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NR 510: DQ 2 Week 2: Theory and APN Role Discussion Part Two

NR 510: DQ 2 Week 2: Theory and APN Role Discussion Part Two

Karen is still not convinced that Theory has any place in APN practice. Provide a specific example of how theory is relevant to APN practice in one of the four specialties (CNM, CNP, CRNA or CNS). Provide evidence to support your arguments.

I think that Karen hasn’t opened her mind to what nursing theories can do and have done for us as nurses. There are so many that have brought us to be the nurses that we are today.  I honestly didn’t think they were that important, until taking the theories course a few months ago.  I had taken multiple theory classes before this.  I just never had thought deep enough about their importance.

I like to describe Katharine Kolcaba’s comfort theory when discussing nursing theories.  I especially like this theory because it describes holistic care to patients.  The patient can be an individual, a family, a community, or institutions who are in need of healthcare (Lima, Guedes, Silva, Freitas, & Fialho, 2017).  This will be especially true for CNS, as we will be treating not only a certain patient.  Education always involves more than that patient.  Family is generally involved.  Community prevention is also extremely important such as childhood obesity or mental health education.  The numbers of those suffering from these two particular diagnosis are on the rise, and education to the community may be helpful in the prevention of them.

Kolcaba also describes the different types of comfort that can be utilized.  The human needs are addressed as relief, ease, and transcendence (Merkel, 2007).  Most patients that present will have some form of pain.  One way of providing comfort is to decrease the amount of pain that the patient is experiencing.  Pain can be acute or chronic, in which cases the pain may not be completely relieved, but if the patient can get back to doing their everyday life activities, then they have been treated appropriately.  Different types of pain relief could be non medicinal, such as a warm blanket or a hand to hold.  Sometimes these patients need something simple like that, but it means more to them than we think.  As a CNS, providing comfort to patients is the key to a successful diagnosis.

 

Lima, J., Guedes, M., Silva, L., Freitas, M., Fialho, A. (2017).  Usefulness of the comfort theory in the clinical nursing care of new mothers: critical analysis.  Scientific Electronic Library Online, 37(4).  doi:

http://dx.doi.org/10.1590/1983-1447.2016.04.65022  (Links to an external site.)

Merkel, S. (2007).  Comfort theory: A framework for pain management nursing practice.  Retrieved from www.aspmn.org (Links to an external site.)

As a future CNP, Karen will establish relationships with patients and colleagues. She is a primary care provider who will deal with patients of all ages. Karen will be trained to individually assess health problems and risk factors and to develop treatment plans. She may decide to collaborate with other health providers and colleagues to identify patients’ health problems and implement the appropriate interventions. Karen’s overall goal is to improve the health of the individual and family. To foster a strong relationship between herself, her patients, and other healthcare providers on her patients’ healthcare teams, Karen must master the art of interpersonal communication. This is the process that allows people to exchange information and feelings through verbal and non-verbal messages (Lee & Doran, 2017). Interpersonal communication is face-to-face communication that determines how well patients and CNPs understand each other and work together to reach health goals (Lee & Doran, 2017).

Psychiatric nursing pioneer, Hildegard Peplau’s Theory of Interpersonal Relations model points out four sequential phases, the primary areas of communication essential to the nurse/patient relationship: orientation, identification, exploitation, and resolution (Nursingtheory.org, 2016). These frameworks help nurses understand their behavior in relation to listening to patients describe their health problems and working with other health providers. Peplau describes nursing as a “therapeutic, healing art” that becomes an interpersonal process because of the interaction between the NP, patient, and other healthcare providers (Arora, 2015). Interpersonal communication guides the way NPs create treatment plans and set health goals for patients and their families. Positive, open, and respectful interpersonal communication help the nurse and patient work together to become mature, knowledgeable partners in the care process (Arora, 2015). In my experience, patients often feel nervous and anxious around medical personnel. Many patients become defensive, passive-aggressive, shy, or uncomfortable all because they do not want to be perceived as uneducated about their health or the diagnosis/treatment information being relayed.

Patients feel nurses and doctors talk at them instead of with them. I have heard patients complain that nurses are rude just because the patient did not understand what the nurse said about a diagnosis or treatment. Karen can use Peplau’s theory to engage in better ways to communicate with patients and help them feel valued. Undergraduate nursing school taught me best practices in creating a solid patient-nurse relationship. In Peplau’s model, this begins with the orientation stage. First, I should introduce myself to the patient then state my credentials and the role I will play. I should ask the patient his or her preferred name. I want to relieve the patient’s anxiety, so I ask the patient if there are any recent health changes he or she would like to discuss with me. I want to normalize the situation, so I may even ask about family life, hobbies, talk about the news, etc. There are so many ways for me to help the patient feel comfortable talking to me. The point is to let the patient know through verbal and non-verbal communication that I am here to help.

 

 

References

Arora, S. (2015). Integration of nursing theories in practice. International Journal of Nursing Science Practice and Research1(1), 8-12. Retrieved from https://www.researchgate.net/publication/283319003_Integration_of_Nursing_Theories_in_Practice

Lee, C. T., & Doran, D. M. (2017). The role of interpersonal relations in healthcare team communication and patient safety: A proposed model of interpersonal process in teamwork. Canadian Journal of Nursing Research49(2), 75-93. Retrieved from https://doi.org/10.1177/0844562117699349

Nursingtheory.org. (2016). Hildegard Peplau Theory. Retrieved from http://www.nursing-theory.org/theories-and-models/peplau-theory-of-interpersonal-relations.php

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