Geriatric Syndrome: Dysphagia

Matthew Wayner & Anne RoaneJames Madison University NSG463 Professional Role TransitionKaren Jagiello, MSN, RNCOct. 2015Innate Compassion:A Discussion of the nursing as caring model

A New Approach to NursingNursing as Caring theory developed in the late 20th centuryCo-authored by Anne Boykin and Savina SchoenhoferFocuses on intrinsically caring nature of humanity as basis for nursing practice

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Anne Boykin, BSN, MN, PhD1Began nursing in 1966Retired in 2011; past dean and professor, Christine E. Lynn College of Nursing (Florida Atlantic University)Noticed throughout her education and early career that nursing education focused on the systems modelNo focus on care of the personIn essence, not being taught how to be a nurseSpent many years using formal methods of study to develop theory of caringStatement of focus for study: nursing is nurturing personsliving caring, and growing and caring

http://www.nursingascaring.com/#!meet-the-theorists/c1enr

Savina Schoenhofer, BA, BSN, M.Ed, MN, PhD1Holds degrees in nursing, psychology, counseling, and higher education Has authored numerous articles and made contributions to many books focusing on nursing as caringServed as a visiting professor, Christine E. Lynn College of Nursing (Florida Atlantic University)Created the Theory of Nursing as Caring websiteForum for discussion of theory and examples in everyday practice

http://www.nursingascaring.com/#!meet-the-theorists/c1enr

Overview of Theory Components2Persons are caring by virtue of their humannessPersons are caring, moment to momentPersons are whole or complete in the momentPersonhood is a process of living grounded in caringPersonhood is enhanced through nurturing relationships with caring othersNursing is both a discipline and a profession

Persons are Caring by Virtue of Their Humanness2The major concept which underlies all other aspects of the theoryNot every act of life is a caring act, but this theory does not focus on the uncaring actsTheory involves assumption that all persons are naturally caring of other beings on a fundamental level

Persons are Caring, Moment to Moment2Theory states that caring is a way of life that is in a constant state of unfolding, ever progressing to the next caring momentEach moment holds potential to grow in caring, growing in caring is an ongoing process, each moment through life

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Persons are Whole or Complete in the Moment2

There is no presumed deficit or dysfunction to be fixed, the presumption is that people are whole in the momentEach moment presents the opportunity to grow as caring person.The goal of nursing care, therefore, is not to make a patient whole again, but rather to heal through enhancing and maximizing what is in place

Personhood is a Process of Living Grounded in Caring2Personhood is being true to oneself in each momentPersonhood signifies that each individual has limitless potential to grow in caringKnowing oneself as caring person involves congruence with beliefs and actions http://blog.crisp.se/wp-content/uploads/2012/02/congruent-circles.jpg

Personhood is Enhanced Through Nurturing Relationships with Caring Others

Every relationship serves as a source for opportunities for caring.Endeavoring in a relationship of nurturing strengthens ones ability to live grounded in caringNursing presents a plethora of unique opportunities for forging caring relationships with others

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Nursing is Both a Discipline and a Profession2

The nurse draws on their values and beliefs, as well as their nursing knowledge and experiences, with caring as the intention and focus

http://www.mchonline.org/nursing-services/nursing-care

Putting the Theory into Practice Boykin and Schoenhofer encourage nurses to expand their understanding of caring, and to be constantly looking for new ways to improve how they care for various patients2Adapting to different situationsEncouraging caring attitudes in other nurses

Honoring each new nurse relationship/interaction as an opportunity to make a person-to-person connection and grow as a human

When a nurses work originates from a mindset of caring, the result is greater compassion

Evidence-Based Support of ModelFor many reasons, many of which are regulatory and financial in nature, the focus of nurses interactions with patients seems to drift away from the betterment of the individual patient and more towards metricsPatients become numbers and dollar signs instead of holistic, sentient beings

Mounting evidence shows the benefits of compassionate care across healthcare3Focus on teaching lessons of compassion to rising doctors and nurses, and in continuing education

Healthcare that begins in genuine, patient-focused caring results in better patient outcomes

Implications for the Future of NursingHuge emphasis on reducing readmissions and better chronic disease management4Aging populationHigher prevalence of chronic diseasesAffects reimbursement and other financial incentives

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Implications for the Future of Nursing (cont.)How can institutions apply the lessons of the Nursing is Caring theory to improve healthcare for providers and patients?Nurse-to-patient ratio reduction: increases nurse job satisfaction and compassion5Practices that re-focus attention on human, psychological elements of careE.g. Pause at the end of unsuccessful resuscitation efforts6Use of technology to expedite care to permit more of nurses time to be spent interacting with patients

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Why This Theory Matters to UsMatthew: Before becoming familiar with this theory, I had the same sense through nursing school that the focus was more on systems than on the person. Caring was learned through clinical experiences, from clinical instructors who made caring their focus. The theory is reflective of part of my nursing philosophy, that everyone has the capacity to the make the world a better place for those around them.

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Why This Theory Matters to Us (cont.)Anne:I was drawn to this profession because of a desire to be a purposeful part of the wellness journeys of othersThis theory emphasizes the uniquely human elements of healthcare from the caregiver side of the equationThe most spiritually satisfying moments for me begin with a genuine, natural motivation to improve the lives of othershttp://www.cpr.org/sites/default/files/styles/full-width/public/images/emergency_room.jpg?itok=GVKw4rGz

ReferencesOliphant, E. (2015) Nursing Theorist: Boykin and Schoenhofer. Texas Womans University Libraries. Retrieved from http://libguides.twu.edu/Boykin, A., & Schoenhofer, S.O. (2001). Nursing as caring: A model for transforming practice. Sudbury, MA: Jones and Bartlett. Lown, B. A., Rosen, J., & Marttila, J. (2011). An agenda for improving compassionate care: a survey shows about half of patients say such care is missing.Health Affairs,30(9), 1772-1778.Hendriks, J. M., de Wit, R., Crijns, H. J., Vrijhoef, H. J., Prins, M. H., Pisters, R., ... & Tieleman, R. G. (2012). Nurse-led care vs. usual care for patients with atrial fibrillation: results of a randomized trial of I ntegrated chronic care vs. routine clinical care in ambulatory patients with atrial fibrillation.European Heart Journal,33(21), 2692- 2699.Khamisa, N., Peltzer, K., & Oldenburg, B. (2013). Burnout in relation to specific contributing factors and health outcomes among nurses: A systematic review. International Journal of Environmental Research and Public Health,10(6), 2214-2240Bartels, J.B. (2014). The pause. Critical Care Nurse,34(1).