Quality Caring in Nursing Essay

8 Caring Factors of Nursing Nurses are one of the largest groups of healthcare professionals. They can contribute to the positive and negative ways to a health care quality problem. The nurse has an intimate knowledge of the patient’s needs and they are continuously interacting with patients and their families. The patient and their family’s experiences and outcomes while in the hospital is highly influenced by the nursing care they received. In 2001, a report published by Dr. Claire Fagin of the University of Pennsylvania, states that some nurses and patients were concerned about their safety while staying in the hospital. Quality Caring in Nursing Essay Paper

Nurses were spending less time with the patients. The reduction in the amount of time professional nurses spend in direct patient care was the cause. There has been a growing use in unlicensed assistive staff in the mid 90’s. This helped contribute to the cause of the perception. Having a shortage of nurses also contributed to this problem. Nurses were unable to spend as much time with the patients and their families at the bedside listening to the patient’s and their family’s concerns. Quality Caring in Nursing Essay Paper

Nursing was a part of this as well as getting to know their families, educating them about their illnesses, and attending to their needs of comfort, support, and security. Due to the shortage of nurses they were focusing more in completing their tasks that are assigned to them and placing a lot of time in front of the computer charting what they have done. This became difficult for the patient and their families to get their needs met while in the hospital. In the U. S. , a study of the quality of nursing care found significant variations of nursing. Quality Caring in Nursing Essay Paper

The rural or smaller community hospitals found to have poor ratings. Why did this occur? Shortage of nursing staff was for one. The large teaching hospitals with residents want to do more for the patient. They wanted to do some nursing tasks such as dressing changes, and treatments. This gave the nurse more of an opportunity to spend nurse more time at the bedside to meet the needs of the patient. Indicators, or measures, that specifically reflect nursing care are used to evaluate and demonstrate to the public how nursing contributes to the quality of healthcare recipients that are hospitalized. In the 1970s, Dr.

Norma Lang developed a quality assessment tool to better assist with enhancing the knowledge of evidence based nursing. The American Nurses Association developed a study of nursing sensitive indicators for acute care. They developed a database using ten nursing quality indicators. Some of these indicators were a challenge, nursing still fell short. They were not able to “be with” the patient. This was the patient’s point of view. There is evidence that registered nurses spend less than half their work time in direct patient care . Although staffing may be a big factor in this report, there are other issues. Quality Caring in Nursing Essay Paper

Nurses may not be motivated, educationally prepared. Perhaps culture may contribute to nursing quality. Nurses are focusing on task completion, technical competence and documentation. This has curbed the process of being with the patient and listening to them in meeting their needs. Many would ask, “Why did he or she go into nursing if they need to be taught on how to be caring? ” The truth is, they do care. And, they want to be with the patient and their families more. Nurses were so worried about getting their tasks completed before the end of their shift; otherwise, they will be questioned as to why it was not completed. Quality Caring in Nursing Essay Paper

Relationships and healthcare do go hand in hand. It is through a relationship that an individual can learn, live, work and grow. This begins in the earliest stages of life. The Quality Caring Model places relationships at the heart of the healthcare process. In 2007, a group of hospital and nursing administrators adopted a caring professional practice model. This model emphasized nursing and will help to facilitate relationship building and the true work of nursing. The outcomes of the patients and their families as well as the nurses will improve.

The Eight Care Factors developed for nursing are as follows: 1. Mutual Problem Solving 2. Attentive Reassurance 3. Human Respect 4. Encouraging Manner 5. Appreciation of Unique Meanings 6. Healing environment 7. Affiliation Needs 8. Basic Human Needs I was first introduced to this topic, I thought to myself. I know this already. I have felt like this my entire life. That is why I became a nurse. To me, this is the type of personality a nurse has, otherwise we would not be in this profession. It’s certainly not the money. Some nurse’s need to be reminded of these things. Yes, it is a fast paced business. Quality Caring in Nursing Essay Paper

Especially when there are so many tasks and procedures that need to be completed as well as the increased documentation requirements that needs to be made for reimbursements for insurance companies. With the pressures, the nurses are strayed away from the patient’s bedside. Humans are complex beings that have physical, emotional, spiritual, social and cultural characteristics. During an illness, these characteristics can be affected when an illness occurs. Illness can represent a basic threat to one’s basic sense of wholeness. Physiological changes can create feelings of discomfort, vulnerability and dependence upon others.

This can affect a person psychologically. Patients feel helpless and under the authority of physicians and nurses. Hospitalization unintentionally contributes to these threats. Patients are being labeled as “the GI Bleeder in room 2”, or the psych patient I room 18 has a court hold”. These patients are not only being labeled, but have to follow the rules. The term caring is an intentional process that requires special knowledge, skills, self awareness and choice. Intention is described being conscience. Being aware of the needs that need to be met is intentional caring. Quality Caring in Nursing Essay Paper

Several healthcare providers have documented certain factors necessary for a therapeutic relationship between the nurse, patients and their families. Watson identified 10 factors in human caring in the nurse patient relationship. Joanne Duffy, identified his first three as a foundation that nurses have: altruism, faith, and sensitivity to others. She founded eight factors that independently explain caring. Mutual Problem Solving is one of the largest factors. This involves the behavior of the nurse to help the patients as well as their families to understand about their illness.

This gives the nurse an opportunity to help them to learn about their illness and to know what to ask. Exploring different alternatives to deal with their illness can be solved by brainstorming. Working as a team with the patient and family. The nurse can listen how the patient cares for themselves at home and assist them to adapt while being hospitalized. Attentive Reassurance refers to the availability of the nurse. It assures patients and families that they can rely on the nurse, and a sense of security develops. Despite the patient’s illness, they want the nurse to be available to encourage them orward in the healing process. When I mention reassurance, I do not mean, “Oh don’t worry the surgery will turn out all right”. Although the patient may have a poor prognosis, the nurse will be there for them to answer any questions that they may have or just be available if they are needed. Using a gentle touch or clarifying any misperceptions is a behavior that nurses use. This is what builds the patient’s confidence in their nurse. This caring factor has two components actually. They are reassurance and attention. Both are necessary for caring relationships. Quality Caring in Nursing Essay Paper

Human Respect is a third identified factor. It refers to honoring the worth of humans by displaying behaviors such as kind handling of the human body or unconditional acceptance, no matter what type of patient you are caring for. Be respectful to patients by calling them Mr. or Mrs. Instead of using their first name. Celebrating or talking about a person’s life when he or she is not ill. Encouraging Manner refers to the attitude of the nurse. This includes verbal and nonverbal messages. An example of nonverbal messages is made by use of body language or facial expression.

An encouraging approach would suggest use of enthusiasm, support, positive comments for the person’s efforts. Even during a bad experience, an encouraging nurse can point out some positive remarks no matter how small. Appreciation of Unique Meanings is knowing what is important to a patient including sociocultural connections associated with their experiences. This factor is more of an approach than a behavior. It values the person as a whole including the patient and their illness. A nurse that can relate to patients and their families in this manner can often help them to feel understood. Quality Caring in Nursing Essay Paper

Jehovah Witness would be an example. They prefer not to receive blood transfusions. Facilitating a Healing Environment has always been considered in the nursing profession. This refers to the setting where caring is taking place. The nurse views the person as being holistic, the surroundings, stressors; structures for privacy, safety, and control are aspect of this factor. A healing environment not only involves the nurse, but it includes the staff and management, the workflow of patient care as well as meeting spiritual needs. The healing environment plays a big part of the healing process. Basic

Human Needs is well known to nurses and include the physical needs such as air, food, and fluids, sleep, rest and elimination. Safety and security, socio and relational needs, self esteem needs, and self actualization. These needs were first introduced by Maslow. Often, physical needs come first due to the fact that they are a symptom of the illness. The higher order of patient needs such as social and self esteem needs are often forgotten. Meeting the basic human needs is a progression of an illness or the return to health. Affiliation Needs refers to a person’s need for belonging. This factor includes the family as well as their families. Quality Caring in Nursing Essay Paper

It allows them to engage in the health care situation, including the decision making. The importance of families to the health and well being of patients is well recognized by rehab centers, oncology nurses, psychiatric facilities, pediatric units and obstetric units. These family members are often assisting with meeting the needs of the patient. This is a fine example of how nurses can appreciate and involve families as they care for the ill patient. These factors are not usually used all at once. Many are used together. Such intentions only contribute to a better outcome not only for the patient, but for the nurse as well.

The eight caring factors that were validated through research have been listed with examples. The use of these factors can only trigger positive feelings in the recipient that informs future relations and advancement toward health. It is important for nurses to balance the doing with the being. By doing this it creates a higher quality of nursing care that can be delivered to the patient. Duffy, Joanne R. Quality Caring In Nursing. New York: Springer Publishing Company, 2009. “Nursing Theory Page. ” July 2, 2009. “Watson Caring Science Institute. ” July 2, 2009.

Caring is an essential pillar in the nursing profession. It plays a crucial role in nursing practice as nurses need to connect with the patient in every aspect. This assignment will discuss what caring means to me as a nursing student. It will examine my beliefs and what qualities; skills and attributes are important to me as I am developing my own individual nursing philosophy of professional caring. By reviewing Jean Watson’s Caring Theory and the Standards of Practice for Registered Nurses I will explore how they are relevant to me as a nursing student and how I will use their concepts and guidelines when I am using Evidence Based Practice, Person Centred Care and the nursing process.

The statement:”In an age where the scientific and the technological are weighed heavily (and often favorably) in human progress, the need to emphasize the humanizing ingredient of compassion . . . is urgent” (Roach 1987, p. 61 You are required to adopt a position on this statement (agree or disagree/take a side) and construct an argument to support your case. Your argument must be supported with evidence from a variety of relevant information sources. Quality Caring in Nursing Essay Paper

This assignment asks Bachelor of Nursing students to adopt a position on a statement – an abbreviated quote from Roach (1987), constructing an argument supported by evidence from a variety of relevant information sources. This assignment will review literature pertaining to theoretical perspectives of nursing, arguing that while our society may be less caring, Registered Nurses, even though now university education are not less caring, than those who were hospital trained. They are however much more technically competent. Shields (1991) reviewing Sister M. Quality Caring in Nursing Essay Paper

Simone Roach’s book “The human act of caring. A blueprint for the health professions” (1987) suggests that the central theme of Roach’s book is an analysis of how the practise of health care professionals and especially nurses has been affected by today’s society which places less value in caring by the individual as well as by the society. What Roach (1995) calls the ‘Postmodern Age’, Kellehear (2007) refers to as the ‘Cosmopolitan Age’, that is today’s society, where people live, and function in an internationalised world, with a global set of economic and social arrangements.

Where “old social divisions and ranks characteristic of past societies such as location, gender, religion, ethnicity” and social class blend into each other (Kellehear, p. 7). The concept of the “five C’s” being compassion, competence, confidence, conscience, and, commitment developed as an attempt to answer the question “what is a nurse doing when they care? ” (Roach, 1987, p. 58). Sister Roach, a nurse educator, infused with a Christian ethic, being a member of the Roman Catholic religious order – the Sisters of St. Martha Antigonish, of Nova Scotia, Canada, defined compassion as: Compassion may be defined as a way of living born ut of an awareness of one’s relationship to all living creatures; engendering a response of participation in the experience of another; a sensitivity to the pain and brokenness of the other; a quality of presence which allows one to share with and make room for the other. It is useful to state the complete quotation, from which the assignment question is taken (Roach, 1987, p. 61): Quality Caring in Nursing Essay Paper

That compassion is an attribute of caring hardly needs defending. In an age where the scientific and the technological are weighed heavily (and often favorably) in human progress, the need to emphasize the human- zing ingredient of compassion and the need “for the cold and impersonal world of science and technology to be infused by things of the spirit”[5] is urgent. The italicised text was edited from the statement that students were asked to take a position on for this assignment. The statement in full takes on more of a Christian theological outlook, placing health care, both nursing and medical in a humanised context, attempting to remove it from the Cartesian clockwork image of the human body as a machine (Kriel 2003). This appears to be context with which the population at large in Australia considers nursing.

Introduction

In latest old ages more than a few issues pertinent to the enlargement of nursing information have been addressed. These comprise of bring outing experiences considered innermost to nursing and the nursing theories and theoretical accounts that have stemmed from them ( Meleis 1997. Fawcett 1993. 1995. Chinn & A ; Kramer 1995 ) . Caring as an imperative perceptual experience within nursing is deriving increasing concentration in the text ( Kyle 1995. Lea & A ; Watson 1996. McCance et Al. 1997 ) . Additionally. a assortment of theories have been offered in the prose. which have caring as a critical idea and are based on a human cognition point of position. Quality Caring in Nursing Essay Paper

These embracing Leininger’s ( 1991 ) Theory of Culture Care. Watson’s ( 1985 ) Theory of Human Caring. Boykin & A ; Schoenhofer’s ( 1993 ) Theory of Nursing as Caring and Roach’s ( 1984 ) theory on caring. However. it is the purpose within this paper to explicate the theory of caring in nursing as in a signifier that focuses in the construct of transpersonal. humanity and caring wellness attention suppliers. I will be utilizing this theory on Acute Care Advance Nurse Practioner. in the Critical Care puting. Further I will pull comparings transversally four caring theories as exposed in Table 1. with the purpose of analyzing them in footings of their similitudes and disparities and to believe their helpfulness in nursing pattern. Quality Caring in Nursing Essay Paper

Theory ON Lovingness

The theoretical perceptual experiences on caring have been explained in the text reciprocally as casts and as theories. McKenna ( 1997 ) highlights the uncertainness among these footings and classifies two schools of contemplation in connexion to the attack they are defined. Descry A backed by Fawcett ( 1995 ) . supports a ladder of theoretical growing with a theoretical account measured more theoretical than a hypothesis. on the other manus. place B advocated by theoreticians such as Meleis ( 1997 ) and Stevens-Barnum ( 1994 ) . advocates the position that all conceptualisations are hypothesis. but at diverse phases of advancement.

WATSON’S THEORY OF HUMAN CARE

Jean Watson’s premise on lovingness was first available in 1979 in a manuscript entitled Nursing: The Philosophy and Science of Caring. This volume symbolized premature phases in the betterment of her hypothesis that was to be prolonged 6 old ages afterwards in Nursing: Human Science and Human Care ( Watson 1985 ) . Watson expresses nursing as a psyche scientific discipline. with the chief limelight being the pattern of human attention for individuals. households and groups. Her hypothesis is based on a form of humanitarianism and has its beginning in metaphysics ( point of view of life signifier and knowing ) . Quality Caring in Nursing Essay Paper

The purpose of nursing inside Watson’s ( 1985 ) caring theory. as offered in Table 1. has its axis about assisting public to accomplish a higher degree of harmoniousness within the mind. organic structure and spirit. She preserves that this intent is achieved through lovingness concern. Watson’s ten carative characteristics. referred to as the intervention of the theory. are accessible in Table 2. She in add-on refers to transpersonal lovingness which is expressed as ‘an superlative of intersubjectivity in which in cooperation individuals [ nurse and tolerant ] are drawn in’ ( Watson 1985 p. 60 ) . Transpersonal lovingness is established in an happening or echt lovingness circumstance.

Neil & A ; Schroeder ( 1992 ) and Schroeder ( 1993 ) . who articulated the Denver Nursing Project. show an illustration of the reasonable entry of Watson’s theory on single lovingness. The strategy limelights on an outpatient hub for people bing with HIV and AIDS which makes usage of Watson’s attempt as the foundation for learning. clinical pattern and follow a line of probe. The occupation declaration for the Center reflects Watson’s doctrine. jointing ‘esteem for the exceptionality and independency of each human being and religion that fittingness and comfort are multidimensional’ ( Neil & A ; Schroeder 1992 p. 105 ) . Quality Caring in Nursing Essay Paper

The idea that human being’s remedial procedures can be supported through echt caring relationships is besides cardinal to the labour carried out in the Center. The force of the mission together in footings of monetary value and in excellence of life for individuals bing with HIV/AIDS has been assessed utilizing every bit qualitative and quantitative techniques. The effects specified that the possible monetary value nest eggs of the Center are of import due to. for case. decreased length of remainder place stay and nurses’ aptitude to set off infirmary entree. Findingss from the appraisal mission’s high spot. more conspicuously. the abridged degree of individual enduring end point from a caring bond.

COMPARISON OF THEORIES

In order to contrast and contrast theories Stevens-Barnum ( 1994 ) talked about the exercising of ‘commonplaces’ . a phrase that points to a expansive bowl without stipulating its substance. When the elements of a figure of theories are arranged into platitudes. so it is likely to contrast and compare them. Quality Caring in Nursing Essay Paper

In add-on. she states that at the same clip as hypothesis analysts make their single sets of platitudes there is no 1 correct set. The world of this preserve noted if one looks at the occupation of nurse meta-theorists ( Meleis 1997. Fawcett 1993. 1995. Steven-Barnum 1994. Marriner-Tomey 1994 ) .

In comparative to the premises on caring. Leininger and Watson’s hypothesis have been examined by Fitzpatrick & A ; Whall ( 1996 ) . Marriner-Tomey ( 1994 ) . Fawcett ( 1993 ) and George ( 1995 ) . Boykin & A ; Schoenhofer’s attempt. which is measured a reasonably new caring theory. has merely been evaluated in a new text by George ( 1995 ) . This paper offers to judge against and contrast the ‘caring’ theories in relation to persons platitudes that the writers regard as relevant. Table 1 current the platitudes used for association intents. numeration: beginning of theory ; graduated table of theory ; categorization of lovingness ; account of nursing ; cardinal perceptual experiences of the theory ; and aim/outcome. in add-on. easiness is besides considered and argued in relation to each hypothesis.

Scope

Span. harmonizing to McKenna ( 1997 ) . relates to how the hypothesis can be functional and its measure of abstraction. On trial of the four lovingness guesss. Watson’s and Leininger’s theories are more superior in their growing than those of Roach and Boykin and Schoenhofer. This is obvious non merely from the capacity of the theories. but besides from a contrast of other criterions. Quality Caring in Nursing Essay Paper

For case. Table 1 exemplifies that Roach and Boykin describe caring instead theoretically and Schoenhofer weighed against to those definitions offered by Leininger and Watson. Nevertheless. it should be outstanding that there is incongruousness among meta-theorists as to the capacity of Leininger and Watson’s theories. Fawcett ( 1993 ) categorizes Leininger’s speculation as a brilliant theory and Watson’s as in-between assortment expressive theory. on the other manus. Marriner-Tomey ( 1994 ) analysis Leininger’s theory as a in-between scope guess and Watson’s as a thought. While sentiments differ from doctrines to magnificent theories to focus on scope theories it would be factual to talk that Watson’s and Leininger’s works present caring in a lesser sum of conceptual manner.

Explanation OF Lovingness AND Nursing

The metaphors of caring accessible in Table 1. and as a consequence the significance of nursing. copy the humanistic environment of nursing. Nursing is besides definite in footings of caring behaviour that fit in a assortment of accomplishments. For case. Watson ( 1985 ) high spots expert. personal. proficient. aesthetic and moral human attention traffics. while Roach ( 1984 ) things to see cognitive. effective. scientific and managerial accomplishments. Furthermore. on appraisal of definitions of gentle and nursing one can acknowledge a double component to caring in intervention — attitudes and criterions on one manus and actions on the other. Quality Caring in Nursing Essay Paper

KEY CONCEPTS

On assessment of the account constructs inside Roach and Watson’s theories. the dual component becomes obvious. For case. Roach’s five Cs of caring include rules and capableness. foregrounding attack and cognition. Likewise. Watson’s carative issues comprise values vital in the assisting connexion. in concert with the accomplishments obligatory in nursing such as crisis resolution and the judicial admission of physical attention. A shutting point to be stressed is the significance and appraisal placed on the nurse-patient bond contained by the four theories on caring. This places involvement on the indispensable human facet within nursing and. as confirmed once. the humanistic focal point of these givens.

Beginning

While the beginning of the lovingness theories vary to some extent. they all draw from from human skill ordinances such as anthropology. It is besides obvious that everyone has been based upon the rule that nursing is a psyche scientific discipline. Watson ( 1985 p. 16 ) draws a measure of chief beliefs on which a human scientific discipline background is founded: Quality Caring in Nursing Essay Paper

• a point of view of human independency. pick. answerability ;
• a natural scientific discipline and psychological science of holistic theory ( non-reducible people interrelated with others and environment ) ;
• an epistemology that permits non merely for empirics. but for enlargement of aesthetics. moral values. inherent aptitude. and process determination ;
• an ontology of point in clip and autonomy ;
• a background of inter-human proceedings. classs. and associations ;
• a logical universe vision that is unbarred.

Watson ( 1985 ) obviously states that the importance construction associating to her premise is based on the criterions cardinal to human attention and single scientific discipline in nursing. Likewise. Boykin and Schoenhofer ( 1993 p. 15 ) affirm that their given positions nursing as a form of human subject that ‘focuses on the information needed to grok the fullness of what it means to be single and on the techniques to corroborate this knowledge’ .

Leininger ( 1991 ) and Roach ( 1984 ) . while non openly