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NSE11. Nursing theory. Art of nursing notes 10.docx

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Donna Zathy

Week 9 2. Differentiate engaged/particular knowledge from general nursing knowledge. General knowledge is empirical or scientific knowledge that is widely used in health care. This includes knowledge about diseases, epidemiology, pathophysiology, anatomy, diagnosis and treatment. General knowledge is pivotal in diagnosing and treating diseases. General scientific knowledge constitutes the basis for most nursing knowledge. Particular knowledge is not generally known or applicable but is particular to the nurse, patient or the circumstances. It is an “engaged knowledge” since it originates in part in an engagement or relationship between the nurse and the patient. Particulat knowledge includes patients feelings and thoughts about illness as well as the patients values and goals. It also includes patients response to treatments and interventions. Also, it reflects patients response to applied general knowledge. 3.Articulate artful nursing practice in terms of the following: Activities of care Caring skills are build on theoretical and experiential knowledge. Leah’s husband cared how things turned out for Leah, but because he lacked skills of care and failed to become involved, his caring was limited. Elizabeth’s care was hands-on and involved. She rubbed patient’s aching body, bathed her, helped her manage her diarrhea and constipation, administered her bolus feedings, listened to her grief, sustained her hope, sat quietly with her or held her when there were no words of comfort. Knowledge and skills of care Activities of care require skills, time and effort. Relating to Elizabeth’s story: Elizabeth was competent, had skills in both assessment and intervention with cancer patients. Understood treatment, how to prepare patient for treatment, how to administer the chemotherapy and how to assess and manage its side effects. She administered the importance of assessing nutritional and elimination patterns. She could put down an NG tube, manage bolus feedings and teach Leah’s friends how to help. Elizabeth understtod the nature of caring, when understanding the contradictions of care when she embraced the fact that caring was good and hard at the same time. She recognized that her involvement with Leah is going to be painful. Her competence and self-knoweledge were cornerstone for her nursing care, but also she needed knowledge of Leah to personalize her care. Example: noting Leah’s grief about leaving her son was more important than her own physical pain and approaching death. Making videotape and knowing what made Leah more physically comfortable. Care as connection Elizabeth was drown to leah by attractive qualities like courage, determination, optimism and hope. Elizabeth recognized that her presence was one means of relieving the isolation of Leah’s unspeakable grief and suffering. Even though she couldn’t take away her grief, she believed that being present with Leah makes it better. Elizabeth’s presense took the form of listening as Leah talked, holding her and quietly sitting with her. Connection extended beyond Leah’s death when Elizabeth, recognizing Leah’s presence in the room after she had died, sat quietly holding her hand until “her spirit was gone”. Challenges to caring • Nurses are expected to be caring in a system that is driven by economics, not care. • Nurses are expected to coordinate many aspects of patient care while working with greater workloads and sicker patients. • Some nurses do not know how to protect themselves from fee
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