“Strategies for Therapeutic Communication” refer to the healthcare provision techniques employed by healthcare providers when handling patients. Developing reliable strategies for therapeutic communication is a priority for any healthcare provider. Our case study involves Alex; a two-year old child who was diagnosed with Cystic Fibrosis one year ago. Alex has also had three consecutive respiratory infections in the last six months and his child well-being records show a low growth and weight compared to his age mates. Caused by a gene mutation, Cystic Fibrosis is an autosomal genetic disorder that causes an accumulation of mucus production systemically primarily in the respiratory, gastrointestinal, and reproductive tracts (Brown et al., 2017). Because of the altered chloride and sodium ion flow and mucociliary clearance, this particularly provides a place for bacterial colonization causing inflammatory response, chronic sinus and respiratory infections, and possibly airway destruction (Brown et al., 2017). The writer is the homecare nurse and is expected to come up with strategies for therapeutic communication to aid the post-discharge homecare for Alex.
Lung Care
It is necessary for the nurse to discuss in detail, the ideal ways to provide lung care and the possible outcomes. For instance, the nurse should major on the disease process, triggers, complications, treatments, side effects from treatments, procedures, and including covering difficult topics like recurrent health issues or premature death (Brown et al., 2017). Education on the type of medication, dosage, and side effects of the medications should be provided. For the case of lung care, breathing treatments, bronchodilators, inhaled hypertonic saline, corticosteroids, mucolytics, pancreatic enzymes, fiber supplements, and antibiotics will be taken daily to treat CF (Brown et al., 2017). Also, an overnight oxygen saturation home-test should be performed occasionally, especially when Alex develops breathing and mucus formation issues at night (Iscar-Urrutia et al., 2018). Oxygen saturation home-test will help contain breathing difficulties for Alex due to mucus formation in his lungs.
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Difficulty Breathing Situation
Inhalers and nebulizers are used to contain breathing complications since there is no cure for them (Tashkin, 2016). Inhalers and nebulizers all serve the same purpose of delivering medicine to the lungs to ease breathing for a patient. In the case of Alex developing a difficulty in breathing condition, then use of inhalers and nebulizers is recommended. Inhalers and nebulizers should always be within easy reach for patients with recurring difficult breathing conditions. The daycare provider, parents, and friends of Alex should follow the following steps on how to properly use inhalers and nebulizers in order to rescue him from difficulty breathing situations;
Inhalers
The protective mouthpiece should be removed from the back cover by pulling down the lip.
The inhaler should then be held in an upright position and the lever pushed up.
Shake the inhaler well.
The patient should be made to breath out gently and then place the inhaler in his mouth. Ensure that the patient closes his/her lips before clicking the inhaler.
When the inhaler clicks, the patient should breath in quickly and hold breath for around ten seconds.
Doses should be given within an interval of one minutes until the prescribed dose is attained.
Nebulizers
Wash hands before handling the medicine.
Connect the hose of the nebulizer to an air compressor.
The medicine cup should then be filled with the prescribed dose.
Attach the hose and mouthpiece to the medicine cup.
The mouthpiece is placed in the mouth of the patient.
The patient should be made to breathe through the mouth until all the medicine is used.
Then the machine is turned off after use.
Care Team for Managing Alex’s Condition
Apart from outlining medication and treatment procedures, the homecare nurse will incorporate other service providers to manage the condition of Alex. Managing Cystic Fibrosis requires a series of professionals who work in unison to improve the wellbeing of a patient (Mogayzel, 2014). The care team for Alex’s condition comprises of several professionals; a pediatrician primary care provider, the nurse, nurse manager, respiratory therapist, physical and occupational therapy, dietician, and pharmacist. Other professionals like otolaryngologist, gastroenterologist, hepatologist, endocrinologists, and Cystic Fibrosis support groups are also needed. Alex’s parents also an integral part of the care team for managing Alex’s condition.
Alex’s Parents
Michael and Kim; Alex’s parents, play an integral part in managing Alex’s condition. The parents spent most of their time with Alex and are the primary care givers of all hygienic services. Michael and Kim also monitor the condition of Alex continuously and fully assume the role of calling for help whenever Alex’s condition deteriorates.
Pediatrician Primary Care Physician
The pediatrician primary care physician is involved with drug prescription to the patient. Cystic Fibrosis affects other organs in the body and requires varied medications to contain (Brown et al., 2017). For instance, bronchodilators are treated by beta2-adrenergic agonist in acute hyperresponsive exacerbations (Brown et al., 2017). The condition of airway blockage is eased by inhaled hypertonic saline which clears the respiratory tract. Stool softeners and fiber is given to the patient to ease stool movement and avoid constipation.
Dietician
Patients suffering from Cystic Fibrosis require a monitored and balanced diet to boost their growth and immune system. CF patients require a lot of calories, protein, fat, and fluid. Fluid eases the movement of mucus in the body thus preventing mucus accumulation in the lungs (Brown et al., 2017). A CF patient should also be introduced to physical exercise and adequate sleeping time.
Communication Strategies
Alex’s homecare nurse is expected to develop good communication strategies among the patient, his parents, and other professionals. As such, the homecare nurse is expected to act as a communicator, collaborator, and educator to all persons involved in maintaining Alex’s condition.
Communicator
The nurse ensures that there is an effective communication between the patient and other healthcare service providers. The nurse uses effective and therapeutic communication and communication skills to promote a good basis of a relationship with the patient (Taylor, 2015). All the information about Alex and his condition is entrusted with the nurse and is shared with the care team on a daily basis.
Collaborator
Collaboration, in the healthcare setting, is defined as two or more team members working towards one goal of assessing, planning, and evaluating patient care in hopes for health maintenance or even improvement in the patient’s status of health (Taylor, 2015). On a daily basis, the nurse works to plan, provide, and to evaluate client health care alone and also with other parts of the healthcare team (Taylor, 2015). Containing a CF condition calls collaboration within the care team. Therefore, the nurse ensures that all members of the care team collaborate towards a common goal towards Alex’s recovery.
Educator
The nurse acts an educator by providing important information to patients on how to improve their conditions. As an educator, the nurse plays a very vital role in ensuring that patients fully recover and live a healthy life.
Conclusion
Therapeutic communication is essential in providing care for CF patients. Therapeutic communication coupled with effective diagnosis and management in CF patients help patients to recover and live a healthy life. There is also a need for team work during providing care for CF patients by involving different professionals from other fields of study. All these measures help patients to recover.
References
Brown, S. D., White, R., & Tobin, P. (2017). Keep them breathing. Journal of the American Academy of Physician Assistants, 30(5), 23-27. https://doi.org/10.1097/01.JAA.0000515540.36581.92
Iscar-Urrutia, M., Madrid-Carbajal, C., J., Rubinos-Cuadrado, G. Fernandez-Alvarez, R., & Vazquez-Lopez, M. J. (2018). Objective and subjective sleep efficiency in adult patients with cystic fibrosis and impact on quality of life. Lung Journal, 196(6), 761-767. https://doi.org/10.11007/s00408-018-0167-x
Mogayzel, P., Dunitz, J., Marrow, L., & Hazle, L. (2014). Improving Chronic Care Delivery and Outcomes: The Impact of the Cystic Fibrosis Care Center Network. BMJ Journals, 23:1. https://qualitysafety.bmj.com/content/23/Suppl_1/i3
Tashkin, D. (2016). A Review of Nebulized Drug Delivery in COPD. International Journal of Chronic Obstructive Pulmonary Disease, 11: 2585–2596. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5076803/
