Septic Shock Affecting Mental Capacity
The assignment is to support an insight into a safeguarding issue where the patient is self-neglecting due to the lack of circumstantial mental capacity to take a decision. I have chosen the Gibbs’ reflective cycle (Oxford Brookes University, 2016) to comprehend and reflect the scenario. The Gibbs’ reflective cycle will enable to follow step by step; focusing on the description of the issue, how I felt about it, initial evaluation and the analysis of the situation and action planning. (Jones, 2014). In respect to “people’s right to privacy and confidentiality” (Nursing & Midwifery Council (NMC), 2015), names and places have been changed. I am an adult nurse focusing on a safeguarding issue of an older …show more content…
Mary is an established HD patient, who undergoes dialysis 4 times a week. Mary is at the end stage of renal failure due to lupus nephritis. Mary had done peritoneal dialysis in 1992 and had done a renal transplant previously in 1999, unfortunately, it never worked. Because of the long history of renal problems Mary is known to most staffs and doctors in the ward and she is considered to be a positive person, never known for any mental health …show more content…
I let Mary know that I am going to put the oxygen mask on her as her saturation was 82% and she needed high flow oxygen. Mary didn’t reply anything but kept shaking the head while I try to put the mask on. I asked if she needed anything before I put the mask on but there wasn’t any response. I explained again why the oxygen is important and try to put it back on, which was a success at that time, but when I tried to put the blood pressure (bp) cuff on her hand, Mary took the mask off and started shouting at me, saying “ you all are trying to kill me”. Calming her down was beyond me as she wasn’t paying attention to what I was saying rather she was repeatedly saying, “you all are trying to kill me”. My mentor, nurse in charge and the doctor came when they hear her shouting. I explained to them what had happened and the nurse in charge tried to explain that we need to monitor the blood pressure. Mary calms down a little bit and the nurse in charge placed the BP cuff on. Doctor told my mentor to start the antibiotic and when the BP reading came upon the screen as 60/35 mmHg we all started to worry, Mary is normally a hypotensive patient with systolic 80 mmHg. To ensure that the BP is correct my mentor tried both arms and it indicates Mary is dropping BP instantly. Doctor suggested it could be a septic shock, and asked to immediately start her on noradrenaline. Mary started to
The assignment is to support an insight into a safeguarding issue where the patient is self-neglecting due to the lack of circumstantial mental capacity to take a decision. I have chosen the Gibbs’ reflective cycle (Oxford Brookes University, 2016) to comprehend and reflect the scenario. The Gibbs’ reflective cycle will enable to follow step by step; focusing on the description of the issue, how I felt about it, initial evaluation and the analysis of the situation and action planning. (Jones, 2014). In respect to “people’s right to privacy and confidentiality” (Nursing & Midwifery Council (NMC), 2015), names and places have been changed. I am an adult nurse focusing on a safeguarding issue of an older …show more content…
Mary is an established HD patient, who undergoes dialysis 4 times a week. Mary is at the end stage of renal failure due to lupus nephritis. Mary had done peritoneal dialysis in 1992 and had done a renal transplant previously in 1999, unfortunately, it never worked. Because of the long history of renal problems Mary is known to most staffs and doctors in the ward and she is considered to be a positive person, never known for any mental health …show more content…
I let Mary know that I am going to put the oxygen mask on her as her saturation was 82% and she needed high flow oxygen. Mary didn’t reply anything but kept shaking the head while I try to put the mask on. I asked if she needed anything before I put the mask on but there wasn’t any response. I explained again why the oxygen is important and try to put it back on, which was a success at that time, but when I tried to put the blood pressure (bp) cuff on her hand, Mary took the mask off and started shouting at me, saying “ you all are trying to kill me”. Calming her down was beyond me as she wasn’t paying attention to what I was saying rather she was repeatedly saying, “you all are trying to kill me”. My mentor, nurse in charge and the doctor came when they hear her shouting. I explained to them what had happened and the nurse in charge tried to explain that we need to monitor the blood pressure. Mary calms down a little bit and the nurse in charge placed the BP cuff on. Doctor told my mentor to start the antibiotic and when the BP reading came upon the screen as 60/35 mmHg we all started to worry, Mary is normally a hypotensive patient with systolic 80 mmHg. To ensure that the BP is correct my mentor tried both arms and it indicates Mary is dropping BP instantly. Doctor suggested it could be a septic shock, and asked to immediately start her on noradrenaline. Mary started to