Once I got the opportunity of caring for a patient who was 85 years old and was suffering from diabetes and osteoarthritis. He was obese with a BMI of 40. His son complained that his father had stopped taking medications. He had developed foot ulcer which had been infected now and constant pus was coming out. The healthcare team immediately started attending to his needs and developed a care plan in order to help him overcome his suffering. However, I noticed that although the healthcare professionals were trying their best to cure him from his symptoms, the patient was completely withdrawn. The patient was not communicating with any of the healthcare professionals and was not responding to the interventions as well. It was very important for me to understand why the patient was so withdrawn from the entire care episode. Gradually I started communicating with him. I used to often engage him in various kinds of conversations that included topics like his favorite food to his favorite hobbies, his favorite places, about books and sports, his experiences and many others. We communicated about both formal and informal topics that helped in developing rapport between us. Moreover, I often talked with him in an empathetic manner and with compassion that made him feel that I have understood his problem and trying my best to cure for him. This helped in developing a bond of mutual trust and respect with the patient. The patient gradually started participating in the care. It was after many days, he revealed to me that he no longer wanted to live as he had become frustrated and agitated living along and with so many disease burdens. This made me understand that he was psychologically and emotionally affected and that he needed a holistic care. Through continuous support and communication, I helped him develop self-management skills that helped him to learn to manage his conditions by himself and live better quality lives.
Caring can be defined as the human behavior that includes cognitive, affective, psychomotor and administrative skills showing empathy to others and helping in developing healthy life for the service users. As per Jean Watson’s caring theory, it is important for every nurse to establish a caring relationship with the patients and needs to show unconditional acceptance of the patient, his needs and well as his wishes irrespective of the background of the patient (Norman et al., 2016). The nurse needs to be authentically present with the patient during his times of suffering as well as during the recovery period as the constant companion providing encouragement and enthusiasm of the patient. The nursing process includes developing a caring environment that would ensure holistic health of the patient where the social, physical, mental as well as psychological health of the patients is ensured (Ozan et al., 2017). Evidence based studies are of the opinion that when nurses successfully develop a therapeutic relationship with patients, the adherence of the patients with the treatment increases. Patients are seen to be more empowered and they can successfully develop self-management abilities to take care of their own selves. Person-centered care mainly advises the nursing professionals to include patients in their own care by allowing them to take their own health decisions and also to participate actively in care planning (Munthe et al., 2018). Evidence based studies are of the opinion that person centered care helps the patients to feel that; the nurses care about their opinion and these makes them feel that their autonomy and dignity are respected. Patients start relying on the nursing professionals and they tend to work in a collaborative manner that brings out positive outcomes on their health.
Standards for practice by the professional includes the standard number 2 which discusses the importance of the nurses in engaging in a therapeutic as well as professional relationships with the patients (NMBA, 2016). Every nurse should try to establish and sustain relationship with patients and communicate with them irrespective of their backgrounds in ways so that people feel respected and cared. This standard also talks about the importance of recognizing that people are the experts of their own lives. Evidence based studies are of the opinion that when nurses develop therapeutic relationship with patients, their participation in the care increases. They tend to comply with the treatments that are set for them. (Poey et al., 2017). Another important standard is standard number 3 which discusses of the importance of maintaining the capability of practice. It also talks about the importance of providing information as well as education required for enhancing the control of people over the health (Tamagawa et al., 2016). It has been found that when patients are given detailed information about their disorders as well as their treatment interventions, they stress and anxiety gets relieved and that they are able to take active decisions about their own health.
Figure: Nurses need to become the best companions to patients in their suffering for they are the only members who can empower patients in living better quality lives through trust, respect and empathy (source: Clarke et al., 2019)
I have realized that it is important for the nursing professionals to not only focus on the physical condition of the patients. This is because interventions designed for developing the physical health of the patient can help the patient to get rid of symptoms but they can never ensure holistic care to patients. Therefore, as per Watson, it is important for the nurses to assess the physical, social, psychological as well as the emotional health of the people to understand their needs and to find out ways to provide best care. In case of my personal experience, I realized that the patient was not only physically ill but he was also not psychologically stable. He was emotionally broken own and therefore, in needed to lift up his spirit, therefore, through constant support, communication and my presence, I ensured that he can come out of this disturbed mental states and live better quality life.
Another important aspect is including the patient in his own care process. I believe that every patient as well as their family members should get the scope of actively participating in the decision-making process and take part in care planning as well. In this regard, the nurses should be first of all, ensure the principle of informed consent. The nurses should first share the information about the disorder of the patient in details and following that they should discuss the pros and cons of the treatments to patients as well (Malmberg et al., 2019). Following this, the nurse should be giving complete authority to the patients to take decision regarding their own health as this is their human rights. Every human have the rights to take decisions about their on selves. In this ways, nurses can not only respect the sanity and authority of the patients but they can also gain the trust of the patients. Patients feel respected and their coordination with the treatment increases. I will always try to include all my patients in active decision making sessions to make them feel that they are respected and that their opinions matter to us.
Another important aspect that is important for the care process is to maintain effective communication skills. The non-verbal attributes of communication like empathy and compassion by the professionals contributes to rapport development with patients. When nurses put themselves in the shoes of the patients, they can feel the sufferings and the concerns that the patients feel and this help them in providing better care to the patients. Empathy and compassion allows the patient feel that the professionals genuinely care about their health. This helps in developing an emotional bond built on mutual trust and respect and hence the collaboration of the patient increases. Patients feel happier and therefore this mental health condition as positive outcomes on their health.
References:
Clarke, P. N., & Fawcett, J. (2016). Nursing knowledge driving person-centered care. Nursing science quarterly, 29(4), 285-287. https://doi.org/10.1177/0894318416661110
Malmberg, L., Rodrigues, V., Lännerström, L., Wetter-Edman, K., Vink, J., & Holmlid, S. (2019). Service Design as a Transformational Driver Toward Person-Centered Care in Healthcare. In Service Design and Service Thinking in Healthcare and Hospital Management (pp. 1-18). Springer, Cham. https://link.springer.com/chapter/10.1007/978-3-030-00749-2_1
Munthe, C., El-Alti, L., Hartvigsson, T., & Nijsingh, N. (2018). Disputing with patients in person-centered care. Journal of Argumentation in Context, 7(2), 231-244. https://www.jbe-platform.com/content/journals/10.1075/jaic.18022.mun
Norman, V., Rossillo, K., & Skelton, K. (2016). Creating healing environments through the theory of caring. AORN journal, 104(5), 401-409. https://doi.org/10.1016/j.aorn.2016.09.006
Nursingmidwiferyboard.gov.au, 2016, Registered nurse standards of Practice, NMBA, Retrieved from: https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/registered-nurse-standards-for-practice.aspx
Ozan, Y. D., & Okumu?, H. (2017). Effects of nursing care based on watson’s theory of human caring on anxiety, distress, and coping, when infertility treatment fails: A randomized controlled trial. Journal of caring sciences, 6(2), 95. doi: 10.15171/jcs.2017.010
Poey, J. L., Hermer, L., Cornelison, L., Kaup, M. L., Drake, P., Stone, R. I., & Doll, G. (2017). Does Person-Centered Care Improve Residents’ Satisfaction With Nursing Home Quality?. Journal of the American Medical Directors Association, 18(11), 974-979. https://doi.org/10.1016/j.jamda.2017.06.007
Tamagawa, R., Groff, S., Anderson, J., Champ, S., Deiure, A., Looyis, J., … & Watson, L. (2016). Effects of a provincial-wide implementation of screening for distress on healthcare professionals’ confidence and understanding of person-centered care in oncology. Journal of the National Comprehensive Cancer Network, 14(10), 1259-1266. https://jnccn.org/abstract/journals/jnccn/14/10/article-p1259.xm
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