NURSING COMMUNICATION
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PATIENT NEEDS AND EFFECTIVE NURSING COMMUNICATION1
Introduction
According to professional standards 7, formulated by the Nursing and Midwifery Council
(NMC, 2019), registered nurses (RNs) are required to established clear communication patients,
their families and associated health professionals for the purpose of sharing relevant information
on patient needs and preferences. A key procedure with which nurses can identify the needs of
patients and initiate effective communication regarding the same, is the Roper-Logan-Tierney
Model for nursing which is based on the assessment of a patient’s ability to perform activities of
daily living (ADL) (Williams 2017). The following essay, will discuss the role of effective
nursing communication via the Roper-Logan-Tierney Model for Nursing, with respect to a
specific patient case scenario.
Discussion
Context of Patient Admission
The following essay will be based on a patient who was admitted in the context of a
musculoskeletal disorder diagnosis (osteoarthritis) and thus, inability to address the health need
of ‘mobilization’ or the ability to be mobile to practice mobility within the range of motion. The
concerned patient is Mrs. X (name of the patient kept confidentiality as per the Standard 5 of the
NMC Code) – a 60 year old woman who was admitted upon complaints of debilitating pain in
both of her knees, which has progressively worsened since the last 3 years. The patient reported
of feeling stiffness and pain in her knees, every day when she woke up in the morning, which
lasted for almost 20 to 30 minutes. She also experienced knee pain and stiffness several times
throughout the day, especially when she arose after sitting for a prolonged time or when she
remained in the same position for a long period of time. While resting and sitting temporarily

PATIENT NEEDS AND EFFECTIVE NURSING COMMUNICATION2
relieved her pain, the same would worsen especially during days which were humid or cold or
while participating in participating in particular movements like climbing the stairs or squatting
to pick up an item – thus indicative reduced mobility.
A physical musculoskeletal examination revealed a diagnosis of osteoarthritis in the form
of a lack of complete knee flexion and extension of less than 120 degree as compared to the
normal range of 140 to 150 degrees respectively (Yousif and Altaee 2018). An additional
radiological X-ray assessment revealed narrowed joint space and loss of cartilage across the
joints in both of her knees. Further assessment revealed that Mrs. X lived with her 65 year old
husband and that both her daughter and son were married and lived away with their respective
families. Due to progressive knee pain, Mrs. X now spends most of her time at home with her
husband doing most of the cooking, cleaning and grocery shopping for her. While she encounters
no problem concerning dressing, grooming or hygiene – she admits to feeling lonely and bored
since her knee pain has restricted her ability to meet her friends during their weekly gatherings.
Considering the above, it can be identified that the key health need of the concerned patient is the
need to practice the ADL of effective mobilization (Williams 2015).
Identification of Health Need
The NMC Code component of ‘Practice Effectively’ recognizes the importance of the
nursing practice of assessing patient needs, with the help of a evidence based, comprehensive
patient screening and assessment tools (NMC, 201). Thus, the health need of the concerned
patient will be identified and assessed with the help of the Roper-Logan-Tierney Model for
Nursing. This model of nursing assists nurses in the development of a nursing care plan using
theoretical perspectives associated with ADLs. This nursing model was formulated by Winfred
W. Logan, Nancy Roper and Alison J. Tierney (Nelson and Welsh 2015). The aim of this model

PATIENT NEEDS AND EFFECTIVE NURSING COMMUNICATION3
is to measure the effect of disease progression or deterioration on a patient’s level of
independence during performance of ADL following which, a nurse can implement specific
health interventions targeting the affected ADL. Thus, the key ADLs which are targeted by
Roper-Logan-Tierney Model are: communication, maintenance of safety, eating and drinking,
breathing, temperature controlling, washing and dressing, elimination, sleeping, working and
playing, and lastly, mobilization (Nelson and Carey 2016).
Considering the above scenario where the patient has been in the context of a diagnosis
of osteoarthritis and affected movement due to worsening pain and stiffness in both her knees, it
is evident that the ADL which has been affected as per the Roper-Logan-Tierney Model for
Nursing, is mobilization. The ADL of mobilization is the name given to the activity of mobility,
that is, the act of moving from one place to another (Holland and Jenkins 2019). Thus, the health
need of the concerned patient is the need to regain mobility, that is, perform the ADL of
mobilization. Mobilization is particularly essential for daily life functioning like walking and
participation in outdoor activities and thus, inadequacy in the same severely impacts an
individual’s ability to socialize. Thus, the nursing care plan to be developed for Mrs. X, must be
centered on restoring her need to fulfil the ADL of mobilization (Turan and Sendir 2019).
Standard 3 postulated by the NMC, necessitates the importance of RNs conducting a
comprehensive assessment of the physiological, psychological, emotional and social needs of the
patient (NMC, 2019). The absence of a comprehensive and holistic patient assessment hinders
nursing ability to effectively communicate patient needs and formulate and evidence based care
plan and interventions – thus hindering effective therapeutic nurse-patient relationship
(Imanipour and Jalili 2016).