THE NATURE OF NURSING ESSAY DRAFT
There are many key concepts and theories involved in sculpting the nursing profession which contribute greatly to creating a trusting, non-judgemental and caring relationship between nurse and patient. In this essay the concepts of Person Centred Care, the Fostering of Cultural and Spiritual Sensitivity and Compassionate Care will be discussed; as will how they can be incorporated into everyday nursing practice - while acknowledging some of the barriers and facilitators to their use.
PERSON CENTERED CARE:
WHAT IS IT/ ITS ROLE
The key concept of Person Centred Care is deemed crucial to be exercised by healthcare professionals to benefit the comfort, trust and relationships formed between nurse and patient. “Quality care is an ongoing challenge” as (Rajamohan,2019) stated, it needs patience, awareness and care to be effective. Being cared for dependently comes with the feeling of vulnerability for most patients who were once independent. Being vulnerable is a human condition (Henriksen & Vetlesen , 2000, cited Angel.S,2016). This can be a distressing time for patients which is why the use of Person Centred Care is necessary to comfort and attend to the patients’ needs. “Nurses are in ideal positions to hear and honour the wishes, hopes, and dreams of recipients of care.” Said (Parse.R.R, 2019.)
HOW TO USE IT:
In order to implement this practice into working life, one must first understand the patients individual beliefs, wishes, experiences and views while obtaining a healing, dignified and respectful environment. In failure to do so the patients quality of life and health outcomes are significantly decreased as Jefferies.D concluded (2018, Journal of Education).
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For a nurse, creating a healing environment is one of the key factors in implementing Personal Centred Care as well as working with management and as a team with fellow colleagues. This will encourage, motivate and improve not only the work environment but also the workers to preform to the best of their ability enthusiastically and confidently. In affect this will contribute to the care and mood of the patients. It is recognised that these improvements and changes are being implemented in hospitals and care homes. This is what keeps Lorraine Bailey to continue to be a committed and enthusiastic nurse as she reflects on the positive changes and developments made in the nursing practice over the past quarter century. (Harulow.S, 2001)
The aim of the nurse should be to encourage and help the patient carry out tasks as independently as possible, if helped correctly a sense of trust, understanding and honesty can be developed between both nurse and patient. A busy nurse may wash a patient herself/himself, who is in fact capable of carrying out such a task but may need some support or help, just to save time. This not only can demoralise the patients needs as a human being but also create medical problems and discomfort such as leg sores and ulcers. To avoid this a nurse should be aware of the patients’ limitations and encourage the patient to be as independent as possible.
Understandably, a nurse may face a barrier when trying to provide personal centred care to a patient if presented with an overcrowded ward on an understaffed night. Time and individual undivided attention to each patient cannot always be an option in these situations. If there is a lack of necessary supports or equipment available on a ward it may be deemed necessary for the nurse to carry out the task for the patient herself/himself. This can sometimes leave the patient with feelings of neglect and unimportance. It is during these times it’s most necessary to involve the patient in decision making and to be honest with patients. It is said by (Hoerger.M,2013) that patients tend to prefer open and honest communication which will result in the breakdown of barriers which may arise between nurse and patient.
FOSTERING OF 1.CULTURAL AND 2.SPIRITUAL SENSITIVITY
WHAT IT IS/ IT’S ROLE:
Another key concept to take account of during nursing practice is taking precaution and awareness of both the cultural and spiritual sensitivity of the patient. Similarly to Person Centred Care this should be done in a non-judgemental and respectful manner. In a study used to examine the importance of cultural and spiritual knowledge in nursing students in Sweden, three important stages were identified by Hultsjo.S, Lindstrom.M.B, Safipour.J and Hadziabdic.E (2018). These three stages consisted of 1.Desire to Learn, 2.Learning by Doing and 3.Caring Beyond Boundaries. Developing a sense of cultural and spiritual sensitivity is necessary to create an understanding, respectful and compassionate space as well as welcoming diversity. It is important for a nurse to be educated in their patients’ cultures and to understand the importance of their wishes and beliefs. In effect this will build a sense of trust and appreciation between patient and nurse.
HOW TO USE IT:
‘To care for someone, I must know who I am. To care for someone, I must know who the other is. To care for someone, I must be able to bridge the gap between myself and the other.’ – Jean Watson (Cited by Anderson, 1987)
To implement and fully understand cultural and spiritual sensitivity, communication is the most important factor. In correspondence to Person Centred Care communication can heighten the understanding and develop the nurses’ knowledge of both their patients’ ethical beliefs and customs. To achieve this goal, nurses and care facilities should cater and care for people of all ethical and cultural backgrounds and aim to incorporate these into the patients daily living regime while in professional healthcare. It is also prevalent that a nurse develops a non – judgemental sense of caring and avoids incorporating her/his own personal beliefs. “Recent studies show that people with greater religiosity or spirituality have a greater general well-being, lower prevalence of depression, lower consumption of illegal or legal drugs, lower incidence of suicide, better quality of life, greater survival, and shorter duration of hospitalization, among other associations.” – Tomasso(2011) cited: (Lucchetti G, Granero A, Bassi R, Latorraca R, Nacif S. Spirituality in clinical practice: what should the general practitioner know? Rev Soc Bras Clín Méd. 2010;8:154-8.)
As Aysha.M discussed in her article (2018), nurses’ beliefs can differ from patients’ beliefs and customs depending on a number of factors such as religious beliefs or upbringing customs. An example of this would be a nurse who was raised a strict catholic and is treating a transgender man or woman or a nurse who may have to perform an abortion. These actions that the patient wishes to preform may cause conflict with the nurses’ beliefs or moral values. This can lead to misunderstanding and lack of communication or empathy between nurse and patient leading to an unprofessional and uncomforting relationship. It is expected for a nurse to put all of her/his beliefs aside and to focus on the patients’ beliefs and customs at that present time even if it may be upsetting. Another aspect to acknowledge is neglect of a patients’ customs or religious values as a result of a nurse not prioritizing the patients wishes such as specific dietary needs or spiritual expression. To avoid this, communication is again prevalent. Communication is also prevalent in achieving Compassionate Care as a nurse.
WHAT IT IS/IT’S ROLE:
“Most nurses enter the profession because they are caring” (Corbin,2008). It is common for nurses to be naturally caring people from the beginning of their education as they chose the profession to care for those who are in need or in sickness. Compassionate care is one of the most important main key factors of nursing practice. It reflects the nurse as a person and also her/his ability to provide the correct care to a patient. The ability to empathise and to comfort patients continuously would be regarded as compassionately caring for the patient.
HOW TO USE IT:
Henderson.A and Jones.J (2017) explains in her article how important it is for a nurse to first discover their own “personal and professional values” and to understand how these can affect their “attitudes and behaviours” towards a patient. In order for a nurse to implement compassionate care she/he must first develop the skill of reflection. Difficulties can arise for a nurse who is unable to be self-compassionate. The skill of reflection has a huge impact on nursing as a profession. It enables a nurse to rethink and learn from their actions of that working day while also acknowledging ways to improve.
There are several ways in which barriers or obstacles may arise when using the key method of Compassionate Care; One of which has already briefly been discussed in cultural and spiritual sensitivity. Stephen.G’s article (2014), excellently discusses some of the main common barriers and obstacles which prevent the correct use of Compassionate Care. Poor work motivation, balance or poor communication between staff members can affect the level of compassion shown to patients and the nurse may be distracted or have high emotions of stress and frustration. The issue between genders may also arise as women are thought of to be more caring and compassionate towards patients. “They (women) tend to spend more time and communicate more effectively with their patients.” – Stephen.G (2014). Of course this is not true in all situations.
The purpose of this assignment was to examine the key concepts/theories that guide and inform the nursing profession. The concepts I focused on were Person Centred Care, the Fostering of Cultural and Spiritual Sensitivity and Compassionate Care. This assignment allowed me to develop a greater understanding of these key concepts and their importance. Seeing different views and opinions on each theory broadened my knowledge further.
- Angel.S & Vatne.S, 2016 (cited by Henriksen & Vetlesen, 2000), Vulnerability in patients and nurses, and the mutual vulnerability in the patient-nurse relationship. From Journal of Clinical Nursing, Issue.26, Pg.9-10
- Aysha.M (2018) Personal beliefs, culture and religion in community nursing care. British Journal of Community Nursing (BR J COMMUNITY NURS), 23(1): 46-47. (2p)
- Harulow.S, 2001. The working Life. Still Enthusiastic after 25 years. Jornal: Australian Nursing Journal. Chpt.8, Pgs.21.
- Henderson.A and Jones.J (2017) Developing and maintaining compassionate care in nursing, 32, 4, 60-69.
- Hultsjo.S, Lindstrom.M.B, Safipour.J and Hadziabdic.E (2018). Cultural awareness requires more than theoretical education - Nursing students’ experiences. Nurse Education in Practice (NURSE EDUC PRACT), Aug2019; 39: 73-79. (7p)
- Jefferies.D & Deborah.H, 2018. Developing Person – Centered Care Through the Biographies of the Older Adult. From Journal of Nursing Education, Chpt.12, Pg.742-746.
- Parse.RR, 2019,Nurses and Person-Centered Care. Vol.32, Issue:4, Pg.265
- Post.S.G, Ng.L, Fischel.J, Bennett.M, Bily.L, Chandran.L, Joyce.J, Locicero.B, McGovern.K, McKeefrey.R, Rodriguez.J, Roess.M (2014), Routine, empathic and compassionate patient care: definitions, development, obstacles, education and beneficiaries, Journal of Evaluation in Clinical Practice, Vol.20, Issue.6, Pgs.872-880.
- Rajamohan. S, Porock.D, Chang.Y, 2019,Understanding the Relationship Between Staff and Job Satisfaction, Stress, Turnover, and Staff Outcomes in the Person Centered Care Nursing Home Arena.
- Tomasso, Claudia de Souza; Beltrame, Ideraldo Luiz; Lucchetti, Giancarlo(2011), Knowledge and attitudes of nursing professors and students concerning the interface between spirituality, religiosity and health. Article: Revista Latino-Americana de Enfermagem (RLAE) (REV LAT AM ENFERMAGEM), 19(5): 1205-1213
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