Introduction
Mr. JS is an 84-year-old male who presented via ambulance to the emergency department of NW Hospital accompanied by his wife. His chief complaints were right second toe pain. After examination and testing, he was admitted to the medical-surgical unit, where he was diagnosed with a right foot wound, cellulitis chose, and osteomyelitis. Mr. JS has a past medical history pertinent to his diagnosis of right foot infection, amputation of the right great toe, left foot wound, CHF (congestive heart failure), hypertension, hyperlipidemia, hypothyroidism, and diabetes mellitus. The reason I choose this patient is he had pertinent illnesses/diseases that encompass various concepts. By selecting this patient, I had the opportunity to utilize interventions and critical thinking skills taught from previous and current concepts.
Analysis of Concepts
Professionalism
Part of the desirable quality of a good nurse is the illustration of professionalism. Professionalism in nursing refers to dedication to behaving with integrity regarding the optimal standards of the profession coupled with engaging in lifetime learning to acquire or expand knowledge and promote the best health. The nature of the nursing profession demands a high level of service output (Association of Licensed Practical Nurses, 2020). Therefore, nursing should seek to promote, protect, avert injury and lessen the pain in patient care. When a nurse demonstrates professional behavior, it will likely result in better management, enhanced team communication, improved responsibility among all medical practitioners, and general improvement in clinical service delivery. Professionalism includes many aspects of conduct, communication, and overall appearance (Association of Licensed Practical Nurses, 2020). Professional presence is a key part of professionalism and a major relational ability in nursing. Therefore, as the space of nursing practice progresses, nursing teams are challenged to emphasize patient care amidst scientific and technical demands. Professional presence needs to dominate the driving force with the eventual objective of rendering safe, ethical, competent, and kind care to every patient.
In the case at hand, a nurse can demonstrate professionalism in many ways to skillfully manage the patient. Firstly, it is apparent that the patient is an elderly person and should expect kind care at all places and not just the healthcare facilities. Therefore, professionalism when handling Mr. JS can be demonstrated through actions, physical appearance, and words as the initial way of establishing a trust-centered nurse-patient relationship. For instance, a conspicuous nametag and brief introduction, encompassing name and designation should aid the development of trust. Speaking with compassion and confidence will result in guaranteeing the nursing professional’s ability to match the job demands and the expectations of the patient (Eid et al., 2018). Mr. JS is sincerely experiencing pain following his conditions, therefore, the therapeutic presence of physically being available and psychologically attending to the patient is critical. In showing professionalism, the nurse will create a professional presence that promotes good practices while instilling trust and confidence in the patient (Eid et al., 2018). Professionalism off and on the job shall promote public trust in the practice, which eventually influences therapeutic relations.
Immunity
Immunity refers to the protective response of the body to diseases and infections. Medical tests reveal that Mr. JS is suffering from a right foot wound, cellulitis, and osteomyelitis. Therefore, it is critical to comprehend the body’s immune response to such a level of infection. Briefly, cellulitis refers to the non-necrotizing inflammation in the subcutaneous tissues and skin, arising from acute infection while osteomyelitis indicates inflammation of the bone’s fatty tissues, usually caused by the infection. The bacteria, Staphylococcus aureus, a critical microbe in humans causes many cases of bacterial soft tissue, skin, and bone infections as seen in Mr. JS (Brady et al., 2018). Staphylococcus aureus is invasive and leads to life-threatening diseases such as pneumonia, sepsis, bacteremia, abscess in various organs, and endocarditis.
The body’s protective immune response to this pathogen is vital since many cases of infection happen at the place of attack or even colonization within the mucosa or skin. Skin is the physical barrier that defends the body from such pathogenic invasions. Besides acting as a mechanical barrier, the skin is better placed in serving as the first line of protection (National Organization for Rare Disorders, 2022). It generates initial immune responses against incoming microorganisms such as Staphylococcus aureus which is responsible for the series of infections in Mr. JS. Since the patient was previously diagnosed with other conditions such as diabetes mellitus, it is possible to link diabetes to osteomyelitis due to blood vessel inefficiency. Such kind of presented infections normally happens in persons with skin ulcerations due to neuropathy as seen in Mr. JS’s medical history. Agreeably, the phenomenon is prevalent among elderly individuals above 50 years, suffering from diabetes mellitus and vascular conditions within the extremities such as toes as well as small bones in the feet.
The body’s response to the responsible pathogen entails an adaptive and innate immune system. Innate immunity is considered to be nonspecific towards inflammatory mechanisms while the adaptive immune system is seen to show high specificity driven by swift identification of T and B lymphocyte antigens. These cells mediate and show antibodies as well as cell-mediated immunity (Abdulkhaleq et al., 2018). The innate immune system has substantial specificity since the body cell has pattern recognition receptors that recognize pathogen-associated molecular patterns that interact with one another (Brady et al., 2018). After recognition, the interaction stimulates the release of inflammatory mediators such as chemokines, cytokines, and antimicrobial peptides that promote the first immune response. All the components of innate immunity participate and respond to eliminate the pathogen. For example, neutrophils encounter the pathogen Staphylococcus aureus and employ many mechanisms to expedite the killing of bacteria (Abdulkhaleq et al., 2018). Specifically, neutrophils express complement and Fc receptors that trigger complement-mediated and antibody phagocytosis to surround the opsonized microbe into phagosomes.
Nursing Intervention
An effective nursing intervention entails combined strategies among various surgical and medical specialties. The main nursing interventions include putting the patient on extended antibiotic therapy and wound dressing to manage the various infections leading to wounds (Brady et al., 2018). Surgical containment of the sites of infection through debridement is needed since antibiotics have poor penetration power into the abscess and necrotic bones. Nursing professionalism is important in managing this patient. The patient’s condition is serious since he is also diabetic and the condition can lead to another amputation of the toe if urgent management is not reached. Moreover, consistent communication and coordination with other medical specialties are needed for better management of the patient.
Conclusion
In conclusion, right foot wounds, cellulitis, and osteomyelitis coupled with previous illnesses make Mr. JS’s case sensitive and demanding. Immunity and professionalism remain integral in addressing and managing this situation. Professionalism would require devotion to behave with honesty regarding the ideal standards of the job and engaging in permanent learning to acquire new knowledge and promote the best health. Professionalism when treating Mr. JS can be illustrated through actions to establish a trust-based nurse-patient connection.
References
Abdulkhaleq, L. A., Assi, M. A., Abdullah, R., Zamri-Saad, M., Taufiq-Yap, Y. H., & Hezmee, M. &. M. (2018). The crucial roles of inflammatory mediators in inflammation: a review. Veterinary World, 11(5), 11-627. Web.
Association of Licensed Practical Nurses. (2020). The importance of professionalism and presence in nursing. Web.
Brady, R. A., Mocca, C. P., Plaut, R. D., Takeda, K., & Burns, D. L. (2018). Comparison of the immune response during acute and chronic Staphylococcus aureus infection. PLoS One, 13(3), 1-13. Web.
Eid, A. G., Ahmed, M. Z., Safan, S. M., & Mohamed, S. M. (2018). Nursing professionalism: A concept analysis. Menoufia Nursing Journal, 3(2), 87-96. Web.
National Organization for Rare Disorders. (2022). Osteomyelitis. Web.