May 30, | nursing, med, NURS, Paper
Musculoskeletal Shoshanna Tillman Follow Up Sick Visit Shadow Health Treatment Plan
Musculoskeletal Shoshanna Tillman Follow Up Sick Visit Shadow Health Treatment Plan
Treatment Plan: 25 of 25 (100.00%)
Problem Selection
9 out of 9
Primary Diagnosis
Review your answers for the Problem Selection activities. You receive one point for each correct diagnosis, and one point for each correct evidence linked to a correct diagnosis. If there are multiple correct diagnoses, you will also receive a point for correctly selecting which diagnosis is the primary diagnosis.
Learner Selection
Model Documentation
Diagnosis: Joint pain
Identified as primary
Evidences:
Bilateral pain
Pain not associated with trauma
Tenderness with palpation
Learner Rationale:
The patient complains of joint and body pain
Score: 5 out of 5
Diagnosis: Joint pain
Primary: Yes
Evidences:
Bilateral pain
Pain not associated with trauma
Tenderness with palpation
Model Rationale:
At this point in the diagnostic process, you can only provide Mrs. Tillman with preliminary diagnoses. In order to determine a definitive diagnosis, more diagnostic testing is required. In primary care, it is common to have multiple concerns in one visit. These two diagnoses may be related or are two unrelated situations, nonetheless, each diagnosis requires individual diagnostic investigation. Mrs. Tillman’s primary diagnosis is joint pain, while her secondary diagnosis is fatigue. The preliminary diagnosis of joint pain is supported by the evidence collected in the physical exam and reported by Mrs. Tillman: tenderness with palpation, pain not associated with trauma, and bilateral pain Musculoskeletal Shoshanna Tillman Follow Up Sick Visit Shadow Health Treatment Plan. The secondary diagnosis of fatigue is supported by the evidence reported by Mrs. Tillman: an unusual lack of energy, feeling tired, and having difficulty completing tasks due to feeling tired. When making a disease diagnosis, it is important to note that disease diagnosis documentation is permanent in the patient’s records and cannot be undone. Therefore, if you do not have the evidence and diagnostic testing to support a disease diagnosis it is best to collect more data before determining a definitive diagnosis, even if the patient’s signs and symptoms point to a likely disease.
Additional Diagnosis
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Learner Selection
Model Documentation
Diagnosis: Fatigue
Evidences:
Difficulty completing tasks due to feeling tired
Feeling tired
Unusual lack of energy
Learner Rationale:
Patient complains of fatigue, geneal stress, sadness and anxiety.
Score: 4 out of 4
Diagnosis: Fatigue
Evidences:
Difficulty completing tasks due to feeling tired
Feeling tired
Education & Empathy : 4 of 4 (100.0%)
During the patient interview, there are a number of opportunities to provide patient education and empathy. The opportunities listed below are those identified by nursing experts to be of particular importance to this patient. A Model Statement is provided as an example of an appropriate response to each opportunity.
Opportunities marked as Not Encountered are opportunities that were not elicited in the interview
Opportunities marked as Not Followed Up are missed opportunities that were present in the interview, but where no statements were made Musculoskeletal Shoshanna Tillman Follow Up Sick Visit Shadow Health Treatment Plan
Opportunities marked as Followed Up were followed up by students, and include the dialogue between student and patient
1 Caffeine
Followed Up
Description: Mrs. Tillman has been drinking large quantities of coffee to make up for her low energy.
Do you take caffeine?
Question
12:58 PM EDT
I do. I’ll have somewhere between 2 to 3 cups of coffee in the morning, then another one or two in the afternoon.
OK, but too much caffeine is not good for your health
Educate
12:58 PM EDT
Ah, OK.
Model Statement: “I know that you have been feeling very tired and that the coffee helps give you energy bursts, but the caffeine may also be contributing to your ongoing fatigue. Decreasing your coffee intake a little bit can help curb those energy dips.”
2 Exercise
Followed Up
Description: Mrs. Tillman has been feeling very fatigued and reports not having a lot of time or energy to exercise, but movement like walking has helped her pain and stiffness.
Do you exercise?
Question
12:58 PM EDT
I probably could be exercising more. I just don’t have a lot of time or energy. I’ll walk the dog 3 or 4 times a week, which is something. But I used to do these yoga classes, and spin classes, but those don’t really make sense for me now.
I understand your concern but you should always exercise
Educate
01:00 PM EDT
Ah, I see.
Model Statement: “I know that finding the time and the energy to exercise is difficult given your exhaustion. However, taking regular, short movement breaks like walking and stretching may help alleviate your pain, improve joint stiffness, and even reduce your fatigue.”
3 Symptoms Stress
Followed Up
Description: Mrs. Tillman has still been having constant fatigue and joint pain in her hands and wrists; she is frustrated about her symptoms and anxious about her health.
What are you sad about?
Question
07:09 PM EDT
Well, I’m still feeling so fatigued and I’m just sad because I feel like it’s not getting any better . . . I just don’t want to feel like this anymore.
Am sorry about that
Empathize
07:10 PM EDT
Thanks.
Model Statement: “I’m sorry to hear that you have been distressed about your symptoms and are still experiencing so much fatigue and joint pain. I know it is frustrating and stressful not having a diagnosis yet, but we’ll work on improving your symptoms and getting you some answers.” Musculoskeletal Shoshanna Tillman Follow Up Sick Visit Shadow Health Treatment Plan
4 Work Stress
Followed Up
Description: Mrs. Tillman’s art gallery requires a lot of her time and energy to sustain, but with her symptoms she is worried about her business and her family’s financial security.
Do you make enough money at your job?
Question
01:02 PM EDT
Now, the gallery is turning a profit and we’re making sufficient income. It’s still a new business, so it’s taken a while to get it here, but that could change. Running a small business is hard and uncertain, especially in the art world.
Any stress?
Question
01:04 PM EDT
Yeah. I’m really stressed with everything on my plate right now.
I’m sorry about that Musculoskeletal Shoshanna Tillman Follow Up Sick Visit Shadow Health Treatment Plan
Empathize
01:05 PM EDT
Thank you, that’s nice.
Model Statement: “It must be challenging and time consuming to run a small business. I know that your symptoms are causing you distress and have made an impact on your ability to work. We will work on improving your symptoms so you can resume your responsibilities.” Musculoskeletal Shoshanna Tillman Follow Up Sick Visit Shadow Health Treatment Plan
May 30, | nursing, med, NURS, Paper
Jean watson human caring theory sample essays
Jean watson human caring theory sample essays
Jean Watson’s Theory of Human Caring
Jean Watson’s Theory of Human Caring is a middle range theory that focuses on the patient and nurse connection. It focuses on caring authentically patient as a whole, which means caring about the patient’s mind, spirit and body, so the process of healing can continue at an ideal level. Described as a model of caring that includes art and science; a framework that intersects and embraces with art, science, spirituality, humanities and a new dimension of body spirit and mind medicine. Jean watson human caring theory sample essays. Watson believes her theory is one that is open to the changing practice of nursing. By applying abstract concepts of faith, hope, love, caring, and trust to nursing can help stratify the concept of human caring (Williams 2011).
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Comprised of 4 major conceptual elements; clinical Caritas processes, caring moment/caring occasion and caring consciousness and transpersonal caring relationships. The clinical Caritas processes emerges from Watson’s own caritas reason that involves trust, love, faith, hope, selflessness, caring, spirituality, energy and understanding.
Nurses must find it within themselves to say and explore on who they are to offer ideal care. If the nurse is aware of what it takes to care for their patient, it will take them on an experience that not only benefits the nurse but the patient. The nurse anticipates the needs of the patient and ensures that those needs are reached. Caring moment/caring occasion focus on the nurse experiencing something greater than themselves. The feeling could be spiritual and encourage the nurse to make connections with the patient that would have never been there. It could open areas for the new possibilities for a human connection at a deeper level that of physical interactions (Watson 2009). The function of caring consciousness means the nurse needs awareness of the dynamics of life and human phenomena. Watson’s goal is to let the nurse know that every person can connect by the healing process of energy. Jean watson human caring theory sample essays.
Watson’s praxis leads itself in providing a different dimension of nursing explored rarely as the art of caring. Developing this theory structured the concept. Caring is a part of nursing and the nurse needs to understand the power of human caring. When reading this theory, it is clear and states the patient care is an ordeal that leads to a healing process for the patient. In an acute setting a patient consumed by fear and anxiety, it takes a caring nurse to find those symptoms and help the patient resolve it.
The relationship that the model describes is between patients and nurse that is intensely deep and intertwined in the eyes of Watson. Theoretical basis for nursing practice is in the transpersonal relationships that focus on the patient as the cherished other. Based on the general concept that patients rely on nurses for spiritual care, psychosocial and comfort. The relationship possesses healing power for the patient. with connection of human beings. Jean watson human caring theory sample essays. A caring model provides a capacity that nurses are to understand how caring behaviors can aid with development of a relationship with patients that puts them at ease and feeling secure. This theory is significant in developing caring behaviors (Watson 2009).
The concept of caring is very broad, with the Watson’s theory of Human Caring, it seems to help nurses understand more about the process of human caring. The theory is easy to follow and introduced a word “caritas” defined in her theory as coming from the Greek word meaning “to cherish and appreciate, giving special attention to, or loving” (Summerell 2015)..
This theory originated with the importance to understanding that the nursing career is an ever evolving work in progress that adapts to our rapid changing nursing practice in society.It responds well to the human dynamics of phenomena that focus on nurse self-care that one can appreciate. The focus is that Watson wants the nurse to understand that one must find their spiritual and inner self that will allow them to go beyond their ego to open up to others with sensitivity and compassion. It also has a potential to influence nursing actions to propel the discipline further into a more holistic context. Self-care is important in nursing because it brings nurses closer to their spirits, allowing them to feel connections with the entire world and to experience a cosmic love (Sitzman 2007). One can apply this knowledge to their nursing practice; it has simple tasks and is easily applied in any setting. With the busy hospital, the nurse can have daily awareness to their practice, by taking a slow deep breath before entering the room to remind them that the need is present for awareness of the present condition. This theory has concepts that seem to enhance the discipline of nursing. Jean watson human caring theory sample essays.
Reference:
Summerell, P. (2015). EB133 Jean Watson’s Caritas Processes: A Model for Transforming the Nursing Practice Environment. Critical Care Nurse, 35(2), e66-e67.
Sitzman, K. (2007). Teaching-learning professional caring based on Jean Watson’s Theory of Human Caring. International Journal For Human Caring, 11(4), 8-16.
Watson, J. (2009). CARING SCIENCE AND HUMAN CARING THEORY: TRANSFORMING PERSONAL AND PROFESSIONAL PRACTICES OF NURSING AND HEALTH CARE. Journal Of Health & Human Services Administration, 31(4), 466-482.
Williams, I. R., McDowell, J., & Kautz, D. (2011). A caring leadership model for nursing’s future. International Journal For Human Caring, 15(1), 31-35. Jean watson human caring theory sample essays
Nursing Theory and Practice
In the early days of nursing, nursing tasks were directed with little regard as to why they are being performed. The development of nursing theory is what gives nursing its basis or structure and it is what distinguishes its practice from other healthcare professions. There are many nursing theorists and theories in existence all of which have been somewhat of an evolutionary development as nursing has grown and each one has some unique attributes. The focus will be on Watson’s Theory of Caring. Watson defines caring as “the ethical and moral ideal of nursing with interpersonal and humanistic skills” (Alligood, 2014, p. 96). Discussion will include the importance of the above theory, a summary of the theory and its application into practice as a family nurse practitioner (FNP). Jean watson human caring theory sample essays.
Importance of Nursing Theory
Evidence-based practice is a large part of Master’s curriculum but more important is the understanding of the relationship between theory, evidence, research and practice is absent in many programs (Donohue-Porter, Forbes, & White, 2011). Meaning that the relationship between theory and practice has been replaced with bringing evidence into practice. While evidence can support decision-making and interventions or action, theory is still the foundation for the evidence. Jean watson human caring theory sample essays. However, if focus is completely on research and evidence, one could argue that it is taking nursing away from the humanistic art that it is and changing it toward more of a medical practice model.
Nursing theory is important because it is what provides basic information and is what guides nursing action (Alligood, 2014, p. 67) and provides direction and purpose. It is what guides nurses and inspires thoughts and actions (Noel, 2010, p. 17). This essentially means that nursing theory is the foundation to nursing practice. Looking at why it is important in a master’s program led me down a path of inquiry and research of the various theories and models of nursing focusing on the nursing meta-paradigm of person, health, environment, and nursing. Then, paying more specific attention to the definition of nursing which is “situated caring shaped by interior and exterior environments” (Jarrin, 2012, p. 3) Jean watson human caring theory sample essays. This is what separates nursing from a “medical model” which essentially is a problem solving, cure based or “fix-it” approach. This translates to patients relying on the advice of the physician, however may lead to clients feeling as if they have no sense of control (Noel, 2010).
One could argue concern for use of theory in practice that many of the nursing theories are older and outdated as they were based on what was actually happening in the world and healthcare during the specific time period they were developed. Another argument is that theory does not give specific guidelines for assessment, diagnosis or intervention (Meleis, 2012).
Summary of Watson’s Theory of Human Caring
Jean Watson developed one of the most recent nursing theorists and in 1979 Nursing: The Philosophy and Science of Caring was published initially as a textbook for nursing curriculum at the University of Colorado (Alligood, 2014) and reprinted in 2005. Her theory has evolved over the past 30 years and her most recent work was published in 2013 titled Caring Science, Mindful Practice: Implementing Watson’s Human Caring Theory. According to Noel, Watson describes caring science as a model that allows us to approach the sacred in our caring-healing work and her writings show the progression of her understanding of caring Jean watson human caring theory sample essays.
Caring overall has many facets and includes physical, psychological, cultural, spiritual and existential aspects (Noel, 2010, p. 17). Watson defines caring as “the ethical and moral ideal of nursing with interpersonal and humanistic qualities, a complex concept involving development of a range of knowledge, skills, and expertise that encompass holism, empathy, communication, clinical competence, technical proficiency, and interpersonal skills” (Alligood, 2014, p. 96). Interpersonal relationships are those based on mutual respect, mutual learning and give and take, meaning that the patient and the nurse learn from each other thus creating a what can be referred to as a shared experience (Noel, 2010).
When looking at the person or human being she views them from a holistic standpoint in where the mind, body and spirit are all connected and the person as a whole is influenced based on ones self-concept. Holistic nursing is described as a practice focusing on the whole person as in the person is not just an illness, it addresses the interconnectedness of the mind, body, spirit, social/cultural, emotions, relationships, context, and environment (“Holistic Nursing,” n.d., para. 1). Therefore in order to heal the person, it is important to look at all of this in determining how they affect ones health.
There are 10 processes to Watsons’ caring theory referred to as “Caritas processes.” Caritas comes from the Latin word meaning “to cherish or give special attention to”. The first three are the foundation for the science of caring and the remaining seven build upon that foundation. She describes nursing as “transpersonal” conveying a human-to-human connection in which both persons are influenced through the relationship and being together in the moment (Alligood, 2014, p. 104). Jean watson human caring theory sample essays. She states that it is important that the nurse find a way to be conscious of Caritas in order to effectively practice within this paradigm.
Nurses and FNP’s, generally look for opportunities to connect with their patients or clients as a way to teach, learn and share. This involves being present or in the moment with the patient, supporting them and building trust as we learn from each other. Watson’s work has been human caring theory sets the framework for current initiatives focused on wellness, health promotion, chronic disease management, case management and crisis intervention.”
Application to Practice
The FNP is set apart from other healthcare disciplines in that the practice is based on promoting overall health and well-being by taking into perspective the whole person, meaning mind, body and spirit and educating the population in making better choices for health and wellness (American Association of Nurse Practitioners, n.d.). Many articles state that the practice of loving kindness is what is most important to patients and families and having it come from the heart, it is the beginning of what can help improve healing relationships and improved patient outcomes (DiNapoli, Nelson, Turkel, & Watson, 2010).
The first Caritas is to practice loving kindness. The practitioner can incorporate this into his or her practice with the affirmation of “Everyday I am here I see that the care is provided with loving-kindness”. Others Caritas processes include decision making, instilling faith and hope, teaching and learning, respect for spiritual beliefs and practices, holistic care, building a helping and trusting relationship, healing environment, promoting expression of feelings and miracles Jean watson human caring theory sample essays. This directly translates to the job description that meets the healthcare needs of the individual and family by providing comprehensive primary care through the lifespan as provided by the University of California, San Francisco (UCSF). As discussed earlier comprehensive care is caring for the whole patient and all of his or her needs.
In my practice as a case manager for a workman’s compensation insurance provider I incorporate this into my practice daily. I have injured worker that I will refer to as Mr. H., who approximately 9 months ago was driving from one work location to another in the scope of his employment and was involved in a very severe head-on collision. He was severely injured and spent several weeks in the hospital and then a rehabilitation facility. His wife was due to have labor induced the day following the accident. While my focus was on planning ahead for the patients potential care needs, I also had the needs of his wife and family to take into consideration. Mr. H. was in the intensive care unit (ICU) and unable to communicate due to the extent of his injuries. I made a trip to the hospital where he was being treated to speak with the ICU staff, treating physicians and also nursing case management in order to collaborate with all parties involved regarding his care and treatments. With this knowledge I was able to educate the patients wife and family on treatment options, recovery and potential future needs. Discussions with his wife prior to his transfer from ICU to rehab included spirituality, instillation of faith and hope, holistic practices and care, helping to promote expression of feelings and practicing loving kindness; thus creating a human-to-human connection and the ability to see beyond the treatments and procedures that lie ahead. This helped to facilitate referrals needed to work on his anger toward the driver who hit him; posttraumatic stress and anxiety related to multiple surgeries and prolonged recovery.
Conclusion
Watson’s theory of caring and the Caritas processes involves knowing, being and doing all at the same time. In many cases theory is not a huge focus in nursing programs and practice as theory-based practice is being replaced by evidence-based practice thus potentially changing nursing into a medical model of practice vs. a nursing model of practice. Watson’s caring theory can help to preserve the practice of nursing as a profession of caring founded upon practicing loving kindness looking at the relationship between mind, body and spirit and how they are connected Jean watson human caring theory sample essays. Nurse practitioners provide care to patients across the lifespan and this care in concentrated on education of the patients by taking into account their beliefs and practices in order to assist them in making choices for improvement of lifestyle and essentially quality of life. The focus is not on treating the patient as a disease or illness, but as a whole person to create a relationship of mutual trust and respect.
This assignment was a growth experience for me and really brought me outside of my comfort zone. In my early years of nursing, I would roll my eyes when discussion of theory came up. I was focused on the procedures and practice, not on the milieu per say. As my experience and knowledge grew, I began to realize that theory is what distinguishes nursing form the other healthcare disciplines and is in itself and art. I recognized this as a hospice case manager where I was forced to focus on the mind body and spirit in order to provide the best care for patients and their families. I chose Watson’s caring theory as this theory is one I now can relate to on a more personal level, and I feel that my research will help to guide me in my future practice as a FNP. Jean watson human caring theory sample essays.
References
Alligood, M. R. (2014). Nursing theory: Utilization and application (5th ed.). [Google Books]. Retrieved from https://books.google.com
American Association of Nurse Practitioners. (n.d.). https://www.aanp.org
DiNapoli, P. P., Nelson, J., Turkel, M., & Watson, J. (2010). Measuring the caritas processes: Caring factor survey. International Journal for Human Caring, 14(3), 16-21. Retrieved from https://www.watsoncaringscience.org
Donohue-Porter, P., Forbes, M. O., & White, J. H. (2011). Nursing theory in curricula today: Challenges for faculty at all levels of education. International Journal of Nursing Education Scholarship, 8(1), 1-18. http://dx.doi.org/10.2202/1548-923x.2225
Holistic nursing. (n.d.). Retrieved from http://nursing-theory.org/theories-and-models/holistic-nursing.php
Jarrin, O. F. (2012). The integrality of situated caring in nursing and the environment. Advanced Nursing Science, 35(1), 14-24. http://dx.doi.org/10.1097/ANS.0b013e3182433b89 Jean watson human caring theory sample essays.
Meleis, A. I. (2012). Theoretical nursing: Development and progress (5th ed.). [Google Books]. Retrieved from https://www.books.google.com
Noel, D. L. (2010, January). Occupational health nursing practice through he human caring lens. AAOHN Journal, 58(1), 17-24. http://dx.doi.org/10.3928/08910162-20091216-02
University of California San Francisco. (n.d.). https://nursing.ucsf.edu Jean watson human caring theory sample essays
