Leo Buscaglia wrote Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around. (4)
Caring is defined differently and interpreted differently by nurses and patients. By answering the following questions, I will define and interpret caring in a way that is understandable and relates to nursing. The different attributes to a caring nurse will be discussed as well as what influences the caring concept in nursing. The perception of an uncaring nurse is mostly associated with the emergency unit environment as will be explained.
2. Explain the concept and meaning of caring
Caring can be described in different ways and everyone you ask has their own interpretation of what the concept means. If you look in the dictionary the concept of caring has two main focusses concern for someone or something, kindness to others, or to do kind things and a feeling of empathy for others. (6)(9)
Nurses and patients have individualized views regarding caring that I found in examining different articles which makes it difficult to find an internationally accepted meaning or definition of the concept of caring in nursing. All the articles do however focus on caring being patient-centred and the knowledge of the nursing process
After reading The Meaning of Caring in Nursing Practice that uses Jean Watsons definition of caring which states that caring is The moral ideal of nursing whereby the end is protection, enhancement, and preservation of human dignity. Human caring involves values, a will and a commitment to care, knowledge, caring actions, and consequences. All of human caring is related to inter subjective human response to health-illness; environmental-personal interaction; a knowledge of the nurse caring process; self-knowledge, knowledge of ones power and transaction limitations. (3)
The article Registered nurses descriptions of caring: a phenomenographic interview study implies that the diverse conceptions of caring is described by nurses that could lead to the nurses adopting different focuses and actions. Caring must: be person-centredness, safeguard the patients best interests, be nursing interventions and be contextually intertwined and that caring could open up the possibility of influencing the patients experiences and well-being in different ways. They propose that caring, regardless of context, is to recognise and acknowledge the person behind the patient and despite profound changes, must always return to its basic principles, which are its human condition. (2)
The Conundrum of Caring in Nursing states that nursing has struggled to clarify, accept and articulate the essence of caring in a way that would satisfy all nursing roles and embody all nursing knowledge and practice. Caring is one of the greatest fundamentals in nursing, introduced by Florence Nightingale, some nursing advocates fear that it is no longer a central theme to the nursing profession and has become only second nature to the busy, overworked nurse in a technologically dominated setting. Caring is a basic human attribute that people demonstrate toward each other and that it is the compassionate act or feeling of concern for another human being and its theme has threaded the profession of nursing. It has a proven and recognized value in nursing, the construct of caring has met much opposition. Some suggest that caring is not essential to the nursing profession. (1)
3. Outline the caring behaviours applicable to a nurse
According to the article Caring Concept caring attributes encountered in nursing include: (7)
Connecting with patients
Being resilient to possible uncertainties in each patients state of health.
A caring nurse is the whole package:
Competence along with demonstrated interest
Reaching out to comfort.
o Caring behaviours include (7)
o The following are the 10 highest-ranked caring behaviours, derived from nursing literature, then selected by nurses as evident in caring situations with patients (8)
? Attentive listening
? Providing information so the patient can make an informed decision
? Calling the patient by name.
4. Describe the importance of caring in nursing
The importance of caring in nursing is vital because everybody wants to feel that they are cared for, this is true for the patient and the nurse. When the patient is satisfied so is the nurse and usually the patient will feel satisfied if they feel that the nurse is caring about them in the way they perceive caring. Patients will be more inclined to share information that might be of vital importance for diagnosing and treating them when they feel cared for. Patients may be more willing to allow procedures that are necessary for treating or diagnosing them for example having bloods drawn. By actively involving patients in their treatment in a caring manner they may become more independent with their treatment plan for example mobilising after an operation. Patients will trust nurses and will be less inclined to lay complaints against the nurses. Patients will feel supported in difficult times and have someone outside of their family and friends that they may express their fears and concerns to for example cancer patients. Involving and informing family of the patients diagnosis and treatment may lessen anxiety and fear, for the patient and the family, because the patient may feel alone during treatment and the family are stressed out. Feeling cared for can shorten hospital stays for some patients by increasing their survival rate and independence. When the nurses feel that the organization is caring about them, they will provide their highest quality of work, be committed to the job and will improve their knowledge and skills at every available opportunity to provide the best care for their patients. Most nurses obtain a high level of satisfaction if they can provide holistic care for a patient and spend some time at each patients bedside. Teamwork helps in creating a caring environment, if the nurses work together to achieve the best outcome for the patient, the patient may feel cared for and the nurses feel satisfied that they are providing the best possible care for the patient. (2) (5) (7)
5. Discuss the application of caring behaviours in your area of speciality
The Emergency Department in a Private Hospital
Because of the environment which suffers from short-staffing, mandatory overtime hours, extensive documentation requirements, and limited resources, increasing admission rates coupled with prolonged stays in the unit due to bed shortages and increasing workloads have left nurses anxious as to whether or not they are meeting their patients needs, this results in interactions that may promote frustration, anxiety, and for a patient a sense of not being cared for by nurses.(5)
Problems relating to this behaviour:
Many patients perceive that nurses do not listen to them in the emergency room because of the high workload, stress and nurses being called away to emergency situations for example a resuscitation or a higher priority patient.
Ways to apply this behaviour:
In our unit we have a triage room to provide a private area for the patient where they can discuss their problem with a nurse without interruptions.
In the treatment area we try to give our full attention to the patient while we are treating the patient to obtain extra information that might have been left out during the triage.
Eye contact is made with the patient and reflection is used while interacting with the patient for them to acknowledge that we are listening to what the patient is informing us about.
The patients choice of treatment is taken into account and related to the doctor