Angela's Illness

As a student nurse, I need to be able to alter my priorities for patient care if there is an observable change in my patient's condition. After assessing Angela, I made adjustments to my care plan and instead of focusing on mobility impairment I decided to change my focus to promoting self-esteem and encouraging more independence. Instead of doing tasks for her I empowered her to take more control over her care by providing appraisal when she would complete activities independently such as performing ROM exercises the physiotherapist gave her to complete at the bedside. I did continue to stand by when she was mobilizing to ensure that she was safe, but promoted her independence through positive reinforcement to help promote her self-esteem.

Had I not realized my assumption was incorrect she could have suffered from these issues and deteriorated faster. By allowing her to mobilize more often and knowing that she was capable gave her more independence and control over her own care. Concept Application

Prior to making my incorrect assumption about Angela’s mobility I could have benefitted from exploring the concept of illness. To me, illness is when an individual is experiencing an imbalance in their health that negatively affects their well-being. Illness as defined by Marinker is stated as:

A feeling or an experience of unhealthy, which is entirely personal and interior to the person of the patient. Often it accompanies disease, but the disease may be undeclared…sometimes illness exists where no disease can be found. (Marinker,

All patients are unique in their own way and we cannot base our assumptions solely on what we have experienced before because no two patients are the same. They can present different signs and symptoms for the same disease, progress at different rates and come from different socio-economic backgrounds.

The lessons I have learned are that I need to be able to adjust my nursing practice as I uncover new information. The patient information we receive prior to clinical presents a very narrow picture of who the patient is and how they are dealing with their illness. It is a good baseline, but assumptions often need to be adapted once we are able to observe our patients in person, perform a H2T and uncover new data. I also, learned that patients are a great resource for information and can help fill in the gaps that may not have been laid out in their patient information. For instance, Angela told me that her left leg weakness is not constant, but has periods of remission and exacerbation depending on her level of stress and