Promotion of repair

- Rest and avoidance of further stress

- Elevation of the effected part

- Drainage of puss

- Moderate heat - helps fibroblasts - speeds up capillary regeneration

- Various drugs, eg antimicrobial to remove offensive agents

- Diet - vitamin C

- Correction of other problems -cardiac function - fluid balance

- Treat patient as a whole person - physical - psychological - social - spiritual

Initial assessment

Airway

Breathing

Circulation

IN SERIOUS ILLNESS OR TRAUMA

Understand - Patients fear of death

- Patients fear of mutilation

- Patients fear of isolation and loneliness

Support - Patients feeling of loss of control

- Convey competence and confidence

- Use calm reassuring manner

Family - Gain cooperation in supporting patient

- Prevent expressions of shock or horror

History - Of immediate illness or trauma

- Previous state of health

- Current treatments - digoxin - anticoagulants

- Allergies

- Bleeding tendencies

- Last ingestion

Following a patients death

- Communicate in private

- Talk to the family together with the doctor

- Assure everything possible was done

- Allow family time to talk and ventilate feelings

- Avoid unnecessary information - drugs - alcohol

- Avoid use of sedation - will delay the grieving process

- Allow family time with the body

PRIORITIES IN MULTIPLE INJURIES

- Airway

- Breathing

- Circulation

- Haemorrhage

- Head Injury

- Fractures

- Other damage

REDUCTION OF PATIENT ANXIETY

- Establish good lines of communication with the individual.

- Always treat as an individual with individualised needs, normal needs because he is human, special needs because he is ill.

- Pay attention to the environment, warm restful, avoidance of noise.

- Avoid contact with other anxious people, eg. patients.

- Use a calm but non patronising approach.

- Use of non verbal methods - body language, touch.

- Convey professional competence.

- Use firmness when indicated.

- Anxyiolytic drugs to deal with the acute phase.

- Avoid confronting and interpretation of patients behaviour.

- Be congruent, empathetic and give positive regard.

- Have self awareness to recognise own anxieties.

- Use of divisional activities.

- Encourage ventilation of feeling when ready.

- Offer brief clear information about all procedures, give details on intimation of desire for more information.

- Appear unhurried.

- Offer reassurance.

- Encourage hope.

- Involve family and friends.

- Involve other professionals, and anyone who may help, Chaplain etc.

Role of the nurse as a teacher

a. teaching other nurses and professionals

b. teaching patients and relatives

c. health education

Assess what the learner already knows and how much they will assimilate as an individual.

Plan the material you will deliver and objectives you may use in evaluation.

Implement in an appropriate way - one to one - one to a group- group discussion - demonstration and practice - use of aids - reinforcement and follow up.

Evaluate, and encourage others to evaluate you.

PRINCIPLES.

The teaching/learning process involves teacher and learner.

The desired outcome of the teaching/learning process is a change in behaviour.

The teacher serves as a facilitator of learning.

Learning is facilitated by progression from the more simple to the more complex, from the known to the unknown.

Learning is helped by the awareness in the learner that progress is being made towards the learning goal.

READINESS TO LEARN

Not when anxious or in physical distress.

Patients full attention should be on the learning process.

Motivation depends on - acceptance of the reality of the threat

- Recognition of need to learn

- Integration with patients life style

Motivation may be promoted by;

- Good atmosphere and environment.

- Patient participation in the learning process.

- Providing encouraging feedback about progress.

- Family and friend involvement.

- Selecting a time when patient is alert, relevant others are present.