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NAME : KRISHNAJA KUNNUMPURATH SHAJI STUDENT ID: 190750 COHORT : N20S CAMPUS : LUTON UNIT : PLANNING, DELIVERING AND COORIDNATING CARE.

INTRODUCTION. The aim of the digital narrative is to: Evaluate the context of a person's health condition, their health needs, and impact of the condition on the patient and their family. Illustrate how the individual's care was planned, coordinated, and delivered in a healthcare setting. Assess how the present policies and legislation have influenced the quality of care provided to the chosen patient. Analyse the role and importance of multidisciplinary team, nurses and student nurses in patient care..

PATIENT CONDITION. Mr DAVID (PSEUDONYM) (NMC,2018).

DIAGNOSIS AND TREATMENT. MR. DAVID REVIEWED BY EAR,NOSE AND THOART SPEACIALIST Plan: Blood test, CT scan and Biopsy of Larynx ( Michaels, 2012) DIAGNOSED WITH LARYNGEAL CANCER OR LARYNX CANCER Obtained consent and explained the care planning-Treatment plan was to undergo Total Laryngectomy (TL) (Atef et al . 2019). MR.DAVID UNDERWENT TOTAL LARYNGECTOMY SUCCESSFULLY After TL, a permanent hole called stoma was made to breathe through (Jackson et al , 2019)..

Areas Where Laryngeal Cancer May Form or Spread Upper part Of the spinal column Carotid artery Lymph n in the neck Esophagus Cartilage around the thyroid and trachea Epiglotti hyroid Trachea Chest Supraglotti Glottis (vocal cords) Subglottis Larynx Trachea Esophagus.

ADMISSION. Admitted to the Surgical ward Handover Skin Checks and Physical Observation. Assessments Past Medical History Completed Pre-Assessment and Care plan. MDT Referrals sent SALT Head and neck specialist Family History Physician Dietician.

BIOPYSCHOSOCIAL CAUSES. Biological Age (Tan et al . 2016) Gender Psychological Anxiety Depression Sociological Alcohol and Smoking ( Connor, 2017) Diet Ethnicity ( Nocini et al . 2020).

ERICKSON’S THEORY. ERICKSON’S THEORY (1950) -PYSCHOSOCIAL DEVELOPMENT 8 TH STAGE INTEGRITY VS DESPAIR (Knight,2017) HAPPINESS OR REGRET MR. DAVID HAD REGRET OVER HIS LIFE. (Dunkel & Harbke,2017 ).

IMPACT ON MR.DAVID’S LIFE. 1. After the surgery Mr. David felt worthless and as a burden to his family. 2. As a result of this situation, Mr David was unable to continue his work, which had a financial impact on his family (Kale and Carroll, 2016). 3. Mr. David was struggling to deal with his family and social activities because he was worried about his communication difficulties and his appearance..

ROLE OF MULTI-DISCIPLINARY TEAM. Physician prescribed painkiller ( Davis et al. 2012) Nutritional nurse reviewed PEG feed after the admission Dietician assessed-Food regimen. ( Steuer et al. 2017) Speech and Language Therapist team (SALT). (Starmer et al . 2015) Head and Neck Nurse- Stoma care, suctioning and focused care. (Hewett and Ross, 2012).

Mr. David showed more progress towards the treatment. Accepted Communication difficulties and managed to use alternative solution. Positive response towards life and Accepted his health condition..

ROLE OF FAMILY AND DISCHARGE. Mr. David’s family Supported him emotionally and psychologically, Accepted his communication difficulties. Mr. David was reviewed by MDT and planned to discharge. Nurse educated the patient and his family to use the PEG feed, to care stoma and also provided dietary and medication information's..

ROLE OF STUDENT NURSE. The role of student nurse in clinical settings is limited. Admitting the patient. COVID and MRSA swabs Safety Checks Assistance with mobility To provide adequate care and support. Effective communication. Monitoring and recording physical observation Administering drugs under supervision Providing psychological support. Helped in discharge planning.

ROLE OF NURSE. Received handover Administered pain relief and PRN medication. Completed Care Plan Assisted in Mouth care Performed Suctioning and Laryngectomy care ( Cancer Research UK, 2021) . Referrals has been made to coordinate care. Educated patient regarding his health condition and to manage PEG and Stoma. Provided emotional support to Mr. David Advised to quit Alcohol and Smoking. Helped Mr. David to overcome depression Discharge Planning Arranged follow-up.

POLICIES AND LEGISLATION. Consent Policy (Placement hospital,2021) Dignity and Privacy (Placement hospital, 2018) Data Protection Act (2018) Confidentiality Policy and Procedures (Placement hospital,2013).

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