Uniqueness of Strength Based Nursing
Strength based nursing is based on the idea that interactions with others is imperative in the healing process. (Gottlieb, 2014). This concept recognizes that the human beings consists of more than the just the physical and for one to recover they must be well in all aspects of themselves. Florence Nightingale describes the role of nurses as creating an environment that would best enable the patient’s body to recover. (Nightingale, 1946).
Strength based nursing is founded on eight core principles. Health and healing. The primary goal of nursing is to foster the recovery and healing of the patient. Nurses work towards promotion of healing of the patient through such processes as sleep, nutrition, and pain control.
Uniqueness: SBN acknowledges that all people are different; everyone is genetically unique and has a certain disposition. Furthermore, the most condusive environment for recovery is different for different people as people thrive in different environments. Nurses must therefore center their care plan along the patient’s individual strengths.
Holism and embodiment: Martha Rogers (1970) explains that people are unitary beings who react to their surroundings as integrated wholes. (Iglehart, 2013). Patients should be regarded as a whole and treated as more than just the disease they are suffering from. Care provided should take into account the physical, mental and social aspects of the patient.
Subjective reality and created meaning: An individual’s perception of their reality affects their response to it. Nurses should therefore be aware of all their actions and words as though they could affect how the patient views themselves as well as their recovery process.
Person and environment are integral: For complete patient recovery the patient must be placed in an environment where they thrive best. Nurses ought to ensure that they create an environment where patients feel supported and safe. This involves allowing them to personalize the place where they are recovering and creating a rapport with the patient.
Self-determination: SBN recognizes that patients have the freedom of choice to make decisions regarding their health. It emphasizes the need for nurses to give patients the leeway to decide what they want with the help and guidance of the nursing staff.
Learning, timing and readiness: It is essential for patients to learn about the illness which they are suffering from. This enables them to mentally prepare for the tasks ahead of them and helps to put in sync mental willingness with their bodies’ capabilities. (Gottlieb, 2014).
Collaborative partnership: A partnership ought to exist between nurses and patients where nurses bring their expertise in the medical field while patients bring knowledge about themselves as individuals. This enables the patients to receive quality care that is tailored towards them as ensured by their involvement in all aspects of their care through consultation. (Delaney, 2018)
The discovery of ones’ illness particularly an illness that could have a fatal ending is petrifying for patients.
Emma describes experiencing increasing anxiety over her cerebral angiogram as she awaits surgery. (Gee, 2016). The situation was aggravated by her lack of knowledge on her disease as she imagines all the things that could possibly go wrong. After being diagnosed she meets a team of doctors who discuss the various treatment plans for her yet fail to engage her in conversation, explain to her clearly the different plans and why they wouldn’t work or even ask about her concerns over her disease.
Holism and embodiment
As a result of this information deficit, Emma remains largely ignorant of the difficulties that await her after her surgery. She is for the most part disillusioned that her life will remain the same. This disillusionment affects her recovery later on. (Klonoff, 2010).
One of the core aspects of strength based nursing is learning, timing and readiness.it is imperative for patients to be thoroughly educated on the disease they are suffering from, the available treatments, the implications of the treatments and the effect that their illness will have on the quality of their life. Such education needs to be delicately handled and the goal of passing information to the patient is to ensure that they have clarity about their situation. (Adams, 2010)
The nurses ought to have taken time to give all necessary details to Emma regarding her illness after her diagnosis. They ought to have explained to her what lifestyle changes she ought to have implemented and any warning signs that would indicate her state was deteriorating. This would serve to alleviate her anxiety and help her focus simply on her recovery.
During her recovery Emma is often disheartened by her progress as throughout the process she maintains an idea of what her life will be like upon recovery. She is certain that she will be just as she was prior to the onset of her illness. Throughout her rehabilitation at Royal Talbot Rehabilitation Centre she strongly believes that she will leave the center with the ability to run even though from all practical medical perspectives this is unlikely.
Nurses have the responsibility to create awareness to patients on the implications of their conditions in a sensitive way that does not dishearten them. They must depict to patients, realistically, what they should expect their lives to turn out to be post recovery.
The nurses dealing with Emma after her stroke ought to have taken time to inform her of the implications of her stroke on her body. While all persons are unique and they extent of their recovery varies, the nurses have a responsibility to paint a picture to their patient of the realities that her future would likely entail.
Upon regaining consciousness, Emma describes her situation as one in which her life depended on the graces of the hospital staff. She states that she feels like “a child” an indicator of the powerlessness she is overcome by in her situation. She is unable to perform the most menial of tasks and is dependent on others to do everything for her such as feed her. (Gee, 2016).
Her inability to perform the most basic of tasks is aggravated by the fact that she feels as if she has lost all dignity as a result of the actions of the people who she relies on to perform tasks for her. One of the nurses feeds her while playing what she describes as the ‘airplane game’ which is belittling for Emma who is a twenty four year old woman and not an infant. (Gee, 2016).
Subjective reality and created meaning
Also, Emma is overcome by the feeling of loss of self-determination. Unable to speak the nurses make all decisions for her and fail to seek her approval and sometimes even fail to inform her of an action they are taking. When Emma messes her bed, the nurses come to attend to her and clean her up. As they do this they roll her over without speaking to her or addressing the fact that this is a matter of great embarrassment to her. (Gee, 2016).Patient choices are vital to their self-worth and respect and are of utmost significance in upholding medical ethical principles. (Ewert, 2013).
Furthermore, Emma describes often being in immense amount of pain which was not dulled in the least bit by pain killers. She is forced to identify what is aggravating her pain and attempt to avoid it. A difficult task given her situation where she is unable to speak and has little control over the movement of her body.
Upon the regaining of consciousness, the nurses should have taken conscious steps to ensure that Emma received patient centered care.
Emma and her family ought to receive health education on her situation. The nursing staff would explain to Emma that she had suffered a stroke and as a result she would not be in a position to perform certain tasks for a period and that the staff would assist her in all that she requires. The nursing staff could then educate the family on all the tasks she required help in so that they could be in a position to help her if the situation required it. This would prepare Emma mentally for the process that lay ahead.
The nursing staff would then establish a relationship with Emma and in particular her family, who knew Emma well as she could not speak at the time, based on collaborative partnership. Upon discovering a problem that would create a challenge for Emma’s comfort the staff could ask the family to help them come up with a solution that served all parties. This would be practical in problem solving as a number of her family members are health professionals. This would also create a power balance between those involved.
In their interactions with Emma, the staff ought to recognise her as the twenty four year old woman that she is. Hence, they needed to treat her in such a manner that befitted her age. Though the patient requires assistance like a child does, the staff ought to acknowledge that she is not a child but an adult. She needs to be treated as more than just her deficits.
The staff ought to appreciate the freedom of choice of individuals especially when there are limits to the choices they can make. Nurses ought to grant to Emma an opportunity to make choices even over trivial things. When the time came to remove staples out of Emma’s head she ought to have been asked about the timing. Reinforcement of self-determination in patients enhances self-efficacy.
Person and environment are integral
The strength based nursing approach requires the staff to be mindful of the patients and sensitive to their needs. When dealing with matters which would generally cause embarrassment to the patient, the nurses ought to offer reassurance to the patient and make sure they understand what steps are being taken to deal with the matter.
|
Assessment |
Nursing Diagnosis |
Patient outcomes |
Interventions |
Rationale |
|
Chronic pain |
Nerve damage from stroke |
Patient will: Inform the nurses of any actions that aggravate her pain |
Administration of pain killers |
Painkillers will help ease patients burden. |
|
Speech impairment |
Damage from stroke |
Attend speech therapy once a day. |
Use of a communication board Observation of patient gestures and non-verbal skills |
Nursing requires collaboration between patients and nurses. Therefore, nurses need to give information and understand patient needs and demands. |
|
Inability to move body |
Attend physical therapy |
Assist patient with task that require body movements such as feeding. Inform patients of all the tasks they will be performing on their bodies before moving any part of their body. |
Patient needs help with the tasks. Preserve the dignity of the patient by giving them a chance to decide what they want. |
Patients constantly need to be encouraged to work through all the challenges they are facing and remain positive throughout their recovery. Nurses ought to help patients focus on overcoming any challenges that arise during recovery as opposed to fearing their challenges.
Strength based nursing is founded on principles which foster hope, healthy behaviour and quality life. (Williams, 2013). Patient outcomes in terms of the extent of recovery as well as recovery time are bound to increase when the strength based approach is applied.
Strength based outcome is beneficial to the patient as it enhances self-efficacy. Patients’ willingness and belief in their ability to meet the targets set to ensure their recovery increases when the care given to them is centered on their needs. (Byrne, et al., 2012). In order to create a mindset in the patients that motivates them to succeed nurses must tailor their care to the areas of strength of their patients.
Preservation of the dignity of the patients while in hospital. The experience of a patient is often described as demeaning as they are often treated as less than human (Lattimer, et al., 2010). Strength based nursing emphasizes on patients as a whole being hence focuses on the fact that they are ill while taking into account their needs and rights as people.
Development of hope among patients is enhanced. With the nurses’ guidance, patients are able to envision their own recovery within realistic bounds. Nurses should be in a position to encourage patients to attempt different action plans to achieve the set goals and such encouragement must be based on hope.
The family members of the patient also feel empowered. Undertaking education of family members on the health problems faced by the patient encourages them to take a proactive role in the recovery process. They are quick to offer assistance to the nurses in simple tasks such as feeding a patient who cannot feed themselves and they can also prove essential in problem solving.
Strength based nursing is of greatest impact on the nursing staff who became aware of their vital role in the recovery of patients by actively assisting patients particularly in non-medical areas of challenge. This enables them to fulfill their job as health practitioners by enabling them to ensure health and healing in a manner that is best suited for each individual patient and often more economical. (Browne, et al., 2012)
Conclusion
Patient care is the primary duty of nurses. This requires nurses to ensure the health and healing not only of the physically incapacitated part of the patient but also of the patient as a whole. (Hansen, 2016).Nurses must ensure that while performing their duties they take into account the physical, mental and psychological health of the patients.
Patients and their families ought to be involved in the development of a health care plan so as to ensure that all their reservations, fears and questions are handled by the nurses.
Strength based nursing prioritizes the needs of the patients and the members of their families over economic and political factors. This establishes a system where individuals are valued over bureaucratic systems. (Gottlieb, 2014).
References
Adams, R., 2010. Improving health outcomes with better patient understanding and education. Risk management and policy, pp. 61-72.
Browne, G., Birch, S. & Thabane, L., 2012. Better Care: An Analysis of Nursing and Healthcare System Outcomes, s.l.: Canadian Foundation for Healthcare improvement.
Byrne, S., Barry, D. & Petry, N. M., 2012. Predictors of Weight Loss Success: Exercise vs. Dietary Self-Efficacy and Treatment Attendance. appetite, pp. 695-698.
Carey, B., 2005. Archives: New York Times. [Online]
Available at: https://www.nytimes.com/2005/08/16/health/in-the-hospital-a-degrading-shift-from-person-to-patient.html
[Accessed 3 October 2018].
Delaney, L. J., 2018. Patient-centred care as an approach to improving health care in Australia. The Australian Journal of Nursing Practice, Scholarship and Research, pp. 119-123.
Ewert, B., 2013. Patient Choice Has Become the Standard Practice in Healthcare Provision: It is Time to Extend its Meaning Comment on “Is Patient Choice the Future of Health Care Systems?”. International journal of health policy and management, pp. 227-228.
Ford-Gilboe, A. B. M., 2004. Hope, health work and quality of life in families of stroke survivors.. journal of adv. nurses, pp. 322-332.
Gee, E., 2016. Reinventing Emma. s.l.:Emma Gee.
Gottlieb, L. N. P. R., 2014. Strength based nursing. American Jouranl of Nursing, pp. 24-32.
Hansen, E., 2016. Whole person care, patient-centred care and clinical practice guidelines in general practice. Health sociology review.
Iglehart, J. K., 2013. Expanding the role of advanced nurse practitioners-risks and rewards. New England Journal of Medicine.
Klonoff, P. S., 2010. Psychotherapy after brain injury: principles and techniques. s.l.:Guilford press.
Lattimer, et al., 2010. Problematic hospital experiences among adult patients with sickle cell disease.. J Health Care Poor Underserved, 21(4), pp. 1114-23.
Lattimer L, Haywood C Jr, Lanzkron S, Ratanawongsa N, Bediako SM, Beach MC., 2010. Problematic Hospital Experiences among Adult Patients with Sickle Cell Disease. JOurnal for the healthcare of the poor and undeserved, pp. 114-123.
Nightingale, F., 1946. Notes on nursing : what it is, and what it is not. Philadelphia: J.B. Lippincott Company.
Rogers, M., 1970. An introduction to the theoretical basis of nursing [by] Martha E. Rogers. s.l.:Philadelphia F. A. Davis Co. 1970.
Williams, B., 2013. Strengths-Based Nursing Care: Health and Healing for Person and Family. Journal of neuroscience nursing, p. 177.
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