Managing Complex Situations

Introduction

In health and social care services, there could be so many complex situations that could create troubles for the patients as well as the service providers. There is a huge requirement for dealing with such situations so that proper and quality services could be delivered. The complex situations could be raised due to social, physiological or psychological problems. It is clear that the complex situations, if not handled appropriately and effectively, create the anxious environment for both patients and the service providers. It is to acknowledge that the psychological problems are very common among the patients as they are due to the fear or any other hidden thought process (Elliott, Hatton and Emerson, 2003). Here in the current scenario, the challenging situation has been discussed along with the explanation of the proper way that enables a service provider to deal with the challenge. These strategies could be immensely helpful in eradicating anxiety in a better manner. At last, in the current study, the self-reflection has also included so that own understanding could also be portrayed correctly.

In work in a hospital, and every day we need to deal with many types of patients. Some of them are quite furious and frustrated due to their pain and medical status. However, in the end, they all have a hope that their life will be saved, and they can live their life properly as they live earlier. Thus, in this situation, the tiff between the service provider and patient is less. One day, while on duty, a lady named Lani, aged 69, was admitted to our hospital for the treatment of accident. Lani suffered a chest compression and complained of excruciating pain on her lower back after the accident (Reid, 2010). She was bedbound and was assisted with most of her daily activities because of left sided muscle weakness with her previous stroke. Lani’s son told the nurse that this confusion was new to them although the son admitted that Lani’s memory was affected by the stroke or Cerebrovascular Accident few years ago. Conferring to The Code, NMC (2008); Act without delay if you believe that there is a risk to patient safety or public protection, So we appointed a full-time nurse for Lani.

However, the accident itself had an enormous negative impact on her psychological thought process. She became so much negative about her health. She was doubtful about her physical situation even though we always counsel her on the regular basis that she will be all right. Socially also, the situation was not as appreciable, as her friends and relatives were not so supportive to her. Therefore, it could be stated that both socially and psychologically she was suffering from the mental problem, and physically accident and pain was also showing its effect. The Code (NMC 2008) states that nurses have a responsibility to ensure they gain ‘consent’ before treatment or care start. It is necessary to convey the condition of the patient to their relatives before starting providing any kind of aid. This reduces the risk on both the parts, that is, for the patient and the caretaker. Thus, before starting the treatment, we took permission from the patient and her relative.

Initially, the consequences of treatment were that sometimes she behaves very furiously and misbehave with the nursing staff due to the excessive pain. She shouts at them and abuses them for no reason. The situation gets worst when she gets angry as it goes against the health of patients. The situation becomes more complicated as she cries for hours in the night and gets faint due to stress (Lloyd, Braithwaite and Southon, 1999). She cries a lot, as she was not able to endure pain, and takes lots of tensions that sometimes her body did not respond to the treatment provided by the hospital. Therefore, the increment in anger and stress level made the situation very complicated. It was the time when she felt so anxious, fear, hope, tension and so on, various emotions work together within her mind. It slows down the process of treatment. My anxious level also increased as I found it little bit disturbing from her side. Due to her anger and irrational behaviour, it becomes tough to communicate with her properly. Sometimes her bad behaviour makes me restless to the core, and I wish to shout at her that she needs to be stronger. However, then I found her psychological problem to be justifiable.

These were the situations which made both me and Lani very much anxious. The psychological and social status of the Lani was not appreciable. There was an enormous requirement of taking certain actions as it may help in handling the complex situations. Royal College of Nursing (RCN 2015), stated that as nurse or HCA we are responsible for safeguarding those in your care, and you must respond to any safeguarding concerns. Being her caretaker and part of the nursing staff, it was my responsibility to ensure her recovery (Ludhra, 2014). For the same purpose, the medicines must have a positive impact on her body so she could respond well to the treatment. All this could have been possible only if the stress and anger level of pain could be minimized.

Further, the doctors assessed Lani using the tool mini-mental state examination (MMSE) and diagnosed her as having an early stage of vascular dementia. Draper (2013), claimed that dementia is a term used medically to describe a syndrome that is caused by many different diseases, these includes Alzheimer’s diseases, vascular dementia, frontotemporal dementia, and dementia with Lewy bodies. Alzheimer’s Society UK (2015) reported that there were approximately 850,000 people in the UK with dementia in 2015. Vascular dementia is diagnosed when disease affecting blood vessels in the brain (cerebrovascular disease) is the reason of dementia (Draper 2013). In addition Hughes (2011), argued that multiple microinfarcts (mini-strokes) are the most common cause of vascular dementia.

According to NHS Choices (2015), vascular dementia is the second most common form of dementia that affects more than 135,000 people in the UK caused by reduced blood flow to the brain, eventually damages and kills the brain cells. Draper (2013), argued that 25 percent of Alzheimer’s cases also have vascular changes in the brain, and the aggressive behaviour can occur during the middle stage of the disease. On the other hand, the impairment in judgement, impaired memory processing, insights, and behavioural control are few of the cognitive effects of frontotemporal strokes that lead to vascular dementia. So I decided to take some actions to help my patient to reduce her and my anxious level.

The first step which I took was that I interacted with her husband and enquired about her behaviour and nature. Familiarity with her behaviour and nature could enable me to take appropriate actions and strategies as well. It was the most fundamental step that was required to be taken to the core. I started to deal with her psychological problem which was related to her pain and anxious level. I became her friend, started to treat her like my mother who has my support during her treatment. The most powerful and significant thing I did was that I narrated her stories of various people who fought such kind of pain as out of their willpower (Johnson and Stoskopf, 2010).

It was motivating for her, and I saw the change, she started enquiring for the previous patients who bring changes to their physical health through their positive thought process. She asked their traits that how they behaved and how they all respond to the situation like accidents. I explained all the positive features like praying to God, being hopeful, talking to other patients, keeping the fighting spirit and so on. I started to spend some extra time with her so that she could share her feelings with me in the absence of her husband. She should not feel loneliness, and her mind must not be distracted once again by those fearful and stressful thoughts. The impact of those stories was so enormous that she started to control her emotions and developed positivity within herself. It was stimulating incidents as she found her motivation level to be very down and most importantly psychologically she was completely broken. However, now these strategies shape her thought process immensely in a positive manner.

During such process, I found that it is not an entirely effective strategy as I am still an outsider for her (Leatherman and Sutherland, 2005). The major drawback of above strategy is that it just put an external impact on her, but there was an enormous requirement for such actions that bring change internally. However, the stories were just incidents for her that were not sufficient for her to come out of her stress and fear altogether. It has been rooted so deeply which demand more efforts. Critically, it could be stated that it was not enough to aid her psychological issues. At the same juncture, it is clear that her pain was endurable which also required handling and curing. So we decided to give her some different pain relief that can help her in getting rid of her pain.

Afterward, I focused on another strategy and started to adopt such practices that have the capacity to bring change internally. Here, I introduced the plan of meditation and music therapy. The impact of meditation could have been enormous with respect to coming out of fear and stress. However, in such situation, it was near to impossible to control the mind and body. Still Lani took the chance as she was driven by the incidents to put efforts by herself. Therefore, I could say that every strategy is connected and interrelated to each another. She started to meditate and soon she found little changes internally. On the other hand, soothing music was also allowed to her so that she can relax her mind and could concentrate on the future of her grandchildren. These were my lines “Future of her grandchildren” which brought spark and light into her eyes and gave new hope of living. It was little philosophical and put a magical impact on my efforts. Both music and meditation give her sense that she was in unnecessary fear and stress which was putting a negative effect on her body and treatment (Fisher, 2005).

Lani understood the expediency of meditation and music and started to practice it more often in a day. She discussed her feeling and habits of her children to me. The most interesting element was that when she did not find me around, she starts to interact with other people in nursing staff and other patients as well. It becomes possible as she wanted to keep her spirit positive. On the contrary, now she got distracted to pain as her body started to respond to the treatment and quantity of pain relief tablets were diluted. However, the negative impact of the music and meditation was that its impact was slow and too much music is not allowed to patients. To this situation, my efforts started to show their positive results, and she started to respond well. However, sometimes she lost her temper and went to the earlier stage. At certain events, she found restless and running to her children which increase her stress level. It was something that made both of us anxious. Now I needed to introduce such strategy that could be more impactful than the meditation and music (Bryan, 2009).

Here at this juncture, book reading was something that could work as hugely helpful and beneficial. I brought some spiritual and motivational books for Lani. She got surprised that I am so helpful to her. She started reading the religious books which were something that gives a sense of freedom from unnecessary thoughts; she become positive and stable in her thoughts. The motivational books made her willpower strong. Spiritual books changed her vision and minimized the level of stress as well. She developed her believe and faith in prayer which increased her capacity to respond to the treatment. Hence, the book reading strategy was also part of my efforts that uplifted her motivational level and gave her strength to deal with psychological problems. Meanwhile, in the whole process, her husband’s role was appreciable. It could not have been possible to implement such strategies without his support and encouragement. Overall, it could be stated that the psychological problems needed to be handled properly as these are just negative thoughts within the mind, and some steps must be followed to uproot those unwanted and negative thoughts.

On the basis of above knowledge, I could state that communication has a massive level of relevance with handling the complex situations (Collins, 2009). Through proper communication, it becomes possible to minimize the anxious level of both patients and service providers. In my situation, the case was worst as she had developed the fear of worst physical health and her social support was also very less. It shattered her from inside, and the stress level of Lani reached its peak. With the help of communication, it became possible to implement the strategies, convincing the husband, winning the confidence of Lani, and so on. At the same juncture, it is essential to mention that communication could become effective through various ways. It includes both, non-verbal and verbal form. The non-verbal communication is just understanding the emotions and gestures or developing a beautiful connection with the person. Contrary to this, verbal communication is direct where every interaction is direct and proper. In my context, I made practical use of both non-verbal and verbal form of communication. It helped me in dealing with the complex situation and controlling the anxious levels. Therefore, I also started following the proper communication as sound strategies to address complex situations (Koprowska, 2010).

The above situation has helped me a lot in gaining the positive experience into the health and social care profession. With the case of Lani, I found out that she is struggling with the psychological problem which actually doesn’t exist. No doubt she was suffering from unendurable pain. However, she developed the sense of fear due to the past experiences of other people, and the impact of the accident and weak physical health was tremendous at her mindset. Thus, I prepared the action plan where I decided to change her mindset towards the disease. So I started to narrate the story of previous incidents. However, I needed a stronger strategy that could bring change internally. So I decided to introduce the meditation and music. After a while, I found that the meditation skills of Lani were not so high, and the continuous music was not allowed to her. Hence, in such situation, I introduced the strategy related to the book reading. It was very impactful to eradicate the psychological problems (Bryan, 2009).

I felt overwhelmed after seeing the improvement in her situation as my action plan was completely justifiable with her situation. I have learned that the psychological problems must be dealt in a proper way. This is my experience that the book reading and music therapy has a tremendous impact on the mind and divert the mind from the random thought process. In the current scenario, my learning level was immense with respect to focusing upon the problems and sufferings of the patients. They have their issues and challenges, and I learned that being a health and social care professional we should handle all the situations.

I would like to mention that I evaluated that the social support is much needed for any patient. Less social support made the situation worst for the Lani. She was not able to share her feelings. During the whole process, I have learned that strong communication skills are much needed in health care profession. As in current scenario, I was able to handle the complex situation just because of my proper communication skills (Collins, 2009). I was able to build a connection with the patient. For the future course of action, I have learned that I will develop my communication skills and will polish them immensely and appropriately. My experience said that patients need moral support in addition to the medical treatment, and every health and social care professional must develop their skills and potential accordingly. The psychological dealing is also required to minimize the anxious levels.

With the help of above discussion, I could mention that the patient within the health and social care not only face the physical problems but sometimes the mental and psychological level problems are also associated with them. It could create troubles for both patients and service providers. In such situation the fear and stress level of both the parties could be increased. To deal with such circumstances, the support is required from the nursing staff. The implementation of proper strategies could help immensely in eradicating the psychological problems. Overall this report is helpful in gaining the intellect related to managing the complex situations in health and social care.

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