PHILOSOPHY OF CARING: AN INDIVIDUAL APPROACH As nurses our jobs depend on our ability to understand the technical portions of patient care in order to keep our patients safe and maintain their health. Our job as nurses is also to provide care to the patient. This is done by tending to their psychological well-being. To be a good nurse in addition to mastering technical skills we need to learn about caring. We need to understand what caring is and how to provide it to individual patients. In order to fully care for a patient, a nurse must not only strive to understand the patient as an individual person, but also to understand themselves as well. Caring Defined To care is to identify the objective and subjective needs of an individual and then strive to meet those needs. In order to do so as nurses we must understand our role as individuals and be able to perceive the needs of a patient. Personal Experience A few years ago my nurse practitioner found a tumor during a routine exam and referred me to a specialist. The specialist I saw exemplified what it means to care for a patient. When I entered his office I was fearful for a variety of reasons. I was worried about the outcome of my medical tests, I did not know if the tumor was benign or malignant, and most of all I feared the presence of a new doctor. The doctor I saw however proved to have an exceptional ability to care for patients. From our small introduction he was able to sense my fears, of both him and my medical issue, and understood that I was not the type of person to be coddled. He was very direct in addressing my condition, kept a serious tone, let me sit in a rocking chair instead of on PHILOSOPHY OF CARING 3
the exam table, and kept his distance. He was able to read me, empathize, and speak with me in a way that benefitted my wellbeing as an individual. Nurse and Patient I have learned more about this physician from other patients and mutual friends since the time of my visit. From their descriptions he is a very comforting and personable individual, which is a contrast from how he interacted with me in his office. This detail is crucial to the development of my understanding of caring and my philosophy of nurse and patient roles. Although he is a physician since he was the primary caregiver in my example, when examining caring he fulfills the role of nurse in the four elements of nursing theory. As the caregiver he was able to adjust his interactions with me to provide the highest level of care. He showed empathy and sensed how I needed our interactions to proceed in order to best benefit me as the patient. The caregiver or nurse must see themselves as an individual interacting with the patient as another individual and alter their interactions to meet the needs of the patient. Travelbee examines this caregiver/patient relationship in terms of a human to human model, with an emphasis on empathy. Bennett (1993) discusses how Travelbees Theory of Interpersonal Relations in Nursing addresses the nurse/patient relationship as an interpersonal process. The caregiver needs to recognize their personal approach to care, how the patient needs to be approached to best receive care, and then act accordingly. Health and Environment In terms of health and environment my philosophy best identifies with Kolcabas Comfort Theory. Kolcaba and DiMarco (2005), discuss how the health of a patient depends on PHILOSOPHY OF CARING 4
relief, ease, and transcendence as well as the manipulation of the institutional environment. These areas of health care apply not only to the objective elements of patient care but to the subjective ones as well. In my experience with the specialist previously mentioned, he addressed all of these areas of health in his interactions with me. He tried to relieve my discomfort through manipulating the environment and placing me in a comfortable chair rather than on an exam table. He also worked on easing my worries by being very direct in his communications. Finally he tried to help me transcend my situation by sharing his experiences with cases like mine, allowing me to understand that the chance of my tumor being malignant was very small. This caregiver recognized my needs as an individual and used his experiences as an individual to provide me with the best care possible. His approach lead to my philosophy that to care for a patient both the patient and the caregiver need to understand that they are individuals not just providers and seekers of healthcare. Conclusion The specialist discussed in this paper used a very specific approach with me as his patient. How he handled himself, how he viewed me as a patient, how my health was addressed and how the environment was arranged all demonstrated a high level of caring. Each element of my visit was tailored to meet the needs of my personality. To have cared for me in such a specific and effective way demonstrated his self-awareness as a caregiver and my individuality as a patient. Each of these elements are necessary in providing the highest quality of care. PHILOSOPHY OF CARING 5
References Bennett, J. (1993). The effects of empathy, knowledge and attitudes about sex, and homophobia on nurses' attitudes about AIDS care: An exploration of Orem's concept of nursing agency using propositions from Travelbee's theory of interpersonal relations in nursing. ProQuest Dissertations and Theses, 297-297. Retrieved from http://search.proquest.com/docview/304050059?accountid=27045 Kolcaba, K., & DiMarco, M. (2005). Comfort theory and its application to pediatric nursing. Pediatric Nursing, 31(3), 187-94. Retrieved from http://search.proquest.com/docview/199528895?accountid=27045