GIBBS REFLECTIVE MODEL

Gibbs Reflective Model

Gibbs Reflective Model

Description

The reflection is about a 74 years old lady who presented hypertension, previously had her right femur broken but now able to walk with a stick and cooperates well in her daily requirements-wash herself with minimum help, eats by herself, changes her clothes -minimum help needed. I have been looking after her for a while and managed to know her well. One day she requested a commode and I offered help. I think it was too late for her to walk to the toilet-slow walker.

The World of Health Organisation (WHO) defines hypertension as:

High blood pressure (HBP) or hypertension means high pressure (tension) in the arteries. Arteries are vessels that carry blood from the pumping heart to all the tissues and organs of the body. High blood pressure does not mean excessive emotional tension, although emotional tension and stress can temporarily increase blood pressure. Normal blood pressure is below 120/80; blood pressure between 120/80 and 139/89 is called "pre-hypertension", and a blood pressure of 140/90 or above is considered high.

The top number, the systolic blood pressure, corresponds to the pressure in the arteries as the heart contracts and pumps blood forward into the arteries. The bottom number, the diastolic pressure, represents the pressure in the arteries as the heart relaxes after the contraction. The diastolic pressure reflects the lowest pressure to which the arteries are exposed.

An elevation of the systolic and/or diastolic blood pressure increases the risk of developing heart (cardiac) disease, kidney (renal) disease, hardening of the arteries (atherosclerosis or arteriosclerosis), eye damage, and stroke (brain damage). These complications of hypertension are often referred to as end-organ damage because damage to these organs is the end result of chronic (long duration) high blood pressure. For that reason, the diagnosis of high blood pressure is important so efforts can be made to normalize blood pressure and prevent complications.

It was previously thought that rises in diastolic blood pressure were a more important risk factor than systolic elevations, but it is now known that in people 50 years or older systolic hypertension represents a greater risk.

An MDT meeting was then arranged to discuss the package of care needed for this lady, to enable her to continue living safely in her own home. The Consultant chaired the meeting by bringing the team to the attention of this lady's medical history and the problems herself and son had been experiencing. He felt she would benefit from medication to help her memory problems.

There were some visitors in the same room who might have seen her. Due to an unexpected situation I didn't have all the materials needed(a new pad, tissues) and I had to go and get them while she remained sitting on the commode on her own. I asked another colleague to help. I felt embarrassed by knowing there were some people who could have seen the incident. I felt that the situation wasn't under control, sad for her because she transformed from an independent person to a ...