NURSES NOTES

Anne Boykin and Savina O. Schoenhofer's Theory which focuses in caring helps us realize its importance, especially in our practice. Human in nature is caring. Caring is the expression of concern for others. It is universal and is expressed innately based on knowledge, culture, and situation. This is experienced in everyday of our lives. This is maybe done with or without the sense of awareness. And, the caring attitude comes out distinctly when a situation calls for it. One example is when you wake up in the morning and make a cup of coffee for your mother. The situation seemed to be simple, yet we must admit that we do not usually consider that action as really pertaining to caring. We used to think of it as a usual task we do everyday, right? But, if you look at the essence of it, it is a simple form of caring. Another example is when you assist one of your family members for a routine checkup, that is a way of showing a noticeable care for a loved one. Last example is when you are walking down the street and you found someone unconscious, and you asked help for that person to be saved. Then, that situation shows the obvious way of caring. Nursing on the other hand has a scientific form of caring, which is usually based on the patient's need for care. As a nurse, I should say that being assigned in NICU/PICU is a very challenging one, especially in rendering care to the patients because patients in this area don't know how to exactly complain about their condition. Crying and irritable look may be a clue but still, a nurse's kin observation is a must to be able to render them the proper care. And care must be given not as an obligation but as with love to be able to bring about well-being state at its holistic level. 

-                                                                                                                             HAREEN L. LUMABAS

·                  As a medical ward nurse, I already get used in supporting unsteady patients while ambulating, keeping the bed ridden patient's skin clean, dry and intact, feeding patients through feeding tubes, implementing the doctor's order to extract blood, keeping suicidal patients closely monitored, doing chest and back tapping, airway suctioning and so many other stuffs. While reading back all the things I've mentioned I make mental images to see how it looks like if we will just do what we are doing without the word "CARING". Definitely, you'll agree with me that doing our tasks without caring is similar to inflicting punishment than doing good, and so our patients will feel that they are being harmed instead of being fostered. Without caring, it is impossible for us to reach our goal of providing comfort to our patients. Caring therefore is one of the most essential part of nursing. The Theory of Nursing as Caring by Anne Boykin and Savina O. Schoenhofer, reminded me of how important it is for us, nurses, to give utmost care to the patients because this is the way we can help them feel better about themselves and improve their health status and management. This tasks is not at difficult at all because it is our nature as a human to give care.

                                                                                             

    MERCY JOY N. LUBIANO

·                      As nurses, we are the one who has the first encounter with the patient. The moment our patient gets in to the hospital, we can automatically render our care. According to Boykin and Schoenhofer, caring is the intentional and authentic presence of the nurse with another who is recognized as a person living,caring and growing in caring. The point is, for us to deliver our care properly we need to focus on the personhood of the person. We must not be judgmental; we should value what is important to them. We should accept our patient wholeheartedly no matter who he was, what his wearing and wherever he came from. How? Try to get to know our patient like how we tend to get know our selves. We should learn to like him, make eye contacts, listen to their stories and we cal also share ours. Just like for example a physically dirty person will often will illicit negative comments, but we nurses would make an effort to understand, to accept and demonstrate our love for him.

                                                                                                                                   HARRIS B. LIDASAN

·            Caring is the art of nursing. In a simple ways, nurses can show they care to their patients by having a therapeutic communication to them and made them feel that they are not alone. As the nurse in a government hospital, I believe in our institution’s quality policy – shall develop and enhance competent and compassionate human resources and ensure safe pace. The direct quality care nursing began spending time with patient shortly after their arrival. The discussion focused on patient’s immediate needs, his feelings, and his concerns. To a newly admitted patient, I made an effort to express his concerns with his present comfort and to encourage the patient to seek at nursing personnel when he feels uncomfortable. Being in hospital is frightening experience. Patients are full of uncertainty of what happened. It is difficult to adopt to environment at times of illness. The main purpose of having a quality interaction to them is to provide comfort. I encountered different kind of patients – came from different places, religion, culture and status in life. I heard a comment from a patient’s watcher that I didn’t like. A patient is having a severe abdominal pain. I gave her PRN pain meds and do some nursing actions to alleviate her pain while waiting for her doctor. Her watcher demanded a doctor now and he said, “Taga media kami..”. For me, it’s not a proper way to say that words and I quite got offended. As a nurse, I ensured that all of the patients receive a quality care despite what he are background. Whatever the background of the patient or his educational attainment, the one thing most important is to render an equal quality care for them. 

                                                                                                                       

 LILIANA MARIE MABAET

·               The theory of Boykin and Shoenhofer which is grounded on the caring aspects of nursing practice is very much applicable to all nurses in all settings. In my case as an ICU nurse in a tertiary hospital, caring is a major issue because the concept of CARING is more directed to the type of patient receiving care with reservations. There are instances wherein a VIP patient would receive more attention than the regular patients. I was deeply sad about this because nursing should not be this way. CARING for our patients especially in the CRITICAL CARE UNIT IS UNIVERSAL and should be done patiently, wholeheartedly and without any form of bias, judgment and reservations more so because all patients in this unit should be given the same kind of nursing care due to the complexity of their cases and conditions. The theory of CARING is a form of awakening for us, nurses to assess our nursing practices and reflect on what is the ideal attitude of a nurse in dealing with patients and their families. Caring is also an integrated approach and focuses not only on the feelings and concerns of the patients but also of their families. If caring is an innate aspect of our personhood as pointed out by these two theorists, then our outlook on our profession as a nurse should also come out naturally. It is a call for us to be more dedicated to our practice and never forget what NURSING is really all about- IT IS ABOUT CARING FOLKS! Guiding us then in our practice, we must be more vigilant and attentive in recognizing the immediate needs of our patient, be at their side the moment we recognize the need, establish a comforting and therapeutic atmosphere wherein the patient should feel that we are listening and we are empathizing with them. If they felt at ease with our presence, we can get more clues on our assessment findings and provide the appropriate nursing interventions directed to meet those needs. The patient would not feel the caring attitude and atmosphere if there is no rapport established so communication is very vital in every move that we make. Indeed, our actions as nurses, would mean a lot if we always incorporate CARING in our profession.

                                                                                                                               PAULA MACALINTAL

·               As a general ward nurse, I am dealing with patients having different diseases and different needs. Patients spend their hospitalization time in their room, where the nurses witness and assist them from illness to wellness. During these times nurse-client relationship develops. As a nurse, it is expected for me to assist the patient in their activities of daily living, to administer medications, to provide an environment conducive for recovery and give health teachings. Appropriate quality care was being given by whenever I view each patient as unique, whole individual with different needs. The longer the patient stays in the hospital, the more quality care the patient receives and means more improved nurturing relationship with the patient. There was a time when the discharged patient left a letter inside his room addressed to all staff nurses who contributed for his well recovery. From simple “thank you” to material representation of gratitude such as gifts, fruits, biscuits, cake and alike are really appreciated when given by the patient. At the end of the day, after a busy work duty, it makes me feel uplifted and fulfilled whenever a patient’s life was touched and satisfied with my nursing service. The longer the patient stays in the hospital, the more quality care the patient receives and means more improved nurturing relationship with the patient. 

                                                                                                                            BERNADETTE LEGASPI

·                  Anne Boykin and Sarvina Schoenhofer’s Theory of Caring as Nursing is focused on the concept that caring is an essential attribute and epitome of being human as well as caring being the root of nursing. In our profession as nurses, it is vital that we embrace the essence of caring in our nursing care enthusiastically for this will help us to improve our practice of being a nurse. Caring does not simply mean being present physically, it must be wholeheartedly because every one of us, nurses or not, has the capability to express caring not only to ourselves but others too.

              As a school nurse, I believe that I have applied Boykin and Schoenhofer’s theory whenever I care for my patients. I give them the best nursing care that I can. I don’t care if they are dirty or smelly or even if they have communicable diseases, what’s important is that I help others who need my help. I also believe that being caring to my patients brought me nearer to them. I became closer to the students, in fact, they do not hesitate in visiting the school clinic whether sick or not and it feels great helping others especially when the students says “thank you” for the help that I’ve given them. Giving our best to care for those who need our help gives us a strong sense of fulfillment that makes us feel proud of ourselves because we know that we did something that is worth living for…

                                                                 JOANNA MAE MACROHON

·             Caring is essential characteristic of nurse, this is inevitable for all of us. Nursing is a lifetime journey of caring and healing, seeking to understand and preserve the wholeness of human existence, and to offer compassionate, informed, knowledgeable human caring to society and humankind. (A. Glover). Being informed by the theory of Anne Boykin and Savina O. Schoenhofer's, it reminds me of the root of our profession and made me realized a sincere heart of a nurse to assist the patient in his/her recovery is priceless gift of our profession. It gives meaning to our work as healthcare provider. 

                                                                                                                     

VENICE JOY T. MALONZO.

·                A caring behavior of nursing practice is very applicable to all nurses in all circumstances. When I graduated and passed the board examination, I promised to myself that I would want to be in a government hospital, because I want to give care and serve people. Thanks to God, he gave me a chance to work in a Provincial Hospital in Cavite as a Staff Nurse. My first area was in medical ward, I got a chance to handle 50 patients and sometimes, not sometimes rather, but most of the time I was the only nurse in duty. It’s really hard for me to get through with all the chartings and be on a patient’s side to meet their demands. But you know being a nurse to a government hospital for me, is somewhat like a very wonderful chance to get learn of people‘s life experiences. Showing to patient, how you CARE is a big covenant for them. A simple thank you especially from less fortunate people, made me realize that being a nurse was not just doing your duties but it is a gift from heaven, and it is by giving a prospect to give bare the fundamental nature of CARE to people.

                                                                                                                         

 LEI KRISTEL LONTOC

          As nurses, we are the frontliners in giving care, our privileged profession is committed to caring, coming to know and respect those entrusted to our care, and responding to their calls for nursing in as competent, compassionate and, personal a way as possible. Our commitments require a lens or a way of seeing through which the nurse makes explicit a desire to be genuinely present with those nursed. Through this presence, personal stories are heard, hopes and dreams, thoughts and feelings. Reflection on these stories, each one is unique, provides the nurse with the wisdom to understand and create appropriate, nurturing responses. As a medical ward nurse in KSA, I encountered different kinds of people, different nationalities with different cultures and beliefs. Aside from differences, as a nurse, I treated the patient equally and as a whole, in giving care, taking care of them, listening to their personal stories and allowing them to verbalize their feelings, thoughts and concerns, calling by their name and having eye to eye contact in order to establish rapport, trust and open communication so that the patient will become cooperative. Our concern is not only the patient but including the families. This theory of Caring by Anne Boykin and Savina Shoenhofer, reminds me on how to become an effective nurse with full of patience when dealing with the patient and family, and as nurse, to treat the patient equally in giving care regardless of their race, color and status in life.

                                                                                                                                    SALLY T. LLEVA

In my practice as a critical care nurse in a trauma center, most of the patients are non-participative due to the magnitude of casualty and severe physiologic compromise in an acute state. As a patient advocate, the focus of caring is geared towards therapeutic maintenance of hemodynamics and oxygenation , provision of comfort and prevention of complications. Responses may be expressed variably against parameters that are tested and proven to be effective and efficient to maintain life. Delicate understanding of patients background and Co-morbidities is essential. In a case of Ventilator-Associated Pneumonia Prevention, set of core measures (HOB elevation at 30 degrees, Sedation vacation, Weaning trials, PPI coverage and round the clock chlorhexidine oral care and suctioning , Annals of Internal Medicine, March 2003) or Prevention DVT (utilization of anti-embolic compression boots to lower extremities, institution of LMWH if not contraindicated, Annals of Internal Medicine, March 2003) that are scientifically tested to prevent its occurrence has been well established and observed as part of evidenced based practice in critical care to cite few examples. Lateral care must also be instituted to the family to assist them deal with psychological and emotional burden. The harmony of integrative nursing to caring a patient and family in its vulnerable conditions evolves in the framework that assures holistic-human approach in the realm of logically scientific indices and performance.                

                                                                                       

  ABNER O. LORIAGA, RN,BSN,CCRN

Caring is the intentional and authentic presence of the nurse with another who is recognized as a person. The nurse endeavours  to know the other as a caring person and seeks to understand how that person might be sustained, supported and strengthened in their unique process of living, caring and giving. Naturally ,people are caring even  by the simple acts in everyday living it manifest in various ways .As a nurse, from the time we’re receiving them in ER, interacting with them ,carrying out our dependent and independent functions, we are already starting caring for them .CARING means NURSING or vice versa. We actually gain expertise from our expression of caring. ’Nursing is a  lifetime journey of caring and healing seeking to understand and preserve the wholeness of human existence and to offer compassionate ,informed, knowledgeable human caring to society and mankind’.

‘’Human is innately caring ,but not every human act is caring’’. Generally, this is true but it isn’t in nursing. Every nursing action is an act of caring. The theory of nursing was derived from the belief that nursing is both a discipline and a profession. As a discipline, nursing is a unity of science, art, and ethics. As a profession, it is based on understanding the social need from which we call nursing. The body of knowledge that was used in creating the response known as nursing.

As an OR nurse here in Maternity & Children’s Hospital in KSA, caring for patients who will undergo and those already undergone surgery (OB, Gyne & paediatrics) is a big task for me considering their ‘’unique” culture and values. My capacity as a nurse is extremely up to the maximum level when it comes to dealing with them postoperatively for they are known to have the least pain tolerance compared to other nationalities. Though most of the time, OR patients are unconscious and in semiconscious state ,caring for them is far more equal to ordinary patients especially during their recovery state where I tend  to be more careful , attentive and compassionate. Monitoring vital signs, keeping them warm &  safe, dressing the wound, and other preop and postop care are amongst the task of a CARING NURSE...

    

                                                                                                              MARITES MACAPAGAL

            Good at IV starts- check. Telemetry trained- check. CPR and ACLS certified- check. We work so hard to have a resume that is full of experience and skills; but have we forgotten one of the most important qualifications needed to be a successful nurse? Do you have a heart for people? Compassion is one to the greatest talents that we can bring to our career and it is a gift that we are able to give to each of our patients. 

            Not all areas of nursing embrace the skill or talent of expressing compassion. I entered the profession of nursing out of the desire to serve others and help them to meet their needs, whether they are physical, emotional or spiritual. I found in hospital nursing that there is rarely time to even address emotional health, and spiritual health…well, leave that to chaplains. But, we have to remember that nursing was born out of individuals desire to compassionately care for patients. Nurses did not have to worry about heart monitors and IV pumps alarming. Nurses had time to talk with young soldiers who missed home or the young mother who just lost a baby. Due to increasing technical demands and increasing workloads, the Art of Nursing has been replaced by a busyness that leaves nurses and patients frustrated.

            If I will applied it to myself as a nurse, I can surely embedded it into my practice, recently someone here in our place ask me to help her sister who diagnosed with cancer of the bones, when I visited their house, I see her sitting in the corner having difficulty of breathing due to build up of phlegm in her throat, she experience pain whenever she eat or drink water that’s why she cannot cough the phlegm due to dehydration, her lips had cracks ,thin body structure and agitated. I initiate a conversation for me to have a baseline assessment to her condition, she said that they thought its was just an ordinary “pigsa”   and what they do is she just massage it. Based on what I see and the conversation we had, I perceived a lack of information regarding her health condition, a poor hygiene care, lack of financial capability, fear of surgical procedure and lost of a part and lack of family support system. What I do is I advice her sister to take her in the hospital and be seen by a doctor for consultation. Few days after, when I visited  her again, she told me that the doctor advise diagnosed her of stage 3 cancer through biopsy and the only treatment is to amputate her leg and undergo chemotheraphy but she refuse to undergo because she doesn’t want to amputate her right leg and be hospitalize,  so the doctor just gave her medicines for pain and bronchodilators. A hospice care is the only thing I can do for, I always visited her to see if she take the medicine properly, getting the vital sign, encouraging her through spiritual thoughts, encouraging her relatives to participate in caring her, teaching proper hygiene especially in the part where the tumor is.

As a nurse we show our caring not just only in the hospital but everywhere, there is caring because we are thought by our parent to have care for people who are in need, Caring is an important aspect in our lives, by this we can show our love for one another.

One of the most common complaints that I hear in my practice is, “They didn’t listen to me in the hospital”. Take time to listen and HEAR what your patient is saying. Caring for a person on an emotional level doesn’t cross professional boundaries; you do not have to give your heart away in order to make someone feel important and valued. Additionally, statistics have proven that emotional health improves patient outcomes. That benefits the patient, the staff, the hospital and your community.

                                                                                                                              

                                                                                                                       

                                                                                                                        ALVIN L. MALATE

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