Strength-based nursing is a care approach whereby certain fundamental principles and values direct nurses’ actions thus enhancing the promotion of empowerment, hope and self-efficacy (Gottlieb, 2014). SBN focuses on a person and family’s inner and outer strengths and resources to facilitate health promotion and creation of suitable conditions for healing (International Family Nursing Association, 2015). This enables nurses to effectively deal with problems that may arise as well as minimize the discrepancies. This discussion therefore seeks to outline the SBN care plan that should have been and those that were implemented throughout Emma’s healthcare journey. Emma’s healthcare story evidently informs health professionals that love, optimistic mindset and support can incredibly improve a person’s health and life (Gee, 2018). A further outline on the SBN care for a patient after going through a surgical operation will be discussed. Emma went into a stroke after going through a complex surgical procedure. Therefore, the immediate post-surgery care while Emma was in a stroke will be discussed as well. A holistic approach, focus on the family and cooperation with Emma will also be presented. A summary on the SBN care practices will also be discussed before a conclusion is drawn.
SBN is an evidence-informed practice that ensures that people have support in their healthcare outcomes and personality (Australian Medical Student Journal, 2018). SBN appreciates the importance of the environment and sociocultural frameworks in the realization of an ideal healthcare result. The objectives of healthcare promotion, facilitation of healing and easing the suffering of patients by making the environment suitable to the patient’s conditions are endorsed in this care plan (Nursing Centre, 2018). Therefore, SBN supplements the medical care provided, the nurses’ input to the patient and family’s health and healing and the empowerment of the patient and family’s control over their health and healing. It not only focuses on the prevention, well-being and person-centred care but also on the patient’s shortfalls. The patient’s deficits are analysed based on pathophysiology, paying attention to the unusual and dysfunctional characteristics with an aim of solving the problems.
The remarkable changes in the healthcare provision services have roused modifications in economic, political and social environments thus making healthcare managers to provide new ways of maintaining and improving the delivery of services Trajkovski, Schmied, Vickers and Jackson, 2013). The involvement of patients and their families in the care and policy making decisions has increasingly become one of the new strategies used by healthcare managers. Involving patients and their families enhances the quality of services provided as well as meets the requirements of the government in service production (Tambuyzer, Pieters, and Van Audenhove, 2014). There are eight principles and values that guide nurses in their actions. These include; health and healing, holism and embodiment, uniqueness, subjective reality and created meaning, self-determination, learning timing and readiness, person and environment are fundamental and collaborative partnership (Gottlieb, 2014). These values and principles enhance the provision of SBN healthcare and quality healthcare service delivery.
Collaborative partnership: This principle states that the relationship between the nurse, the patient and the family is collaborative. Each of the party incorporates its own knowledge, skills and experience to the relationship. The nurse possesses the medical knowledge of the patient’s health and healing conditions. On the other hand, the family and the patient have the facts about their health background and vulnerabilities. When the nurse is cooperative and open to the patient and the family, a collaborative relationship is created. The patient and the family feel respected by the nurse when their strengths are appreciated and recognized.
Health and Healing: SBN endorses health and healing as the fundamental objective of nursing care. Health enables the patient to flexibly adapt to the challenges in life. Healing restores a person’s wholeness and during this process people develop different abilities that are capable of improving and sustaining their health. Nurses enhance the promotion of health by assisting people in the development of new skills that will enable them to cope with life. Nurses support the patient’s healing capacities through encouraging them to sleep, ensuring proper nutrition and controlling the patient’s pain (Byrne, Barry, and Petry, 2012). The nurses also ensure that patients recover from physical and social issues by availing healing environments.
Holism and Embodiment: Holism identifies that the parts of a person are intertwined and each part affects the functioning of the person. The presence of symptoms, for instance, signals that there is a problem with the person’s functioning. The symptoms that cause dysfunction in a person should be treated or rather eradicated to enable the healing process to reinstate a person’s sense of completeness. The nurse’s role according to SBN is to assist the patient in achieving their objectives. The nurse should also work with the patient in order to come up with solutions to the medical problem and thus fix the problem.
Learning, Timing and Readiness: Learning is central to a person’s continued existence, development and transformations as it involves psychological processes. Humans are able to traverse the environment through learning. Learning also entails being ready to participate in a new action altogether. According to SBN, timing involves coordinating the outcome anticipated with the proficiencies of the body and the willingness of the mind. The nurse should be accustomed to the patient in order to know the exact and perfect moment of administering intervention. This principle is necessary for healing as people learn how to care for their health. The timing of the intervention focuses on a person’s knowledge and circumstances.
Person and Environment are Integral: The environment physically and socially affects a person and the family. A person may portray strength in a certain environment while on the other hand; he or she may be vulnerable in some environments. People develop and thrive in a suitable environment. Suitable environments enable people to maximize their strengths and seize the opportunities for healing and transformations.
Self-Determination: SBN ensures that a person’s self-determination, knowledge and choice of values are respected and upheld. However, the choices available are limited to a certain degree as the person’s knowledge and situation affect his or her ability to act in accordance to his or her interests. Majority of the living acts entail making a choice on what way to react to certain situations and restrictions in healthcare and the interventions that should be undertaken. SBN views the role of nurses as attentively listening to patients and providing clarifications and not making choices for them.
Subjective reality and created meaning: Understanding shapes experiences since they hold precise meanings. A person’s understanding of events is directed by emotions and experiences which then affect their reactions. SBN requires nurses to recognize and enhance patients’ communication.
Uniqueness: SBN identifies that people are different genetically and in terms of specific dispositions. The variation between people is determined through strengths and weaknesses; how they affect their physical reactions and behaviours. In order to identify a person’s uniqueness, the strengths and flaws should necessarily be understood. A patient’s strength could be in the effective exercise of autonomy; being able to make appropriate decisions. The family’s strength can also be visible in the proper implementation of autonomy. Different people make different choices therefore they cannot be identical.
In 2005, Emma experienced a left-side paralysis which kept worsening (Gee, 2016). This was one of the symptoms of an impending stroke that Emma suffered after a complex surgical procedure. Nurses should have practised exercises and physical therapies for Emma so that movement would be regained the area affected. Restoration and strengthening of the neural pathways that regulate movement in the brain is an important stroke recovery method brought about by rehab exercises (Flint Rehab, 2017). Nurses should have carried out language exercises with Emma to help her regain her speech and writing skills. Exercises in speech therapy helps patients like Emma recover from the stroke and improve their language. Emma was barely able to mumble words out of her mouth even though she wanted to. But the nurses did not initiate any speech therapy exercises on her that would have helped in regaining her speech. Emma also lost the ability to swallow. This made it difficult for nurses to help in the nutrition of Emma as well as administration of medicine. This was a side-effect to the speech loss and could only be regained through speech therapy.
Emma suffered a stroke after going through a surgical procedure. A stroke takes place when the supply of blood to the brain is interfered with (Disabled World, 2018). Strokes can be recognized and prevented once the patient has gone through a surgical procedure. The risk of perioperative strokes is high among the female gender as well as surgeries pertaining to head or brain injuries or tumours Based on this knowledge, nurses should have been able to anticipate the stroke that Emma suffered. Emma had blood clots and internal bleeding and swelling in the brain thereby causing the stroke. Ultrasound should have used in order to break the blood clots so as to reduce the risk of a stroke.
Emma was diagnosed with Arteriovenoces Malformation (a knot of the blood vessels in the brain) and therefore a surgery was necessary. Emma consented to the surgery; the doctors were aware of the risks but they did not enlighten her or her family. The surgery aggravated the internal bleeding thus leading to a stroke. The principles of collaborative partnership, readiness and timing were not adhered to in this case. Emma’s intervention timing was poor that is why she suffered a stroke. The doctors and nurses should have first dealt with the blood clots and internal bleeding before performing a surgical procedure to remove the AVM.
After the surgery, a post-surgical recovery nurse should have been placed in charge of Emma. What happens at the initial phase after post-surgical or anaesthetic operation, patients are assessed and managed closely for a better recovery. (Nursing, 2017). It is the duty of post anaesthetic recovery unit nurses to make sure that patients like Emma go through the whole process safely after surgeries for a better and efficient recovery in the transition to this type of care, Emma should be assessed regularly, making sure she is careful monitored and her information about recovery is appropriately documented. In this type of care also, the major systems of the body are evaluated, like, respiratory systems, cardiovascular and renal systems. (Akhtar, 2013). Emma’s comfort from pain is primary and it should be prioritized as she seemingly has a brain swelling that could be a confirmation of infection.
Emma went into a coma after going through a difficult surgical procedure. Internal bleeding in the brain and blood clots were the core reason she suffered a stroke. Nurses had to device plan to deal with her during the stroke and after she regained consciousness. Emma lost her speech after the stroke therefore nurses could not involve her in the planning of her care. Her twin sister, Bec, was called on in order to assist in the communication with Emma. Bec went with a red magnetic letter board that finally enabled the doctors and nurses to communicate with Emma. However, Speech therapy exercises would have greatly assisted in the communication with Emma. Emma also had trouble swallowing after the stroke (dysphagia) and she therefore needed tubes jostled down her throat in order to swallow. Emma thus became vulnerable to deficits such as ataxia, diplopia, dysarthria, nystagmus, mobility and sensory deficits after the stroke. A nurse had to be assigned to her to help her in controlling her bowels as well as find solutions to the deficits she suffered.
The administration of care during critical health situations should be guided by the principle of holism (Iglehart, 2013). The nurses were aware that each part of Emma’s body would affect her general condition. Emma has a blood clot and swelling in the brain but the doctors still went ahead with the surgical procedure to remove the AVM in Emma’s brain. IN the end Emma went into a coma due to internal bleeding in the brain. The doctors were aware of the risks associated with performing a surgery on Emma in her state but they still did not inform the family or Emma. The principle of collaborative partnership was also not adhered to as well as the doctors agreed on a plan of care after Emma suffered a stroke without consulting the family. The main objective of nurses and doctors should be to relieve Emma of her pain and treat her effectively.
The nursing practices that should have been promoted to ensure Emma regained her old lifestyle are; implementing the principles and values of SBN, administration of physical and speech therapy exercises, consulting Emma and her family before drawing out a plan of care and giving attention to the risk factors surrounding the patient.
The anticipated outcomes in Emma’s healthcare situation are; enhancement of sense and mobility, family’s contentment, regaining of Emma’s former lifestyle, empowerment of Emma and regaining of speech-language by Emma.
Conclusion:
Love, support and empowerment can assist in the SBN care of patients. Collaboration between the nurses, family and the patient can lead to the achievement of the desired outcomes. This is possible through the safeguarding of the principles and values of SBN.
References:
Akhtar, A. (2013). Pre-Operative Assessment and Post-Operative Care in Elective Shoulder Surgery. The Open Orthopaedics Journal, 7(1), 316-322. doi:10.2174/1874325001307010316
Australian Medical Student Journal. (2018). Forget everything you thought you knew: how your assumptions are impacting the health outcomes of your patients. Available at: https://www.amsj.org/archives/5550 [Accessed 18 Oct. 2018].
Byrne, S., Barry, D. and Petry, N.M., 2012. Predictors of weight loss success. Exercise vs. dietary self-efficacy and treatment attendance. Appetite, 58(2), pp.695-698. doi: 10.1016/j.appet.2012.01.005
Emma Gee (2018). The Book | Emma Gee. Available at: https://emma-gee.com/the-book/ [Accessed 18 Oct. 2018].
Flint Rehab. (2017). Left Side Stroke Recovery: 5 Things Everyone Must Know – Flint Rehab. [online] Available at: https://www.flintrehab.com/2017/left-side-stroke-recovery/ [Accessed 18 Oct. 2018].
Gee, E. 2016. Reinventing Emma. The inspirational story of a young stroke survivor.
Gottlieb, L.N., 2014. CE: Strengths-based nursing. AJN The American Journal of Nursing, 114(8), pp.24-32. doi: 10.1097/01.NAJ.0000453039.70629.e2.
I., News, P., News, R., News, E. and Newsletters, I. (2015). Strengths-Based Nursing (SBN) – International Family Nursing Association. International Family Nursing Association. Available at: https://internationalfamilynursing.org/2015/01/30/strengths-based-nursing-sbn/ [Accessed 18 Oct. 2018].
Iglehart, J.K., 2013. Expanding the role of advanced nurse practitioners—risks and rewards. New England Journal of Medicine (368) 20 pp. 1935-41 doi: 10.1056/NEJMhpr1301084
News-Medical.net. (2013). Strokes that occur during or shortly after surgery can be devastating. [online] Available at: https://www.news-medical.net/news/20130212/Strokes-that-occur-during-or-shortly-after-surgery-can-be-devastating.aspx [Accessed 18 Oct. 2018].
Nursing, A. (2017). Post-anaesthetic Recovery Unit Nursing – Australian College of Nursing. Australian College of Nursing. Retrieved 19 October 2018, from https://www.acn.edu.au/education/single-unit-of-study/post-anaesthetic-recovery-unit-nursing
Publications (2018). Stroke: Symptoms Causes & Treatment. [online] Disabled World. Available at: https://www.disabled-world.com/health/neurology/stroke/ [Accessed 18 Oct. 2018].
Tambuyzer, E., Pieters, G. and Van Audenhove, C. (2011). Patient involvement in mental health care: one size does not fit all. Health Expectations, 17(1), pp.138-150.
Trajkovski, S., Schmied, V., Vickers, M. and Jackson, D., 2013. Using appreciative inquiry to transform health care. Contemporary nurse, 45(1), pp.95-100.
Essay Writing Service Features
Our Experience
No matter how complex your assignment is, we can find the right professional for your specific task. Contact Essay is an essay writing company that hires only the smartest minds to help you with your projects. Our expertise allows us to provide students with high-quality academic writing, editing & proofreading services.
Free Features
Free revision policy
$10Free bibliography & reference
$8Free title page
$8Free formatting
$8How Our Essay Writing Service Works
First, you will need to complete an order form. It's not difficult but, in case there is anything you find not to be clear, you may always call us so that we can guide you through it. On the order form, you will need to include some basic information concerning your order: subject, topic, number of pages, etc. We also encourage our clients to upload any relevant information or sources that will help.
Complete the order form
Once we have all the information and instructions that we need, we select the most suitable writer for your assignment. While everything seems to be clear, the writer, who has complete knowledge of the subject, may need clarification from you. It is at that point that you would receive a call or email from us.
Writer’s assignment
As soon as the writer has finished, it will be delivered both to the website and to your email address so that you will not miss it. If your deadline is close at hand, we will place a call to you to make sure that you receive the paper on time.
Completing the order and download