Journal of IiME Volume 2 Issue 2 www.investinme.org A Severe ME-aware nursing model (continued) Table 3 Ms H is 50 year old woman with severe ME . Nursing intervention : assisting patient with eating lunch Assessment Ms H’s main symptoms are : Symptom Impact Pain : cannot bear touch Transient paralysis unable to use limbs affected. Numbness Muscle fatigueability Light sensitivity Noise sensitivity Food sensitivity/allergies Gastritis cannot feel properly Muscle weakness cannot grip properly post exertional malaise/pain increase needs dark glasses, low light any noise can hurt and aggravate symptoms can only eat certain foods, no dairy, wheat or oil stomach pain, bloating Hypoglycaemia irritability, distress, worsening symptoms Swallowing difficulties Breathing difficulties Spasms food gets stuck malaise increases, chest muscle pain head, limbs, body shaking violently, Presenting Issues : Variability of symptoms and severity Functional difficulties in eating Potential deterioration to complete incapacity Sitting up/postural issues Planning : Intention : Provide finger food Provide padded seating and back/neck support Low light Quiet, peaceful environment Ensure appropriate diet Provide assistance with drinking (straw). To have a warm open accepting posture with no quick movements, minimal noise, sensitivity to physical pain. To proactively respond to the person’s needs, in partnership. Patient not to be stressed or rushed. Implementation : The nurse followed the intended plan however there was a complication which needed creativity, adaptability, patience and calm especially, on the part of the nurse. Complication requiring immediate response : Patient began to spasm severely immediately she attempted to eat. Food fell everywhere, patient became distressed, tearful, breathing difficulties and swallowing difficulties manifested. Response : maintain valuing posture . Wait for spasms to subside. Maintain silence but thinking what to do to help the patient. Patient tried several times to eat unsuccessfully, reduced ability to bite rice Invest in ME (Charity Nr. 1114035) Page 40/74

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