Bob Pain Free: A Case Study

During this clinical situation, I was trying to make Bob pain free. To assist this a nursing assessment was performed, followed by planning and clinical reasoning to determine a clinical decision. I intervened to make Bob comfortable. A focused nursing assessment was performed, this included onset of pain and an abdomen assessment. It is important to focus on the patients’ presenting problem to establish a decision (Bickley,2017). On assessment Bob had a distended lower abdomen. A distended lower abdomen can often be one of the signs of urinary retention but further test such as a bladder scan is needed to confirm this (Thomas, 2004). A bladder scan was performed, to rule out or confirm urinary retention. A bladder scan is a simple, non-invasive
Bob had a bladder scan result of over one litre. According to Lai et al (2014) catheterisation is often done after the bladder scan has a result of over 300mls in bladder. During this situation, I found it hard to build a therapeutic relationship with Bob. Consequently, this challenged my communication skills as Bob was demanding and became physically aggressive. Due to Bobs aggression I handed over to another nurse to look after my own safety. Hiscock et al (2008) explains patient centred care refers, to care that is established through therapeutic relations between the nurse and the patient. Furthermore, another consequence for Bob was delayed catheterisation due to agitation and the pain he was experiencing. A negotiated partnership was established, it was decided to administer morphine before the procedure. A negotiated partnership is a way in which a nurse and patient work together that enable choice, equity and trust (Beal, 2012). By establishing this partnership and decision Bobs agitation had eased as we were listening to his presenting problem. The consequences of my actions for myself was that Bob became aggressive, I did not notice when to use de-escalation techniques. Additionally, this lead to delayed