Working on Health
Name
Internship period PLP 3, April 17 – July 8
Internship Dr Wahidin Sudiro Husodo Hospital &
UNHAS Hospital
Departement Lontara 3, ICU, CVCU, wound care &
UNHAS Kantinting
Internship teacher
Internship supervisors
,Table of contents
INTRODUCTION............................................................................................................................................. 3
1. BUILD TRUST.............................................................................................................................................. 4
2. CASE AND ANAMNESIS............................................................................................................................... 6
2.1 CASE..............................................................................................................................................................7
2.2 PATTERNS OF GORDON......................................................................................................................................7
Clarification.....................................................................................................................................................9
2.3 ECOGRAM.....................................................................................................................................................10
Clarification:..................................................................................................................................................11
Conclusion:....................................................................................................................................................12
2.4 SELF-RELIANCE RADAR.....................................................................................................................................12
Clarification:..................................................................................................................................................13
Conclusion:....................................................................................................................................................14
2.5 POSSIBLE RISK DIAGNOSIS.................................................................................................................................14
3. NURSING DIAGNOSIS............................................................................................................................... 15
3.1 CLUSTERING..................................................................................................................................................16
3.2 (RISK) DIAGNOSIS...........................................................................................................................................17
3.3 PRIORITIZING.................................................................................................................................................19
Clarification:..................................................................................................................................................20
4. CARE OUTCOMES AND INTERVENTIONS................................................................................................... 21
5. NEEDED BEHAVIOR CHANGE.................................................................................................................... 24
5.1 STAGES OF CHANGE........................................................................................................................................ 25
Current situation:..........................................................................................................................................26
5.2 ASE MODEL..................................................................................................................................................27
6. PREVENTION PLAN................................................................................................................................... 28
7. MONITORING/EVALUATING..................................................................................................................... 31
PROCESS EVALUATION...........................................................................................................................................31
PRODUCT EVALUATION..........................................................................................................................................33
BIBLIOGRAPHY............................................................................................................................................. 34
ATTACHMENT.............................................................................................................................................. 38
1. POSTER IN INDONESIA.......................................................................................................................................38
2. PATHOLOGIES.................................................................................................................................................. 39
1.2.1 Acute Heart failure...............................................................................................................................39
1.2.2 Hypertension........................................................................................................................................41
1.2.3 Type 2 diabetes.....................................................................................................................................42
1.2.4 Chronic kidney disease (CKD)...............................................................................................................43
2
,Introduction
Working on Health is a module that focuses on risk diagnoses. Based on Mr. X's case study,
it looks at what risks exist and how they can be prevented. It is prepared using Rosendal &
Van Dorst (2019) seven steps. These steps cover the case from anamnesis to
implementation and evaluation of care (Rosendal & Van Dorst, 2019).
In this report, we look at the situation of Mr. X. These cases were chosen because Mr. X has
a high-risk illness. Which involves risks that need to be prevented. For this, several lifestyle
modifications are needed, and this is where Mr. X receives support.
By following the seven steps of baker, all CanMEDS roles will be addressed. The CanMEDS
roles represent a comprehensive framework that outlines the occupational profiles of
healthcare providers, including nurses. These roles define the crucial competencies required
to fulfill diverse responsibilities within the healthcare field. There are seven distinct roles:
3
, caregiver, communicator, collaborative partner, reflective evidence-based practice
professional, health advocate, organizer, and professional and quality promoter. Each role
emphasizes specific competencies that healthcare professionals, including nurses, must
possess to effectively execute their responsibilities and deliver comprehensive patient care
(Enurse.nl, 2023a).
The learning outcomes of the module Working on health:
- The student methodically and responsibly describes the potential patient problems
and justifies this choice based on recent scientific sources and/or clinical expertise
and insights.
- The student methodically assesses together with the caretaker, his relatives and
informal network the joint burden and carrying capacity and justifies in which phase of
self-management the caretaker is and takes this into account when indicating the
preventive care.
- The student explains risky behavior and motivation for behavioral change using
common models and uses this information when indicating preventive care.
- The student prioritizes, identifies, and justifies preventive care and assigns care to the
appropriate level of expertise considering effective allocation of resources and
making this transparent to all involved.
- The student organizes care effectively and efficiently, works according to standards,
guidelines and protocols and can monitor care transparently.
1. Build trust
This section outlines the process of establishing trust between a client and a caregiver. The
strength of the bond between the client and caregiver depends on the effectiveness of
nursing procedures. Collaboration and effective teamwork can only occur when trust is
present. To gain the client's trust, the nurse should demonstrate respect, exhibit their
competence, and genuinely express interest in the client's well-being. Throughout the
process, it is crucial to regularly assess the level of trust and prioritize rebuilding it if it has
been compromised (Rosendal & Van Dorst, 2020).
7 ways to build trust with you patient:
1. Engage in consistent eye contact when speaking with the patient.
2. Display empathy to demonstrate your understanding of the patient's emotions.
3. Foster open and transparent communication.
4
Name
Internship period PLP 3, April 17 – July 8
Internship Dr Wahidin Sudiro Husodo Hospital &
UNHAS Hospital
Departement Lontara 3, ICU, CVCU, wound care &
UNHAS Kantinting
Internship teacher
Internship supervisors
,Table of contents
INTRODUCTION............................................................................................................................................. 3
1. BUILD TRUST.............................................................................................................................................. 4
2. CASE AND ANAMNESIS............................................................................................................................... 6
2.1 CASE..............................................................................................................................................................7
2.2 PATTERNS OF GORDON......................................................................................................................................7
Clarification.....................................................................................................................................................9
2.3 ECOGRAM.....................................................................................................................................................10
Clarification:..................................................................................................................................................11
Conclusion:....................................................................................................................................................12
2.4 SELF-RELIANCE RADAR.....................................................................................................................................12
Clarification:..................................................................................................................................................13
Conclusion:....................................................................................................................................................14
2.5 POSSIBLE RISK DIAGNOSIS.................................................................................................................................14
3. NURSING DIAGNOSIS............................................................................................................................... 15
3.1 CLUSTERING..................................................................................................................................................16
3.2 (RISK) DIAGNOSIS...........................................................................................................................................17
3.3 PRIORITIZING.................................................................................................................................................19
Clarification:..................................................................................................................................................20
4. CARE OUTCOMES AND INTERVENTIONS................................................................................................... 21
5. NEEDED BEHAVIOR CHANGE.................................................................................................................... 24
5.1 STAGES OF CHANGE........................................................................................................................................ 25
Current situation:..........................................................................................................................................26
5.2 ASE MODEL..................................................................................................................................................27
6. PREVENTION PLAN................................................................................................................................... 28
7. MONITORING/EVALUATING..................................................................................................................... 31
PROCESS EVALUATION...........................................................................................................................................31
PRODUCT EVALUATION..........................................................................................................................................33
BIBLIOGRAPHY............................................................................................................................................. 34
ATTACHMENT.............................................................................................................................................. 38
1. POSTER IN INDONESIA.......................................................................................................................................38
2. PATHOLOGIES.................................................................................................................................................. 39
1.2.1 Acute Heart failure...............................................................................................................................39
1.2.2 Hypertension........................................................................................................................................41
1.2.3 Type 2 diabetes.....................................................................................................................................42
1.2.4 Chronic kidney disease (CKD)...............................................................................................................43
2
,Introduction
Working on Health is a module that focuses on risk diagnoses. Based on Mr. X's case study,
it looks at what risks exist and how they can be prevented. It is prepared using Rosendal &
Van Dorst (2019) seven steps. These steps cover the case from anamnesis to
implementation and evaluation of care (Rosendal & Van Dorst, 2019).
In this report, we look at the situation of Mr. X. These cases were chosen because Mr. X has
a high-risk illness. Which involves risks that need to be prevented. For this, several lifestyle
modifications are needed, and this is where Mr. X receives support.
By following the seven steps of baker, all CanMEDS roles will be addressed. The CanMEDS
roles represent a comprehensive framework that outlines the occupational profiles of
healthcare providers, including nurses. These roles define the crucial competencies required
to fulfill diverse responsibilities within the healthcare field. There are seven distinct roles:
3
, caregiver, communicator, collaborative partner, reflective evidence-based practice
professional, health advocate, organizer, and professional and quality promoter. Each role
emphasizes specific competencies that healthcare professionals, including nurses, must
possess to effectively execute their responsibilities and deliver comprehensive patient care
(Enurse.nl, 2023a).
The learning outcomes of the module Working on health:
- The student methodically and responsibly describes the potential patient problems
and justifies this choice based on recent scientific sources and/or clinical expertise
and insights.
- The student methodically assesses together with the caretaker, his relatives and
informal network the joint burden and carrying capacity and justifies in which phase of
self-management the caretaker is and takes this into account when indicating the
preventive care.
- The student explains risky behavior and motivation for behavioral change using
common models and uses this information when indicating preventive care.
- The student prioritizes, identifies, and justifies preventive care and assigns care to the
appropriate level of expertise considering effective allocation of resources and
making this transparent to all involved.
- The student organizes care effectively and efficiently, works according to standards,
guidelines and protocols and can monitor care transparently.
1. Build trust
This section outlines the process of establishing trust between a client and a caregiver. The
strength of the bond between the client and caregiver depends on the effectiveness of
nursing procedures. Collaboration and effective teamwork can only occur when trust is
present. To gain the client's trust, the nurse should demonstrate respect, exhibit their
competence, and genuinely express interest in the client's well-being. Throughout the
process, it is crucial to regularly assess the level of trust and prioritize rebuilding it if it has
been compromised (Rosendal & Van Dorst, 2020).
7 ways to build trust with you patient:
1. Engage in consistent eye contact when speaking with the patient.
2. Display empathy to demonstrate your understanding of the patient's emotions.
3. Foster open and transparent communication.
4