Reflective Journal on Roper Logan and Tierney Model of Care and Clinical Reasoning Process

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Reflective Journal
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After reading the Roper Logan and Tierney model of care I am now conversant with how
activities of daily living can be applied in nursing care to improve a patient’s quality of life and
reduce dependency. The model is named after the people who developed it inspired by Virginia
Henderson’s work (Williams, 2017). From the theory, I have learned what living means and how
as a nurse I can intervene to support patient’s independence where the patient might find it had to
be dependent. The twelve daily living activities are eating, breathing, drinking, eliminating, body
temperature control, personal cleansing, sleeping, playing and working, mobilizing and dying
(Williams, 2017). All these activities are applied as a guide in planning, assessing, implementing
and evaluating a patient in care provision. Using the model, I can assess the dependence of the
patient and his or her potential for independence in daily living activities. Also, I can assess the
psychological, social and biological factors causing the problems in the patient’s activities of
daily living. Thereafter, I can determine which intervention when applied will lead to an increase
in the patient’s dependence and also any kind of support needed to end any form of existing
dependency.
On the other hand, the clinical reasoning process was a great read. I learned that as a
nurse, it is important to have clinical reasoning skills in order to improve patient outcomes
(Ashley & Stamp, 2014). Nursing training should start at the undergraduate level in order to
enable students to develop clinical thinking and critical thinking skills. The clinical thinking
process has eight main phases which include looking, collecting, processing, deciding, planning,
acting, evaluating and finally reflecting. Despite the fact that each phase stands as a distinct
element, they all merge and the distinction between them becomes blurred. As a nurse, one
should combine the different phases or move back and forth between the steps before deciding
on the right intervention. A clear understanding of each phase is crucial for nurses to avoid

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making a fake assumption concerning the patient’s problems and coming up with interventions
that are not well thought of.
The Roper Logan and Tierney care model and the critical thinking cycle have influenced
my nursing practice greatly. In future practice as a nurse, I can comfortably apply the Roper
Logan and Tierney care model and the Clinical cycle of reasoning. In this section, I am going to
discuss a personal experience in the hospital where I will apply the Roper Logan care model and
the critical thinking cycle. I will apply Gibb’s reflective cycle in writing the reflection (Johns,
2017). In this write up I will focus on an aged patient with diabetes, dementia, high blood
pressure and a wound from an accidental fall.
My first step will be to assess the patient for activities of daily living. I will apply the
Roper Logan and Tierney care model to assess the patients breathing. The patient has irregular
movements of the chest and the patient lacked enough oxygen thus in need of oxygen therapy.
The cause of the patient’s irregular breathing can be attributed to the biological factors like
patient’s diabetic condition and high blood pressure. Thereafter, the patient will then be trained
on exercises to improve breathing. Monitoring the patient’s blood pressure and blood sugar and
providing appropriate medication is crucial (Newcomb-Anjo, Barker & Howard, 2017).
Secondly, I will assess the mobility of the patient and prescribe pain medication to
minimize pain and promote mobility. I will assess the cause of the patient’s immobility. The
patient’s inability to mobilize is caused by biological factor of pain from the wound and also his
old age. The patient’s inability to mobilize can be due to psychological stress resulting from his
health condition. Counseling the patient to prevent stress and training the patient to try and
mobilize without aid through regular practicing is essential (Nelson, 2016).