The paper will focus on the role of nurses in assisting a patient who has had a total hip replacement, and living with a husband suffering from Parkinson disease. With the current condition, it means that the patients (Mrs Allen) will have limited movements, and may not be able to perform the normal chores she used to before the hip replacement. It also means that she may be unable to take care of her 68 year old ailing husband. The current situation is likely to predispose Mrs Allen to psychological and emotional disorders that might interfere with the healing process. There is a lot of pressure on her side, owing to the fact that besides being sick, there are a number of activities she will be forced to perform for survival purposes. For this reason, apart from medical intervention, the nurses will need to focus on other objective strategies to respond to the current situation. The psychosocial intervention can be an important strategy that will ensure that both Mrs Allen and her husband recuperate. It will also ensure that they do not succumb to emotional disorders such as depression, which counteracts the healing process. For this reason, the paper will focus on the analysis of this problem, how it affects the patient’s physical, social and psychological wellbeing and also indicating how the nurses will be able to find an amicable solution. The goal is to ensure that the client is able to go back home, and to run her normal duties.
Having made analysis of the presented cases, there are a number of problems that are likely to affect the well-being of the patient. Firstly, there is a physical effect on the patient. With the complete hip replacement, regular movements may be hampered. This means that the patient is unable to perform some of their activities, especially those involving walking long distances. Further, the patient will not be able to carry heavy loads, as this has the effect of hampering the healing process. Prior to the current situation, the patient indicated that she used to walk to church daily for spiritual nourishment. However, this may change as this kind of movement is not possible.
Secondly, it is possible that the patient will experience emotional and psychological disorders. This can be attributed to the level of stressful situations that the client is going through. As she confessed, she is in a hurry to leave the hospital in order to take care of her ailing husband. While this is important, her health is also at stake, owing to the fact that the nurses have to ascertain that she is fit to return home. The current assessment indicates that she is suffering from depression, as she has been exhibiting some symptoms. She has been vague lately, and has been unable to state the main cause of her problem. Some of the major symptoms of depression are confusion, sleeping disorders, loss of appetite, lack of interests, and the suicidal thoughts (Armstrong, 2011). Her current situation is likely to predispose her to trauma, which is an advanced stage of depression.
The third problem is that Mrs Allen may not lose close friends due to her deteriorating emotional health.
Depression has a potential to interfere with social interaction (Baille & Gallagher, 2009). Lack of warmth and interest in social issues may also negatively affect the social skills, prompting the friends to avoid her (Bee, 2010). One is also likely to become irrational and succumbing to stress easily. Currently, Mrs Allen needs friends most, but this may not be realized unless she is able to control her emotions.
Fourthly, a possible problem is that of financial constraint. Both patients are old and ailing, meaning that they do not have the energy to work in order to earn any income. Unless they have invested, it will be difficult for them to meet their basic needs and to pay for medical bills. With both the medical and psychological interventions being expensive, they may not afford (Rumbold, 2012). This means that their healing process is faced with a real challenge. The financial problem is another root cause of depression.
All the mentioned problems need strategies that will ensure that they are addressed. Failure to do this will negatively affect the ability of the patient to go back to her normal life. While the patient has a role to play in the healing process, the nurses also need to intervene. First, they need to assure the client that all will be well. The patient a need to be encouraged, and given hope that all will turn out well (Breier-Mackie, 2010). As it appears, the patient is hopeless, and despite the treatment given, she may not be able to benefit a lot. In assuring her, the nurses need to tell the patient that they have dealt with such cases before, and that they know what needs to be done to ensure that she feels relieved (Gastmans, 2011).
Professional counselling services can be extended to Mrs Allen based on her current emotional and psychological status. As indicated above, she has been exhibiting some signs of depression, whose root can be attributed to her sickness and that of her husband. She is worried that she will not be able to go back to her normal life. For this reason, psychotherapy will play a vital role in addressing the current status of her mind. According to Sigmund Freud, the main causes of the psychological disorders are the presence of unaddressed issues in the unconscious mind. To foster healing in such patients, it is imperative that the unconscious motives or drives are brought to the conscious.
The hospital should therefore create a serene environment that will prompt the client to talk freely. As she expresses herself, she is likely to begin healing. The counselor should take the advantage to have the insight of the problem, in order to assist the client in coping with the current situation. As indicated earlier, one of the main strategies will involve the reconstruction of the thought process of Mrs Allen. Currently, all she thinks is that the life is unfair to her, and that this is the end of her life. For this reason, there will be a need to address these irrationalities, by giving her hope, and empowering her to think clearly and objectively.
The third intervention will be to focus on how to foster social relationship as this will play a huge role in alleviating depression and other emotional disorders. The nurses need to take advantage of the existing social networks that Mrs Allen has already established. In her confession, the patient had indicated that she attends a local church almost daily. It is clear that if she is an active member of the church, she has been able to form relationships with many people. This kind of social bond will play an important role in offering emotional support to the family. As it stands, it will be almost impossible for Mrs Allen to go back to her usual tasks. She will need the presence of social support network. Apart from the church, it is important to know if she has any family members who will be willing to assist them. This is especially in terms of financial support, which is likely to become a major issue. The social support alone will not assist, as the couple needs to survive.
While it is important to ensure that Mrs Allen goes back to her normal life, it is also vital to remember that her joy will increase if her husband’s health also improved. While there is no cure for Parkinson disease, there are simple strategies that can be used to manage it (Bronstein et al., 2010). The nurses should focus on diet, social networks and physical activities as ways to assist Mrs Allen’s husband (Ceravolo, 2009). The Parkinson disease is characterised by the difficulties in motor coordination and movement. However, this can be improved by encouraging the patient to take part in light physical activities, which will improve flexibility, strength and enhance mobility (Crain, 2011). The patient should also have the access to a balanced diet. Due to the fact that the digestive muscles may be affected, it is imperative to ensure that the food is high in fibre and low in fats (Goldenberg, 2010). The patient also needs to take a lot of water. This will facilitate digestion, and assist in preventing constipation and gastroparesis (a situation where food may remain in the stomach longer than usual).
This kind of information will assist Mrs Allen in making informed decisions when she goes back home. If she follows these instructions, she will be able to ensure that the health of her husband improves.
Effects on Mrs Allen’s physical and psychological well-being
If all the suggested intervention strategies are followed, it is possible that the patient will be able to go back to her previous life. To improve her physical well-being, the nurses should perform the surgery successfully to replace her hip. Once she has healed, the nurses should encourage her to walk short distances as a way of practicing (Rumbold, 2009). This will also mean that she will be able to go to church, and also perform other light duties in the house, and probably go for shopping. The psychosocial intervention will assist significantly in improving her psychological well-being. As indicated before, this will assist her to become rational, and be hopeful in life. She will be able to overcome the negative thoughts that deteriorate psychological health, and impede the healing process (Tschudin, 2010). Having a healthy mind may also improve the immunity system, which means that she is able to protect herself against other infections. Further, the fact that her husband will also get assistance means that she will be happier. This, coupled with the presence of social networks will definitely assist the couple in their healing process, and gaining the physical and psychological fulfillment.
How to assist Mrs Allen go back to her previous state of Health
As indicated before, the psychosocial and medical interventions are the major strategies that will ensure that Mrs Allen goes back to her normal duties. The healing should however be treated as a continuous process, and not a onetime event. This means that the nurses should make follow-ups even after the patient is discharged from the hospital. This will play an important role in knowing whether the client has healed or will require any other method of intervention. For instance, depression is one of the main problems that are likely to recur depending on the current situation the client is going through. Making regular contacts and encouraging her to make contacts with the hospital any time she is in health problem will assist in the recovery process. It is also imperative to ensure that the couple are having a balanced diet, which will go along improving their ability to fight infections, as well as enhancing their physical wellbeing. Being surrounded by a support system will also give the couple strength and hope for brighter days. With time, Mrs Allen and her husband will have improved health. This will ensure that she is able to go back to her normal life, with the ability to perform most of her usual duties.
In conclusion, the main goal that the nurses and other medical practitioners should aim is to ensure that a patient is able to go back to their normal life. The health institutions should focus on all necessary strategies that have the ability to improve the physical and psychological wellbeing of the client. As for Mrs Allen, the nurses should ensure that she can be able to take care of her ailing husband, and to have meaning of life.
- Allen, E. (2003). Developmental Profiles Pre-Birth Through Twelve (4th ed.). Albany, NY: Thomson Delmar Learning. ISBN 978-0-7668-3765-2
- Armstrong, A. (2011). Nursing Ethics: A Virtue-Based Approach. Palgrave Macmillan. ISBN 978-0-230-50688-6.
- Baille L, Gallagher A. & Wainwright P. (2009). Defending Dignity. Royal College of Nursing.
- Bee, H.(March 2009). The Developing Child (12th ed.). Boston, MA: Pearson. ISBN 978-0-205-68593-6.
- Breier-Mackie, S. (2010). “Medical Ethics and Nursing Ethics: Is There Really Any Difference?”. Gastroenterology Nursing 29 (2): 182–3.