Exploring own skills in assessment of Ms A’s needs

Exploring own skills in assessment of Ms A’s needs

Introduction

The needs assessment of the service users is required so that the demands and needs of the service users regarding care can be determined and the gaps which are hindering current care services to reach desired care goals can be resolved. Thus, assessing the needs of the service users is significant so that the care priorities can be identified and proper resources can be allocated to offer them satisfactory care. In this assignment, care needs of Ms A are to be assessed and the desired care goals to be achieved are to be discussed. The personal skills required in assessing the needs of the Ms A are to be identified and reflection on individual role for the implementation of care for Ms A is to be provided.

Assessing the care needs of Ms A

The case study informs that Ms A is found to be in control until her mental illness interfered with her emotions and perceptions to control her psychological thinking while applying to get a council home to live alone. Thus, a need assessment is made to examine care needs of Ms A so that effective care can be provided to improve her current health and promote well-being. As mentioned by Paton et al. (2015), people with emotional unstability personality disorder (EUPD) are found to be anxiety-ridden, have self-destructive behaviour and are emotionally unstable. This is because EUPD leads the individuals to develop psychotic condition where they face doubts regarding themselves and others that affect their emotional thinking. The case mentions that Ms A is seen to be suffering from EUPD and this may have made her develop anxiety-ridden thoughts regarding her physical illness contributing to her thinking of inability to get a council home to live freely.

The people suffering from emotional unstability personality disorder (EUPD) are seen to show symptoms of having extreme mood swings along with explosive anger (Moukhtarian et al. 2018). In case of Ms A, her current anger, use of abusive words and non-compliance with multidisciplinary care team for her physical care can be regarded as a result of EUPD. Thus, it informs that she needs inclusion of proper medications and psychotherapy to control her mood swings and anger related to EUPD to act normally and in constrained way. As argued by White et al. (2017), people with EUPD feels being empty and lack of confidence in themselves. This contributes to their self-destructive behaviour as they lack the zeal to live out of emptiness. In case of Ms A, it may be determined that out of EUPD she is feeling empty as she cannot control her emotions along with previous and present trauma regarding her brother’s death can also be contributing to her current irresponsible behaviour of being self-destructive. Thus, it informs that Ms A needs effective psychological counselling and support to control her mental and emotional health which has been deteriorated due to her previous experiences and EUPD.

The case study informs that Ms A has developed challenging physical and mental health situation after she started to have doubts regarding the delay of her council home arrangement and approval. This informs that one of the needs of Ms A is that she is to be assured of getting immediate council home accommodations so that her doubts can be resolved and she can be made emotionally stable to comply with care as well as develop stability in health. As mentioned by Gaudet et al. (2019), renal failure is the condition in which the kidneys lose their filtering ability making them unable to filter wastes out from the body. This leads the individuals develop muscle weakness, chest pain, high blood pressure, diabetes and others as a result of build-up of wastes in the body which disrupts the chemical balance. Ms A is seen to have renal failure and has currently seen to show non-compliance in taking medication. In this situation, the key need of Ms A is that she is to be put under dialysis so that toxin build up in the body can be avoided and later required to make her emotionally clam through psychological therapies to make her comply in taking medications for controlling her renal failure.

The visual impairment leads individuals often unable to take their own care and face hindrance in performing daily activities such as socialising, reading, driving and others (Wong et al. 2018). In case of Ms A, it is seen that she is visually impaired and is not currently accessing proper care required to ensure her good health. In this condition, Ms A needs a personal carer who can support her both physically and emotionally to make her comply with care and develop stable health condition. As asserted by Rise Consortiunm (2018), avoiding to take insulin medication by diabetic patients leads their blood sugar to become uncontrolled. The raised blood sugar creates negative impact on the health of the individuals by making develop renal failures, increased blood pressure and others. Since Ms A is avoiding taking insulin medication, she is needed to make understood at the first the way her decision is going to impact her health and required to be put under insulin therapy where through injection insulin medication is to be provided to her to control her diabetes.

Exploring own skills in assessment of Ms A’s needs

The 6 C’s of Nursing Model informs that nurses require to have effective ability to care, show compassion, have competence, execute communication, have the courage and show commitment (NHS, 2015). In assessing the needs of Ms A, the personal skill explored is competence. This is evident as while identifying the needs of Ms A it was ensured that proper diagnosis techniques are used which as within the qualification and training received in nursing or social care so that her essential care needs are properly determined without error. The nurses or social workers when work out of their competence develops errors in care as they do not have proper ability and skills for the task undertaken to be accomplished resulting in negative healthcare to the patients (Zhu et al. 2016). Moreover, the communication and courage skills were also explored while assessing the needs of Ms A. This is evident as while Ms A was showing agressive behaviour yet being a social worker courage was shown to ignore her attacking attitude to determine the exact care needs required by her to ensure better health. The courage in social work is required so that the social workers are able to show strength in taking the right decision to offer high-quality care to the service users (Sadooghiasl et al. 2018). During assessment of health needs of Ms A, the person avoided to respond to any queries properly. However, by developing effective communication with her carers who previously tried to support, her care needs are analysed and determined.

The compassion while identifying the needs of patients as well as providing healthcare is required to be showcased by the nurses to make the service users feel empathetic and caring (Hofmeyer et al. 2016). The empathy is required as it helps individuals to get connected and showing value is required towards the service users to make them feel dignified (Hofmeyer et al. 2016). Thus, while assessing the needs of Ms A compassion was showcased by avoiding any negative comments towards her inappropriate behaviour and instead patience was maintained to understand her needs. This indicates that 6 C's of nursing was effectively followed during needs assessment of Ms A so that her care needs can be determined to provide quality care based on the her needs. In order to disseminate information between the multi-disciplinary team and social workers entrusted to care for Ms A, information and communication technologies (ICT) are used. The ICT in nursing is significant to be used as it helps to develop communication between team and nursing professionals in an immediate and easier manner without any boundaries (Koivunen and Saranto, 2018).

The good practice in healthcare is referred to the process which includes proper identification, collection, evaluation, dissemination and implementation of information as well as monitoring the healthcare outcomes for the patients (Thokala et al. 2016). As a social worker for Ms A, the identification of her needs of care is done by analysing her social and health condition to ensure good practices are abided. This is because understanding the needs of the patients can lead the social workers to determine the care to be arranged for the patients to ensure their good health (Stevens and Raferty, 2018). The Multi-disciplinary team to deliver good practices for service users gather information about the needs of the patients by communicating with the individuals as well as their family members and health professionals and accordingly develop care to be delivered which are later monitored to ensure positive outcomes are achieved (Donnelly et al. 2018). Thus, the multi-disciplinary team to establish good practices for Ms A are required to collect information from the social workers, health professionals attending her and her family members about her needs and based on the information are to arrange care practices.

In order to establish good practice, proper monitoring of the patients are required because it would help to understand to what extent the care provided is effective for improving the patient's health (Maguire et al. 2015). Thus, the multi-disciplinary team along with the social workers to deliver good practice for Ms A ensures monitoring her health each month so that the impact of care provided can be determined and accordingly changes can be made to ensure positive health development is seen in the patient. (Refer to Appendix 1)

Reflection

In this reflection, Gibb's reflective model is to be used for assessing the actions and experiences related to the role of examining and implementing care for Ms A's needs (Lestander et al. 2016). The Gibb's reflective cycle includes six steps which are as follows:

Description

In order to assess the needs of Ms A, my role as a social worker was to determine her requirements of care based on her current health and social condition. I personally analysed the case study of Ms A and identified that all the deterioration in her health were seen after her wish to move to council home was tried to be institutionalised through her efforts rather than other taking initiative to execute it. I further identified that Ms A was suffering from emotional unstability personality disorder (EUPD) which makes person to become emotionally unstable, develop self-destructive behaviour and anxiety-ridden. These symptoms were seen in Ms A as she was found to be suicidal, involve in sexual and financial exploitation, use of abusive behaviour and others. Thus, I ensured she is provided with Mentalisation-based therapy and Schema-focussed therapy to overcome the situation. I also identified that she was suffering from renal failure along with diabetes and due to non-compliance is avoiding taking medications. Therefore, I immediately thought her need is to involve in taking peritoneal dialysis and insulin therapy as alternatives to medication. In regard to visual impairment, I ensured that she is provided a personal carer who could offer her continuous support and show compassion to make her calm and perform everyday activities properly.

Feelings

I felt that Ms A’s health was deteriorated because the social worker previously allocated to assess her health situation did not take proper examination of the efficiency of her mental health capacity. This is because if she had proper ability to make best decision in true manner then she would not have been so easily frustrated while just applying for the council home. I feel that instead of the social worker, a psychiatrist could be sent to assess her mental health capacity to make personal decisions even having peritoneal emotional unstability personality disorder (EUPD) is identified in her. This is because psychiatrists are trained practitioners who have the ability to properly diagnose the mental health condition of individuals (Brownie and Oywer, 2016). I also felt that Ms A is to be involved in two different therapies to control her EUPD so that her emotions and unmet needs that are contributing to her deterioration in mental health are resolved properly. I also feel that involving Ms A in dialysis and insulin therapy is effective step to control her diabetes and renal failure when she is not taking medication.

Evaluation

The thing which went well during the event was that I was able to determine the care to be provided to improve physical and mental health of Ms A. This is because I was able to determine the alternative therapies and methods in regards to medication regime to be used to ensure improved health of the individual. The thing which did not go well is that I ignored how Ms A can be made complied to accept care from the multi-disciplinary team. Moreover, I ignored how the trauma received for her brother’s death can be resolved as it is an important aspect which is found to be contributing to her deteriorated mental health.

Analysis

The situation led me to develop information that while implementing care on the basis of needs assessment for patients like Ms A I need to think of the strategies to be used which could not only resolve current health complication but also the causes that led the patient to be at the situation. Moreover, I need to develop my skills to implement care based on the needs of Ms A by considering the way the multi-disciplinary team can be involved in the process and the patient shows compliance in accepting care from them. This is because without Ms A forming compliance with the multi-disciplinary team no form of care can be provided to control her health as the team are expert professionals trained to provide the determined care.

Conclusion

I understood from the situation that I have effective ability to determine alternative care to be provided to Ms A for controlling her health in a better way. However, I lack thinking skills regarding the way the determined alternative care can be provided as I never thought that Ms A may not show compliance with the multi-disciplinary team. Thus, the condition led me to understand that while meeting care needs of Ms A in future I need to identify the way she can develop compliance with the multi-disciplinary team who are the expert carers.

Action plan

In future, I am going to ensure alterative care for service users are framed by considering how they may comply with the multi-disciplinary team who will be actually providing the care.

Conclusion

The above discussion informs that Ms A is suffering from visual impairment, diabetes, renal failure and emotional unstability personality disorder (EUPD). The patient has currently expressed relapse of the disease as she is not taking her medications out of frustration that her wish to move to council home would not be fulfilled due to her physical illness. The current health needs regarding Ms A indicates that she is to be provided alternative care for diabetes and renal failure to keep her physical health condition stable and she is to be provided psychotherapy to control her emotional unstability personality disorder (EUPD) and current mental distress. A care plan is developed for Ms A which informs that dialysis, insulin therapy, Mentalisation-based therapy and Schema-focussed therapy is to be provided to control her current mental and physical condition. Moreover, the evidence-based practice and 6 C’s of nursing are discussed to inform the way they are to be followed to develop skills in assessing Ms A’s needs.

References

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The establishment of evidence-based care is important and good practice in nursing as it helps the multi-disciplinary teams and nurses determine the safest and most effective care for the service users. This is because in this nature of practice the nurses and the team analyse and research various clinical information which has proven a success for patients to understand which care is to be finally used for the particular patients to ensure their good health (Zeitlin et al. 2016). The multi-disciplinary team to ensure good practices are established while providing care to Ms A made sure evidence-based care is implemented. They ensured it by researching and gathering information about care from previous patients who had similar condition like Ms A. This is because it would help them to identify which care system or method would be more effective for MS A to ensure her speedy recovery from the current situation.