The Essential Concepts of Nursing - Essay Example

The Concept of Coping Not everyone will be able to respond positively in times of crisis. Patients in healthcare settings in particular could face undue stress due to the physical and the emotional demands of those traumatic situations. In order to alleviate this stress, coping mechanisms are fundamentally needed. Nursing interventions play a significant role in promoting effective coping mechanisms for the patients, who might habit themselves with maladaptive or ineffective stress management. As the concept of coping manifests itself differently from person to person, it is essential for the nursing staff to figure out the right coping strategy for each. This paper aims at providing an exploration of the concept of coping and the way it impacts the lives of persons with chronic illness. The attributes of this concept and nursing intervention are discussed with relevance to the book, At the Will of the Body written by Arthur Frank (2002). Furthermore, the paper discusses how the connotations in the book influence nursing practices, in particular to the concept of coping. Frank (2002) details the health challenges he faced, reflecting on his journey of pain, endurance and illness experiences that transformed him to cope with the traumatic situation. One of the concepts of coping strategies that he stresses is the process of coping with grief as it is essential for patients with chronic illness to move to the stage of renewal and recovery from their emotional burdens. Frank clearly expresses how patients are disturbed and affected, when their mourning is limited, and what this restriction does to their emotions when disregarded by the external factors. His distinction between disease and illness sheds light on the fact that treatment of the disease of the body is not the same as the care for the illness experience of the patients living in the collapsed state. “Illness is the experience of living through the disease” (Frank, 2002, p. 13). Frank’s illness expresses the importance of sharing and emotional support, and what happens when it is delivered efficiently for the patients by their caregivers and medical professionals. Coping can be defined as the “constantly changing cognitive and behavioral efforts to manage specific external and internal demands that are appraised as taxing or exceeding the resources of the person” (Contrada & Baum, 2010, p. 197). Coping is a holistic phenomenon which involves physical, psychological, emotional and social perspectives that possibly impacts individual behaviors. Moreover, coping involves the ability of the person to manage traumatic and stressful situations, thereby minimizing, avoiding or tolerating those stressful events. “Coping is conceptualized as purposeful responses that are directed toward resolving the stressful relationship between the self and the environment (problem-focused coping) or toward palliating negative emotions that arise as a result of stress (emotion-focused coping)” (Lerner & Steinberg, 2009, p. 573). These definitions reveal certain key attributes of coping which are worth emphasizing. Coping is a changing process; it is the outcome of emotions, and it involves cognitive, behavioral and emotional responses for the adaptive behaviors. Mostly, the antecedents of coping is comprised of a combination of inward traits as well as external factors, and these includes the individual’s perceptions, life experiences as well as the availability of adequate resources and assistance of support groups like caregivers and nurses. In addition, the concept of coping and stress appraisal depends upon the individual’s capacity, along with certain attributes determining the coping strategies. These attributes include the calm effect, appropriate use of resources, effective communications and the patient’s ability to perform the activities of daily life. When a patient is efficient in dealing with these attributes, it is easier for him or her to manage the traumatic situation. “Eliminating personal stress appraisals (particularly perception of threat), however, is dependent upon a combination of an individual’s personal strengths, the environment, organizational structure, and/or the coping abilities of nurse managers” (Shirey, 2006, p. 30). The fact that the response to stressful situation differs for each individual shows that the concept of coping cannot be treated as a single dimension and it has to be related to various external and internal factors. The understanding of the situation, the influence it exerts on the patient’s behavior and how the individual responds to the stressors is important for determining the coping strategies. “Coping is an individual response, and while different people may have different innate abilities to cope, the behaviors and skills associated with coping can be learned and refined” (Cutcliffe & McKenna, 2005). It implies that the concept of coping is multi-dimensional, focusing on varied attributes such as the individuals social integration, threat minimization, resource availability and personal experiences. Problem-focused and emotion-focused coping, assimilative and accommodative coping, preventive, anticipative and reactive coping are a few of the distinct multi-dimensional approaches that can be suggested as efficient coping mechanisms to deal with chronic patients. In his narrative, Frank stresses the fact that coping is a personal transition that requires continuous cognitive and behavioral adaptations over time towards the changing circumstances. The important attributes that can be identified with Frank’s illness are a positive expression of feelings, effective coping mechanisms with the support from the caregivers, leading to a mastery of feelings. Moreover, the acceptance of a situation and an optimistic approach towards life’s experiences are also important for an individual to overcome the traumatic experience. In the context of the book, it could be observed that Frank faced negative experiences and emotional pain from the lack of effective doctor-patient relationships in the healthcare organization. This is the reason why he implies the importance of the healthcare staff in not only physical treatment of patients but importantly in emotional management as well. According to Frank, nursing interventions can deliberately help the patients in coping with the stressful situations through constructive means. “The way of response to stress in nursing staff depends not only to the personality of the individual and one`s defensive styles but also the healthcare work environment” (Laal & Aliramai, 2010). Nevertheless, Frank suggests that nursing professionals are less inclined to empathize with the grievances of the patients, dismissing their anger, sadness, fears and tears, which are necessary ways to cope with the situation. However, the concept of coping can differ with the individuals capacity to respond and recover from a crisis, owing to emotional vulnerability, hardiness and optimism. It is the responsibility of the nursing practitioners to help the patients to adapt and overcome the problem by adopting customized coping strategies. This concept of coping with grief, on the part of the patients, has to be actively supported by the nursing practitioners to improve the healthcare delivered to the patients on an emotional level. Since the patient outcome is greatly influenced by the nursing practice, an in-depth knowledge about the physical, psychological and emotional problems of the individuals would help the nurses to deliver an effective nursing care. “Both painful problem solving and positive reappraisal are coping methods that can be enhanced through increased educational preparation and work experience.” (Gholamzadeh et.al, 2011). On reading the book, as a nursing intern, i could get a clearer perception towards the illness experiences, which would in turn help me in providing a supportive counseling with an emphasis on alleviating the stress and anxiety among the patients. The required understanding that any nursing professional ought to have for the efficient patient care can be acquired from the Frank’s story of coping with illness. Recovery and renewal becomes more meaningful when illness experiences are shared openly, without the fear of embarrassment and social stigma. According to Frank’s experiences, coping with grief is the way for the patients to speak out their fears, anxiety and frustrations, ultimately helping them strengthen their values with closer relationships and poignant appreciation. From the perspective of nursing, the book suggests lot many issues that could help in providing better illness care to the patients. I learnt that analyzing the roots of the emotional problems of the patients is essential and it could be done by appraising the individuals cognitive and emotional ability to manage the situation. Since nursing practice has a substantial influence on the coping mechanisms of the patients, I need to deliver an effective support and care towards the patients which would bring positive changes to the patients’ recovery. To sum up, the target goals for the nursing practitioners have to rely on promoting and maintaining wellness at the same time preventing or alleviating the distress the illness experience can cause. References: Contrada, R & Andrew, B. (2010).The Handbook of Stress Science: Biology, Psychology, and Health. New York: Springer Cutcliffe, J. R. & McKenna, H. P. (2005).The essential concepts of Nursing: Building blocks for practice. London: Elsevier Health Sciences. Frank, A. W. (2002). At the Will of the Body: Reflections on Illness. London: Houghton Mifflin Harcourt. Gholamzadeh, S, Farkhondeh, S and Fereshteh, D. R. (2011). “Sources of occupational stress and coping strategies among nurses who are working in Admission and Emergency Department in Hospitals affiliated to Shiraz University of Medical Sciences, Iran.” Iranian Journal of Nursing and Midwifery Research 16 (1): 42. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3127386/ Lerner, R. M. and Steinberg, L.(2009). Handbook of Adolescent Psychology, Individual Bases of Adolescent Development. New York: John Wiley & Sons. Laal, M & Aliramaie, N. (2010). “Nursing and coping with stress.” International Journal of Collaborative Research on Internal Medicine & Public Health 2 (5):168-181. Shirey, M. R. (2006). “Stress and coping in Nurse Managers: Two decades of research.” Nursing Economics 24 (4): 193. Read More