1. Psychological Care of a Patient Essay.
Psychological Care of a Patient Essay. Nicolls indicates that the psychological skills should
be routine provision. Discuss this statement using a case study from clinical practice.
Discuss the relevance of psychology and how it is applied and integrated into a case study.
Identify the medical and nursing problems and the related pathophysiology to set the
context of the case study. (1000 words.)Psychological Care of a Patient Essay.ORDER A
PLAGIARISM-FREE PAPER HEREPortfolio 2Psychological care refers to an approach of
looking after the ill, (in this case also the parents) and should be integrated with nursing to
provide an organised and practical psychological content to overall care. Krigger et al
(2007). They also state it represents a big step towards meeting the requirements of truly
holistic care. As mentioned it requires an organised approach with various skills and
objectives and to deal with psychological issues arising from the event of illness. Firstly for
psychological care there has to be an awareness. Secondly intervention and thirdly refer on
if necessary for therapy. Nicolls states that it should be common provision’ in hospitals. He
also states that common psychological reactions to illnesses include shock and even post-
traumatic stress, confusion, distress and loss of self-worth, lowered self-control and even a
collapse into dependency.Psychological Care of a Patient Essay.Kevin (not his real name for
the purposes of confidentiality) was a term +10 day baby. Spontaneous vaginal delivery. His
birth weight was 3.2kgs. Apgar score was 9 at one minute of age and 10 at ten minutes of
age. He cried at delivery, no resuscitation required just dried and suctioned. He was pink
and given to mother for skin to skin. He was her first baby. At fifteen minutes of age baby
was on the breast and sucking. All was well. At 30 minutes of age, mother’s partner noticed
that the baby while still on the breast was not sucking and not breathing. He immediately
called for help. The neonatal team came immediately. Cardiac massage was given, the baby
was intubated and ventilated, and adrenaline 1:10,000 was given by three individual doses
via the endotracheal tube. He was transferred to the neonatal unit. A team decision was
made to start the baby on cooling as per cooling guidelines. Umbilical arterial and venous
lines were inserted and he was commenced on morphine. Pancuronium (muscle relaxant)
was withheld initially so the team could observe if there any abnormal movements.
Continuous monitoring functioning was commenced. His mother Mary (not her real name)
came down to the unit accompanied by her partner shaken and shocked at the fact that her
baby had been taken away from her so suddenly. She went from euphoria the birth of her
first baby a beautiful baby boy to a lifeless baby cold to touch in a cooling supported by a life
support machine with bags of intravenous fluids, syringes and pumps. This for her was so
2. surreal.Psychological Care of a Patient Essay.After initially explaining to Mary how we were
actually nursing Kevin being continually aware that it was pretty much going over her head
but as Drewery in his article states ‘repetition is the prime influence in memory’ None of the
team at this point could actually tell her what had happened because we did not know. We
as a team were also shocked as to what happened. We tried to internalise the situation. The
baby was pink, was at the breast and sucking. What happened?Each time Mary came to the
neonatal unit she would spend long periods of time there sometimes on her own sometimes
with her partner or family members. She appeared vague as if everything was going over
her head and it was to a certain degree. Emotional and psychological care was paramount
for her at this stage. By day four it was clear that Kevin would not survive without the
ventilator, psychological preparation for that was of vital importance. Communication with
the parents seeing exactly at what point each of them were at and bridging that gap. To
build a bridge from where they were at that point and helping them cross that bridge
metaphorically speaking where they needed to be without them falling. That was a huge
challenge for us as a team. According to Egan (1998) Attending, Listening and
Understanding are the three basics in communication skills. Attending which is being
present for the person or persons. Listening which must be active listening as this will
encourage the clients to talk and how they feel and what is going on for them at that present
time. Egan (1998) also states we have to listen to nonverbal cues as very often as in this
case the present was familiar (at least the baby was present) as opposed to the prospect of
change. They appeared to have understood the consequences of withdrawing ventilation
but their body language clearly stated they did not want it to happenThe bond of
attachment had already formed especially with Mary. As Bowlby (1989) states ‘attachment
is a close emotional bond between infant and the care giver in this case between infant and
mother. She said very little initially how she felt, just asked very appropriate questions
regarding Kevin. It was difficult nursing him as we both knew the outcome but on the other
side she had built up a relationship with us. One of trust one that had been formed on the
basis of been open and frank with her and she with us. We left them decide when they
wanted to withdraw ventilation. This bridge was built and crossed. The initial conversation
about withdrawing treatment went completely over their heads, but as mentioned earlier
Repetition is the prime influence in memory. Dewey (2012). Traumatic news sometimes
cannot be processed. One can proceed to the responses of grief: denial, anger, bargaining
and finally acceptance. According to Krigger et al (2007) grief often manifests itself with
features similar to depression and it is vital as health care professionals can distinguish
between the two, as this may require professional help example counselling or
psychotherapy. With this particular case the parents had very good family
support.Psychological Care of a Patient Essay.CONCLUSION.In conclusion I agree from my
experience of dealing with this particular case and other cases also that psychological care
of a patient and in this case the parents is paramount. They must be treated in holistically,
physiologically, psychologically and spiritual care is also of great importance. Holistic care is
central to nursing and also intuitive. As Wynne (2013) describes palliative care is ‘an
approach that improves the quality of life of patients and their families facing life
threatening illnesses’. One has to care in a way that counts one has to be emphatic and kind
3. also to look after one’s own needs to ensure that psychological care is of routine
provision.Psychological Care of a Patient Essay.
