Enacting Professional Caring: Nursing Practice and Diabetes Care

This report provides a comprehensive overview of enacting professional caring within the nursing practice, emphasizing the multifaceted nature of the profession. It delves into essential aspects such as therapeutic communication, the establishment of trust-based relationships, and the provision of holistic support to patients and their families. The report highlights the critical role of effective communication in building rapport, minimizing errors, and fostering a positive environment within healthcare settings. Furthermore, it explores the nuances of palliative care, particularly for older adults and individuals with diabetes, detailing the importance of pain management, symptom control, and patient education. The report also addresses the specific needs of patients with uncontrolled type II diabetes, including the development of nursing care plans that encompass blood glucose monitoring, dietary adjustments, exercise regimens, and medication management. It underscores the significance of recognizing and addressing potential complications, such as hypoglycaemia and infections, while also emphasizing the importance of patient education and adherence to treatment plans. Finally, it examines the role of nurses in utilizing research-based knowledge to improve patient outcomes and contribute to advancements in the field of nursing, while providing insights into best practices for patient care, including communication, hygiene, and patient empowerment.

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Enacting Professional Caring
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The Nursing practice requires many qualities. It requires specialised skills, knowledge and
independent decision-making skills. There are many aspects of nursing practice. It includes
the type of client, different disease management, therapeutic approach and also rehabilitation.
This relation is based on mutual respect and trust. It is a helping relationship in which the
nurse should be sensitive to self and others . Providing physical, emotional, spiritual support
to the patient and their family.( Holloway, I., & Wheeler, S. 2013).
To be a successful nurse excellent communication skills are important. This helps in building
an interpersonal relationship with patient and family. The nurse is able to take better care of
the patient if she able to communicate properly with the patient. This also helps in building a
relationship among the staff of the institute. More the communication by the nurse there is
fewer chances of error. Also, it helps in creating a trust and positive environment.
The therapeutic practice involves communication between nurses with officials , patients and
also their relatives. By effective communication, a comfort level with the patient is developed
by which patient conveys his pain, fear , shares anxiety. (Johnson, M., Cowin, L. S., Wilson,
I., & Young, H. 2012).
Listening is a very important mode of communication. It requires nursing skills and attention.
By this nurses can access the situation and problems of the patient. By being a good listener
nurses can provide care at all levels of recovery.
Along with listening , speaking with the patient also becomes important .Conversations
should be held in appropriate condition. (Duffy, J. R. (2013). Each patient has its own way to
discuss the problem. After the nurse has listened to all the problems she can talk to the
patient.

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The most important core role of nursing practice is known as the therapeutic relationship. Its
key role comes during palliative care. In this a person and its family members require
support. This requires great sensitivity . Palliative care nurses need to be knowledgeable and
they should carry enough experience in nursing to deliver sensitive information in a proper
manner. The role of the palliative nurse is extremely stressful . It is important for the nurse to
focus on self-care along with the care of patient and family members.
Physically palliative approach is followed to manage pain and physical discomfort in most of
the situations. Pain being the most important complaint in the palliative approach to
treatment. As the discomfort increases the need for palliative approach increases. It becomes
very important where treatment is painful .( Potter, P. A., Perry, A. G., Stockert, P., & Hall,
A. (2016).
Old age people become prone to life-threatening disease or their suffering increases due to
the natural ageing process. In many countries, palliative services are provided at home only.
Mostly people by the end stage of their life prefer to spend their time at home. The palliative
approach helps patient’s family to cope with the terminal illness of the patient. Palliative care
leads to hospice care which includes focusing on comfort and quality of life. A personalised
action plan is required for every patient for comfort and care. In this, it has been found that
the survival expectancy is increased by 6 months. In this, the main focus is on pain control
which troubles the patient most. Pain control is done by analgesics and comfort measures
which can be achieved at home.
It is important to develop an integrated care pathway for the dying patient. This is for the
patients whose diagnosis is known and loss of life is inevitable. In this symptoms are closely
monitored and palliative approach is followed accordingly. In few cases, older people denied
access to palliative care. In these cases, their admission in hospital and nursing home

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becomes very important. Specialised palliative care is required in many patients.( Roach, M.
S. (2013)
Proper symptom control is impossible in older adults without proper communication. An
accurate assessment of patient’s health requires effective communication. Communication is
the centre of all treatment. Communication will deliver a great amount of palliative care to
the older adults. In the society conversation about death is often very awkward and difficult.
Among the health care professionals, there is a requirement of improvement of techniques to
overcome these obstacles. In last two decades, there is awareness of the importance of
communication skills
Nursing based care and in time quality decision, based on clinical expertise. The aim is to
provide better, healthy and safe care to the patients with most new techniques available. To
practice, nursing knowledge of the nurse along with multiple studies needs to be utilised.
These all are part of nursing education.( Wolf, Z. R., & Bailey, D. N. (2016).
There are many patients of Diabetes type II which are being hospitalised for various reasons.
It contributes high rates of mortality and morbidity. The main complication of diabetes is foot
ulcer and retinal detachment.
A Patient age 60 years gets admitted to the hospital with uncontrolled type II diabetes.
Nursing is very much required in this area. As a patient with Diabetes type II may require
guidance, treatment and proper monitoring. Diabetes patients often stay on treatment for life-
long. Here the nursing plans include the treatment to normalise blood sugar. The blood
glucose should be around 120. More than these needs to be reported to the treating physician.
Also to implement a strict and balanced diet for the patient. Also, it is important to make sure
that adequate exercise regime is being followed. Also, it is important to monitor the day to

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day sugar levels of the patient. As here we can see the patient is having unstable blood sugar
this can be due to many factors like inadequate blood glucose monitoring. There can be also
non-adherence to diabetic management. A nurse needs to keep a check on these. (Dunning, T.
2013). Also, it is important to manage the timely medication of the patient. Also, it is
important to give adequate knowledge to the patient regarding diabetes management. There
should be a proper chart formed on the day to day development of the patient. So that the
patient’s development can be monitored. Also, a nurse should be able to address any stress
related concerns. As in diabetes, the main factor is stress. Stress causes aggravation in
diabetic condition. Also, it is the duty of the nurse to encourage the patient for exercise. A
sedentary lifestyle causes weight gain and this will cause increased chances of uncontrolled
diabetes.
It is the duty of the nurse of access the sign and symptoms of hyperglycaemia through
regular blood glucose tests. Also, it is important to keep a check on blood sugar before meals
and along with blood sugar, it is important to access Hab1c values of the patient. It should be
between 6.5 -7. Being a nurse it is important to monitor its level in every 2-3 months. At
times the diabetic drugs cause immediate hypoglycaemia, There are few signs of
hypoglycaemia like anxiety, tremors, slurring of speech. A nurse should be able to recognise
these sign and symptoms. Also, it is important to keep a record of temperature and pulse of a
diabetic patient. In many cases the patient is diabetic but he does not have any knowledge
regarding diabetes. It is very important to inform and educate the patient about the changes he
needs to bring in his lifestyle due to diabetes. Exercise causes lowering of blood sugar. It is
important to educate the client about proper exercise regime. It will help managing diabetes.
Also, the old patient is on insulin, it is important to give him insulin on the prescribed
timings. Also once the patient is discharged from hospital he needs to teach how to monitor

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his glucose levels at home. There are many cases that hypertension is also associated with
diabetes.
Along with blood sugar management, the patient has to monitor its Blood pressure. BP
control will prevent many diseases like stroke, retinopathy etc. Also, regular urinary
checkups are also important as it will help the patient to monitor the urine albumin levels. Its
increased levels are found in renal nephropathy. The oral medications and insulin schedule
need to direct properly to the patient. Also as the patient is on insulin there are few things
which you need to tell him. Insulin injection should not be given at the same site again and
again. Insulin needs to be refrigerated at 2 degrees to 8 degree Celsius. Check the expiry date
of insulin every time before use. Also, it needs to be told to the client that insulin has to be
injected only once or twice daily. Regular prandial insulin which has been prescribed to the
client has to be injected 30 minutes before the meals. Also, it is important to mention the
patient that insulin dosages are to be reduced if he is fasting or not eating or when there is
hypoglycaemia. Rotation of insulin site is very important. Pushing injections on the same side
may cause fat deposits. Also, most important factor to be told is the injection should be
injected perpendicular to the skin. Also, it is very important to check that the patient
understands the demonstrations . Also patient needs to be taught to follow a low fat diet
which is high in fibre and low in sugar. There should be a proper balanced three meals daily
which can include a healthy evening snack. There should be an increase in fibres diet. Also if
hypoglycemic conditions set in then treat it with a snack or a glucagon injection. (American
Diabetes Association. 2015).
Infections are very common in diabetic patients. As due to high blood sugar, these infections
don’t heal rapidly. It is important to observe the signs of infections. There are many signs of
infection such as fever, cloudy urine and wound drainage. Immediate hospital admission may

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be required at this stage. It is important to follow some basic hygiene rules. The skin needs to
be dry. The linens have to be washed properly and kept in hygienic conditions. It is important
for the patient to monitor its vital signs during the stay at home. While instructing the patient
we need to check that he is aware of his time and orientation. It is important to call the patient
by name. This helps in gathering the attention of the patient. The instructions given to the
patient should be short. We need to speak slowly and clearly. Also, we ask the patient to
repeat in case he does not understand we need to explain him again. The patient needs to
follow a strict routine so that he does not forget his medications and injections. It is also
important to tell the patient that he need to avoid injury. Also, we need to access the problem-
solving capacity of the patient from the past experience. Is patient able to take care of himself
or there is a requirement of a home nurse. It is important to encourage the patient to take
decisions, he should be able to take decision related to his care. Also, we need to schedule
appointments and other activities henceforth. It is important to encourage the patient to take
part in outdoor activities. It will keep his exercise regime good. Also, physical activity will
help him reduce his blood sugar and live a healthy life. It will also promote positive health
care in the patient and feeling of control over the situation.
Nurses should be able to use scientific evidence to their critical thinking and skills. Lack of
knowledge can lead to less importance in research utilisation.( Alligood, M. R. (2014).
Nursing has a very strong impact on our society .Nurses can use their research knowledge
and skills to answer questions related to nursing diagnosis also they can prepare care plans
for patients. It includes learning about drugs and diseases. Obtaining information from the
patient which is a very crucial practice for nurses which will help them in their further
research. Through patient interaction, they can investigate new topics pertaining to their

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interest. All this will promote the professional development. There are certain laws related to
nursing. Over 100 years ago these laws were made to ensure the safe nursing practice.
Caring is the term always associated with nursing. The nurse's behaviour should be holistic
and the actions should aim at creating and maintaining an environment which will support
healing. To support the nursing profession the nurses need to engage themselves in a broad
range of activities when enacting professional roles. There should be a deeper understanding
of the term care. There are multiple levels of care.( Desmond, M. E., Horn, S., Keith, K.,
Kelby, S., Ryan, L., & Smith, J. (2014) Caring comes with professional experience. It may
have a different meaning for different nurses. The concept of care depends on different
factors. It depends on the amount of professional experience, the level of nursing education,
professional values and how and where the nursing skills and concepts are being applied. The
caring concept is central to the nursing practice. It requires great amount of discipline and
dedication to follow. There should be intentional and conscious caring. This will bring out
the best of the nursing practices from you. Being a nurse means you have to be fully present
in that moment and take proper care of the patient. It is all about having a trusting, helping
and caring relationship with the patient. This should not be limited to the patient but also
should be extended towards the other staff and most important the caregivers of the patient.
This gives a positive feeling in the patient and the caregivers. Caring is a very integral part of
nursing. It is important to engage yourself in genuine care by learning through various
experiences with the patients. This will come with years of practice and dedication. Caring is
an art which has to be studied but more than this it is an attitude in life which nurses should
flow for the patients and also the people around them. It is a there duty to create a healing
environment. Researchers have proved that if a patient is given adequate care and timely
medication it can even have miraculous results. For terminally ill patients care is the most

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important thing they required. This may add few more months or years in their lives. Caring
is the most important aspect of the nursing profession. As we know that in old age many
patients suffer from lack of care. A proper caring institution can give relief to old age patient
in many aspects.( Reid, J. (2012).
A nurse should have the ability to think critically when the situation demands. There should
be the ability to take judgements . There has to be knowledge to address complex issues. The
knowledge should be utilised in creating an effective client and nurse relationship. There is
also required conflict management skills along with excellent communication skills. The
nursing practice is used to achieve best client care and health outcomes. There should be a
vision of excellence .( Swanson, K. M. (2012).

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References-
Swanson, K. M. (2012). What is known about caring in nursing science.Caring in Nursing
Classics: An Essential Resource, 59.
Roach, M. S. (2013). Caring: The human mode of being. Caring in nursing classics: An
essential resource, 165-179.
Alligood, M. R. (2014). Nursing theorists and their work. Elsevier Health Sciences.
Wolf, Z. R., & Bailey, D. N. (2016). The Moral Construct of Caring in Nursing as
Communicative Action: Foundational Elements and Applications.International Journal for
Human Caring, 20(2), 107-113.
Potter, P. A., Perry, A. G., Stockert, P., & Hall, A. (2016). Fundamentals of nursing. Elsevier
Health Sciences.
Reid, J. (2012). Respect, compassion and dignity: the foundations of ethical and professional
caring. Journal of perioperative practice, 22(7), 216-219.
Desmond, M. E., Horn, S., Keith, K., Kelby, S., Ryan, L., & Smith, J. (2014). Incorporating
caring theory into personal and professional nursing practice to improve perception of
care. International Journal for Human Caring, 18(1), 35-44.
Duffy, J. R. (2013). Quality caring in nursing and health systems: Implications for clinicians,
educators, and leaders. Springer Publishing Company.
Johnson, M., Cowin, L. S., Wilson, I., & Young, H. (2012). Professional identity and nursing:
contemporary theoretical developments and future research challenges. International Nursing
Review, 59(4), 562-569.

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Holloway, I., & Wheeler, S. (2013). Qualitative research in nursing and healthcare. John
Wiley & Sons.
American Diabetes Association. (2015). 13. Diabetes Care in the Hospital, Nursing Home,
and Skilled Nursing Facility. Diabetes Care, 38(Supplement 1), S80-S85.
Dunning, T. (2013). Care of people with diabetes: a manual of nursing practice. John Wiley
& Sons.