Jean Watson is a household name synonymous to the philosophy and science that brings to the fore the care given to patients by nurses. Watson believes that the art of caring is uniquely transmitted via the tradition that is the nursing profession. This is opposed to a general mindset believing that it can be passed from one generation to the other. According to Watson’s theory, the art of caring enhances a patient’s growth. As such, a caring environment appreciates the patient’s medical state while looking on the brighter side in future (Newman, & Corcoran-Perry, 1991).
Incidences of fall among the elderly generation are of great public-health concern. The consequences of these falls are always devastating, causing long-term injuries, enhanced morbidity and death, panic, loss of autonomy, deteriorative quality life, increased inactivity and additional treatment costs. As such, these consequences could be stemmed via proper care thanks to carative/caritas nursing.
In a nutshell, the objective of this paper is to adopt Jean Watson’s caring theory to offer care to an elderly victim of fall.
Description of the Patient
Patient X is a 91 year-old female exhibiting syndromes including confusion, failure to thrive, chronic obstructive pulmonary disease (COPD) and aerial fibrillation. The patient was admitted to the hospital owing to the increased risk of falling. According to her personal account, she had previously experienced a dozen falls. However, she could independently and successfully accomplish a number of tasks. Recently, on 9th of November 2014, she got admitted after tripping over her rug. At the moment, she is awaiting to be discharged, seemingly alert and oriented. The detail of her fall is such that upon tripping she hit her face against the fridge. The impact of the fall is evident on her face which is bruised, prompting a physician to take an X-ray examination to reveal any broken bones if any. As per the patient’s account, nothing has been done to prevent her previous falls. According to the woman, she has been tripping over floor rugs and she moved hastily before tripping. The diagnostic values done to the patient prior to her discharge was an X-ray examination to reveal any broken bones. To this end, the remedy that was given by a pharmacist was an ointment to apply.
The Patient’s Need for Activity-Inactivity
Activity-inactivity need basically refers to the human body structure that offers support to the entire body, giving it its upright posture. This need is principally “connected energetically and metaphorically with being ‘grounded’ in the earth plane, in that it includes physical body and support” (Watson, 2008). In a synopsis, this practice encompasses both the feet and the spine support vital in enabling one live a purposeful and a satisfactory life. As such, this need is optimally experienced when one has the ability to ‘stand up’ and freely perform his/her duties without straining. In addition, this need contributes holistically to an individual’s well-being. To this end, it enhances one’s “ability to trust life, to see larger patterns related to values, ethics, courage, and selflessness beyond self” (Watson, 2008).
With regards to aforementioned patient, there is a need to decrease activity-inactivity levels in order to reduce the energy loss for an already weakened body of the old aged woman. This will help to decrease falls. Moreover, this will enhance her competence, mastery, relaxation and restoration of energy. Sleep is another benefit derived from this need vital in promoting biorhythmic balance and restoration emanating from deep sleep (Duffy, 1992).
Nursing Intervention and Strategies to Meet Patient’s Needs
As part of my assessment I asked the patient what caused her falling. From her personal recollections, she said that she tripped over a rug or dropped whatever she was holding only to trip over it. She recounts that she walks faster and then falls hurting herself. Moreover, I asked her whether she uses non-slid sock to prevent her falling. As such, she did not own one; therefore, I provided her with a pair and asked her to try and see if it will prevent her from falls. Moreover, I advised her to clear her way of any objects before walking to prevent herself from falling. Objects present potential hazard for one to stumble. The socks that I gave the patient are specially manufactured to reduce sliding. As such, they provide the necessary grip on the flow to prevent skidding.
For this patient, exhibiting high-risk falls, I would have advised further on the kind of diet that she would take to improve her condition. Based on the fact that at her age the patient is osteoporotic, she consequently prone to fractures. To this end, I would have advised her diet rich in vitamin D supplemented with calcium. This would restore her bone density and thus reduce the possibility of fractures. Moreover, I forgot to mention to her the importance of having a hip protector and to wear it on all the time. Hip protector would have helped her against injuring the femur in case she trips. Finally, it is important that I would have mentioned to her about cardiac pacing, a remedy researched to have reduced falls in elderly people by 58% (Brignole, 2004).
The nursing interventions and the rational of their applications on the patient include, as mentioned above, vitamin D and calcium biased diet, cardiac pacing, hip protector and home-hazard assessment (Kaplan & Greenfield, 1989). Moreover, interventions such as reduced psychotropic medication and expedited cataract surgery are equally important. With regards to the former intervention, a research study carried out on gradual withdrawal from psychotropic medication reveals a reduction in sight by 66% (Campbell, Robertson, Gardner, Norton, and Buchner 1999). Cataract surgery is vital in eliminating visual impairment that results in misjudged visual impression of depth, a defect that prompts falls in elderly. A study revealed that this surgery reduced falls by 34% (Lord, Clark & Webster, 1991).
Carative Process
Caritas process is a model of nursing that goes beyond the superficial nursing practice. It incorporates the spiritual world together with the belief in miraculous healing (Horvath & Symonds, 1991). As such, this practice is not meant for any professional nurse. It is a calling meant for nurses who dig deeper into their profession to care for people and achieve a quick healing process (Duffy, 2003). In a nutshell, this process goes past health-healing and disease (Martins & Garske, 2000). It aligns “nursing and its authentic mission of health-healing with a deeper humanitarian and spiritual cause” (Cara, 2003).
It was effectively administered to my patient through nurturing a sense of sensitivity to both of us. I exhibited a sense of responsiveness to both the woman’s needs and her feelings. As a consequence, I was in a position to create that feeling of trusting-helping-caring relationship. This was practically achieved when I carefully and humbly cross-examined the woman into the cause of her falls while responding to her needs. I provided her with the non-slid socks and asked her to clear her path whenever she wanted to move. I responded to her feelings by asking her to have enough rest and sleep to achieve the restoration vital for her to execute her chores effectively. By listening to her attentively, I genuinely expressed my feelings to her by showing a keen interest to her condition and advising her accordingly from the depth of my heart. To me, as a nurse taking care of a patient, the literature above means that the best care goes beyond health-healing and involves the inner-self. This is vital in instilling faith in a patient in order to achieve divine healing (Hoskins & Seifert, 2007).
Conclusion
In a conclusion, caritas nursing comes in handy where health-healing has failed to prevail. Despair, fear and low self-esteem can creep in when one is experiencing a health condition as exhibited by the elderly woman (Bent, 2005). A sure remedy to supplement health-healing of the elderly woman would be via caritas nursing. As such, the nurse’s objective was to instill faith in the woman to believe if divine healing would really help. One of the main objectives of keeping the elderly healthy is reducing the cost of treatment that emanates from induced injuries. To this end, it was important to advice the woman on engaging in inactivity aimed at enhancing natural healing. Effective healing is achievable when the caritas process supplements the health-healing process. As such, it was important to perform a diagnosis on the patient to determine the other probable causes of her falls. This would be followed by the caritas process.
References
Bent, K. (2005). Being and Creating Caring Change in a Healthcare System. International Journal of Human Caring, 9 (3), 20–25.
Brignole, M. (2004). Cardiovacular risk factors for falls in older people. Journal of International Symposium on Preventing Falls and Fractures in Older People, 1, 1-8.
Campbell, J., & Robertson, C., Gardner M. M., Norton R. N., and Buchner D. M. (1999). Psychotropic medicine withdrawal and a home- based exercise program to prevent falls: a randomized controlled trial. Journal of American Geriatric Society, 47(7), 850–853.
Cara, C. (2003). A Pragmatic View of Jean Watson’s Caring Theory. Medical Care, 27(3), 110–127.
Duffy, J. (2003). The Quality-Caring Model. Advances in Nursing Science, 26(1), 77– 88.
Duffy, J. (1992). The Impact of Nurse Caring on Patient Outcomes. Journal of the Presence of Caring in Nursing, 2(3), 780-783.
Horvath, A. O., & Symonds, D. (1991). Relation Between Working Alliance and Outcome in Psychotherapy: A Meta-Analysis. Journal of Counseling Psychology, 38 (2), 139–149. Hoskins, L., & Seifert, R. (2007). Dimensions of Caring: Psychometric Properties of the Caring Assessment Tool. Advances in Nursing Science, 39(3), 1–12.
Kaplan, S. H., & Greenfield, S. (1989). Assessing the Effects of Physician-Patient Interactions on the Outcomes of Chronic Disease. Medical Care, 27(3), 110– 127.
Lord, R., Clark, D., & Webster, W. (1991). Visual acquity and contrast sensitivity in relation to falls in an elderly population. Age Ageing Journal, 20(3), 175–181.
Martins, J., & Garske, J. (2000). Relation of the Therapeutic Alliance with Outcome and Other Variables: A Meta-Analytic Review. J. Consulting Clinical Psychol., 68(3), 438–450.
Newman, M., & Corcoran-Perry, S. (1991). The Focus of the Discipline of Nursing. Advances in Nursing Science, 31(1), 1–14.
Watson, J. (2008). The Philosophy and Science of Caring. Advances in Nursing Science, 39(3), 161-169.