The purpose of this paper is to explore how my personal worldview, religious beliefs, cultural background and spiritual philosophy apply to my practice as a nurse and to explore nursing theories that coincide with my beliefs. Jean Watsons theory of caring is like my beliefs as a Christian as it provides guidelines on how to provide patient centered, holistic and compassionate care free of prejudice.
As a practicing Christian, I believe it is vital to show compassion and deliver judgement free care to all. As the Bible says, “Whoever closes their ear to the cry of the poor will himself call out and not be answered” (Proverbs 21:13). Christianity I India evolved when St. Thomas one of the 12th apostles of Christ came down to the Southern part of India and established churches. This is how the early Christian orthodox churches came into being and in 16th century European Catholic mission and 18th century the protestant missionary came and now there is a lot of categories of Christians in India (Collins,2016). I am an Indian Syrian orthodox. Being a Christian helps me to be strong, have a compassionate and caring approach towards my co-workers, patients and family.
I personally always believe in keeping a positive attitude and smiling. My faith and trust in The Lord have helped me build strength to enter the rooms of patients with a belief that I will be able to attain their trust and develop an inter-personal relationship with my patients throughout my day. I believe we have one life in this world. We are here for a purpose to take care of each other. Being from India and raised in Kuwait and different cities in India has helped me to adapt to different culture and religious views. Even though I might not believe in Hinduism, Jainism, Buddhism, Sikhism, Islam to name a few, I respect their individuality and their faith in one true God. I have learned to adjust to the societal needs and keep my thoughts to myself and not be judgmental or stereotype anyone.
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Helping people is why I chose nursing as a profession. When patients from different countries and culture come to the United States and are admitted to the hospital, they are anxious as they do not understand and are also confused about the whole process. Cultural humility is seen as an important step in redressing the power imbalance between the provider and the patient. As a nurse, if we can recognize that our own perception is an assumption, we are more likely to work with an open mind, be respectful and not behave as his/her way is the only best way to proceed. (Denisco,S & Barker,A, 2016,pg.584).
Jean Watson’s theory of caring is closely aligned with my personal, religious and spiritual beliefs as it encourages nurses to demonstrate compassion towards patients and family and approach every individual with respect. Jean Watsons theory of caring constitutes 10 caritive factors in which the provider practices compassion and holistic patient centered care. The care principles of carative theory or 10 caritas are authentic presence, creating a caring and healing environment and treating all individuals with dignity and respect.
The caring model is based on self-reflection, being authentically present and supportive to the patients and family, allowing them to express their feelings it was whether positive or negative, administering sacred nursing acts of caring healing by attending to basic needs, opening and attending to spiritual/mysterious and existential unknowns of life and death. It also encourages the provider to engage in teaching and learning experience (Alligood M.R,2017, pg.69). The caring model advises practitioners to practice equanimity by treating everyone equally and without bias. My personal approach and patient care are like Jean Watson caring theory as I also believe in treating everyone equally with respect. My personal philosophy is to respect everyone’s culture, religion and beliefs without prejudice.
In the unit I work which is Progressive care unit, I see patients who are chronically or terminally ill. Building trust and a good interpersonal relationship with patients and families is important. Providing with a listening ear to hear the patients’ needs throughout the shift and working with them to develop a plan of care that is best for them during their stay is important. We have white boards in the room which has a section for plan of care, time of next pain medication, question for the physicians and plan of care which can be discussed with patients and family.
Making sure that all patient issues are being addressed prior to discharge by involving all multidisciplinary team assist with quicker recovery, patient satisfaction and assist with proper transition of care is my goal. Bedside handoff also helps in building an interpersonal relationship at the beginning of shift, facilitates communication and encourages patients and families to make their needs heard and emphasizes holistic care of patient. Another new trial in my unit is the quiet time hours between 11pm to 3 am to provide rest for patients thus promoting their healing process.
We cannot assume that a patient comprehends information given to him/her even if the individual speaks English fluently. We need to do teach back method where we ask patients or families to repeat back the information provided to them to know they have comprehended the information (Denisco, S &Barker, A,2016, pg. 583). For example ,recently I had a patient who was admitted for shortness of breath. Unfortunately, during the stay she was heartbroken and was informed of the news that she had metastatic cancer that had spread. She was devastated. It was difficult for us as staff to do bedside handoff.
We would give report outside the room as we did not want to keep repeating about the findings of cancer. It is very painful to listen to it daily. We did do bedside report about plan of care, discussed any questions for the physician to answer in the morning. The patient was appreciative that we did not talk about her disease process inside her room as there were family members and she did not want to hear about her disease process. At night I asked her what was important to her for the night make her stay better. All the patient wanted was lights turned off and less noise.
During the night the patient cried as she did not know what she did in her life to be punished. It was a very busy night. But I took the time to pull a chair, sat with the patient and held her hand. She did not believe in God, but I asked her if it was ok for me to say a prayer. She agreed. I held her hand and said a silent prayer. I talked about my family, culture of India, different religions, rituals etc. She talked to me about her life experiences, talked about what options and resources were available, explained to her about chemotherapy, radiation therapy, educated on the side effects, discussed palliative care as she also wanted information, offered chaplain services to help her through the difficult times and we laughed together. Next day morning she thanked me for the time I took to listen to her and allowing her to ventilate.
I arranged Chaplain services so she could talk to them and have her spiritual needs met and placed a palliative consult per her request. Her eyes expressed more than her words. That feeling that you can make a difference in one person’s life is the best feeling a nurse can achieve. Jean Watsons theory of caring states to be supportive to patients, allowing them to express their feelings, helping them to open about spiritual/mysterious existential unknowns of life and death. In the above scenario, the patient was going through emotions and wanted to be heard and I provided the support she needed to help her to cope and make the right decision.
Another example is when Hispanic/Asian patient is admitted in the hospital the entire community comes to visit the patient. To the healthcare workers this annoys them and might interfere in their routine. But to the patient the family is important. They feel loved and cared for. I had a patient from the Middle East. The patient only spoke Arabic. We had shared rooms. There were two patients in the room. There were a lot of family members and in respect to other patients we asked the family members of the Arabic patient if they would kindly go home as per the request of the other patient. They agreed and left.
The patient was very modest and started getting agitated as her family had left and she had no one to communicate to. We used the interpreter phone to communicate but the patient did not comprehend or follow instructions per the interpreter. The patient wanted to use the restroom but refused any of us to help her or stay with her in the bathroom as she was a fall risk and very unsteady on her feet. I decided to talk to the patient’s daughter to see if one of the family members could stay with the patient. We provided a private room to the patient so she could have her privacy.
The daughter agreed to come in and spend the night. I provided a recliner for the daughter. After the daughter came patient was calmer. She comprehended to what the daughter said and understood the plan of care better. Since the patient trusted her family more than the healthcare workers who to the patient are foreigners, it helps alleviate the anxiety building in her and helping her to recover mentally and spiritually. Understanding and having the knowledge and my personal philosophy and worldview of respecting every individual helped me to consider the patients view, culture and belief to make the appropriate decision for the care of the patient.
As an Advanced practice nurse Jean Watsons theory of caring would assist me in building an interpersonal relationship with patients, build trust, provide patient-centered care, respect them as an individual and educate them to be responsible for their health and how to take care of themselves. It would also allow me to know the patient, their surroundings and assist me as a nurse practitioner to provide resources to patients to help them recover and provide optimum care. As an Advanced practice nurse,
I have to understand that every individual is different. We are all raised differently with different views in life. Every individual hope to be heard and understood. Listening to the patients, knowing their background, their views on health and how they perceive a disease process helps me as an Advanced practice nurse in the future to reflect on my own thoughts and be non- judgmental but to involve the patient in their own decision making and provide them with the education required using teach back method and assist them with the resources needed to provide them with optimum care.
In conclusion, my personal worldview, philosophy and Jean Watson’s theory of caring both emphasize compassion towards others and treatment of the whole person by ensuring compassion towards others and treatment of the whole person by ensuring that their beliefs, culture are taken into consideration. Each person deserves to be treated with respect, dignity and are encouraged to express their feelings and participate in their plan of care.
References
- Alligood, M. R. (2017). Nursing Theorists and Their Work – E-Book. St. Louis, MO: Elsevier Health Sciences.
- Collins, P. M. (2016). Christian Inculturation in India. London, England: Routledge.
- DeNisco, S. M., & Barker, A. M. (2016). Advanced Practice Nursing. Burlington, MA: Jones & Bartlett Publishers.
- Moving Shift Report to the Bedside: An Evidence-Based Quality Improvement Project. (n.d.). Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No2-May-2018/Articles-Previous-Topics/Moving-Shift-Report-to-the-Bedside.html
- Tan, A. K. (2015). Emphasizing caring components in nurse-patient-nurse bedside reporting. International Journal, 8(1), 188.
- Watson Caring Science Institute | Jean Watson | Human Caring. (n.d.). Retrieved from https://www.watsoncaringscience.org/
- Watson, J. (1979). Nursing: The philosophy and science of caring. Nursing Administration Quarterly, 3(4), 86-87. doi:10.1097/00006216-197900340-00010
