Evaluation of Nursing as a Human Science

INTRODUCTION

Nursing is a healthcare profession that is structured and requires discipline. Nurses play a vital role in the healthcare field and thus no healthcare facility can function without their nurses. Nursing which was lowly regarded back in the days is now a highly esteemed profession in the healthcare field. Nursing is practiced based on knowledge gathered from sound research into the health science and also natural and social sciences. Nursing as a result has become a human science that focuses on the humaneness of the person and seeks to provide a patient centered care which is directed towards improving the life of a unique individual (Hopkinson& Hallett, 2001). However, the individual is able to express his needs, preferences and exercise control over the care that he/she receives. This paper focuses on nursing as a human science and its relevant applications.

NURSING AS A HUMAN SCIENCE

Paterson and Zderad (2008) define nursing, as a response or a feedback to a human situation. This situation is usually witnessed in scenarios whereby the patient in this case relies on the nurse for a much needed assistance. It employs a holistic approach rather than a conventional approach to treating the patient. Nursing as a human science to put it basically is an intersubjective experience or interaction between two or more individuals (the nurse and the patient) in which the nurse provides the patient with the care that he/she needs. Both individuals involved in this experience are able to affect and influence each other. They are both depending on each other to achieve the optimal health of the sick patient. The goal of this humanistic approach to nursing and nursing as a human science is to achieve the ideal health of the patient rather than just focus on the diseased-medical state of the patient. The focus of nursing as a human science is patient centered. It focuses on the well-being and ‘more-being’ which is the overall health of the patient. It goes beyond just the well-being which is medicine focused and geared towards ridding the body of disease but rather  focuses on the more being which is well-being and overall outlook of the patient- a holistic approach. Nursing as a human science is characterized by its authentic commitment, call and response, inter-subjectivity, individuality, interpersonal relationships and so forth.

To be committed authentically to a situation is when the nurse becomes involved with the patient, personally and professionally and is truly there for the patient in the moment. It is goal directed and requires genuine commitment from the nurse.  Since nursing as a human science is an inter-subjective transaction, it is characterized as a call and response. The nurse is there to respond to the patient’s needs in order to achieve the optimal health. The nurse also recognizes the uniqueness of each patient and thus tailors care to meet each specific need. The nurse provides health education, health promoting behaviors and prevention tips to the patient in addition to providing the expected medical care.

NURSING DEPARTMENT PHILOSOPHY

The philosophy of the Department of Nursing at Lehman College seeks to evaluate and treat patients’ responses to the actual problem not the potential problem. It does not rely on just medical, dependent or independent nursing interventions but rather it is based on a collaborative effort involving the patient and his family, the nurse and the rest of the other health care team. The goal of the nursing is to recognize and promote the wellbeing of the patient through activities as health teaching, counseling and providing assisting care. The nursing department philosophy relates to the theory of nursing as a human science in that it is patient centered and recognizes health as not just the absence of disease but looks at health as the overall wellbeing of the patient.

CONCEPT: CALL AND RESPONSE

Call and response is a concept of humanistic nursing theory that is defined as a two way transactional exchange between a nurse and a patient in which the patient is expecting to be cared for and the nurse is expected to be needed. With call and response, there is an expectation from both sides of the aisle. The nurse is aware of his/her own worldview, values and understand herself and the patient. The nurse engages in a therapeutic exchange with the patient with the end goal of obtaining the utmost health of the patient.  According to Paterson and Zderad (2008), nursing is a purposeful call and response that is related to giving help in regards to health and illness.  Call and response is an exchange when initiated in the right way, at the right time and in the right context, will lead towards achieving the maximum health of the patient.

Hopkinson and Hallett (2001) discuss the concept of call and response as satisfaction with care provided as evidenced by healthcare providers responding to the individual concerns of terminally ill patients. The terminally ill patients responded that the care they received were more than they expected. They reported feeling comfortable, welcome, understood and less isolated due to the fact that the providers were able to meet their expectations in the hospice care. The humanistic care that they received helped support them with their terminal cancer, enhanced their self-worth and reduced their feelings of being isolated. Additionally, the concept of call and response in relation to nursing as a human science can be evidenced in the reflections in Wit movie, Sentimental Woman, the self-concept paper and experiences throughout clinical rotations.

As a nursing student, clinical rotations are a prime way to gain experiences. You run into nurses who inspire you and motivate you to keep following your dreams to become a nurse whereas other times, you run into nurses who make you question your decision of going into the nursing field. I happen to have been fortunate to have nurses who inspire me to learn more and appreciate the field of nursing. They always say, “Sure the money and the benefits aspects are there but if it were money alone, then we will be doing something else”. This saying reminds me of the concept of call and response which is encountered almost every day in the hospital. An example of call and response was encountered at one of my clinical rotations working with nurse V.  Throughout the course of the shift, she was providing care for a high risk fall patient who is also a vegetarian. Consequently, Patient C had been advised by nurse V to use the call bell if she needed anything and not to walk around on her own. Patient C dutifully followed Nurse V’s order. She called during lunch time when she was served meals without the fruits and vegetables she requested. She called and I responded to her call by visiting the pantry and checking with the nurse if it was okay to give her the fruits she requested. I was able to meet her needs. She reported being satisfied with the care she received throughout the course of the shift.

Another experience during clinical rotations was when I was assigned to a patient who spoke my dialect- Twi. She was having a difficult time describing where her pain was originating from, her food preferences and what she wanted to be done for her. There was a communication barrier between her and the healthcare providers as they did not understand what she was saying. Before I met her, she was saying that she just wanted to go back home and die. She did not want to stay in someone’s country and die. After she realized I was able to understand and communicate with her, she felt more comfortable talking to me and asked me to relay her sentiments to the healthcare team. She was given pain medications to alleviate her of her pains. She had a need that needed to be met and I was able to respond to her need. The patient after having her needs met was more receptive to receiving medical care from the healthcare team.

In the movie, Wit (2001) that supports this concept of call and response is when Ms. Bearing is undergoing treatment with no support from family and friends and no empathy from the healthcare professionals around her. Technically when someone is undergoing a life changing event, support from family and friends and those around him/her can make the person more receptive to healthcare interventions. Nurse Susie uses the call and response approach when she tells Ms. Bearing to use the call bell if she needed anything and also when she availed herself by offering to pop in to the room once in a while to check on her. This little effort that she put into her care made Ms. Bearing a little more receptive to improving her health. On the other hand, Ms. Bearing complains of feeling isolated when the medical providers were focused on her pathology rather than her as a human being with feelings. This conventional medical approach led to detrimental effects on Ms. Bearing’s health. She felt humiliated and isolated.

Lastly, an example that supports call and response is seen in Sentimental Woman. As I watched and reflected on the movie, I realized how call and response concept is integrated in the movie. The inexperienced and untrained volunteer nurses met the needs and expectations of the wounded service men by washing their wounds, feeding them and also writing letters for them. The untrained nurse somewhat irrelevant was able to meet the need of the wounded men. These simple things yielded profound results. The patient presented with a need and the nurse met those needs.

VALUES AND MEANINGS

“Do to others as you would like them to do to you” (Luke 6:31, New Living Translation). This is the golden rule in the New Testament’s bible based on Jesus’s teachings. Basically it translates as, “do not do something that you do not want to be done to you”. For example, do not gossip about someone when you know that you do not want someone to gossip about you. This is a rule that I also live by. When it comes to nursing, I treat my patients the way I would want myself or a family member to be treated. During clinical rotations, I try to do my absolute best for the patient and give the patient my utmost respect regardless of the treatment I receive from the patient. During the transactional interaction with the patient, as a nursing student, I do my best to be there for the patient and respond to his needs in the best way that I can. I respond to the needs by answering the call bell, fetching a cup of water, calling the nurse or just by staying with the patients and listening to them talk. Sometimes, the satisfaction we gain from responding to a patient’s call is what pushes us to treat and give the patients our absolute best.

Also, I believe in the diversity and the uniqueness of each individual or patient. There is no one standardized method of caring for all patients. Patient A might respond differently to the care provided to Patient B. Care has to be tailored to meet each individual need. Therefore as a nursing student, I meet the patient’s needs by responding to their uniqueness-their call. What I do for patient A will be different from what I do for patient B.

CONCLUSION

Nursing as a human science is based on Paterson and Zderad’s theory of humanistic nursing. It is a holistic approach that focuses on the care of the overall health of the human as opposed to traditional and conventional medical approaches which focuses on the pathology and disease state of the patient. It involves characteristics like the well-being and more being of a patient, call and response, inter-subjectivity, and interpersonal relationships. Humanistic nursing takes into consideration the uniqueness of each individual. Care is tailored towards each patient’s individuality and needs. Intervention provided for patient A will not work the same way for Patient B. The nurse also seeks to provide the patient with health promoting and health prevention tips to the patient in order to achieve the best possible health not just the absence of disease. In conclusion, one can say I am not my disease when looked at health and the patient from the humanistic nursing lenses and nursing as a human science relating it to the concept of call and response.

REFERENCES

• Department, L. C.-N. (n.d.). Philosophy of the Nursing Department. Retrieved from http://www.lehman.edu/academics/health-human-services-nursing/nursing/documents/Undergraduate-Student-Handbook-updated-2016-2018.pdf
• Hopkinson, J. B., & Hallett, C. E. (2001). Patients’ perceptions of hospice day care : a phenomenological study, 38, 117–125.
• McCamant, K. L. (2006). Humanistic nursing, interpersonal relations theory, and the empathy-altruism hypothesis. Nursing Science Quarterly, 19(4), 334–338. https://doi.org/10.1177/0894318406292823
• Nichols, M., Thompson, E., Bosanquet, S., Lloyd, C., Atkins, E., McDonald, A., Woodward, J. M., HBO Video (Firm). (2001). Wit. New York, NY: HBO Home Video.
• Paterson, J. G., & Zderad, L. T. (2008). Humanistic nursing. NLN Publications. Retrieved from http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=med3&NEWS=N&AN=3357765