NR 451 Week 1 Graded Discussion Topic: Our Care Culture
This week's graded topic relates to the following Course Outcome (CO).
CO1: Applies principles
... [Show More] of nursing, theories, and the care philosophies to self, colleagues, individuals, families, aggregates and communities throughout the healthcare system. (PO#1)
Care expressed and practiced in professional nursing models provides a way of looking at the nursing role from the aspect of care. It may seem excessive to consider aspects of caring and compassion in nursing. However, precisely because it IS nursing makes it crucial to our continual progress of defining and upholding one of our central professional principles.
Address each of these items:
• Reflect on a caring and compassionate experience with a patient or family encountered in your practice. How was your compassion demonstrated? What other ways do you wish you would have expressed caring?
• How does your thinking about compassion expand to include self and colleagues?
Please complete the iCARE Self-Assessment (Links to an external site.)Links to an external site. and download for your own use and information. The self-assessment is not a graded item.
ANSWER
A recent experience was with a patient who was in his late twenties. He was withdrawing from opioids (oxycodone, Fentanyl.) He was fearful of returning to his family unit where substance abuse was part of the fabric of his family life. His mother was a high functioning alcoholic and his father smoked marijuana on a daily basis. When I was rounding on him, he had just found out his girlfriend was breaking up with him because she knew if he went back home, he would quickly revert back to his old behaviors and she could not handle the stress. This patient also had other medical issues that were resolving but created a high level of anxiety and lack of confidence in himself that he could “make it” once discharged. His father was at the bedside, was very over powering and did not see a problem bringing him home. I asked the father to allow me to have time with his son alone and he accepted this offer, going to the family room. During our conversation, my patient expressed his feeling of confusion, frustration, loneliness and difficulty in communicating with his family. He expressed feelings of not seeing a way out of the situation since he felt it was a “dead end”. To demonstrate compassion, I used verbal and non-verbal communication to ensure that this patient felt that my attention was on him and only him. I repeated back to him concerns he expressed to me and frequently allowed for silence and reflection during our conversation. He basically was refusing to go home. I asked him if we could include the case manager in our conversation because she may have some suggestions for community resources that he would like to hear about. Even if he went home it might be possible to provide a lot of support within the community for him as he continues on his new lifestyle without drug dependence. He did not want her to come in but gave me permission to discuss with her. During our conversation I used therapeutic touch frequently, either resting my hand on his or patting his arm as we spoke to promote a caring perception and to provide much needed comfort. Collaborative efforts with the primary, psych consultant and the case manager we were able to place him in an in-patient treatment center locally. This center is funded and the cost to him was minimal. A family meeting was called for with his parents and they agreed this discharge plan for their son was appropriate, seemingly presented well as a united front. The situation of their own substance abuse was also addressed by the social worker and resources were provided to them.
After feeling somewhat accomplished and walking down the hall I heard the father behind me, he was walking fast trying to overtake me and when I turned around, he had tears streaming down his face and he could barely walk. I took him to my office, and we spoke about the years of ups and downs he had with his family and various forms of dependence on alcohol, drugs etc. He shared his financial woes and personal struggles with his wife and son and how every time he works with him on a journey of recovery, they are all filled with such hope, but it never lasts. He said the disappointment was almost too much to bear for him and his wife. He also shared that the tough and strong persona he presents is a form of self-preservation. I realized that my compassion had not extended to his father or family and I could have made more of a difference had I been more aware of his struggles by asking open ended questions and listening more during our talks. I was focused on the discharge plan for his son. I try to dig deeper now and seek out opportunities to learn more about patients and families that can help me influence decisions for them regarding discharge planning, inpatient care, resources etc. Technology can help us only so much with the reminders and flags and drop downs but in the end, it is the compassion, insight and intuitive care and the verbal and non-verbal communication we provide that can really tell us what we need to know about a patient’s needs. By reflecting on this communication dynamic I became more mindful of my ability to extend compassion beyond the patient but to the family as well, even when they appear strong and in control supporting my own professional growth.
Throughout my career compassion has always been in the forefront of many of my roles. Durkin, Gurbutt and Carson, state that nurses should be recruited based on the attitude’s values and behaviors of compassionate care (Durkin, Gurbutt and Carson,2018). According to our lesson this week, "Nightingale shared with us the importance of being intentional and purposeful in our thoughts and actions as nurses". As a nurse recruiter we always looked for the “heart” and the intention of caring that our candidates demonstrated upon interview, to determine their fit for a position in patient care at our hospital. We focused on empathy to promote that our patients know our intentions and truly understand their situations. (Durkin, Gurbutt and Carson, 2018). As a manager, I recognize the importance of professional nurses having it all, including empathy, compassion, a strong sense of self, intellectual, superior communication as well as critical thinking abilities for example. Durkin, Gurbutt and Carson discuss the importance of approachability with patient and family involvement and collaborative care delivery. Having time for patients, creating those very important moments that matter are what connect us through demonstrated compassionate connections.
Chamberlain.instrucure.com. Week 1 Lesson. Translation into practice. Retrieved from: https://chamberlain.instructure.com/courses/40928/pages/week-1-lesson-translation-into-practice?module_item_id=4901360
Durkin, M., Gurbutt, R., Carson, J. (2018). Qualities, teaching, and measurement of compassion in nursing: A systematic review. Online Nurse Education Today, 63, pp. 50-58. doi.org/10.1016/j.nedt.2018.01.025. Retrieved from https://chamberlainuniversity.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=128165171&site=ehost-live&scope=site (Links to an external site.)Links to an external site. [Show Less]