Healthcare Professionals: Nursing, Application of Theory - Essay Example

?Application of Theory Introduction The literal meaning of the word ‘nurse’ as described by the Sage online dictionary as a noun is “a woman who is custodian of children/one skilled in caring for young children or the sick”, and as a verb it is described as an action to “try to cure by special care of treatment, of an illness or injury” (Sage). Healthcare professionals include physicians who may be super specialists in their respective fields, technicians, paramedics, diagnostic and laboratory technicians, hospital administrators, health insurance providers and others. All these professionals perform their respective and essential roles with integrity and dedication. However, the delivery of their services is in a detached manner, in which they have minimal physical and social contact with the patient. The nurse however is deeply involved at all stages with the patient, and has a stellar role to play throughout the recovery process, even after discharge. The nobility of the profession, already exemplified by Florence Nightingale, has been firmly established. The tremendous developments in science, education, medical techniques and information technology during the last and the present century have brought forth new concepts, Ideologies and roles for nursing as well as other professionals. An important aspect during this period has been the identification, conceptualization and practical application of numerous nursing theories’ which have established themselves as hallmarks for the nursing profession. A nursing theory has been defined as the body of knowledge that is used to support nursing practice with most of the presently recognized twenty theories’ generated in the last 20 years, with new concepts being identified and added continuously(Web). Nursing theories have been pictorially visualized as a tree whose trunk is represented by Florence Nightingale’s whose significant contribution to the reduction of mortality in soldiers’ during the war in Turkey and efforts to bring about an association of nursing with spirituality, devotion and knowledge revolutionized the way nurses were looked at in society as well as the manner in which they operated (Tourville, 2003). Based on the strong foundations laid down by Nightingale, numerous nursing professionals have contributed to the development of this virtual tree whose roots have been described as the four meta-paradigms defined as person, environment, health and nursing (Tourville, 2003). Each subsequent contribution to the knowledge on nursing theories’ has been attributed to individual nursing practitioners’ who made a significant impact on the subsequent school of thought in the profession. Jean Watson, who came up with the idea of her ‘carative theory’ in the latter part of the twentieth century has held great appeal in the subsequent years. Watson was influenced by philosophy and thoughts of eminent psychologists and personalities such as Carl Rogers, Yalom, Chardin, Sartre and Kirkland (Tourville, 2003). In addition she had vast experience in the nursing profession in multinational and multicultural environments. Watson relegated the scientific and medical aspects of healing to an altogether different aspect which she labeled as ‘Trim’ and stressed upon ‘caring’ for the patient as the most important aspect. She appealed for the nurses’ to treat themselves with gentleness and dignity while establishing a deep, caring relationship with the patient. She felt that the caring attitude of nurses’ as been buried under the technical aspects of healthcare. Unless and interpersonal relationship is established between the patient and the nurse, it is difficult to justify one’ duty as a nurse. The crux of her ‘carative factors focuses on unselfish concern for every human being, instillation of faith and hope in the sufferer, cultivation of sensitivity towards self as well as others, developing a helping attitude to strengthen trust, encouraging the patient to express freely, decision making through a problem solving technique, promotion of teaching and learning, building a supportive aura in the environment and allowing for existential-phenomenological forces (Tourville, 2003). Watson’s theory of care is completely valid, as a suffering patient, especially the ones with critical injury or terminal diseases are alone, in great pain and in dire need of consolation and solace. The attending nurse is the first person who can offer some semblance of concern for the patient and a carative attitude can work wonders in most circumstances. Theories developed after Watson, such as the one’s by Joyce Travelbee, Katharine Kolcaba, Rosemarie Rizo Parse and Ernestine Wiedenbach also address similar issues on patient care with a humane attitude just as Jean Watson has suggested(Web). In fact, most of the nursing theories, beginning from Florence Nightingale and ranging from Dorothea Orem’s self-care theory pinpoint the strong bond and relationship that should exist between the patient and the nurse, for effective healing of the ailment as well as the psyche. The bond does not cease to exist after a patient is cured or has to leave the hospital but carries on as an affectionate human relationship. Expression of concern for the patient at hand, establishment of trust, instilling the patient with courage and caring with dedication are therefore essential features of modern nursing practice. Application of Selected Theory to Professional Area The Intensive Care Unit (ICU) has a solemn atmosphere where patients requiring utmost care are housed during their hospital stay. Some of them are in great pain while others are in semi comatose or comatose states with life support systems inextricably entangled with their body parts. The psychological state of such patients is hard to imagine unless one has been in a similar situation. The pain in their eyes and the numbness in their limbs and body can easily be discerned by an expert eye. If anybody is in dire need of care, this is the location which cannot be ignored. Jean Watson’s theory of a carative attitude assumes great significance in the ICU. As close relatives and friends are seldom permitted into the ICU, the attending nurse is the only one whom the patient can look forward to for succor. The duty of a nurse therefore assumes prime importance. The experience can be a psychologically damaging and traumatic one for both the patient as well as the caregiver. Leaving aside patients of traumatic injury, who are incumbents to the ICU out of sheer misfortune and accidents, most cases that are encountered within the premises of an ICU are those suffering from congestive heart failure, end stage liver, kidney or heart failure, and those suffering from incurable terminal diseases such as cancer of any vital organ. In most cases such patients belong to the geriatric group with eventual death staring them in the face due to poor prognosis. For taking care of such patients the nurse has to assume almost a religious hue in order to provide them in any solace in this dire hour of need. It is not surprising, therefore, that theology based nursing theories have also been put forward and discussed, such as the one’s by Ann Bradshaw and Katie Eriksson (Lundmark, 2007). The idea of religious devotion in imparting duty as a nurse was not foreign to even Florence Nightingale, who suggested the profession as a vocation linked with divinity. Within an ICU, it therefore becomes even more important for the nursing professional to establish trust, display a caring attitude and prepare the patient for the stark reality staring him or her in the face. The process has to be an ongoing one with not a single instance of the patient feeling neglected. The meaning of Watson’s carative theory therefore becomes clearer in such a situation. Real Life Example of Theory Jean Watson’s nursing theory not only describes and enumerates the various facets and importance of a carative attitude, but also prescribes it as an essential element of good and ethical nursing practice. In the present era of evidence based practice, availability of knowledge sources at the click of a mouse and continuing advancement of professional skills and abilities due to training programs, a nurse is prepared to handle the specialty of her choice with great confidence. Exposure with patients suffering from similar conditions and similar dilemmas gives them the experience to handle patients with end-stage terminal diseases. For nurses practicing in ICU's, prolonging the living-dying process in patients' suffering from terminal diseases with inappropriate measures is a distressing ethical dilemma (Robichaux & Clark, 2006). For example, in an old patient with end stage renal failure and cardiovascular comorbidities and diabetes, not amenable to cure by any means, preparing the patient for a dignified death is the only option left, which has to be communicated to the patient and relatives, according to the readiness and willingness of the patient to understand the grave situation. Some patients may be ready for the inevitable, but the nurse's professional limitations prevent her from acceding to the demand, although she is the only one who can recognize the patient's inner desire. The nurse has to ensure that no false optimism is shown by making believe that the available medical procedures or facilities may provide relief. Such measures delay the initiation of palliative care and prevent the nursing professional from providing moral support, which is the need of the hour. Palliative care in such cases has to be initiated at the right time so that the misery experienced by the patient as well as the relatives is reduced to some extent. The nurse has to assist the patient as well as the relatives to overcome their sorrow, at the same time informing the attending physician/s and the institutional ethical committee of the patient’s situation and desire. Gaining the confidence of the patient is the first and foremost duty of a nurse and is the first sign of care which the patient interprets. Other things follow one after the other and the nurse can utilize her knowledge and experience to educate the patient about the reality of the situation without implying much about the complications of a condition. Such measures are bound to instill faith in the patient and make him or her face the daunting situation with courage. Displaying sensitivity and a helping attitude can eliminate apprehension and fear from the patient’s mind. Allowing the patient to express freely can enable the nurse to understand the needs on a continuous basis which can assist her to take appropriate evidence based decisions according to her education and professional competence. Some authors’ have even gone as far as to state that nursing theories created so far are on the verge of being identified as having philosophical nuances to the point of them being considered as nursing ontologies (Flaming, 2004). The authors’ visualized an increasing role of philosophy in nursing practice which they believe might reflect the experience of being a nurse. Conclusion The nursing profession has come to be recognized as a vital component of the modern healthcare delivery system, a far cry from the derogatory status they had at the beginning of the twentieth century. Towards the end of the same century, numerous nursing theories have been built upon the sound foundation laid down by Florence Nightingale. In this mechanical age, it becomes all the more relevant to reawaken the human bond between the nurse and the patient. Jean Watson’ carative nursing theory therefore reminds one of the vitality of establishing a human bond with the patient and administering professional services in a spiritual and dedicated manner so as to alleviate human suffering in the right manner and context. References Flaming, D. (2004). Nursing theories as nursing ontologies, Nursing Philosophy, Vol. 5, pp. 224-229 Lundmar, M. (2007). Vocation in Theology-Based Nursing Theories, Nursing Ethics, Vol. 14(6), pp. 767-779 “Nursing Theories” (Web). Retrieved June 1, 2011 from: http://currentnursing.com/nursing_theory/ Robichaux, C.M. & Clark, A.P. (2006). Practice of Expert Critical Care Nurses in Situations of Prognostic Conflict, American Journal of Critical Care, Vol. 15 (5), pp. 480-489 Tourville, C. (2003). The Living Tree of Nursing Theories, Nursing Forum, Vol. 38(3), pp. 21-36 Read More