2014 Winning Essay

2014 A Nurse I Am Scholarship winners were asked to answer the following: Each of the nurses in the film A Nurse I Am was united in their complete care for the patients they served and went above and beyond the call of duty. As a nurse, you may be tempted to take shortcuts in patient care to meet demands and complete your workload - sometimes at the expense of patient-centered care. In light of the increased demands and workload that you may face as a nurse, how will you overcome the temptation to become goal-focused instead of patient-focused? What steps can you take as a student to help prevent this mentality and to view each patient as an individual worthy of your best work as a nurse?

Valeena Legaspi

University of Massachusetts, Amherst

Care is a universal language. It is expressed in some form or another in every culture. Care is a broad term that can have several different meanings; it can encompass empathy, beneficence, compassion, respect, and physical help. Nursing embodies the notion of care. The metaparadigm, or foundation, of nursing theory focuses on four important aspects: client, environment, health, and nursing. These paradigms interact on many different levels and at the center is the notion of care. A good nurse understands these concepts and provides the best care possible to his or her patients; however with the increasing level of responsibilities and constricted time to accomplish tasks, it becomes harder to remain focused on care that is centered on a patient. To overcome the temptation of becoming goal oriented rather than patient focused; a nurse needs to follow a set of tools and interventions that allow for mutual patient centered goals which is a compromise between patient focus and goal attainment. A good set of interventions proposed by Irwin and Richardson (2006) are: communication, partnerships, health promotion, and physical care. These interventions will not only guide my nursing practice, they will serve as the foundation in focusing on patient centered care.

Communication is a key factor in all healthy relationships. In order to facilitate a good nursing-to-patient relationship, there has to be clear communication. Irwin and Richardson argue that communication entails being “personable, friendly, and open to a patient’s agenda” (2006). In essence, this requires observing a patient’s needs, responding to them and working together with the patient to develop a mutual plan of action. There is evidence that the more a patient is involved in their own health care, the more patient compliance there will be, and the better the outcome (Cameron, 2008). As a nurse, I plan to use open communication with my patients by being respectful, honest, sincere, and confident. Communication will help me understand a patient’s point of view, will improve multidisciplinary interactions, and will help direct focus on the patient and their health.

Along with communication comes partnerships; or forming a positive bond with a patient. This is important because our face is often the one they see the most. It is up to the nurse to establish a relationship where open communication, respect, trust, and friendship can be established. A professional, approachable, and respectful partnership can be the doorway to a patient becoming more involved in their own care and feeling supported by the medical staff. In order to facilitate a partnership, I will respect the patient as a person with different views, beliefs and culture. I will nurture a relationship that establishes my role as nurse and their role of patient as equals. A partnership implies equality; the patient is no longer just a patient, rather a partner who can make decisions, produce actions, and contribute to their overall health goal. In other words, our partnership will be a professional friendship.

Lastly are the notions of health promotion and physical care. These two tie in together because without health promotion, you cannot have quality care. Patient teaching is the foundation of health promotion. Patient teaching must follow certain criteria, for example various people learn via different styles so teaching cannot only be in the form of reading material. Also, material presented has to be easily understandable, unbiased, and pertinent to a patient’s health concerns. One way I can promote health is to assess a patient’s health beliefs and if they are contraindicative teach alternative ways to attain healthier life patterns. Another way I can promote health and improve nursing care is by assessing a patient’s nutritional status and developing a plan that incorporates their food preferences with healthier nutritional choices. Nursing care involves health promotion and therefor it is important to include patient teaching into the care plan.

In sum, nursing care is a culmination of good communication, establishing a partnership, promoting health and remaining patient focused. It requires open and honest communication, respect, knowledge, and compassion. Remaining patient focused could be the determining factor in patient compliance, achieving health goals, and improved health status and outcomes. Completing tasks is important, however, the patient should ultimately be the center of care. My daily motivation will be to remember the reason I became a nurse; to provide the best care possible to patients. Patient care is not only the foundation of our job, it’s the essence of nursing.

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