On my very first day on the floor of the clinical site in which I was assigned my clinical instructor had assigned me a patient who had suffered from not only a spinal fracture, but also from Clostridium difficile (C. diff). When my instructor had reviewed the patient’s report she had then informed me that if I would like to change patient’s I would be able to due to the fact that she had not known he was suffering from C. diff. I decided ultimately that this would test my abilities to express compassion and competency as prior to this day I had never interacted with a patient in a clinical setting. Thus, I was gowned and gloved and had aided my patient in activities of daily living and started my assessment. When my clinical instructor had come to check on me and to ensure I was assessing correctly we began to assess the integumentary system only to realize that this patient had not been changed in a very long time. Due to the infection and spinal fracture the patient was incontinent thus, he was wearing a brief which was spilling out with feces. We began to clean the patient, only for him to continuously have bowel movements. However, we both maintained composure. We continued to demonstrate respect and compassion no matter the circumstance. After we had cleaned the patient, my instructor had other obligations which she had to attend to. Thus, I had replaced his blanket, pillows, and most importantly his gown, as he was not clothed minus his brief. Physical therapy was on their way, and the patient had already appeared embarrassed by his lack of control of his bowel movements and I wanted to prevent the patient from any further embarrassment the patient might have felt.
Watson’s theory of transpersonal caring primarily focuses on that caring is a crucial component perpetuating that this is the central focus of nursing (Jean Watson’s Philosophy of Nursing, 2012). With maintaining composure, this had as one caritive factor depicts the sensitivity to the patient’s ailment. That with the awareness of the implication of my actions, that this demonstrates sensitivity to the patient’s condition and the empathy for how my actions may impact their emotional state. Thus, when discussing the emotional status of the patient, and being able to perceive how the patient feels is empathy. Whereas compassion is when the perception is then placed into action in order to aid or assist that individual. Through bathing the patient, as well as therapeutic conversation, I was able to develop another caritive factor which Watson had discussed: the helping-trusting relationship. During my make up clinical, I had discovered that this patient had enjoyed nursing students caring for him as through this they were able to learn new skills and practice their assessments. Thus, this depicts not only another caritive factor the interpersonal teaching-learning, but also depicts the importance of the helping-trusting relationship. Without the helping-trusting relationship which the patient and I had, as I was the first nursing student this patient had, then, the patient may have been wary of future nursing students. These three factors are especially crucial in the patient nursing student relationship, depicting empathy to the sensitivity of the patient’s current state, establishment of a helping-trusting relationship which will thus in return promote a teaching-learning relationship. Throughout clinical I have learned that the patient is the one who knows their own body best, without open communication there is extreme difficulty in caring for a patient. With open communication I have been able to elevate the head of a patient who suffered a spinal fracture with blankets as pillows are contraindicated in these conditions. I have the knowledge as to how to assess blood pressure in patients who have fistulas in their arms for dialysis. As well as the ability to communicate while performing a wound dressing for an amputee what works best for them in terms of wrapping and placing a sleeve over the amputated extremity.
Caring not only has to be associated with skills or assessments which are implemented by nursing students and nurses, but also can be completed through another caritive factor which Watson has discussed the gratification of human needs and how a nurse may assist in this (Jean Watson’s Philosophy of Nursing, 2012). Throughout my clinical experience I had ensured when I was unsure of what I should do, I simply started to answer call bells. Many call bells where either for assistance in repositioning for comfort, or for a cup of ice water. Whenever I had answered these particular call bells the patients were truly the most content, all of these patients were exceptionally grateful for assistance in repositioning or a cup of water. Prior to clinical this semester, I had not phantom the idea that patients would be most thankful for a cup of water, being repositioned, or even having someone to talk to. Therapeutic conversation is one of the foremost crucial components of gratification of human needs as many patients especially during this pandemic are experiencing the deprivation of socialization. Deprivation of socialization is a human need of high importance, as without socialization many individuals may feel a sense of anxiety which one can see in many various scenarios. Those who enter isolation, for example in prison due to behavior or action, have been recognized to have an alter in mental status due to the isolation in which they are subjected to.
Through allowing the patient to discuss their emotions no matter the nature of the emotion the patient is thus, encouraged to confront their emotions and find the strength within themselves (Jean Watson’s Philosophy of Nursing, 2012). With multiple patients who I have cared for that have suffered spinal fractures through therapeutic conversation I was able to allow the patient to discuss their emotional status about the injury, and thus through this they were able to go from a negative emotion towards the injury to a positive outlook on this ailment. They had recognized that although this injury was not ideal, that they had a great support system that surrounded them in their life, and thus, they had someone to help them through this. Not only did they have the aid and support through this implication, but they as well had individuals in their lives which they realized that they had now had to adapt to their now limitations in order to support them as well. One patient was a mother of eight, and thus, she realized that through this time, she had to learn how to adapt in order to support her children, herself, and all those in her life. Through therapeutic conversation the caring role of the nurse or nursing student enables the patient to come to terms with their impairment/ailment on their own terms.
With the implementation of these caritive factors, as well as the conversion of empathy to compassion the patient is thus, more likely to have a positive outlook on their diagnosis. Although not all conditions are curable, with a positive outlook a patient is more inclined to adapt to their condition. If the mother of eight had not had a positive outlook, had received no compassion from the health care professionals the patient would be less inclined to participate in physical therapy in order to improve, or to relearn activities of daily living. The patient would have a negative outlook which would thus, progress into other areas. With that being said, I have learned throughout my clinical experience the importance of compassion, the importance of therapeutic conversation, and most and foremost the importance of the implementation of these caritive factors. The caritive factors which Watson discusses are of high importance to ensure the patient has a positive outlook and can be achieved through simple implementations, the most crucial is therapeutic conversation which allows the nurse to gain the patient’s perspective and the patient’s needs.
Reference:
Jean Watson’s Philosophy of Nursing. (2012, January 26). Retrieved November 17, 2020, from http://currentnursing.com/nursing_theory/Watson.html
