teaching project going in different direction...Please help

[TessaMae]

Our final project is to identify a patient in need of teaching regarding a disease/illness/problem they are having, and develop a plan of care based on one of the things they need to learn. My broad topic is low-back pain and my patient is a pregnant woman. I initially thought (after talking with her) that she would need some nonpharmacologic measures for reducing low back pain. I thought I would teach her techniques to reduce/relieve back pain during pregancy - like exercises, posture, lifting, good shoes, etc. but it turns out she was given all that info from her doctor...she is feeling so overwhelmed(has a small child at home, not sleeping well, hormonal changes) she just can't focus on helping herself. The back pain is something she wants to work on but doesn't know where to start, makes lots of excuses, and puts her own needs last in the list of priorities for the day. I really want to change directions and make my patient teaching be geared toward stress management techniques or relaxation techniques. I know stress can affect how a person manages pain and managing it would also probably assist in her trying out some of the techniques to actually help with the pain. Does that make sense? I just don't know how to directly relate the stress management to the back pain, like how will I measure if my teaching was effective? I am kind of thinking out loud here because my dear husband has no clue about this stuff and can't really bounce any ideas back and forth with me. TIA for any feedback.

[Always_Learning, BSN, RN]

Tessa,

Has your instructor indicated that you have to base the care plan around back pain per se? If not, and you have identified that another nursing diagnosis might be more appropriate, I don't see why you couldn't use something else. For example, maybe Ineffective Self-Health Management, Readiness for Enhanced Self-Health Management, Ineffective Coping, Anxiety...something of that sort based on what she has conveyed to you.

You could make the back pain the "as evidenced by"...for example, "Ineffective Family Self-Health Management, r/t family and social stressors, AEB continued chronic back pain." Something like that... :)

Best wishes!

[TessaMae]

This is honestly the most vaugue assignment I have had, thank goodness it is the last! We had to pick a topic based on a real person with a real issue that we could teach outside of school. The paper actually is not going to have an actual nursing diagnosis in it, so no related to or as evidenced by we just need to identify the persons issue, what teaching the person needs related to their issue, and then based on what they need to know, we pick one of those things to develop a teaching plan on (we describe in paragraph form over 3-5 pages of the 10 page paper this teaching plan, the goals and how we will measure them, etc) pick something to teach that is measureable, explain why we picked it, how we will teach it and why. I think I made it tough on myself with my topic being low back pain. Most people picked hypertension, asthma, diabetes, and things like that.

Tessa,

Has your instructor indicated that you have to base the care plan around back pain per se? If not, and you have identified that another nursing diagnosis might be more appropriate, I don't see why you couldn't use something else. For example, maybe Ineffective Self-Health Management, Readiness for Enhanced Self-Health Management, Ineffective Coping, Anxiety...something of that sort based on what she has conveyed to you.

You could make the back pain the "as evidenced by"...for example, "Ineffective Family Self-Health Management, r/t family and social stressors, AEB continued chronic back pain." Something like that... :)

Best wishes!

[Always_Learning, BSN, RN]

Ah, I see...well, that makes it easier, I think. You could still conceptualize it as a care plan, with your teaching items as "interventions." And you could elaborate on things that the client could do to remove the obstacles preventing her from properly addressing her back pain. I think you're right on target with the relaxation, etc.