Improving Patient Care
By Finaz Daniel

Bandar Seri Begawan - Ripas hospital is seeking to improve nurses' capabilities in caring for patients, by arming them with better skills in documenting the patient's health, state of mind and treatments.

The nursing process committee at Ripas yesterday organised a nursing diagnosis workshop, which aimed to provide nn ses with better shills and confidence in nursing diagnosis, a standardised statement about the health of a patient for the purpose of providing nursing care.

The subject of the one-day workshop is an important component of the Nursing Process booklet, which is used as a systematic problem-solving approach to individual nursing care.

"If it (nursing diagnosis) does not function smoothly, it will bring about an imbalance in nursing care towards patients," acting nursing officer, Hjh Rostina Hj Kepli, told the 40 Ripas ward nurses, who participated in the workshop.

Hj Abdul Rahim Hj Damit, head of clinical at the Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah College of Nursing, acted as mentor yesterday as he conducted a lecture on how to make an accurate nursing diagnosis.

According to Hj Abdul Rahim, nurses who question the value of nursing diagnoses suggest that the awkward wording of the diagnostic labels contributes to difficulties in doing their work. In view of this, many nurses lack the knowledge and experience to document nursing diagnoses with confidence, he said.

He said expert clinical practice requires not only psychomotor and affective skills, but also complex thinking skills.

"When we treat a patient, sometimes we forget to treat them as an individual," said Hj Abdul Rahim, adding the first step to making a diagnosis is to gather information about a patient's physiological, psycho logical, sociological and spiritual status.

He reminded the nurses that patients come from different races and religions and have their own beliefs and traditions and, therefore, cannot be blamed for their eccentricities, such as bringing their own dukun, or traditional healers, to the hospital.

"Let the dukun come in, don't be mad when patients bring them to the hospital," Hj Abdul Rahim said.

In collecting a patient's data, Hj Abdul Rahim said the nurses should make sure the data is valid and relevant.

He also stressed that nurses should orientate the patient on the facilities available at the hospital after admission. "As nurses, you have to make sure the patient knows where the bathroom is and introduce your patient to his or her bed neighbour so that they can communicate with each other."

Hj Abdul Rahim also suggested that information from the patient's family on the patient's habits can further determine the diagnosis. "Finding out from the family that the patient snores could be a symptom and would help in further diagnosing the patient's problem," said Hj Abdul Rahim.

"Patients often require assist ance. Don't allow them to only sleep on the bed, get them involved in their own care," he said, stating that getting the patient to be involved in his or her own care is also one of the duties of a nurse.

"The process of making nursing diagnoses is difficult because nurses are attempting to diagnose human responses," he said. "Humans are unique, complex and ever-changing, thus, attempts to classify these responses have been laborious and difficult."

Following the lecture, the participants were then divided into five groups and taken to the wards to make a group assessment and diagnosis on patients.

Speaking to The Brunei Times, one of the participants who wished to remain unnamed, said with regards to individual care of patients, the shortage of ward nurses does not allow for personal attention to all patients in that ward. "The ratio of nurses to patients in the ward is not balanced. They need to provide more ward nurses in order for us to give our full attention to all the patients."

The workshop was held at the second floor lecture room at Ripas and was attended by some 40, nurses from the hospital.  -- Courtesy of The Brunei Times

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