You are caring for an 82-year-old woman who has been hospitalized for several weeks for burns that she sustained on her lower legs during a cooking accident. Before the time of her admission, she lived alone in a small apartment. The patient reported on admission that she has no surviving family. Her support system appears to be other elders who live in her neighborhood. Because of transportation difficulties, most of them are unable to visit frequently. One of her neighbors has reported that she is caring for the patient’s dog, a Yorkshire terrier. As you care for this woman, she begs you to let her friend bring her dog to the hospital. She says that none of the other nurses have listened to her about such a visit. As she asks you about this, she begins to cry and tells you that they have never been separated. You recall that the staff discussed their concern about this woman’s well-being during report that morning. They said that she has been eating very little and seems to be depressed. 1. Based on Nightingale’s work, identify specific interventions that you would provide in caring for this patient. 2. Describe what action, if any, you would take regarding the patient’s request to see her dog. Discuss the theoretical basis of your decision and action based on your understanding of Nightingale’s work. 3. Describe and discuss what nursing diagnoses you would make and what interventions you would initiate to address the patient’s nutritional status and emotional well-being. 4. As the patient’s primary nurse, identify and discuss the planning you would undertake regarding her discharge from the hospital. Identify members of the discharge team and their roles in this process. Describe how you would advocate for the patient based on Nightingale’s observations and descriptions of the role of the nurse.

1. Based on Nightingale’s work, there are several interventions that can be provided in caring for this patient. Nightingale emphasized the importance of maintaining a clean and sanitary environment to promote healing and prevent the spread of infection. Therefore, it is essential to ensure that the patient’s room is clean and well-maintained. This can be achieved by regularly disinfecting surfaces, keeping the room well-ventilated, and promoting proper hand hygiene among staff and visitors.

Additionally, Nightingale stressed the significance of proper nutrition in promoting recovery. It is important to assess the patient’s nutritional status and provide appropriate interventions to address any deficiencies. This can include consulting with a registered dietitian to develop a personalized meal plan, monitoring the patient’s food intake, and providing support to address any barriers to eating such as difficulty chewing or swallowing.

2. In regards to the patient’s request to see her dog, the theoretical basis of the decision and action can be grounded in Nightingale’s understanding of the psychological and emotional well-being of patients. Nightingale recognized the importance of providing psychological support and maintaining the patient’s morale during their recovery. Therefore, in this case, it may be beneficial to consider allowing the patient’s friend to bring the dog to the hospital if it can be done without compromising infection control measures or causing distress to other patients.

However, it is crucial to assess the hospital’s policies and consult with the healthcare team to determine if such a visitation is possible. If it is not feasible, alternative measures should be explored. This can include arranging for visitations from the patient’s friend outside the hospital, or arranging for pictures, videos, or virtual visits with the dog. These alternative measures can help provide emotional support to the patient and alleviate feelings of isolation and depression.

3. In terms of nursing diagnoses, two potential nursing diagnoses for this patient may be:
– Imbalanced Nutrition: Less Than Body Requirements related to decreased appetite and inadequate food intake
– Risk for Impaired Emotional Well-being related to lack of social support and feelings of isolation

To address the patient’s nutritional status, it is important to conduct a thorough assessment to identify any underlying factors contributing to the decreased appetite and inadequate food intake. Interventions can include working with the registered dietitian to develop a personalized meal plan tailored to the patient’s preferences and dietary restrictions. Additionally, measures such as providing small, frequent meals, offering assistance during meal times, and monitoring the patient’s weight regularly can be implemented.

To address the patient’s emotional well-being, interventions can include providing emotional support through active listening and therapeutic communication. Encouraging the patient to express her feelings and concerns can help alleviate feelings of isolation and depression. Engaging the patient in meaningful activities that she enjoys, such as reading, listening to music, or engaging in hobbies, can also promote emotional well-being. Referrals to support groups or counseling services may also be beneficial in addressing the patient’s emotional needs.

4. As the patient’s primary nurse, planning for her discharge from the hospital involves coordinating with various members of the discharge team. This can include the healthcare provider, case manager, social worker, and any other relevant personnel. The primary goal is to ensure a safe and smooth transition for the patient from the hospital to her home environment.

In advocating for the patient based on Nightingale’s observations, it is essential to ensure that the patient is well-prepared for discharge. This includes providing thorough education on self-care management, medication administration, wound care (if applicable), and any necessary follow-up appointments. The nurse should also collaborate with the social worker to assess the patient’s support system and explore available community resources that can provide ongoing assistance, such as home healthcare services or meal delivery programs.

Furthermore, the nurse should advocate for a holistic approach to the patient’s care, addressing not only her physical needs but also her psychosocial well-being. This can involve coordinating with the social worker or case manager to facilitate social support, such as connecting the patient with support groups or community organizations that can help address her isolation and promote her emotional well-being. In doing so, the nurse embodies Nightingale’s understanding of the nurse’s role as a patient advocate and promoter of holistic care.