Nursing Practice 3

who is discharging home following a TURP (transurethral resection of the prostate). Mr Atkins is a retired farmer who lives with his wife. He has a history of constipation.

Cues Collected From Scenario:

· Difficulty reading without his reading glasses
· Speaks English only
· Is literate (he has been completing his menu and reading books and the newspaper)
· States he doesn’t need to learn anything as ‘he trusts the doctors’


Movicol in the trade name of Macrogol 3350 which is an osmotic laxative. It works by increasing stool bulk/volume, this in turn then activates colon motility via neuromuscular pathways. This medication is used for both the treatment of constipation and also the management of long term constipation (Smith & Ball 2017). Script Justification Good morning Mr Atkins, my name is Anna and I am a Registered Nurse.

The pharmacy has sent up your medication. I would like to talk to you about this before you go home today. Granger (N.D.) argues that ‘Introduction is the first step on the ladder of a therapeutic relationship’.

They will be right, just put it in my bag. Mr Atkins, the medication is new and it iimportant that you understand what it is for and how to take it.It will only take a few minutes. Would it be ok with you if I sit down? Please feel free to ask me any questions as we go through the medication.

According to adult learning principles, adults are relevancy oriented. It is important to convey why Mr Atkins needs to know this information (Knowles 2015).

I would sit down as then I can make eye contact and display comfortable body language including sitting forward to engage Mr Atkins (Smith, 2016).

A supportive environment is vital, Mr Atkins should be able to ask questions and should encouraged to do so (Jones & Harvey 2016) All right, I suppose I had better know something about them. I don’t want to end up back here.

Adult learning principles state that adults need to be motivated to learn and avoiding readmission is a motivating factor for Mr. Atkins (Knowles 2015).

Thank you, I will get your reading glasses for you so that we can look at the packaging and instructions together. This is Movicol. This medication is a laxative to help prevent and manage constipation. Do you remember yesterday Mr. Williams (urology surgeon) spoke to you about some of the things you should do and not do when you get home?

Ensuring Mr Atkins can see the packaging and instructions is one of the keys to the success of my education plan. According to Duff & Lee (2012) ensuring the patient has access to aides such as glasses and hearing aids should be a key consideration at the start of the education process.

2 Yep, he said to drink heaps, lift nothing heavy and not get constipated.

Adults should be given the opportunity to build on their existing knowledge (Smith 2016). Excellent, so this medication helps to manage constipation. You should take one sachet each day (I would remove a sachet from the box to show Mr Atkins). You need to empty the sachet into a glass and then mix the powder with 125ml of water. Side effects of this medication are very rare, but you may experience abdominal pain or diarrhoea. If you do, it is
important to let your GP know.

How have you managed your constipation in the past? It is important to include several learning preferences in my plan – while verbal communication is the main method ofeducating in this situation, I need to consider that this may not be Mr Atkins learning preference (Smith, 2016).

Well, I try and drink a bit more, and go for a walk around the farm and they tell me that fibre is good, but I’m not much for that brown bread. That’s great. Gentle exercise, drinking more fluids and fibre are all important – if you don’t like brown bread there are other ways of increasing your fibre intake, increasing the amount of fruits and vegetables you eat is another way. I will get you one of our leaflets on preventing constipation. It has some good suggestions.

Using print documents is an important way to support learning and reinforce material (Smith 2016)

I want to make sure I have explained the medication clearly. Can you tell me what the medication is for and how you are going to take it? At this point, I will use the teach-back method to confirm Mr Atkins understanding (Barrett 2013).

I put one of those sachets in a glass of water and drink it. Do I need to stir it or does it just dissolve? That’s a good question, yes you will need to stir it with teaspoon before drinking it.

I am reinforcing the importance of asking questions by positive feedback (Williams, 2014).

Did you have any other questions or concerns? When you are at home, if you are worried you can contact your pharmacist or doctor. I have also printed out some information on this medication to take home with you.