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?

April Narvaez

University of Houston - Victoria

The topic of patient-centered care is integral to the practice of nursing which has weaved its way through each and every single one of my nursing courses. We are trained to complete each nursing assessment and action with the understanding of how that specific intervention contributes to the patient’s care. Our actions must be evidence-based for that specific patient’s condition, and we must serve with the end goal to keep the patient at the center of our care. Watching the videos, it was clear to see how Ardis, Angela, Mona and Robert would always put the patients first, taking their time, not rushing, and establishing a real connection. Never once did you see them cut off their patient in the middle of answering a question or description of a symptom. It’s the combination of little actions that makes these Inspired Comfort winners exceptional nurses, and I intend to uphold that very spirit as a student nurse and throughout my career. Recently in my Nursing Roles course, we discussed, at length, the importance of communication after viewing the Josie King story. Countless medical errors at all levels caused the senseless death of a young girl. That movie alone made an impact on me to never take a shortcut- for each and every patient. Johns Hopkins is an upstanding medical facility, however the culmination of actions was ultimately to blame. In my practice as a nurse, I intend to keep Josie King in mind when caring for countless patients while understanding that each patient is a mother, father, sibling, aunt, uncle, or grandparent. People mean something, and that doesn’t just end at the single person we are treating. Nurses care for that entire family, population and community which means our excellence in care extends further past what we can imagine. I think about a friend who had a very sick baby, and she would post all over Facebook how wonderful the Texas Children’s Hospital nurses were in helping care for her now-improving baby. Nurses, in essence, take care of the whole family while making them feel at home in a place that certainly isn’t home. In my friend’s case, she was 150 miles from home seeking care for her daughter yet the nurses made her feel welcome and calm. All of these instances are my inspiration for delivering patient-centered care 100% of the time. Thinking of each and every patient’s interconnections with others is how I plan to overcome the temptation of giving anything less than patient-focused care.

To prevent the mentality of goal-focused care, I will first improve my communication technique. This includes communication to the patient, family, and the rest of the health care team. Communication is integral to better patient outcomes, and I intend actively create as many positive outcomes as possible. First, I will take my skills back to the basics by explaining each and every procedure, medication and action to the patient and family.
This will not only help to put their minds at ease, but it will also prompt me to verbalize the rationale behind the action I am performing, serving as a “double check.” The second part of that interaction would be actively listening to the patient and family’s concerns then responding in a reasonable manner. In the case of Josie King, the mother’s fears were not adequately addressed and several opportunities were missed to dig deeper and discover the root of the problem. It is tragic that a burn victim died from dehydration, which is a primary concern for patients which such conditions. The dynamics of that situation are not fully understood, but if I am delivering patient-centered care the likelihood of such errors would be greatly reduced. The family’s concern over a specific pain medication would prompt me to double and triple check medication and orders, but we must do this even when family isn’t around. Every condition we treat will not be as serious as others, however, as nurses we must understand that, at that point in time, it is an extremely difficult time for that specific patient and family who is vulnerable, worried, anxious and fearful. Remembering this is integral to combating a goal-focused mentality and understanding that each individual is worthy of my very best work as a nurse. As nurses, we treat the whole person, not just the disease or symptom, as reminded by Ms. Bush, and when we remember that fact, it is easy to deliver patient centered care.

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