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Comfort fundamentals of nursing
Comfort fundamentals of nursing
Comfort fundamentals of nursing
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Similarities between Comfort Care and Family Centered Care Family centred care and comfort care theory both work for the well being of patient. Family centred care focus to work with family while providing care for the sick child. Family and pediatric staff works in collaboration to make care plan that works the best for sick child (Coyne, O'Neill, Murphy, & Costello, 2011). Similarly, comfort care theory focus on child’s physical, psychospiritual, sociocultural, and environmental aspects. “When comfort needs are addressed in one context, total comfort is enhanced in the remaining context” (Kolcaba & Dimarco, 2005, p. 190). When nurses apply comfort care theory, it is to achieve holistic care of sick children by focusing on all aspects (Kolcaba
& Dimarco, 2005). Comfort theory involves other disciplines to achieve its goals. For instance; nurse will involve translator if there is language barrier to provide holistic care (Kolcaba & Dimarco, 2005). Both theories believe in patient’s comfort. Family centred care involves family and health care providers (HCP) to make care plan for the comfort of child. For instance, both parents and HCP work in partnership to make a plan that best fit child’s needs; therefore, child’s comfort is definite (Bridgeman, 1999). Comfort care theory also emphasize on patient’s comfort holistically. Comfort is immediate outcome of comfort care theory (Kolcaba K. , 2003). Pediatric nurse identify need for relief, ease, and transcendence; therefore, ensure patients comfort (Kolcaba & Dimarco, 2005). Both theories work in partnership. Family centred care partnership between family and HCP; similarly, comfort care theory partnership between nurses and other disciplines. Family centred theory focus on plan of care that is initiated by HCP team and family members. This theory believes in family’s wishes and expectations (Kuo, et al., 2012). Care plan includes cultural values and personal needs of child (Kuo, et al., 2012). In comfort care theory nurses involve other discipline to achieve outcomes. For instance, involving translators for the patients with language barrier is one example (Kolcaba & Dimarco, 2005).
The boundaries of right to die with dignity are hard to determine. Keeping the terminal patient comfortable is the purpose of comfort care, however there could be a very thin line between what we consider terminal sedation and euthanasia. In theory, comfort care is quite different from euthanasia. Keeping the patient comfortable and letting the nature take its course is at the core of comfort measures (Gamliel, 2012). Yet, the line between keeping comfortable and facilitating death is often blurry. Euthanasia refers to the practice of intentionally ending a life in order to relieve pain and suffering (Gamliel, 2012). The purpose of this paper is to highlight the ethical issue of keeping comfortable vs. hastening death, and the ethical principles involved. Facilitating or hastening death is considered unethical or even illegal.
Manipulation of the human condition, by where and with who contentment and satisfaction is found, is fabricated through experiences which dictate direction and purpose. William Shakespeare’s pastoral comedy, As You Like It (1611) explores individuals escaping a world poisoned by man’s inhumanity to man, to an ideal bliss where community thrives from the joyous aura circulating amongst people. Gillian Dawson’s short story, East Wind captures disconnection from place and people as a powerful driving force to find fulfilment. Further, the texts explore comfort and security spurring from the unexpected, revealing change in human nature at an instant.
American Academy of Pediactrics. (2003). Family-Centered Care and the Pediatrician’s Role. Available: http://pediatrics.aappublications.org/content/112/3/691.full. Last accessed 23/01/14.
Nursing theory is important in the work that a nurse does on a daily basis. Having nursing theory allows the nurse to know what his or her role is in the health care field (Iskandarani, Al Hammadi, & Al Gizani, 2012, p. 115). Nurses do not always recognize when he or she is using nursing theories in his or her practice. This writer believes that Katharine Kolcaba’s theory of comfort is important in nursing practice. Making sure that the patient is comfortable improves the healing process for the patient. The two articles that this writer chose explains how the implementation of Kolcaba’s theory improved the patients care, specifically related to cardiac patients.
Also, the whole family needs to come to term with the health condition, make change in priorities and schedule, and keep the family. For example, it can be much more stressful for a young or a newly married couple because they may have more experience to overcome life's difficulties. As a result, as with individual maturation, family development can be delayed or even revert to a previous level of functioning (Hockenberry, p 762.) Therefore, health care providers need to apply family development theory while planning care for a child and family with chronic health condition. Indeed, family centered care should be a part of that intervention. Parents and family members have huge and comprehensive caregiving responsibilities for their chronically ill child at home or at hospital. Moreover, the main goal taking care of chronic ill child is to “minimize the progression of the disease and maximize the child’s physical, cognitive, psychological potential” (Hockenberry, p 763). Therefore, it is essential to family being part of the child care to give highest quality of care. On the other hand, we are as a part of the health care provider need to give attention to all
Family centred care (FCC) encompasses the concept of parental participation in their infants care (Franck and Callery 2004). It aims to place the needs of the infant in the context of the family (Saunders et al 2003). FCC is adopted within many neonatal units and is considered the gold standard of care aiming to underpin and guide neonatal care towards the partnership between health professionals and parents (Hutchfield 1999). Subsequent to the interruption of the bonding process between infant and family when a baby is admitted to the Neonatal Intensive Care Unit (NICU) it is suggested that the NICU provides an ideal opportunity for FCC practice (Allerman Beck et al 2009) as nurses and parents are compelled to develop an effective relationship in order to satisfy the infants care needs (Reis et al 2009). However a study by Higman & Shaw (2008) found that it appears to be more difficult to achieve on the neonatal unit as FCC is reliant on the family’s relationship with the child. In order to deliver effective FCC neonatal nurses need an understanding of parents needs and how to address them. Mundy (2010) in a study researching the assessment of family needs in neonatal Intensive Care Units found that assumptions of parent’s needs were often made by healthcare professional’s resulting in unfounded and inappropriate conclusions. The importance of treating each family as individual is paramount when assessing how best to involve parents in the care of their infants (Higman & Shaw 2008). Review of the literature shows a lack of research into these assessments and highlights that enhancing family centred care requires appropriate assessments of family needs and the incorporation of this into individualised plans of care. A study into nurse’s perceptions about the delivery of FCC by Higman and Shaw (2010) supports this view, throughout the study it is apparent that although nurses realise the importance of FCC it is not always consistent within their own practice. Peterson et al (2004) suggests reasons for these inconsistencies could be the deficiency of adequate training and, the stress implementing FCC can impose on nursing staff due to an already demanding workload, potentially creating negative attitudes towards the relevance and practicalities of its delivery. The consensus view of FCC is positive although limitations to its execution are manifested throughout the literature. Staff shortages are suggested to hinder the performance of FCC within the clinical area, creating time constraints with nurses having very little opportunity to build good relationships with the families (Higman and Shaw 2008).
Nursing should focus on patient and family centered care, with nurses being the patient advocate for the care the patient receives. Patient and family centered care implies family participation. This type of care involves patients and their families in their health care treatments and decisions. I believe that it is important to incorporate this kind of care at Orange Regional Medical Center (ORMC) because it can ensure that we are meeting the patient’s physical, emotional, and spiritual needs through their hospitalization.
Primary caregivers are given an opportunity to take care of their loved ones; however, this job comes with a lot of stress and its consequences (Tsai, 2003). Primary caregivers take care of those with a chronic illness such as a family member or friend, are given a task that is so immense that it induces a lot of stress. In the previous decades, many research articles have developed studies which focused on stressors that were associated with the task of being the primary caregiver; yet, a theory surrounding this topic has not been developed until the early 2000s. Tsai (2003) developed the Theory of Caregiver Stress based on the Roy Adaptation Model to identify the caregiver’s response, perceptions, and adaptations to the stress and burden that primary caregiver’s experience.
Comfort theory by Katheryn Kolcaba is the experience of having Physical, Psychospiritual, Environmental and sociocultural needs met by the relief, ease, or transcendence of each problem. For example pain is the physical issue, Low self-esteem would be a psychospiritual, being in a noisy room can be environment, and not having sufficient finances for sociocultural problems. To relieve any of these problems is to meet each need and solve the problem. Ease is to calm the problem reducing or taking it away, and transcendence is rise above the needs or outgrow the needs (Flood, 2013). This theory addresses how one would identify and solve problems related to care, it also is used in nursing assessment. Identification of the problem is the first
An in-depth description of the theory will be followed to establish and explain the concepts. Finally, an application of the theory concepts to a real-life nursing situation will follow afterward. The comfort theory is a middle range theory, and its concepts include patient healthcare, institutional integrity, institutional outcomes, intervening variables, health seeking behaviors, nursing interventions, and patient comfort. Before advancements in medical discovery in early 20th century, comfort theory was widely used in nursing environment. These comfort measures were administered by physicians, and had significant improvements in both the patients’ mental and physical condition (Peterson & Breadow, 2009). With the discovery of modern medicines and methods, comfort application reduced drastically. However, comfort theory is still applied to mentally ill patients. (Peterson & Breadow,
The provision of patient/family-centered care, which assure safety and quality in the service, would have a team work approach as a foundation and underpinning. In a healing process or in the preservation of health intervene several factors, some of them are closely related with the environment. Healthcare providers constitute an important part of that environment, and definitely, communication with patients, families, and among themselves, have a significant impact on it. The environment would influence the patient’s perception of care, and the staff’s level of
The role of the nurse in the Neonatal Intensive Care Unit, or NICU, setting is to provide multiple levels of care for infants who experience problems early on after birth or who are born prematurely and require additional medical attention. Many children in the NICU have many different specialized needs. These needs may include, but are not limited to, specialized feedings, intravenous care, oxygenation issues, temperature issues and issues with respiration. The NICU nurse performs the many duties a neonate requires multiple times throughout his or her shift. These duties are executed utilizing a type of care referred to as cluster care. This is defined as specific scheduled hands on times completing a majority of the care the neonate requires at one time so that there are periods of rest in between. The child requires these periods of rest to promote healing, growth and wellness. The NICU nurse not only has to care for a severely sick or premature child but he or she also has many responsibilities. Some of these include educating the parents or primary caregivers on the advanced care that their infant may need, handling psychosocial issues, legal factors, ethical dilemmas and socio-cultural factors. Due to these factors the NICU nurse must also have competent interpersonal skills, knowledge on current legislature and understanding of many different cultures.
Comfort is important to caring in nursing because it is the nurse 's job to try and help the patient feel at ease and be pain free.
Furthermore, nurses have a unique job when working beside these families. “Too often health care providers talk to parents rather than with them” (Potts & Mandleco, 2012, p. 87). Nurses need to strive to work beside the caregivers in order to gain as much understanding of varying influential behaviors as possible. This would include their cultural background, valued beliefs, parenting styles, and social expectations to name a few. Despite the demands the role of the nurse has, it is crucial he/she takes the time to sit down and talk with the family and collaborates a plan of care for the
In order to compliment understanding student behaviors, Roosevelt must also strive to adequately prepare staff to appropriately intervene on behalf of victimized students. According to their study (O'brennan, Waasdorp, & Bradshaw, 2014) on school staff connectedness and level of comfort intervening, the researchers found that “having resources available regarding bullying, receiving training on the school’s bullying policy, and being involved in bullying prevention efforts were significantly associated with comfort intervening.” In order to provide adequate preparation, training that educates teachers about the signs and progression of bullying and appropriate ways to intervene in order to decrease the bystander effect is crucial. In addition