The Role and Responsibilities of a Registered Nurse When Treating Diabetic Patients

This essay is to consider the role and responsibilities of a Registered Nurse (RN) by considering the model of Roper Logan and Tierney (RLT) as a sample. This model will incorporate with the brief history of the chosen patient with Long Term Condition (LTC) by nursing interventions for their patient care practice. The purpose of it is to elaborate on the impact of LTC type 2 diabetic patients to consider the effect of treatment and the psychological influence with respect to the concerned patient’s life and family. It will consider government policies and guidelines which is relay to the management of diabetes, and the role of district nurses. The NMC code of professional conduct Guidance has been kept throughout this essay and therefore, all the names have been changed for the purpose of confidentiality and anonymity.

Currently, in the UK there are over 15.5 million people have a long term condition. The long term conditions are conditions for which is no cure and which is managed with drugs and other treatments, for example, Diabetes, chronic obstructive pulmonary disease, arthritis, and hypertension. Universally LTCs, account for over 36 million deaths each year, with the most early deaths (those before the age of 60) happening in low and middle income countries. In the UK, people in the poorer socioeconomic groups have a 60% higher incidence of LTCs than those in the higher groups. Universally cardiovascular disease, cancers, respiratory diseases and diabetes account for 80% of deaths and between them, they share the following risk factors; tobacco use, physical inactivity, harmful alcohol use and unhealthy diets.

A seventy-year-old patient is being described who is living with his wife and resides in the City Center in the flats. Mr. Med is suffering from type 2 diabetes for the past 15 years, which is getting a more severe day by day and not managed by diet and medication. Mr. Med, diabetes has now more and more get worse and he has been started a therapy plan of self-managed insulin. Mr. Med’s wife is also taking care of her husband and he also gets himself registered with the team of the nursing community. Mr. Med also consults with his local general medical practitioner, and he visits a diabetic clinic on a daily. Currently, he has diagnosed a hypoglycaemic attack in the shopping trip, and then he rushes towards the hospital and gets a treatment accordingly.

Type 1 and type 2 are considered as the two principal classes of diabetes Mellitus; in the region of about 90% of the population who are suffering from diabetes is from type 2. However, the obliteration of the Beta cells is regarded as in the category of type 1 diabetes. Alpha cells produce and discharge glucagon while beta cells produce and discharge insulin. Patients who are suffering from type 1 diabetes have not this insulin creation frequently because of obliteration of the beta cells. So reason, diabetes of type 1 is treated with insulin. However, when there is a lack of insulin production in the body, raised blood glucose level as well as a breakdown of fats and proteins in the body, all these are the symptoms of type 1 diabetes. Type 1 diabetes is also characterized as a metabolic disorder.

The nursing is centred on individual nursing. In the past years, several tasks were assigned to nurses, instead of patients to care for. Now, the significance of patient-centred care is acknowledged and registered nurses are assigned patients rather than jobs. The whole procedure of nursing is consisting of four interactive phases. To get access is the first phase, which is carried out at the initial stage of treatment but is vital to keep remember continuity in evaluation as the treatment or disease may progress.

Planning is considered as the second phase, the purpose of the planning is to stop happening earlier identified problems which are moving ahead to real problems. The third phase is carrying out the care goal. Nursing interferences are passed out as part of this; though it is considered as cooperative and essential for nurses in order to make clear the whys and wherefores and decisions that lay in arrears of these interferences. The last phase is an evaluation, which is comparable to the assessment.

An activity of living is derived from the Roper, Logan and Tierney model of nursing which comprises of a number of activities. The model of Activities of living is very miscellaneous and so it is argued it is the furthermost common used by nurses of British. Models have been assessing critically for not obliging all patient circumstances and being too unbending. Salminen et al., (2016), reported that Models are not fixed in tables of stone, but then again to some extent are loose outlines of notions whose purpose is to enable care, not to get in the way. Salminen et al., (2016), also put emphasis on that person who reads have to question any absence of psychological and social dimensions of the model of Roper, Logan, and Tierney and put forward that it is the simplest method of assessment.

Maintaining a Safe Environment

Mr. Med is a person who is not depending on others and should to be conscious of all the aspects that are influencing their external surrounding. On the other hand, because of his ageing, Mr. Med has lost his independence and found him becoming more at the mercy of others to support him in keeping a safe environment. Diplopia is a factor which can affect Mr. Med safety, however, diplopia is a symptom which makes happen by their diabetes and it might result in his blurred vision. At what time Mr .Med has suffered from hypoglycaemic attack and then he turns out to be confused, at that time he is at his most susceptible phase.

Communication

Mr. Med has face a difficulties day by day when communicating with other people. Though there are a number of aspects which have exaggerated his communication in the course of hypoglycaemic attack and for the duration of stay in the hospital. In effectual communication could be a result of hypoglycaemic attacks and by reason of the neuroglycopenic symptoms of slurred speech and tingling around the lips.

Breathing

Mr. Med has usually difficulty in breathing, on the contrary at what time he agonized from hypoglycaemic attack his breathing was interrupted. Uncertainty he had not to get instant treatment from the registered nurse he might turn into the unconscious and then his breathing will become slow.

Eating and Drinking

Until in recent times diabetes of Mr. Med had been managed by medication and diet, though as this was no longer providing adequate control Mr. Med was started on insulin. He further said that because of the skipping meals, his dietary consumption has become reduced, this was determined as his origin of the hypoglycaemic attack. Nursing staff approved the analysis of blood sugar and identified a low blood sugar level and after that directed a quick acting carbohydrate.

Eliminating

Mr. Med has no difficulty in eliminating yet his diabetes has triggered polyuria because of the concentration of glucose in the glomerular filtrate. There is a probability of incontinence throughout a hypoglycaemic attack that’s why urinalysis must be voted for on admission to hospital.

Mobilizing

Mr. Med was unable to mobilize when he was suffered from hypoglycaemic attack because of the symptoms of neuroglycopenic such as faintness and instability. Sometimes muscle twitching and appropriations might happen. During such attacks, his safety becomes the main concern. When Mr. Med was in the hospital he was capable to gain his mobility independently.

Sleeping

When Mr. Med was in the hospital, he has found he is a victim of polyuria which can lead to a problem with nocturia; which might be disturb the amount and quality of sleep he acquires. He was informed regarding his promotion in sleep when he stayed in the hospital as this will affect the person's physical emotional and psychological well-being.

Ethical Responsibility

On account of the nurse, the major ethical legitimate and the professional concern here is the patient's sovereignty. Autonomy is considered as the most authoritative phase of an ethical outline of nearly throughout the nationwide. 'Autonomy is such a notion which is originated in moral, political, and bioethical philosophy”. The theory of ethics is grounded in 4 moral principles that are autonomy, justice, beneficence, and non-maleficence (Williams, 2015). Ethical principles should be highlighted while providing care towards patients in determining how to deal with them. Professionals have to respect sovereignty in a sense to give priority to patient’s decisions and choices. According to this situation, by conferring to the right of autonomy, nurses have to admire the decisions of the patient. Ethical issues and alterations in society are accountable for the nurse-client relationship. Nurse's duty is to keep the patient's autonomy, keep up and recover health and encourage a professional relationship of trust.

In the year of 2009, the World Health Organisation (WHO) bring into being that over thousands of population who are residing in the UK are suffering from diabetes. As discussed earlier, over 80 per cent of people with type 2 diabetes are the victims of overweight. Controlling diabetes in the initial stage by doing exercising and consuming a healthy diet is dominant. Health care experts could give suggestion on this and there are so many health creativities run all the way through the state to help. The role of the nurse working with a team is very essential and could not give emphasis to enough as they can enable person's all-inclusive care and be the main point surrounded by the health care team to comfort communication.

By concluding this essay, it is analysed that nursing plays an important role in terms of patient medical care. However, after the core analysis of patient’s journey with respect to every single phase in terms of LTC, it is evident that LTC is considered as a life-changing factor when a person is diagnosed with it. This study targeted the ethics and responsibilities of Registered Nurse by focusing on the above-mentioned factors with the help of Roper Logan and Tierney’s model.

Reflection

In this essay, I will use the Gibbs Reflective Cycle in order to reflect my personal professional practice that needs improvement in some areas concerning the role of me as a Registered Nurse (RN).

I personally felt that I should assist the medical caretaker in order to make the patient, Mr. Med, comfortable since I analysed that this must be considered on high priority by means of evaluating the drugs. However, I retrieve the concepts that I would supposed to do the same at my place too if the concerned person gets busy. Though, I was only obsessed with the comfort level of the patient and realized that I might not do just with the patient by leaving him in such a critical condition. However, being a nurse, I believe that such decisions are supposed to make for the sake of the patient’s health.

However, I decided to support the assistance of health care in order to assure that the patient was comfortable, as this was the priority of time. Though, on account of the NMC code of conducts, one should take care of individual by means of your priority and ensure their autonomy and dignity as well, which I already did. Moreover, as an RN, I must be able to differentiate the uses of drugs with respect to their purposes.

Concerning the growing intensity over the effectiveness and potency in the health department, it is crucial to analyse that how should I utilize my time in the concerned area of study. However, it is identified as the significant element regarding the nursing practice, as an RN; I will need to focus on my time management skills to prioritise care.