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NUR 700 Discussion 4.1: Story Theory and Clinical Comfort in Nursing

NUR 700 Discussion 4.1: Story Theory and Clinical Comfort in Nursing

ST. Thomas University NUR 700 Discussion 4.1: Story Theory and Clinical Comfort in Nursing-Step-By-Step Guide

 

This guide will demonstrate how to complete the ST. Thomas University NUR 700 Discussion 4.1: Story Theory and Clinical Comfort in Nursing  assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

 

How to Research and Prepare for NUR 700 Discussion 4.1: Story Theory and Clinical Comfort in Nursing  

 

Whether one passes or fails an academic assignment such as the ST. Thomas University NUR 700 Discussion 4.1: Story Theory and Clinical Comfort in Nursing depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

 

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

 

How to Write the Introduction for NUR 700 Discussion 4.1: Story Theory and Clinical Comfort in Nursing  

The introduction for the ST. Thomas University NUR 700 Discussion 4.1: Story Theory and Clinical Comfort in Nursing  is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

 

How to Write the Body for NUR 700 Discussion 4.1: Story Theory and Clinical Comfort in Nursing  

 

After the introduction, move into the main part of the NUR 700 Discussion 4.1: Story Theory and Clinical Comfort in Nursing  assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

 

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

 

How to Write the Conclusion for NUR 700 Discussion 4.1: Story Theory and Clinical Comfort in Nursing  

 

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

 

How to Format the References List for NUR 700 Discussion 4.1: Story Theory and Clinical Comfort in Nursing  

 

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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NUR 700 Discussion 4.1: Story Theory and Clinical Comfort in Nursing

Story Theory

The story theory presents a framework where the nurse and person can develop an intimate relationship critical in improving the quality of care. The practitioner has a favorable understanding of the perspectives of the patient regarding the treatment process and its cultural implications; thus, they are uniquely placed to tailor the plan to the required specificity for the realization of positive health outcomes. Connecting with self-in-relation involves the practitioner identifying with the needs of the person. The nurse engages in hypothetical speculation through intentional dialogue to create ease (Brodziak et al., 2017). The practitioner endeavors to explain the treatment plan in relation to the medical condition by immersing themselves in a story to make it relatable and expedite movement towards a resolution. The professional seeks to create a feedback channel where the patient can participate in the provision of care by offering insights and other critical information required to achieve improved recovery prospects.

The first strength of the leadership theory is that there is follower inclusivity whereby, once the employees see the leader’s dedication, they will follow them. There is the discouragement of unproductive behavior (Burkus, 2020). When the leader serves the employees well, they, in turn, offer customer satisfaction. Secondly, there is a positive work environment as the leader supports and builds a shared goal (Whitney, 2018). Another strength is that servant leadership helps boost morale in an organization. Contrarily, there are weaknesses to the theory; the first weakness is that it is challenging to explain and communicate the concept of servant leadership (Burkus, 2020). The next one is that retaining servant leaders in the healthcare system is challenging and time-consuming. Another weakness is that followers view servant leaders as weak; therefore, it may be hard to heed their rules (Burkus, 2020). Servant leadership is hard to achieve as it requires an individual with high authenticity levels.

Duffy’s (2008) quality caring model explores the value of empathetic nursing within the modern context of evidence-based practice. Patient care is segmented into a variety of satisfaction indicators that, if met, significantly improves the prospect of achieving positive health outcomes. The theory advocates for relationship-centered professional encounters between practitioners and patients to relish a sense of being cared for, thus, expedite recovery prospects and enhance the subject’s well-being. One particular case that resonates with me the that of Mrs. M, a 76-year-old female who was not responding to treatment. I noted that the patient’s poor response was primarily caused by immense psychological stress caused by increased financial uncertainty. Being an immigrant and a low-income earner, she was ineligible for Medicaid and was unable to afford private insurance. The patient’s daughter had lost her job during the pandemic. Mrs. M was worried she might not be discharged from the facility after receiving treatment. I assisted her by informing her of the available facilities for persons in her situation. The patient was grateful that someone had expressed genuine concern for her plight and recovered soon after.

References

Brodziak, A., Wolinska, A., & Rozyk-Myrta, A. (2017). The story theory is a key element of many holistic nursing procedures. J Gerontol Geriatr Res6(454), 2. https://www.longdom.org/open-access/the-story-theory-is-a-key-element-of-many-holistic-nursing-procedures-2167-7182-1000454.pdf

Duffy, J. R. (2008). Quality caring in nursing: Applying theory to clinical practice, education, and leadership. Springer Publishing Company.

Story Theory and Clinical Comfort in Nursing

Story theory, a middle-range nursing theory, can strengthen the care that nurses provide to their patients. Stories are a vital facet of human experience and nursing practice. Story theory depicts a narrative event that transpires through intended nurse-person dialogue (Liehr & Smith, 2018). It strengthens nursing care by improving the bond between practice and research (Liehr & Smith, 2018). Story theory is comprised of three correlated ideas: intentional dialogue, connecting with self-in-relation, and creating ease (Brodziak et al., 2017). Intentional dialogue is the pivotal action between the nurse and the patient that animates the story (Liehr & Smith, 2018). It allows for the nurse to question what is most important about a complex health issue (Liehr & Smith, 2018). Connecting with self-in-relation happens with insightful mindfulness on one’s own experiences (Liehr & Smith, 2018). It is a dynamic course of identifying self as linked with others in an emerging story plot revealed during intentional dialogue (Liehr & Smith, 2018). Creating ease is recalling fragmented story instances to encounter flow all while establishing a grasp on the complete story (Liehr & Smith, 2018). When the different parts of a story come together in a noteworthy way, there is frequently advancement in the direction of solving and answering a health issue. Story theory also brings about listening and true presence (Brodziak et al., 2017). Using story theory with my rehabilitation patients strengthens the care I provide by permitting my patients to transition to further independence. This is achieved by allowing myself to question what it is about the patient’s current diagnosis that matters most to them, reflect on past events that may have contributed to this new diagnosis, and linking those different parts together to create ease of resolving the health issue at hand. I can engage in intentional dialogue about the effects of the patient’s new diagnosis to see if it is the newfound need to rely on others, the inability to express themselves appropriately, or maybe the change in body image that is largely bothering them. I can help them determine which aspect they want most to correct. I can assist the patient to reflect on past decisions and choices that may have led to this key moment in their life, and help them determine new care methods and positive changes they can make to prevent something like this from happening again.

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I can recall a specific instance in which I could have used Kolcaba’s Theory of Comfort to care for a patient. The patient was a younger male who was recovering from COVID-19. He spent two months in the intensive care unit prior to being transferred to the rehabilitation hospital that I work at currently. The patient had a tracheostomy, a gastrostomy tube, a stage 3 sacral pressure injury,

NUR 700 Discussion 4.1 Story Theory and Clinical Comfort in Nursing
NUR 700 Discussion 4.1 Story Theory and Clinical Comfort in Nursing

an unstageable pressure injury to the occipital area, and ‘COVID rash’ covering both lower extremities. The patient also suffered an acute kidney injury now requiring hemodialysis. Kolcaba’s Theory of comfort entails assessing the patient’s comfort requirements, creating and executing suitable nursing care plans, and evaluating the patient’s comfort after the care plans have been carried out (Bice & Kolcaba, 2020). Comfort occurs in three ways: relief, ease, and transcendence (Bice & Kolcaba, 2020). Relief is meeting a patient’s specific physiological comfort needs (Bice & Kolcaba, 2020). Ease addresses comfort in a state of tranquility (Bice & Kolcaba, 2020). Transcendence is described as the state of comfort in which patients are able to overcome their problems (Bice & Kolcaba, 2020). For relief, I helped the patient achieve this through medication administration for pain management. I could have improved his relief by adding extra pillows or an air mattress topper to help reduce pressure on his sacrum. For ease, I helped the patient achieve this by answering questions to decrease his anxiety of the unknown. I could have done a better job on this aspect by holding the patient’s hand, sitting with him so that he did not feel alone, providing a communication board to help him communicate needs due to the inability to speak as a result of the tracheostomy, or by helping him video chat with his family. For transcendence, I do not recall helping the patient achieve this level of comfort. Reflecting back, I could have begun to teach him how to manage his own bolus feeds through his gastrostomy tube, which would have assisted him with overcoming a new challenge in his life. However, I just did the feedings myself, but I now realize, that should have been a teachable moment as well as a moment of transcendence for him. Adding all of these things to my interventions would have improved this patient’s quality of care.

 

References

Bice, A. A., & Kolcaba, K. (2020). Katharine Kolcaba’s comfort theory. In M. C. Smith (Ed.), Nursing theories and nursing practice (5th ed., pp. 371–381). F. A. Davis.

Brodziak, A., Wolinska, A., & Myrta, A. (2017). The story theory is a key element of many holistic nursing procedures. Journal of Gerontology & Geriatric Research, 6(6). https://doi.org/10.4172/2167-7182.1000454

Liehr, P. R., & Smith, M. J. (2018). Story theory. In M. J. Smith & P. R. Liehr (Eds.), Middle range theory for nursing (4th ed.). Springer Publishing. https://doi.org/10.1891/9780826159922.0011

Story Theory and Clinical Comfort in Nursing

Story Theory

Story theory provides an opportunity for patients and caregivers to address health-related challenges, allows patients to reflect on perceptions of their current health, and allows caregivers to encourage positive thinking (Chuang et al., 2018). In addition, the use of story theory allows nurses to establish what is most important to the patient. As we identify what is most important to the patient, we can develop a plan of care that promotes a higher level of healing. The story theory consists of three concepts: intentional dialogue, connecting with self-relation, and creating ease. Intentional dialogue centers around purposely engaging with the patient to determine what matters most regarding their complicating health challenge. Connecting with self-relation includes individuals being aware of others and connecting the relationship between the past and present health challenges. This can consist of high points, low points, and turning points. Finally, providing or creating ease for the patient does not always imply that it will be permanent. This can be a fleeting moment, but it is still a step toward recovery and healing (Smith, 2020). The story theory will strengthen my care towards clients through the implementation of these three concepts. As a recovery nurse, I have to repeatedly assess what current health issue is most pressing to my patient. This could be nausea, pain, thermoregulation, fluid intake, circulatory issues, or education. I must never assume what is most important to the patient, but if I am willing to listen and have a purposeful engagement, I will establish how to best provide for my patient’s needs. Many individuals recovering from anesthesia have previous experience, or it is their first time, and is unsure what to expect. As I promote reflection of past experiences or fears, I can foster awareness and ease the patient. By implementing intentional dialogue, I can determine their greatest health challenge, allow for reflection and self-evaluation of past experiences, and foster a positive mentality for themselves.

Comfort Theory

Comfort is defined as being strengthened by meeting the three types of comfort and the four contexts of the human experience. The three types of comfort are relief, ease, and transcendence. The four contexts of the human experience are physical, psychospiritual, environmental, and sociocultural (Coelho et al., 2016).  Relief is meeting your comfort needs. Ease is a care experience that promotes calm and contentment. Transcendence is an experience that allows the patient to rise above the pain (Vo, 2020). As I reflect on my nursing experience, I think of a patient I cared for when I was a new graduate. I was working in a Cardiovascular Thoracic Unit caring for a middle-aged female who had stage four lung cancer and had recently undergone a lung decortication. The patient had a double lumen chest tube and was in agonizing pain. I could have provided relief through the physical context and addressed her pain more frequently. I attempted to provide some psychospiritual relief in telling her about the pain relief from the chest tube removal, but I see that this only provides hope and does not address current pain. This patient expressed her religion as catholic and carried a small statue of the Virgin Mary. She needed it visible at all times. I could have provided psychospiritual relief by addressing her anxieties and making sure that her statue was visible to her at all times. I attempted to address environmental factors such as lighting and temperature, but I could have addressed noises in her room and potential odors. I could have addressed her sociocultural needs by sitting with her and establishing her support system, performing more thorough teaching, and discussing her barriers to healing. As I reflected on providing her with ease, I attempted to address questions and pain to the best of my ability at that time. However, I now know the care I provided did not provide transcendence. If I could care for this patient again, I would readdress my patient’s needs, add this theory to my practice, and provide a higher quality of care.

References

Chuang, H. W., Kao, C. W., Lee, M. D., & Chang, Y. C. (2018). Effectiveness of story-centered care intervention program in older persons living in long-term care facilities: A randomized, longitudinal study. PloS one13(3), e0194178. https://doi.org/10.1371/journal.pone.0194178 (Links to an external site.)

Coelho, A., Parola, V., Escobar-Bravo, M., & Apóstolo, J. (2016). Comfort experience in palliative care: A phenomenological study. BMC palliative care15, 71. https://doi.org/10.1186/s12904-016-0145-0 (Links to an external site.)

Smith, M. C. (2020). Nursing theories and nursing practice (5th ed.). F.A. Davis.

Vo T. (2020). A practical guide for frontline workers during COVID-19: Kolcaba’s comfort theory. Journal of patient experience7(5), 635–639. https://doi.org/10.1177/2374373520968392

Story Theory
Patricia Liehr and Mary Jane Smith’s Story Theory is a middle range theory that focuses on using story to help patients connect with self-in-relation using nurse-patient intentional dialogue to create ease (Smith & Liehr, 2018). The nurse and patient work together to create a story by identifying a health challenge that is meaningful to the patient. They further investigate what lead up to this challenge, how the challenge is affecting them currently, and ways to resolve the challenge. The goal of creating this story line is to cultivate a sense of ease and help the patient work towards resolving the health challenge (Smith, 2020). Using the Story Theory in practice will help me to better understand my patient’s situation and what is meaningful to them. It will also help my patient accept the whole story as his/her own and light the path towards resolving the health challenge. Using Story Theory in my nursing practice will allow me to connect with my patients on a deeper level and ensure that I am taking their priorities into consideration in their plan of care.

Quality-Care Model
Joanne Duffy’s Quality-Caring Model is another theoretical framework used in nursing practice. This model focuses on the idea that patients heal faster in an environment where they feel cared for (Davidson et al., 2017). It also proposes that those who feel cared for are more likely to involve themselves in health-promoting behaviors. I cared for many patients with new colostomies while working on a colorectal surgery unit. These patients are going through a major life transition and require a lot of teaching, reassurance, and emotional support. One of my patients was a 26-year-old girl with Crohn’s disease who required a colostomy. While I tried to provide the best care possible for this patient, I could have utilized the Quality-Caring Model in my practice. One way I could have used this model is by forming caring relationships. Taking care of a patient with a new ostomy requires a lot of undivided attention, making it essential to slow down and be fully present in all of my conversations with my patient. I could have made sure my charge nurse knew that I was going into this patient’s room to do teaching and asked if she could keep an eye on my other patients so that I was fully immersed in her care. Additionally, I could have used caring behaviors while working with this patient to ensure I was providing quality care. For example, mutual problem solving and attentive reassurance are two behaviors that are extremely important when caring for patients with new ostomies. If I used these behaviors in my practice, I could have focused on any specific needs she may have had and been able to provide a positive outlook and reassurance. When my patient was being discharged she was extremely anxious and had a lot of last minute questions. I remember thinking that I wish I had taken more time to sit down with her and go over ostomy care more thoroughly. This would have been a perfect opportunity to implement Duffy’s Quality Care Model into my nursing practice.

References

Carpenter, R. (2010). Using story theory to create an innovative honor level nursing course. Nursing Education Perspectives, 31(1).

Davidson, J., Baggett, M., Zamora-Flyr, M. M., Giambattista, L., Lobbestael, L., Pfeiffer, J., & Madani, C. (2017). Exploring the human emotion of feeling cared for during hospitalization. International Journal of Caring Sciences, 10(1).

Smith, M. C. (2020). Nursing theories and nursing practice (5th ed.). F.A. Davis Company.

Smith, M. J., & Liehr, P. (2018). Middle range theory for nursing (4th ed.). Springer Publishing Company.

Patricia Liehr and Mary Jane Smith created Story Theory as a nursing framework to recognize increased health promotion occurs when the context of a patient’s situation is considered (Smith, 2020). The three concepts forming Story Theory include connecting self-in-relation, intentional dialogue, and creating ease (Smith, 2020). A study was done to research the ethnocultural beliefs regarding organ donation among selected Chinese-Canadian, Indo-Canadian, and Coast Salish Canadians. The results highlighted the impact cultural beliefs and trust in the healthcare system had on decisions made regarding organ donation (Hain, 2006). The complicating health challenge is these families having a dying family member eligible for organ donation. The healthcare team may ask these families for permission for organ donation. End of life decisions are complicated and emotionally exhausting for family members. The nurse should communicate with the family to develop the story plot for better understanding of decision-making. For example, the study found cultural beliefs about death and lack of knowledge about organ donation prevented families from committing to donation (Hain, 2006). The more knowledge nurses have about a family’s situation allows them to provide patient education tailored to the learning needs of the family. If a patient’s culture requires them to be buried fully intact, the nurse should know and respect the patient’s customs. The context of these situations is gained through using Story Theory. The final step is moving towards resolution by creating ease (Smith, 2020). If the family from the study is adamant about refusing organ donation, the nurse can create ease through other practices. The nurses can provide other rituals or comfort measures that are more culturally competent for the situation. The story of a patient is necessary for providing holistic care. As a dermatology nurse, I often use Story Theory to understand patient’s medication non-compliance. If a patient did not use the medication as instructed, there is usually a reason. A patient stated he did not use the anti-fungal shampoo prescribed. I asked why he did not use it and he stated it is too long to lather and wait five extra minutes in the shower when he is a single father of two children. He needed his showers to be quick and efficient so he had more time to attend to his kids. Based on this information, we were able to offer the patient the anti-fungal medication in a cream form. The new formulation was more applicable to the patient’s lifestyle and increased his adherence to the medication.
Comfort Theory was created by Katharine Kolcaba to encompass the influence comfort has on patient well-being (Smith, 2020). The article regarding comfort theory and its application to pediatric nursing focuses on the initiative of comfort practices as a standardized care instead of as a response to uncomfortable situations (Kolcaba & DiMarco, 2005). The healthcare needs of pediatric patients are proactive assessment and interventions to increase quality of life (Kolcaba & DiMarco, 2005). The nursing interventions can be physical, psychospiritual, sociocultural, and/or environmental (Smith, 2020). For example, the case study references a 12-year-old Hispanic female admitted to the PICU following a spinal fusion surgery(Kolcaba & DiMarco, 2005). The nurse provided a Spanish translator to answer the patient’s questions and explain the recovery process in a language the patient understood (Kolcaba & DiMarco, 2005). The translator was a sociocultural intervention that eased patient anxiety and explained pain management options. An example of an intervening variable would be the patient’s age and developmental stage. The nurses could offer ways to communicate with friends and family while the patient is in the PICU for emotional support and enhanced comfort. The health seeking behavior outcome of this situation can be decreased length of stay if the patient understands how to correctly use her patient-controlled analgesic pump (Kolcaba & DiMarco, 2005). The institutional integrity can be seen through the enforced trainings and policies to empower nurses to provide optimal patient care.
An instance I utilized Comfort Theory for my patient is when I worked in the operating room. An anxious patient came into the operating room extremely nervous about intubation. I recognized his need for comfort and offered to put on his music of choice. The patient appreciated my intervention and was visibly relaxed after his favorite song started playing. I also used education to help him feel more comfortable about his new surroundings. Before anesthesia, I put a pillow under his knees and foam padding under his arms for a comfortable position. These interventions eased the patient’s worries and made him easier to intubate. The safety of the procedure was contingent on the patient’s comfortability. I was glad there were steps I could take to make the entire situation better for the patient and our healthcare team.
References 
Hain D. (2006). Use of story theory to explore health challenges of hemodialysis patients. Nephrology Nursing Journal33(2), 141.
Kolcaba K, & DiMarco MA. (2005). Comfort theory and its application to pediatric nursing. Pediatric Nursing31(3), 187–194.
Smith, M. C. (2020). Nursing theories and nursing practice (5th ed.). F.A. Davis.