NUR 700 Discussion 5.1: Community Meaning and Technological Competency

Technology in Nursing Care

        Technology is always evolving, this includes healthcare. There are many positives to technology in nursing, but there are still

some negatives to this evolution. Negatives to technology in nursing care include the ease of sharing, even accidentally, patient information and the need for HIPPA (Yeter & Mesude, 2020). Some older adults have a disconnect from the rise in technologically based communication. Technology can make some clinicians more task oriented, and less concerned with the patient as a person (Yeter & Mesude, 2020). Technology should be used as a tool to aide in a more conductive and efficient healthcare experience. Technology has also helped in providing better nursing care (Yeter & Mesude, 2020). Electronic medical records have literally changed nursing care in so many ways, for the better. EMR allows nurses to have all of the patient’s medical history in one place, medications, previous procedures and diagnoses, a social history, clinician notes easily accessible and transferrable. A patient’s medication list can be quickly accessed by their pharmacy. This allows nurses a head start to learning the patient, and allows them to focus on learning the patient as a human being (Yeter & Mesude, 2020). Images and diagnostic findings can be be received by other physicians in a more timely fashion, reducing patient radiation and faster interventions. Inquiries into patient illnesses and disease processes can be answered more quickly with evolving technologies, such as thinner sections in CT scanners, portable Xray machines and EKG readers. In the cardiac catheterization lab, technology is always upgrading. Moving surgical lights and monitors have aided in the cardiologists ability access and view the arteries more clearly. Portable ultrasound machines have made it easier to gain access to the artery, to reduce the number of sticks to a patient. Defibilators have allowed for a more timely intervention in emergency situations.

The ability of the fluoroscopy and procedure table to move allows the cardiologist to see different views of a two dimensional image, allowing them to find hidden blockages in the arteries. The vitals monitoring systems allow nurses to watch the vital signs and cardiac rhythms continuously, allowing for faster interventions when there is a drop in blood pressure, heart rate, cardiac rhythms, or arterial pressures. Contrast injectors has shortened cardiac catheterization times. Smaller sheaths, wires and catheters have reduced patient blood loss during cardiac catheterizations. Pyxis machines have reduced medication administration errors, especially during code situations (Smith, 2020). Transesophageal echocardiograms have allowed the cardiologist to observe emboli before a cardio version, preventing blood clots from traveling and becoming life threatening. The EMR is extremely helpful to a nurse in the cardiac catheterization lab as we can quickly find medications ingested, allergies, and notes from the cardiologist following a clinic appointment. Sedation is sometimes given during a catheterization, so knowing if the patient has taken any other narcotics is extremely important. The nurse needs to know any allergies the patient may have to prevent anaphylaxis, contrast dye is a common allergy and can be life threatening. Notes from the cardiologist following a clinic appointment can give the nurse insight into why the procedure is being performed and any abnormalities or variances they want to the procedure. Sterility of instruments used in arterial procedures prevents post procedural infections. Cardiac pacemakers quite literally allow a patients heart to beat fast enough to pump blood to their vital organs. All of technological advancements have enabled cardiac catheterization nurses the ability to work more efficiently, and provided more moments to learn each patient, or advocate for them more appropriately if needed.

Logotherapy and tragedy in a community

        September 11, 2001 is probably one of most traumatic events in history, while the community involved is a massive one, there were several different coping mechanisms that were used. there were many victims and loved ones following this tragedy, so there are many different ways to utilize the three core concepts of Logotheory. With Freedom of will, the survivor has the responsibility to their own outlook on the meaning of their own life. The person can choose to feel as though their loved one is in a better place, that their loved one didn’t die in vain, and find a reason that they are still alive. Possibly, the belief that the loved one would want them to do great things in life (Weathers & Murphy, 2014). Will of meaning would be the need to pursue a helpful role. Survivors that initiated support groups, provided financial and emotional aide, started scholarships, reached out to other survivors, or shared their stories were all answering to will of meaning; as they chose to find a purpose in their life, and an outlet to cope with their tragedy (Weathers & Murphy, 2014). Meaning in life refers to remembering the importance of one’s existence post traumatic event.  With this concept, the individual may think of other surviving loved ones, they may find importance in helping others, they may  take solace in keeping the memory of their loved one alive (Weathers & Murphy, 2014). Personally, I would practice active listening with the grieving person. I would learn the patient as a whole person to attempt to draw out the biggest anxieties and stressors (Smith, 2020). After understanding the root of the patient’s highest priority issue, we can discuss their own freedoms and responsibilities. I would discuss what is important to them as a person, and encourage them to do more of those things. Reassuring a patient that the feelings they are experiencing are normal and try to understand what may aid in getting through the stages of grief, as the transition process is different for everyone and is not linear (Ozan & Duman, 2020). Personally, I may refer the person to a support group for survivors and possibly a therapist. Respect the grieving person at all times, never making them feel as if their feelings are irrelevant, or as if they are psychologically ill. Never compare a patient’s situation to your own, even if you think it may create a bond, but create a trusting rapport with the patient. Rapport is one of the most important tools in a trusting relationship between client and healthcare provider, it is imperative to determine how the patient best communicates (Smith, 2020). Attending conferences that allow the nurse to speak to other people about the crisis involved with loss may bring breakthroughs in counseling services in the workplace, so people dealing with loss can easily find support in a time of need. Encouraging people to come forward when dealing with the hardships of the loss of a loved one to destigmatize the psychological process that acompanies a tragedy may bring forth an environment in which these people can feel more at ease and understood. Creating an environment in which a sufferer feels comfortable may be the key to helping them through the transition to their new normal (Smith, 2020).

 

Ozan, Y. D., & Duman, M. (2020). Nurses’ Perceptions Regarding the Use of Technological Devices in Nursing Care Practices. International Journal of Caring Sciences, 13(2), 901–908.

Ameli, M., & Dattilio, F. M. (2013). Enhancing cognitive behavior therapy with logotherapy: Techniques for clinical practice. Psychotherapy, 50(3), 387-391. http://dx.doi.org.ezproxy.bradley.edu/10.1037/a0033394

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

Weathers, E., & Murphy, M. (2014). Theory of meaning. In J. Fitzpatrick & G. McCarthy (Eds.) (PDF), Theories guiding nursing research and practice (pp. 324–338). Springer.

Community, Meaning, and Technological Competency

Technological competency is the congruous concurrence amid technologies and caring in nursing (Locsin, 2017). The basic point of technological competency in nursing is to recognize that the individual is the emphasis of nursing and that numerous technologies are able to be used to assist in the understanding of the individual (Miyamoto et al., 2017). Technological competency has been a very strong foundation of my nursing career. Having only been a nurse during the modern times of electronic health records (EHR), I am unfamiliar with written charting. EHRs are considered a safer and more secure means of charting, more efficient, and delivers an improved process of communication than does written charting (Spencer & Lunsford, 2010). EHRs have assisted me with efficiently gathering information about my patients in a concise format to be reviewed at any given point by myself or other nurses and providers. Admission assessments are one specific example that I can think of that EHRs have assisted nurses, especially myself, in completing them in a more proficient manner. Our admission assessments touch on the specific points that need to be conducted and documented such as pertinent patient history, mobility, diet, sleep, depression, physical assessment, advanced directives, immunizations, emergency contacts, measurements, wounds, tubes and devices, brief interview for mental status (BIMS), Glasgow coma scale (GCS), elopement risk, fall risk, dysphagia screening, and so much more. A vast amount of this could be missed if it were not for the computer prompting us to ask these questions and perform these assessments. This enables me to ensure I get a clear, overall picture of my patient so that I can truly know them as a whole rather than one minor aspect which might only be why they are being admitted. This example illustrates the well-balanced connection linking technological competency and caring in nursing.

On June 12, 2016, 49 people were killed and 53 more were wounded in a mass shooting at Pulse nightclub in Orlando, Florida (Zambelich, 2016). This hits home for me as I live an hour outside of Orlando, and had friends who frequented Pulse. Some of these friends were nurses themselves. I am lucky to have not lost my closest friend from both school and work who was planning to attend that night but picked up a shift at work instead. He, however, lost friends of his own that night. Reflecting on the Pulse nightclub shooting, I can see how logotheory would have been beneficial to those affected by this tragedy. Logotheory is the Theory of Meaning, which is a theory concerned with finding meaning in life (Weathers & Murphy, 2015). The three fundamental principles of logotheory are freedom of will, will to meaning, and meaning in life (Weathers & Murphy, 2015). Freedom of will is the self-determination of how we express ourselves in response to various situations (Weathers & Murphy, 2015). Will to meaning is the inner motivation to find meaning in life (Weathers & Murphy, 2015). Meaning in life is specific meaning in a person’s life at a particular point (Weathers & Murphy, 2015). I would have used logotheory to help the individuals of the Orlando community cope with the post-disaster symptoms such as anger by giving them the knowledge to know that what they are feeling is anger, but the tools to express that anger via a better means than violence or outbursts. For example, that anger could be channeled into a seminar educating the public about hate crimes against the lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) community. Logotheory would have also helped by showing them that they must want and choose to find the meaning of this situation rather than someone else telling them the meaning behind the lost lives. Finally, I would have led them to understand that everything happens for a reason, and they must come to terms with the tragic events by finding meaning in their life as a result of this event. That meaning might be that they are an ally for the LGBTQ community, and might want to specialize in social work geared at helping this particular sector of the public.

The four themes (nursing, person, community, and environment) of the Community Nursing Practice Model (CNPM) can help guide the care of victims after traumatic community events. To meet the standards of the nursing theme, nurses can be authentically present in the community (Parker et al., 2020). This can be displayed through community and school-based wellness centers which can focus on improving and maintain mental health following a traumatic event. For the person theme, nurses can show respect for their clients and acknowledge that each individual is the expert in their own care based on their experiences (Parker et al., 2020). An example of this could be an inquiry group method using coparticipants and a nurse facilitator to encourage expression and provide nursing guidance on how to manage oneself after a traumatic event. For the community aspect of the CNPM, it entails providing safe spaces for individuals to feel secure, included, and honored (Parker et al., 2020). This could occur within a clinic, public park, school, or even a church as long as it helps construct and shape relationships based upon acceptance of individual and cultural diversities among those involved but linking it back to the traumatic event. Finally, for the environment portion, nurses must consider how both animate and inanimate objects affect human beings and can influence health and illness following a traumatic event (Parker et al., 2020). After a traumatic event, people may have drastic life changes requiring them to find a new job, obtain housing, seek treatment for a new injury or ailment, attain childcare, or find a means to pay bills and keep their families fed that may not have been an issue prior to the traumatic event. Taking in these four themes, it is evident that nurses are urged to reach out and reinforce and broaden the relationships with coworkers, patients, and community members.

 

References

Locsin, R. C. (2017). The co-existence of technology and caring in the theory of technological competency as caring in nursing. The Journal of Medical Investigation, 64(1.2), 160–164. https://doi.org/10.2152/jmi.64.160

Miyamoto, M., Miyagawa, M., Tanioka, T., Yasuhara, Y., Locsin, R., Osaka, K., Ito, H., & Kongsuwan, W. (2017). Comparative examination between the perceived inventory of technological competency as caring in nursing (pitccn) and the technological competency as caring in nursing instrument (tccni). International Journal of Nursing & Clinical Practices, 4(1), 267–271. https://doi.org/10.15344/2394-4978/2017/267

Parker, M. E., Barry, C. D., & King, B. M. (2020). The community nursing practice model. In M. C. Smith (Ed.), Nursing theories and nursing practice (5th ed., pp. 421–435). F. A. Davis.

Spencer, J. A., & Lunsford, V. (2010). Electronic documentation and the caring nurse-patient relationship. International Journal for Human Caring, 14(2), 30–35.

Weathers, E., & Murphy, M. (2015). Theory of meaning. In J. Fitzpatrick & G. McCarthy (Eds.), Theories guiding nursing research and practice (pp. 323–340). Springer Publishing. https://doi.org/10.1891/9780826164056

Zambelich, A. (2016). 3 hours in Orlando: Piecing together an attack and its aftermath. NPR.org. https://www.npr.org/2016/06/16/482322488/orlando-shooting-what-happened-update

echnological Competency 

Technology in healthcare is continuously developing and advancing. With these advancements, it is vital for nurses to maintain technological competency to enhance the care that they are able to provide to their patients. Locsin’s Technological Competency as Caring Theory works to frame the relationship between nursing care and technology. He focuses on the idea that technology does not replace caring, but rather it improves the care patients are receiving by allowing nurses to work more efficiently, know more about their patients, and provide safer interventions (Brodell, 2009). Technology is utilized in many aspects of healthcare including, but not limited to, vital sign and cardiac monitors, charting systems, and IV pumps. Proficiency in these technologies is imperative when taking care of patients, especially in that it enhances the nurse’s ability to know their patient as a whole (Locsin, 2001). In my nursing career I have noticed that utilizing technology can be very effective in providing a more caring experience to my patients; however, it also has the possibility of providing the opposite if the nurse is not competent in the technology, or if the patient does not understand the intention of the technology. I noticed this while working at my current travel nursing assignment. In this facility we use both walkie-talkie headsets and iPhones to facilitate communication between staff. The iPhone has many different applications to assist in patient care, such as a video translator, an interprofessional messaging platform, and a medical library. I have found that using this iPhone can allow for easy communication between staff, and can provide patients with immediate answers to their questions. However, it is essential to be fully transparent with the patients about the phones’ purpose so that they do not think you are utilizing a personal device.

 

Traumatic Community Event and Logotheory 

Viktor Frankl’s Logotheory focuses on the idea that life can have meaning despite traumatic circumstances. His theory can be applied to many tragic events that have transpired, including the Sandy Hook shooting in Newtown, CT, which occurred less than ten miles from my home. On December 14, 2012, twenty first-grade students and six staff members were murdered at Sandy Hook Elementary School in what would be the second-deadliest school shooting in the United States. This traumatic event had lasting impacts on, not only the town of Newtown, CT, but people all over the world. The three tenets of Logotheory can be applied in this situation to aid in the coping of those involved in this mass shooting. Freedom of will refers to the idea that people have choices and can choose how to respond to tragedy. Will to meaning is the idea that people are motivated by the need to find meaning and value in life. The final tenet, meaning of life, focuses on the idea that meaning can be found in even the most tragic of circumstances (Wong, 2011). These tenets can help those coping from tragedy by enabling them to endure their suffering and find meaning in their life as a whole, not defined by their specific situation (Weathers & Murphy, 2014). They can turn the unthinkable event that occurred into an inspiration to help others or to advocate for what they believe in.

The four themes (nursing, person, community, and environment) of the Community Nursing Practice Model can guide the care of victims following traumatic community events, like the Sandy Hook shooting. When providing nursing care to these patients, I would focus on the patient as a whole, taking the time to understand how I can be helpful to that patient and target what is meaningful to them. Additionally, providing patients with a safe-space in their community and offering opportunities for support groups can help victims as well. Being around those who share common strengths, concerns, and values can foster a healing environment for individuals following a traumatic community event.

 

References

Brodell, E. G. (2009). Views of Student Nurses on Caring and Technology in Nursing. UND Scholarly Commons.

Locsin, R. (2001). Advancing technology, caring, and nursing. Westport, Connecticut: Auburn House.

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

Weathers, E., & Murphy, M. (2015). Theory of meaning. In J. Fitzpatrick & G. McCarthy (Eds.), Theories guiding nursing research and practice (pp. 323–340). Springer Publishing. https://doi.org/10.1891/9780826164056 (Links to an external site.)

Wong, P. (2012). From logotherapy to meaning-centered counseling and therapy. In P. T. P. Wong (Ed.), The human quest for meaning: Theories, research, and applications (pp. 619–647). Routledge/Taylor & Francis Group.