Health and social care for patient undergoing urostomy surgery
Discuss the health and social care provision for a client undergoing a urostomy formation for bladder cancer. This essay will discuss the health and social care provision for a client observed while on clinical placement, diagnosed with bladder cancer undergoing surgery to remove his bladder with a stoma formation. The client will be known as Mr Phillips throughout in order to maintain patient confidentiality and anonymity (NMC, 2002). ... A history of Mr Phillips as an individual and his condition will follow with an explanation of the surgery that Mr Phillips underwent. A discussion of the health and social care Mr Phillips received and that on offer to stoma clients will be the main focus. It will concentrate on the biological, psychological, social and environmental factors in relation to health and social care provision. These key factors will highlight the importance of a functional care plan and discuss whether the care plan used in the clinical placement was fully utilised. The conclusion will identify what contribution the care plan has made in facilitating Mr Phillips through his cancer diagnosis and surgery, and whether it has helped Mr Phillips experience the holistic individual care that should be fundamental to health and social care provision. ... Firstly I was involved in Mr Phillips care from the day of his hospital admission, through his surgery and post operatively. ... Secondly I wanted to further my understanding of stoma care and feed my curiosity of living with an altered body image. The Consultant Urologist suggested the only treatment available was to have a cystoprostatectomy with a urostomy formation. ... A urinary stoma is called a urostomy. ... Mr Phillips was now in hospital to undergo surgery to remove his bladder and prostate and have the urostomy formation. In order to provide the correct nursing intervention to restore Mr Phillips back to optimum health he needed a holistic approach. In order to maximise health, the concept of ‘health’ should be defined as to understand how an individual’s health could be maximised. The World Health Organisation (WHO, 1946) states that “Health is a state of complete physical, mental and social well being and not merely the absence of disease or infirmity.” This definition of health suggests that a holistic approach to health care should be more appropriate and tailored to the individual. Factors that make up the holistic approach must consider not only the physical aspects of care but also the psychological, environmental and social factors. The tool that would enable the multi-disciplinary team to carry out this care would be a care plan. The care plan used in the clinical placement where Mr Phillips would be cared for was a care pathway specifically devised for clients undergoing a cystectomy and urostomy formation. It would encompass a pre-determined structure for care including care given by the multi disciplinary team including the Stoma Clinical Nurse Specialist (CNS). The care pathway would help provide the holistic approach that the World Health Organisation suggested is beneficial for the individual. A care pathway is a way of providing a uniform sequence of care for specific patient groups and is seen as the strategy, which best manages the way healthcare is provided. Pathways are designed to demonstrate the sequence of interventions necessary for specific patient groups, merging both nursing and medical plans of care together (Gordner and Moritz, 1995). The care pathway is based on evidence from research and incorporates national and local guidelines. Each page of the care pathway documents activities or tasks that need to be completed on a particular day for the care of the client. The first and obvious factor of the care pathway is the physical or biological care that Mr Phillips received. Assessment of physical care began when Mr Phillips attended a pre-operative clerking clinic (pre-op), where a nurse completed an initial assessment to provide and establish baseline information. ... Details of medication taken, blood pressure, urinalysis, weight and previous surgery among others are recorded on the care pathway.