Most nursing processes require assessment that is guided and well-structured following the various models of care. This draft is a presentation of one of my patients in the placement ward during one of my shifts. Applying the Roper Logan Tierney (RLT) Model, the nursing practices encompasses helping patients despite psychiatric or medical diagnosis to facilitate the management of their activities during their daily living to facilitate the attainment of their optimal state of health (Roper, Logan and Tierney, 1985). Nursing processes aim to tackle the problems that may arise in their patients during their everyday living resulting from the psychiatric and medical conditions (Turan, and Sandir, 2019). Through the application of the Roper Logan Tierney model of daily living, which emphasizes on the daily living activities, the patient care in the placement ward is well described. The reference to the patient is M.J, which is a pseudonym to ensure patient confidentiality.
Roper Logan Tierney Model
Roper Logan Tierney's model major concept hopes to organize health care and all the nursing practices around the daily living of the patient. According to Marudhar and Bashir (2019), the RLT model works towards providing the nurses with requisite information necessary in planning care for their patients towards the achievement of independence. Therefore, the model works as an aid that assists in assessing patient’s ability towards the achievement of independence at every care level. Roper, Logan, and Tierney (1985) highlights the 12 daily activities as sustaining a safe environment, breathing, communication, eating and drinking, mobilizing, eliminating, controlling body temperature, personal cleansing, and dressing, working and playing, sleeping, expressing sexuality and dying. Marudhar and Bashir (2019) asserts that the various daily activities as outlined by the RLT model provides a framework through which a nurse assesses, plans, implements as well as evaluates the care process towards independence.
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Exemplar
M.J is a 25-year-old, single woman with one child at the age of ten, who she gave out for adoption immediately after birth. She works in the first food canteen part-time as she is still in school pursuing a degree in marketing. The patient complained that she felt a sharp pain in the umbilicus part, which then intensified in the lower abdominal quadrant on her right side. Upon examination, it was noted that M.J’s abdomen was gardening and tender in which the surgical team admitted her. More prevailing symptoms in M.J included fever, nausea, constipation, and appetite loss. With a past medical history of an infection in the urinary tract, urine analysis was performed to rule out the reoccurrence of the condition. Blood samples were also taken to assess any raised white blood cell count. M.J had no previous history of abdominal pain. On factors affecting the condition, she was feeling some relief when lying down with her knees pulled up. The patient denied any alcohol consumption, with no types of medication whatsoever, and never presented any urinary symptoms. M.J on observation seemed tired and anxious especially resulting from the pain.
During the assessment in the process of formulating a therapeutic relationship, M.J revealed that she was always eating unhealthy snacks with no time to prepare a balanced meal without any consumption of fruits and vegetables. Nonetheless, she explained she was not exercising, thus with the type of diet she immensely gained so much weight.
The appendix is the short, thin blind-ended tube that appears at the end of the caecum. Appendicitis is a condition that results when the appendix is filled with fecal and other wastes (De Moura et al., 2015). More so, in a state where the caecum is obstructed, it can result in blockage or damage of the appendix, which then causes an inflammation that result in the rupturing of the tube which requires an appendectomy surgery for prevention of other abdominal inflammatory problems. Appendicitis is a condition that affects any age in the population hence the reason for choosing M.J’s case.
Application of the RLT model
A nurse can use the theoretical knowledge and awareness to dislodge any fears in a patient (De Moura et al., 2015). The outline received for M.J showed the patient’s sleeping pattern, discussing her mobility, including analgesics prescribed for relieving pain including tramadol and paracetamol. The patient's physiotherapy sessions were outlined in the chest exercises. More so, an elaboration on the wound care and the removal of the catheter was included. Assessment of the handover was necessary to understand the priority areas in which communication skills were used to gather the necessary information to begin planning the care process (Turan & Sandir, 2019).
Breathing
Assessing M.J, it was confirmed that she was tired even after a full night's sleep. Listening to her speak, it was notable that she had a quiet speech with irregular chest movements. To use the oximetry machine, M.J was assessed of any nail polish to avoid any alterations on the readings in which the machine confirmed the oxygen levels of the patient was enough at 94%, which is within the normal range. To prevent any development of chest infections, a physiotherapist worked with M.J to teach deep breathing exercises. Communication is highly adopted when giving M.J care in the process of inspecting her sputum's color to assess any infections.
Mobility
M.J had no real barriers to mobility on assessment in which she showed improvement in her fatigue and breathing levels. The surgical team had prescribed the TED socks, which the patient refused to wear. Applying communication as a therapeutic intervention, M.J revealed that she was afraid of dying in which she explained she was the only hope in her family. Remembering her parents, she discovered she needed to heal faster and resume her studies in which she accepted to use the anti-embolism stockings
Personal cleansing and dressing
M.J's wound was cleaned using the aseptic technique after assessment in which there was an application of a new dressing. She was then assisted with the personal cleaning needs in which she confirmed some improvements, thus an indication of improvement of the body image while avoiding the infection period increase.
The application of the RLT model in post-operative care is a great teaching and understanding experience in which it creates awareness of the process offering an opportunity to gather the necessary information in a useful manner. RLT model gives knowledge necessary in dislodging any fears in patients while giving assurance of their healing processes. RLT model helps in treating and meeting the care needs of an inpatient as a way of enabling them to solve their health problems as well as taking control of their living by becoming self-sufficient physically, psychologically, and socially. Therefore, RTL is an important model in offering a framework through which care can be offered to the patient.
References
de Moura, G. N., do Nascimento, J. C., de Lima, M. A., Frota, N. M., Cristino, V. M., & Caetano, J. A. (2015). Activities of living of disabled people according to the Roper-Logan-Tierney model of nursing. Rev Rene , 16 (3).
Marudhar M., & Bashir J. (2019). Nursing theories. Presentation. https://www.researchgate.net/publication/333022822_nursing_theories
Roper, N., Logan, W. W., & Tierney, A. J. (1985). Model of nursing: explanatory booklet. https://www.lenus.ie/bitstream/handle/10147/333669/modelofnursing.pdf?sequence=1&isAllowed=y
Turan, N., & Sendir, M. (2019). Defining Care Needs for Inpatients in the Orthopaedics and Traumatology Clinic. International Journal of Caring Sciences , 12 (2).
