Nursing Reflection: Complex Patient Care & Interprofessional Team

This assignment presents a narrated PowerPoint presentation reflecting on the care of a complex patient encountered during a clinical placement. The presentation focuses on a patient presenting with chest pain, fatigue, and other symptoms, detailing their medical and psychosocial history, including Type II Diabetes, depression, and lifestyle factors. It provides a brief overview of the patient's pathophysiology, highlighting the potential links between diabetes, hypertension, obesity, and depression. The reflection utilizes Gibbs' reflective cycle to analyze the experience, including the author's feelings, evaluation, and analysis of the situation. The presentation identifies and discusses the involvement of interprofessional team members such as a nutritionist, counselor, and community nurse. The author concludes with an action plan for future practice, emphasizing the importance of cultural safety and patient-family partnerships. References to relevant literature are also included to support the analysis.

COMPLEX CARE
-SUBMITTED BY:

PRESENTING COMPLAINT:
 Rachel presented to the outpatient department with severe
chest pain and a pounding sensation in the chest, neck and
ears
 She reports feeling fatigued and experiencing burning
sensation in her feet
 Vitals assessment:
Temp: 101̊̊ F, Respiratory Rate: 28 breaths per minute, BP:
140/90, Pulse: 102 beats per minute
Body Weight: 174 pounds

Medical History:
 Rachel has a medical history of Type II Diabetes since the previous 6
years
 Her current medication include:
 Metformin 500 mg PO
 Lisinopril 20 mg orally once a day
 No reported allergies

Psychosocial History:
 Suffered from depression because of bullying at school at the age of 14
years
 Does not stay with parents but shares a good relation
 Has recently gone through a bad breakup
 Reports not indulging in social interaction for the far of being bullied
because of her weight
 Relies heavily upon take away meals
 Worked at a salon but had to quit because of her increased health
complications and at present sustains on her savings

Pathophysiology:

Inter-professional team
members involved:
 Nutritionist
 Counsellor
 Community Nurse

Gibbs Reflection Framework:
Fig: Gibbs Reflection Cycle

Description:
 Upon presentment, the patient experienced increased shortness of
breath and a pounding sensation in her chest, neck and ears. The
patient also complained about experiencing a burning feet sensation.

Feelings:
 The patient seemed to be distressed and in pain. It seemed as though
the patient was experiencing the pounding sensation because of
hypertension. The patient appeared to be obese and found it difficult to
breathe normally. I thought it was appropriate to assess the patient and
conduct a vital assessment.

Evaluation:
 I conducted a vital assessment of the patient
 The vital assessment of the patient revealed high blood pressure,
elevated respiratory rate, pulse rate, temperature and obesity.
 The medical history of the patient suggested that the patient had been
suffering from Type II Diabetes
 The health condition of the patient seemed to be influenced heavily by
the life stressors.

Analysis:
 Life style stressors such as sedentary lifestyle and unhealthy diet
routine has triggered obesity and poor management of the symptoms
of Type II Diabetes.
 Obesity could have triggered hypertension
 Poor management of the symptoms of Type II Diabetes might have led
to hypertension
 Increased social isolation and emotional turmoil on ground of breakup
could have triggered depression.

Conclusion:
 Prior to conducting the patient assessment and proceeding with the
care process, I could have asked the patient about her cultural specific/
spiritual requirements.
 Prior to proceeding with the care intervention, I should have asked her
if she would like to involve one of her family member in the process of
care intervention.