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The case study will be elaborating on the significance of rural nursing with regard to emergencies situations in the remote areas. The primary nurse in charge of the rural facility will also describe the scope of rural and remote nursing and also stress on nursing measures and interventions integrating the nursing concepts and theories and explaining the impact of environment of a person. During the Christmas games at Porous village in Eastern Highlands Province, there was an incident were one of the rugby league players was hit on the head with an iron rod.
The fight started between two drunken supporters outside the field and eater emerged into the playing field. The players were surprised as to how the fight started and why they were fighting with each other. On the scene the particular player was badly injured and was brought to the clinic. They traveled almost five hours before they reached Okapi rural health centre. Upon arrival at the clinic he was diagnosed with brain injury. The patient was identified as John Dud from Chimed married to Joyce Karri from Porous. This rural health clinic gets to dealt with similar cases since 2005.
Most of the rural dwellers find it difficult to travel to Okapi station health centre cause of the fact that it is severely understaffed, with not enough medicine and the health facility being run down. Due to poor infrastructure development in the district, most of the rural people in Okapi district find it difficult to travel to Okra base hospital to get treatment. Rural population often encounter difficulties during emergencies due to distance from their home to the nearest clinic. Often times people die while traveling to the clinic while others die upon arrival at the major hospitals.
Most mothers and young woman die during child birth because there were o trained midwives at the clinic to help them when encountering difficulties during labor. At the clinic there were only four health workers, three community health workers and one nursing officer. Since there is only one registered nurse on the ground, the nurse had to serve him immediately and save his life. Before doing other procedures on him, they rushed him into the emergency room whereupon they shaved his hair and sutured the wound which is three stitches deep and tied his head with a bandage and allow him to lie on the bed.
The nursing officer inserted an IV and ran it for eight hours. After that the nursing officer interviewed the guardians as to how the accident had occurred and did documentation on the patient’s condition. The type of relationship that a nurse establishes with the patient affects the quality and amount of information that he or she can gather about that patient (Hygiene et al, 1997). According to (Bradley, 1998) the majority of nurses who remain in the remote and rural areas of nursing find their practice rewarding.
The nurse took care of the sick person from the time the need of care of identified until it no longer existed. The chief complaint of the patient was headache, vomiting, nausea, lack of tutor coordination, dizziness, difficulty balancing, lightheartedness, blurred vision or tired eyes, ringing in the ears, bad taste in the mouth and fatigue. However, the objective data that they collected for further assessment and treatment was severe bleeding from the nose as well as the head, occasions noticed on the head, BP was 100/60, pulse was 65, respiration was 28 per minute and the temperature being 35. C. To clarify the mixed thoughts about his health, the nursing officer explained the condition of the patient to the guardians and assured them that he would be recovering and regains his consciousness within a few hours. Rural nurses have more skills on average than urban practitioners because they practice in remote areas where no special care is available. They are more competent because they perform procedures without supervision. Doing it over and over, they are familiar with the particular procedure and can manage similar situations in the future without a problem (Lee, 1998).
The need problem identified during the assessment was occasions related to severe bleeding from the nose and head as evidence by pale skin color. Since it affects the circulatory system, blood pressure and pulse fluctuates. Failing to maintain blood pressure can result in inadequate blood flow to the brain. The respiration also increases in order to supply sufficient supply of oxygen to the cells while the temperature drops inversely due to inadequate supply of blood in the cells to insulate the whole body.
After collecting all the necessary information through thorough assessment of the patient they began to prioritize the need of the problem. In this situation they gave more attention to John because he was losing blood and he was likely to die if not given much attention. The scientific rational behind proportioning the problem identified during the assessment of John was severe blood lose can cause anemia and can lead to shortness of breath and palpitations of the heart (Mattson and Levin, The expectations from the community health workers are to help him 1990). Recover from his injuries.
Their goal as a team working together at the clinic was to stop bleeding and assist him to recover within expected time frame. They were very positive that he would be able to move his head and able to control his normal physiological functions. The nurse in-charge advised the guardians to massage his limbs whenever he wanted to. The next step is rehabilitation. Rehabilitation aims to improve independent function at home and in society and to help adapt to disabilities and has demonstrated its general effectiveness, when conducted by a team of health professionals who specialize in head injury. Bushy, 1998) The scientific rationale behind ambulating and massaging is to allow blood to circulate in the body and help the muscles to stretch and become flexible. Movement disorders that may develop after head injury include tremor, ataxia (uncoordinated muscle movements), anonymous (shock-like contractions of muscles), and loss of movement anger and control in particular with a loss of movement repertoire (Mattson et al, 1990). The nurse assessed his neurological status every hourly by taking vitals and took note of his level of consciousness and level of motor response.
With this information they are now be able to either adjust medicine and other treatment measures. After two days in the clinic, the nursing officer in-charge made a referral to Okra Base Hospital for further assistance and diagnosis of his health status. Rural people cannot afford to pay for the hospital bills which are very expensive. Most rural clinics were run down and closed due to lack of health workers, poor infrastructure, and tribal fights between two rival clans over land dispute.
People in rural and remote areas, while experiencing increasing levels of poverty, have to face increased cost of travel and accommodation should they require anything other than basic health services (McLeod, Browne and Leapers, 1998). For example many women now have to travel to major hospitals to give birth, and this is an additional cost to all of the rural family. For this reason, many rural people don’t seek medical attention as soon as they encounter illness till they are very sick.
There is other reason why rural people do not seek medical assistance in the first place. It is the lack of culturally acceptable services. Most of the rural health care givers are ignorant and do not respect their dignity and culture. They treat them with little or no respect for who they are. Therefore, most people in the community don’t want to seek medical assistance till they were very sick and cannot care for themselves. Others come to seek medical attention only from someone whom they trust and have established a good relationship with.
Rural dwellers tend to be independent and self-reliant in health-seeking behaviors. In the rural environment, help is usually sought by residents through informal rather than formal systems (Bushy, 1998). When formal systems are utilized, rural dwellers tend to resist accepting help or services from those seen as outsiders and utilize formal networks less frequently than informal networks (Lee, 1998). Nurses in rural communities face much greater role diffusion than counterparts in urban settings.
Nursing practice is significantly affected by a lack of anonymity within the community. Nurses in the rural settings practice under pressure to assume some of the functions that traditionally are in the realm of other spineless. Bushy (1998), argued that rural nursing practice is different from urban practice and it is perverse to suppose that rural health care and nursing practice will mirror that in urban environments. She goes on to emphasize that rural nursing is especially different from what most nursing students have experienced in their education.
This can pose huge barriers to practice to an urban prepared or new graduate nurse working as a rural nurse, regardless of skill level. For example, nursing in a rural hospital does not require the specialized care that is often present n urban hospitals. Although rural nurses are function as generalists, taking care of patients from birth to end-of-life with a wide range of health problems and disease states but most often they refer their patients to major hospitals for specific treatment and assistance from the specialist doctors (McLeod et al, 1998).
It is also imperative for rural nurses to have a well-grounded community and public health background to better serve the rural population, which has difficulty accessing and utilizing care due to geographical and socioeconomic disparities. (Lee, 1998). The remarry concern of community health nurses is to improve the health of the community. The level to which a nurse in the community can provide a wide range of services depend in large part on his or her knowledge in which he or she works, the kind and quality of services and resources available to the population under his or her care.
The health of rural people can be influenced by physical environment, rural lifestyle, the problems imposed by distance and the economic activity of the area. (Hygiene et al, 1997). Rural population often encounter difficulties during emergencies due to distance from their home to the nearest clinic. Often time’s hospitals. To conclude, the provision of health care in the community is a team work. Nurses, Health Extension Officers and Chow’s must work collaboratively to achieve the highest level of health.
Be in the community with the people so that you can better understand their way of doing things especially their culture and life style. Have a strong relationship with the local community is very important because they will trust you to help them because they know you very well. They will protect your properties and respect you in the community. In such places where there are limited sources, understaffed and deteriorated health facilities it needs very committed and trust worthy nurses who can manage the health centre with a mission to serve others in good and bad times.