Sample Nursing Paper..

Nursing Paper for School

I'm still whirling from my recent realizations. Clinical nursing is much more interconnected with healing and hospice care than I ever suspected.

While in classes, the theory of Modeling and Role-Modeling of Erickson, Tomlin and Swain seemed a bit esoteric to me and seemed to have no place in the world of professional nursing. The very idea of deciphering what the patient's worldview is and then me utilizing the worldview to provide patient centered care for that particular patient seemed tedious and unnecessary. In most patient cases, I felt that this theory-based approach was a superfluous step as most of my patients and I shared a similar background. However, while on rounds, I saw first-hand that this will not always be the case. There were at least 8 patients on the floor that were of very different ethnic backgrounds that I was unfamiliar with.

In each of those cases, I noticed that the staff nurse took the time to get to know each patient; they spoke with the patient, the family members present all the while taking notes. It seemed more of an interview than a nursing assessment!

I questioned my teacher later and found out that even though externally it looked as if no clinical nursing assessment was taking place, I was mistaken. The staff nurse was listening to the patient and observing physical signs of distress, disease and mannerisms; vital signs were taken, the family was questioned and the nurse observed how they referred to the patient and noted their total interaction with each other. Based on the staff nurse's observations, she began to accommodate her behavior so as to comfort the patient and gain their trust. In this way, the nurse would be able to perform more intrusive actions, such as taking blood, later on without unduly upsetting the patient.

One of these 8 patients was Muslim, during that nurse's assessment, he found out that during specific times during the day, the patient wanted to pray. At those times, the patient was unwilling to undergo any sort of nursing care or treatment. By this nurse getting this information, he was able to role-model himself into this patient's way of life and work with the patient's beliefs as opposed to forcing an unwelcome schedule onto the patient. (The nursing assessment utilized helped the nurse to categorize the patient's strengths, areas of positive adaptation, and state of arousal (Frisch, 2001)).

The prayers only took a few minutes and did not in any way interfere with the patient's care, but by modeling this patient's religious beliefs and allowing the patient to pray at specific intervals, that patient was given respect and his way of life was honored and his care was not in any way diminished. In fact, it may well have been enhanced since the patient felt more comfortable, and had one less alienating thing in this most probably strange and disconcerting environment.

The following week, I had a Chinese patient named Lu who was ambulating but needed supervision as she became disoriented and lost her balance easily. I had sat with the senior nurse as she did the nursing assessment for Lu and we learned that she enjoyed practicing Falun Dafa, a meditative exercise that helped with healing, focus and serenity. We both thought that would be incredibly risky in Lu's condition (she had a mild stroke and was weak on her right side), but Lu and her children insisted that she practice 2 times a day for at least 5 minutes each time.

The agitation was so great in the patient and her family at the prospect of not being able to practice this meditation that the senior nurse acquiesced and said we would try it for a day and see how it went. The senior nurse asked me to supervise Lu while she practiced and the tremulousness of Lu seemed to give way after a few moments of practicing her active meditation. The very postures and movements seemed to help Lu. After the first session, on that first day Lu's blood pressure was down by 6 points and her pulse was much steadier.

Both the senior nurse and I learned something that day, by allowing the patient to take the lead in her own care; she was able to effect positive changes in her progress. In addition to the various nursing interventions performed, Lu regained much of the use of her right side during her 2-week stay.

I've learned that nursing is much more integrated with holistic concepts than I had originally thought. When you couple this kind of approach with the traditional nursing role, you create a very effective and powerful healing approach that will positively affect patient outcomes.

References

Frisch, N.C. (2001). Nursing as a context for alternative/complementary modalities. Online Journal of Issues in Nursing, volume 6.

Appendix

Patient Situation

It was my first year as a nursing student and I was in the geriatrics unit. A male patient, Thomas, was on a respirator and had to be suctioned every few hours to ensure that his air passageways were clear. Thomas' family was very concerned about him. He was 99 and his 100th birthday was coming up and they wanted him to get well in order for him to attend the party they had begun planning the day Thomas turned 99.

Thomas had a corner room and the window shutters were always closed; the family did not want the harsh glare to keep him from resting as much as he could. The senior nurses were always busy accommodating the family's anxious questions; the party was coming up in 10 days. They wanted to know if he would be well enough by then. Thomas caught a cold which turned into a mild case of pneumonia, but was otherwise in good health and spirits. I and the other nurses could see that Thomas needed some rest - from his family! They were so worried about him getting well quickly that they were making Thomas anxious which was hindering the healing process.

One Thursday afternoon, Thomas's grandson was so conscientious in "helping" his grandfather eat all of his food that Thomas began to choke. The head nurse and I were the only ones in the room and she immediately suctioned him to clear his airway passages while I firmly asked the grandson to leave the room and not return until the following day. When the head nurse finished, she allowed me to check all of Thomas' vital signs and then I turned my attentions to the patient himself. He was still agitated. I sat with him, rubbing his arms, legs and temples until I felt some of the tension leave his body. My touch and presence seemed to help him immensely and he thanked me.

It was a late summer evening around 7pm. And it occurred to me that the room was a bit dark and dreary and I asked Thomas if he would like me to open the shades and he agreed. He told me that he loved the sunshine. As I opened the window, the evening rays spilled across the bed and Thomas closed his eyes and the final furrow on his brow slowly relaxed and I saw him sigh deeply. In a few moments, Thomas was fast asleep in the sun-drenched quiet room.

It was at that moment when I realized that the theories of Humancare, Modeling and Role-Modeling were not some far-flung Eastern philosophy that was patch worked into nursing philosophy. These were complementary modalities that functioned well within the realm of nursing, something I did not originally think was appropriate while I was in classes.