Impact of Bad Communication on the Patient

Impact of Bad Communication on the Patient Patient’s outcomes and the impact of appropriate consultation carried out by an aesthetic nurse. Introduction Aesthetics is one of the fastest growing specialties of medical practice. Aesthetic nurses play a significant role in delivering aesthetic non-surgical treatments. They administer around 70 per cent of all non-surgical treatment. They typically work in a range of roles within the NHS and the private sector. Aesthetic nurses practise in clinical settings. Their roles span a broad range of task including systematic problem solving and the management of patient requirements. Aesthetic nurses play a key role in patient care pathway and are responsible for the provision of the right information about treatment and products, making diagnoses, creating a care plan and ensuring that patients receive the best treatment. Aesthetic nurses are also accountable for evaluation of patient’s treatment outcomes and progress towards achieving well-being and health (Fry et al., 2011). The management of health problems poses several challenges including having the right skills, attitude, expertise and knowledge to manage patient’s needs. Aesthetic nurses need to possess the right knowledge, communicative and ethical skills to minimise the risk of clinical errors. These aspects are crucial to delivering effective and positive outcomes during the management of patient’s needs. The general patient pathway comprises of an assessment that is carried out by the nurse during a consultation. This step is key to the management of patient risk, health and choices. Ineffective assessment and consultation could result in the wrong treatment prescription with the potential emotional, physical and psychological harm of the patient’s health. In this case study, I will apply Gibb’s reflective model (Jasper, 2003) to describe and present how lack of communication and incorrect treatment could lead to patient’s distress caused by the development of adverse effects following an aesthetic treatment. Case description using Gibb’s approach A 35-year-old woman came in to the clinic complaining of painful, irritated skin on both the right and left side of her face and the forehead. In particular, she reported signs of inflammation around the nasal-labial fold and perioral area, and in the buccal and frontal area. She noticed the problem within a day after receiving an aesthetic treatment at the clinic. She underwent a course of dermal filler injections containing Restylene to reduce the signs of lines and wrinkles in the frontal, buccal and nasal-labial areas. Although she was warned, she may experience some soreness and redness the patient was not aware of the type of active substances in her dermal fillers. She also has not been given a range of options of treatment and she did not receive any leaflets about the after care. She was presented with red, swollen and painful skin in particular during smiling or speaking. The patient came in to the clinic three days after her treatment and she was assessed by her aesthetic nurse. The nurse examined her face and prescribed her 1% hydrocortisone cream with the application of three times a day to the patient’s face for the duration of 7 days. Unfortunately, her symptoms worsened within three days of this treatment and the unhappy and distressed patient went to see a doctor. After careful examination and consultation with the doctor, the patient was diagnosed with a skin infection caused by the treatment she had at the aesthetic clinic. The patient’s skin presented with even greater inflammation characterised by pustules and yellow crusts in the area where the dermal filler injections took place. The doctor prescribed the patient a course of antibiotics taken externally as a cream in the form of Bactroban three times daily and Clarithromycin 200 mg 4 times a day. The course of antibiotic treatment lasted 7 days resulting in positive outcomes for the patient. During the patient’s visit to the doctor, I took part in the consultation, ex amination and medical history assessment. I reflected on my practice trying to identify the signs and symptoms that I missed to correctly diagnose this patient. I realised that perhaps I did not understand fully what the patient was feeling and therefore, misdiagnosed the risk of her signs and symptoms. I realised that effective risk assessment is crucial to correct diagnosis and treatment prescription as well as management of quality patient care. What is more, I did not give the patient enough information about the after care and did not ask to pay attention to possible signs of possible adverse effects. Evaluation The case study described above shows an example of negligence in clinical aesthetic practice. It underlies common mistakes health care practitioners make when consulting and prescribing products and treatments. To avoid negative practice it is crucial to identify the cause of the problem, how the symptoms developed and what steps can be taken to avoid the problem. Reflective practice and the right consultation between patients and health care professionals are valuable tools for effective treatment management and provision of high quality care (PMETB, 2008). It is evident that in the case study described above the aesthetic nurse failed to inform the patient about the choice of products and their possible side effects. Today’s patients need to be fully informed about the chemical composition of the products and their effects on their physical health. This is very important especially that today’s health care aims to address patient’s physical, emotional, psychological and well-being needs. As the patient was not presented with options followed by informed instructions, the patient was not able to make the right decision concerning which products she should have chosen. Whilst dermal fillers are not legally regulated and are accepted as harmless (MHRA, 2009), evidence suggests they may lead to health complications (Funt and Pavicic, 2013). For example, intra-arterial dermal filler injection with hyaluronic acid might lead to extensive injury of the tissue and necrosis (Delorenzi, 2014). Other products such as Juvederm Ultra may also lead to local inflammation, formation of nodules, tissue damage, and necrosis and other adverse reactions (Allergan, 2010). Common clinical symptoms following hyaluronic acid injections include skin blanching, delayed refilling of the capillaries, discolouration of the skin, livedo reticularis that might be followed by more adverse symptoms such as formation of blisters and tissues damage (Delorenzi, 2014). Prompt recognition of these signs and symptoms by the aesthetic nurse are the mainstays of effective treatment. The effective treatment at an early stage would involve prescription of hyaluronidase, administration of anti-inflammatories such as oral acetylsalicyclic acid (aspirin) and topical occlusion with nitropaste. Warm compresses and vigorous massage to affected ar ea can also help to minimise stress (Delorezni, 2014). Meticulous technique during the dermal filler injection could prevent the above adverse effects. Therefore, patients should be informed about the types of products and their respective composition and possible adverse reactions. Aesthetic nurse plays a key role in the provision of this information and after care. In particular, patients can be empowered by receiving the right information about the after care and should be alarmed to keep an eye on any possible adverse effects (Cohen, 2008). Early identification of any adverse effects generally results in lower negative health impacts. All nurses should follow the guidelines set out by the Nursing and Midwifery Council as described in Standards for medicine management (NMC, 2011). This highlights that communication between the nurse and the patient is extremely important in minimising risk following aesthetic treatments as well as provision of high quality patient care and lawful practice. Analysis This case study highlights an example of aesthetic nurse negligence, where firstly, she failed to inform the patient about the possible consequences of the products and treatment she had, secondly, she did not provide the right after care and thirdly, failed to diagnose her symptoms correctly after the treatment. She misdiagnosed patient’s symptoms as an inflammatory reaction rather than infection and therefore, prescribed the wrong treatment of 1% hydrocortisone cream to treat the symptoms. The nurse failed to carry out a correct assessment and examination and failed to address the health symptoms adequately according to the guidelines developed by National Prescribing Centre (Courtney and Griffiths, 2010). The guidelines follow principles of good practice recommending considerations for the patient including a thorough medical examination, choice of appropriate treatment, and prescription of correct drugs for the respective symptoms. 1 % hydrocortisone cream was inadequately prescribed because it is not the right treatment to alleviate symptoms of infection. What is more, its immunosuppressing properties could worsen the symptoms and increase the predisposition to infection (JFC, 2011). The right treatment should have been prescription of antibiotics according to the guidelines for the treatment of skin infections set out by the British Association of Dermatologists (BAD, 2008). The treatment of a topical cream in the form of Bactroban three times daily and Clarithromycin 200 mg 4 times a day was confirmed by the doctor at a later stage and resulted in improved outcomes for the patient’s symptoms. If the symptoms were identified and diagnoses at an earlier stage, the patient could have been just treated with the topical form of antibiotics. However, due to the advanced form of inflammation oral administration of antibiotics was also prescribed. Effective consultation and accurate diagnosis by the aesthetic nurse could have prevented unnecessary distress to the patient. A meticulous technique used by the aesthetic clinician during dermal filler injections could have prevented development of the adverse effects all together. Conclusion and action plan The rapidly growing range of non-surgical treatments and products including dermal fillers for the use in aesthetic soft tissue augmentation has benefits to both patients and physicians, but as indicated in this case study, as the number of products grows, the number of complications is also likely to expand. There are a number of steps that can be taken to avoid errors in aesthetic nursing practice. Communication at the right time with the patient as well as written advice may help empower patinet’s choices over the types of products and treatments that are most suitable to them. Today, patients have access to information through the means of internet and expect to be well informed about all possible complications associated with the use of aesthetic products. It is the role of the nurse to make sure patients have the right information at the right time. The information about the side effects and adverse reactions of the aesthetic products is available on many of the pharmace utical companies’ websites. Companies such as Allergan, Merz and Galderma usually provide detailed protocols and guidelines to practitioners about their products. They even provide templates for taking demographic and medical history notes, treatment guidelines, and flyers containing all the information patient needs to know about pre and post-care and possible adverse reactions. It is recommended that aesthetic centres develop their own standards of care so that their patients can be informed well. The above strategies can be easily deployed to minimise the incidence and impact of complications associated with dermal filler injections. Knowledge about the products and potential adverse effects and their risk management will enhance the use of the products and influence good aesthetic nursing practice. For optimum outcomes, aesthetic clinical practitioners should have good knowledge of the anatomy of facial structures; the prospective characteristics of the wide range of derm al fillers; their implications, contraindications, beneficial effects and setbacks; and strategies to prevent and avoid possible complications. Continuing professional development is a good way to keep up-to-date with the latest scientific findings and allows engagement with other professionals in the field to develop optimum treatment options and management. Poor practice should always be reported to ensure best outcomes for the patients in the future (NMC, 2011). Overall, quality care that patients receive depends on accurate diagnosis and prescription of drugs and treatment that involves communication skills, compassion, and care from healthcare professionals as well as knowledge, experience and expertise that is necessary to make correct diagnoses. Effective management of patient clinical risk and learning from reflective practice leads to the provision of high quality care to patients at the right time in the right place and satisfied patients. References Allergan (2010). Juvederm Ultra 4. Summary of Product Characteristics. Pringy: Allergan. Cohen, J., L., (2008) Understanding, avoiding, and managing dermal filler complications. Dermatol Surg. 34 Suppl 1:S92-9. . Courtney, M., Griffiths, M., (2010) Independent and supplementary prescribing. An essential Guide. 2nd Ed. Cambrdige. Cambridge University Press. Delorenzi, C., (2014) Complications of injectable fillers, part 2: vascular complications. Aesthet Surg J. 4(4):584-600. Fry, S., T., Veatch, R., M., Taylor, C., R., (2011) Case Studies in Nursing Ethics, Jones and Bartlett Learning, 4th Ed. Funt, D., Pavicic, T., (2013) Dermal fillers in aesthetics: an overview of adverse events and treatment approaches. Clin Cosmet Investig Dermatol. 12;6:295-316. Jasper, M., (2003). Beginning Reflective Practice. Cheltenham. Nelson Thornes. Joint Formulary Committee (2011). British National Formulary 61. London. British Medical Journal Group and Pharmaceutical Press. Medicines and Healthcare product regulatory agency (MHPRA) (2009). Borderlines with Medical Devices. London. MHRA. Nursing and Midwifery Council (2011) Remote prescribing and injectable cosmetic medicinal products. London, NMC. Postgraduate Medical Education and Training Board (PMETB), (2008), Patient’s role in healthcare. The future relationship between patient and doctor. General Medical Council.

The Pigman Essay

The 40 Developmental Assets are the positive building blocks that young people use to guide them to a successful future. These assets can even be seen in fictional book called The Pigman by Paul Zindel. One of the 40 developmental assets thats in The Pigman is â€Å"responsibility†. Responsibility is the ability to act or decide something by yourself. Responsibility or lack of responsibility is seen in The Pigman when John and Lorraine take responsibility for their lies, when John and Lorraine throw a wild party at Mr. Pignati’s house, and how John always drinks and smokes.One way responsibility is seen in The Pigman is when John and Lorraine take responsibility for their lies. Well, at the beginning of the book, we learned that John is a frequent liar. He lies to get out of trouble. So he told Mr. Pignati that they are charity workers. Later on in the book, John reveals that him and Lorraine aren't adult charity workers and says, â€Å" We just had to be honest with y ou because we like you more than anyone we know. † (Zindel 102) That quote showed that John was really starting to care for Mr.Pignati and he didn’t want to live his life on one big lie. In this way, John and Lorraine took responsibility for their lies they created. One way responsibility isn’t seen in The Pigman is when John and Lorraine threw a wild party at Mr. Pignati’s house. One day out of the blue when John, Lorraine and Mr. Pignati were hanging out, Mr. Pignati had a terrible heart-attack and was rushed to the hospital. John thought it was a great idea to throw a party so he said, â€Å" Don’t you think Mr. Pignati wants us to have a social life? He smiled, his great big eyes glowing. (130) That quote doesn't relate to responsibility because during the party many things happened that John and Lorraine didn’t anticipate to happen. Music was played so loud, you could hear it outside. Also Mr. Pignati’s precious pigs got destroye d and his dead wife Concetta's dress got ripped and ruined. In this way, John and Lorraine didn’t take responsibility for their actions. Another way responsibility isn’t seen in The Pigman is how John is always smoking and drinking. Well, in the beginning of the book, Lorraine was talking about John’s dad and how he was a heavy drinker until he developed sclerosis of the liver.And she thinks he influenced John to do these things at a very young age. Lorraine is always trying to show John what drinking and smoking can do to you. Once Lorraine showed John the book on Sigmund Freud and said, â€Å"I almost had him convinced that smoking was an infantile, destructive activity when he pointed out a picture of Freud smoking a cigar on the book's cover. † John replied, â€Å"If Freud smokes, why can't I? † Then Lorraine said, â€Å"Freud doesn't smoke anymore†¦. He's dead. † (8) This quote shows that John really doesn’t care that smokin g and drinking can do terrible things to your body.He doesn’t care because he drinks and smokes to escape his problems. In this way, John isn’t taking responsibility for his own health. One of the 40 Developmental Assets thats seen in the novel The Pigman by Paul Zindel is â€Å"responsibility†. When John and Lorraine take responsibility for their lies, when John and Lorraine throw a wild party at Mr. Pignati’s house, and how John always drinks and smokes are some ways The Pigman shows characters acting responsibly and characters acting irresponsibly. Its clear when people act responsibly things turn out much better for everyone.

Child Abuse Prevention and Control Essay

Child abuse is a serious and widespread problem throughout the world. It can take the form of sexual abuse, physical or psychological mistreatment , or child neglect. Can child abuse be prevented? Can the child abuser be rehabilitated? What can be done within your own home or community to prevent or control child abuse? Once discovered, child abuse can be addressed, but how does one report child abuse, and what are the legal requirements for reporting the abuse? Are you aware of the effect that the abuse has on other family members, or what the long term effects of child abuse can be? Learn how you can be part of the solution to the tragic problem of child abuse. Child abuse, regardless of what form it takes, is extremely damaging to the child, the family, and society. Approximately eighty percent of twenty-one year olds that have survived childhood abuse have at least one psychological disorder, and about thirty percent of abused or exploited children become abusers themselves as adults. Statistics tell us that five or more abused children die every day in America alone, not including the many abuse-related deaths that go unrecorded. Child abuse is a worldwide occurrence which crosses all boundaries. No financial, racial, religious, cultural or other situation has been found to preclude child abuse. Reporting child abuse United States, Guam, and Puerto Rico are among several areas of the world that have mandatory reporting laws. In these areas, any person who suspects or observes child abuse of any type must report the situation to the legal authorities. There are several professions in which the mandate to report is even more thoroughly enforced. Traditional authority positions such as school teacher, law enforcement, and physician are a few examples. The importance of reporting the abuse cannot be stressed enough. The younger the child is when the abuse is stopped, the better the chances of healing the psychological and/or physical damage inflicted. The longer the abuse is allowed to continue, the more damage is done, and healing becomes progressively more difficult. Studies show that children who simply witness abuse within the family are just as negatively affected as the subject of the abuse, further demonstrating the scope and gravity of this type of situation, and the importance of early intervention. Preventing child abuse The following are some ways that we can attempt to prevent the abuse before it even starts. If you are a parent, be sure you are able to de-stress in a healthy way instead of directing your frustrations toward your child. Physical activity, meditation, or involvement in a support group outside the home and away from the children are all excellent ways of positively redirecting anger or frustration. If you believe that you, or someone in your family is at risk of losing control or becoming abusive, do not ignore the issue or delay taking action. The person on the verge of losing control must get help before the abuse ever occurs. If you notice a parent clearly struggling under a lot of stress, try sympathizing, and perhaps offer to babysit, or even trade babysitting services to give the adults some ‘down time’. Donate, volunteer, or become otherwise actively involved in raising awareness about, or assisting, families and children in crisis. Controlling child abuse already occuring in the home It is no simple task to rehabilitate a child abuser. Generally, it is a long term process, involving not just the abuser, but the entire family unit. Each family member must be willing to cooperate in the rehabilitation program. Mental or psychological instability or illness, and/or substance abuse often contribute to the abusive behavior, complicating matters even more, and and making rehabilitation much more difficult. If the abuse violation is considered ‘low level’, the abuser may possibly be permitted to remain within the home while treatment takes place, as long as steady improvement is observed and no further abuse occurs. This is normally decided on a case by case basis. The definition of ‘low level’ varies according to local laws, but one example would be mild incidences of neglect, as opposed to actual physical or sexual abuse or exploitation, or more severe cases of neglect. Instances in which the abuse has become more serious usually require removal and temporary relocation of the child, or removal of the abuser, until such time as the offender is determined to be rehabilitated. Requirements vary depending on locale, but in all instances, there are specific conditions that must be satisfied before the family is reunited.

Night Essay - 1604 Words

In reading, Night by Elie Wiesel and A Mans Search For Meaning by , many stories of the torturous life in the concentration camps during the second world war. In each book, the reader gets a different point of view from each book because in Night, you get to read about a teenagers view and in the book, A Mans Search For Meaning, you get to read about a middle aged mans view. In the book, Night, Elie, his family and his community go through a system of indoctrination which in each step it makes you seem less and less of a human. The first step is that the Hungarian police made all the Jewish people wear yellow stars, so they could be picked out easily. The next step is that all the Jewish people had to get rid of all their valuable†¦show more content†¦The next step is that all the people had to get tattooed and the tattoo was that of a number and that number now replaced your name. Then after that the sent you into room and they gave you the same clothes. After that moment y ou definitely lost your individuality because you looked like everyone else and everything about you has been taken away so you start to think that you a just one of a million. These ideas are taken from pages 8 to 39 in the book, Night. The concentration camps seemed to bring out the worst in people because what happen was that all the people there reverted to animals and they only thought on their minds was me. Most of them wanted to survive as an individual rather than helping out and surviving as a group. One example of this is when the relationship the young and old is not that good. The young felt like the old was hindrance to there survival because they had to worry about themselves and it was more work and stress if they had to worry about someone else. One example of this is when Idek, the little Jewish boy, began to beat Elies father because Idek felt that Elies father was not working to his potential and that could get Idek in trouble. If Idek let Elies father slack off, then he would get in trouble because all the work has not been done and when you get in trouble it usually means a beating and or death. This can be seen on page 52 of Night.The issue of primaryShow MoreRelatedShadow of the Night619 Words   |  3 PagesShadow of the Night On a freezing, dark blue night of Li, in the Village of Li-Marta. This was an old little village, the houses were nothing but ash and rubble except an old abandoned barn. The barn had creaking floor boards and a rotten wooden roof. In this abandoned barn there lived a young and confident farm boy; his clothes were ragged and full of holes. The young boy was called Rye named after the agricultural god Ren-Rye. As Rye was sitting on the creaking floor boards a thought hit himRead MoreThe Night By Elie Wiesel904 Words   |  4 PagesIn Night by Elie Wiesel, the author reflects on his own experience of being separated from his family and eventually his own religion. This separation was not by any means voluntary, they were forced apart during the Holocaust. Wiesel was a Jew when the invasion of Hungary occurred and the Germans ripped members of his religion away from their home in Sighet. A once peaceful community where Wiesel learned to love the Kabbalah was now home to only dust and lost memories. Most members of that JewishRead MoreNight, By Eliezer Wiesel1585 Words   |  7 Pages There are many important themes and overtones to the book Night, by Eliezer Wiesel. One of the major themes from the book includes the protagonist, and author of his memoire, Elie Wiesel’s ever changing relationship with God. An example of this is when Moche the Beadle asked Elie an important question t hat would change his life forever, as the basis of his passion and aptitude for studying the ancient texts and teachings of Judaism, â€Å"When Moche the Beadle asked Elie why he prayed, Elie couldn tRead MoreNight Market Marketing Essay833 Words   |  4 Pages Preparing for Night Market Success Its funny how some night markets transform almost magically into something romantic even. Is it because of the moon, the lighting, the food, the music or the people? I believe its all of those features that make a momentous night at the market. In light of this, we believe market booths have the ability to return higher profits after dark. Therefore, we have come up with several key ideas to prepare your market stall for night success. Most vendors relyRead MoreStarry Night971 Words   |  4 PagesStarry Night is a beautiful painting, representational in the type of art. The size of the painting is 29 in. by 36  ¼ in., and oil on canvas were the materials used. Van Gogh is using an expressive quality and an emotionalism viewpoint. On the left side of the painting, there is a group of black lines that curve in waves upward, coming to a point. To the lower right, there is a small town that leads up to hills and then mountains. The painting is set at night, and the sky is a wondrous swirl of burstingRead MoreThe Night Sky - Original Writing926 Words   |  4 PagesIt was a dark and stormy night, the wind blows as the ghostly moonlight filled the darkness. George the highwayman made his way toward Bess the innkeeper’s daughter. She was gazing out the window when the two of their eyes met. Hers, black as the night sky, and a dark red love knot placed on her hair. A red dress made of the fabric silk. Her h air was a dark brown, but could have been mistaken as black. Her outfit fit her personality as much as it did the highwayman. I hope he loves poetry.Read MoreSummary Of Night By Eli Wiesel1561 Words   |  7 PagesNight by Eli Wiesel Amrinder Bhuller P.2 Author: The author of Night is Elie Wiesel. In my opinion, he did a very good job in writing this story! Eli was born on September 30, 1928. Eli is currently 86 and has written a lot of books. Eli had served as a prisoner Auschwitz and other concentration camps. He wrote all his experiences in this book. The Night talks about his experiences in these concentration camps and all he went through. Everything is probably historically correct because he wentRead MoreThe s Night - Original Writing1526 Words   |  7 PagesEverything that happened in Elie Wiesel’s night. I will see, smell, and feel the holocaust through the eyes of Wiesel. â€Å"Alright, uh, Yavin. Nice name. I’m Mr. Hiraku. Are you ready?† the teacher asked, looking down at his chart for my name. â€Å"Yes sir.† I answered, a bit shakily. I had used VR before for video games, but never for something so important. â€Å"Alright. I’m going to read you off some side effects involved with this experience. ‘While participating in the Night VR experience software, you may encounterRead MoreNight, Hope, By Elie Wiesel1580 Words   |  7 Pagesthey grabbed onto it as tightly as they could. Throughout Elie Wiesel’s memoir, Night, hope is a recurring theme. Elie and the people he was around were living in the darkest of conditions, but they still were able to shine a bright light on their situation. They remained hopeful, and this inspired the world. Putting all of this together, it is evident that the theme of hope was demonstrated throughout the book Night because Elie and the Jewish people tried to remain hopeful as they were forced intoRead MoreNight Time Tour951 Words   |  4 Pagesonce more at the sea where the sunset splattered colors of red and orange on the rough surface of blue and violet. Although the boardwalk was lively with smells of French fries and the cries of s eagulls, I nuzzled into the car seat and waited for the Night Time Tour to begin. I absolutely loved long car rides; it was the perfect excuse to let idle thoughts roam and to isolate myself from the world. I only observed the outside through the window of the family van, my personal theater. The images that