Simone Voigt
Writing Assignment 4
Nursing Research
NUR 3130-8516
Dr. Theresa Keane
New York City College of Technology
Fall 2012

I am a supporter of Jean Watson’s theory of human caring. I believe that caring is the essence of nursing and should be the “foundation” of a nurse’s work ethics.   A Caring Leadership Model for Nursing’s Future, The effectiveness of Watson’s Caring Model on the quality of life and blood pressure of patients with hypertension, and The Watson Theory of Human Care applied to ASPO/Lamaze perinatal education all also describe how patients benefit from Watson’s theory of human caring.  Unfortunately, I have as well witnessed internal and external barriers within nursing to displays of caring.  Some common external causes of these barriers are burn-out and a loss of trust among nurses to both their leaders and organizations.

There are three core principals of Watson’s theory that I stand by and practice: being supportive of expression of positive and negative feelings, engaging in genuine teaching-learning experience and cultivation of one’s own spiritual practices and transpersonal self (Williams, McDowell and Kautz, 2011).   I find that integrating these principals in my patient care help me to prevent barriers to giving caring nursing care.   A lot of times patients have negative feelings towards their current physical state.  These negative feelings are often ignored and even sometimes discouraged by nurses.  I find that nurses sometimes forget about the importance of supporting your patient through the good and especially the bad.  Whenever, I see a patient who is angry or depressed, I make it my goal to allow them to express what emotions they are feeling.  I presently work with a homecare agency.  One time I had a three year old patient and as soon as her mom left she started hysterically crying.  I instinctively took the little girl and held her.  She ended up crying until she fell asleep in my lap, as I rocked her.  When the little girl woke up, she gave me a simile.  To me that was her way of thanking me for staying with her and allowing her to express herself.

I always try to find out a patient’s usual care measures.  I develop my care plan around my patients usually health practices.  I find this to be a good way for the both of us to learn. I can use as much advice as possible, since I am a new nurse and a patient is more willing to learn when they feel like they are a part of their care.  I deal with patients with chronic illnesses and sometimes I find them and their family to be the best teachers.  The first patient that I had was a two year old girl.  The girl’s mother gave me tips on how I should prepare medication and on her daughter’s treatment.  I was able to provide more efficient care thanks to the mother.

Cultivation of one’s self to me means reflecting on one’s values and experiences. Reflection is sometimes needed in order to prevent one’s feelings from transgressing into their work.  I didn’t realize how important reflection was until I had to work with this 19 year old girl.  I had a cousin around her age that I never got along with. I always found my cousin to be disrespectful and rude. When I received a report of the 19 year old having behavioral problems, I was already anticipating a hard day’s work. Just as I expected the patient was very similar to my cousin. I found myself getting frustrated easily.  I couldn’t even bare making eye contact with her. It wasn’t until my next day of work that I noticed that I was displacing feelings, I felt towards my cousin to my patient.  I realized this when I noticed my facial expression in her bedroom mirror and my patient’s response.   I had to make myself aware of my feelings in order to allow myself to form a caring connection with my patient.  I noticed that as my frustration decreased, my patient’s rudeness decreased.  I learned self-actualization, self-healing and self-control from this experience.

Barriers to displays of caring have trickled in from the nursing shortage.  One barrier that has developed is burn- out.  Williams, McDowell and Kautz state, “Too many nurses are mentally and physically exhausted and have difficulty caring for themselves and for each other, let alone their patients”.  The nursing shortage has left nurses with enormous lists of tasks. This has caused some nurses to feel too tired to care.  The nursing shortage has correspondingly caused a shortage of nurse managers, who are not grooming staff nurses to take on the leadership role when manager turnover occurs (Williams, McDowell and Kautz, 2011).  This is creating a loss of trust and confidence among staff nurses to their leaders and organizations.  If you don’t have leaders to care and guide nurses, how can you expect nurses to care for patients?

In The effectiveness of Watson’s Caring Model on the quality of life and blood pressure of patients with hypertension, and The Watson Theory of Human Care applied to ASPO/Lamaze perinatal education the benefits of Watson’s theory of human caring on patient care was explored. In The effectiveness of Watson’s Caring Model on the quality of life and blood pressure of patients with hypertension, the authors are interested in seeing the impact that nursing caring relationships had on hypertensive patients’ quality of life.  The results showed that there were statistical significances in general well-being, physical symptoms and activity, medical interaction and blood pressure (Erci, Sayan, Tortumluoglu, Kilic, Gungormus, 2003).  The implications of study suggested that there was a relationship between care given according to Watson’s Caring model and increasing quality of life and decreasing a patient’s blood pressure. Meanwhile, The Watson Theory of Human Care applied to ASPO/Lamaze perinatal education explored the benefit of applying Watson’s Caring model to perinatal education.  Watson’s theory is applied to child birthing education courses to inform families of alternative health care options and empowering them to make positive personal choices that will support wellness and health promotion (Capik, 1997).  Further studies are needed to explore the relationship between childbirth education course and Watson’s theory.  The Watson Theory of Human Care applied to ASPO/Lamaze perinatal education has provided guidelines for Watson based childbirth education.

Nurses should always remember that when they are performing patient care that patients are human beings.  Patients deserve empathy, warmth, and sincerity.  Nurses can make the difference between a patient feeling despair or hope.  A caring nurse is able to enrich the soul.  I find this is the basic underpinning to Watson’s Caring model.  If Watson’s principals are practiced in nursing care, many barriers towards exhibiting transpersonal human care could be avoided.

References

Capik, L. (1997). The Watson Theory of Human Care applied to ASPO/Lamaze perinatal education. Journal of Perinatal Education,                6(1),1 – 9. Retrieved November 27, 2012, from the CINAHL database.

Erci, B., Sayan, A., Tortumluoglu, G., Kilic, D., Sahin, O., & Gungormus, Z. (2003). The effectiveness of Watson’s Caring Model on the   quality of life and blood pressure of patients with hypertension. Journal of Advanced Nursing, 41(2), 130 – 139. Retrieved November 27, 2012, from the CINAHL database.

Williams, R. L., McDowell, J. B., & Kautz, D. D. (2011). A Caring Leadership Model for Nursing’s Future. International Journal for    Human Caring, 15(1), 31 – 34. Retrieved November 27, 2012, from the CINAHL database.

 

Group Discussion

Negative economic impact and adverse effects on health outcomes have prompted clinicians to address noncompliance through a change in approach called partnering.  Partnering with the patient in decision making requires more than having the patient’s agreement with activities an interventions outlined in the plan of care (POC).  Huffman wants healthcare practitioners to shift their attitudes from patient compliance to adherence and concordance, both of which highlight a patient’s right to autonomy and mutual agreement. Partnering entails a token effort by both parties and it requires a mutual sharing of responsibility for the patient’s health.

 Steps for form a partnership with patients are listed in compliance, health outcomes, and partnering in PPS: acknowledging the patient’s agenda.  The first step is getting to know the patients beliefs and feelings towards their illness.  Opening the door of discussion about beliefs related to the illness gives the patient an opportunity to share personal concerns and cultural values.  Secondly, the health provider must make sure they approach the patient in a nonjudgmental and friendly manor.  Thirdly, commitment from the provider and patient is needed.  It is important to allow for the patient to be an active member of their care. This increases their commitment to their care.
Some strategies that can help improve compliance are include: patient self-management, patient and caregiver education, assistance with medication management, and effective communication and follow-up. Self-management can be encouraged by recognizing patient and caregiver strengths and priorities, and asking open-ended questions to understand the patient’s perspective of his or her condition. Providing simple, clear messages, tailored to the individual and verifying that the messages have been understood is key to successful patient education. During the assessment of medications, it is important to uncover any preconceived notions, fears, misconceptions, or myths that the patient has about the condition. Follow-up allows for caregivers to convey concern for the patient’s well being  as well as allowing for an opportunity for the clinician to solicit questions and provide encouragement.
I believe that health care providers can enhance compliance with prescribed regimens and achieve desired outcomes by partnering with patients and caregivers to make healthcare and treatment choices.  I work in the home care setting and I find that patients a lot of times do not follow their prescribed treatment.  A lot of times these patients are defense and hide how they manage their health conditions.  Some of the strategies listed in this Compliance, health outcomes, and partnering in PPS: acknowledging the patient’s agenda  are useful to improve adherence.  I find that once you take the time to understand a patient’s feelings and beliefs about their condition, you are better able to navigate an acceptable plan of care.  It is also important to know your patient’s schedule. This way the patient’s treatment plan can be made according to their lifestyle.  Patients are more receptive when their care is flexible and comprising.