Patient in the hospitalPatient in the hospitalJana Hermanova

The admissionThe admissionPlanned

◦ElectiveUnplanned

◦Acute◦Urgent

ReceptionReception

HeliportHeliport

EmergencyEmergency

Types of unitsTypes of unitsGeneralSpecializedAcute careLong term careIntensive careCritical careOther services

Nursing StationNursing Station

Nursing StationNursing Station

Hospital RoomHospital Room

Patient ´s RoomPatient ´s Room

Intensive CareIntensive Care

Basic Equipment ICUBasic Equipment ICU

ICUICU/ARO/ARO

Long Term Intensive CareLong Term Intensive Care

Long-Term Intensive CareLong-Term Intensive Care

Social CareSocial Care Services Services

Social CareSocial Care

Social CareSocial Care

LaboratoryLaboratory

Magnetic ResonanceMagnetic Resonance

Radiology CTRadiology CT

Operating TheatreOperating Theatre

Eye SurgeryEye Surgery

SterilisationSterilisation

Occupational TherapyOccupational Therapy

Spiritual CareSpiritual Care

VolunteersVolunteers

PracticePractice

The healthcare teamThe healthcare team

• Doctors• Nursing staff• Physiotherapists• Occupational

therapists/ergotherapists

• Nutritional therapists

• Social workers

• Pharmacists• Respiratory

therapists• Speech therapists• Spiritual support

persons

Who is missing?

The four R’sThe four R’sRolesRulesResponsibilitiesLines of reporting

Each has different role to play, subject to different rules related to their different responsibilities

Each will be responsible, accountable to different arbiters of their performance

The patient is a human – The patient is a human – he/she has Human needshe/she has Human needs…according to Abraham

Maslow…

Physiologic needsPhysiologic needsAirFoodFluidsSleepRestSexShelter

Exercise and activity

EliminationPain avoidanceMaternal

responseStimulationExcitementManipulationExplorationNovelty

Safety needsSafety needsSecurityStabilityDependencyProtectionFreedom from

fear and anxietyStructure

Safety needs incorporate the need for structure, law, order, limits and the strength of a protecting person

Love and belonging needsLove and belonging needsThe need to be

with othersTo have a wife,

husband, children, colleagues, friends, acquaintances

Important for adequate mental health

If not met the person can feel◦ lonely ◦ separated ◦ rejected ◦ friendless ◦ abandoned ◦ restless

Love and belonging needs are expressed through our desire for:◦ tenderness◦ affection◦ contact◦ intimacy◦ togetherness ◦face-to-face encounters

Esteem needsEsteem needsThe need for firmly based

wholesome self-evaluation and for respect and esteem of self and esteem for others

Need for feeling a confidence, for independence, for freedom, reputation, dignity, appreciation

Esteem needsEsteem needs

Fulfillment results in:

Self-confidenceFeelings of worthStrengthCapabilityUsefulnessAdequacy

Deprivation results in feelings of:

InferiorityHelplessnessWeaknessDiscouragement

When serious, it leads to compensatory or neurotic behavior

Self actualizationSelf actualizationThe person is self fulfilledHe must be what he can beHe must fulfill his purpose in the

worldSelf actualization is confined to

adults

Characteristics of a self Characteristics of a self actualized personactualized personIs realistic, sees life clearlyJudges people correctlyHas clear notion of right and wrongIs usually accurate in predicting future

eventsUnderstands art, music, politics and

philosophyListens to others carefullyIs dedicated to some work, task, duty

or vocationIs highly creative, flexible,

spontaneous, courageous, willing to make mistakes

……Is self confident, has self respectIntegrated personality, low degree of

self- conflictPossesses a feeling of self controlIs highly independent, desires privacyCan appear remote and detachedIs friendly, governed more by inner

directivesCan make decisions contrary to

popular opinionIs problem centered rather than self

centered

How do we meet our How do we meet our needs?needs?Healthy ways – not harmful to others or

self, conform to socio-cultural values, are within the law x Unhealthy behaviors

Independently x with assistance

It may all change during hospitalizationEach member of the team contributes

by their special way to the patient’s needs being met