We all are unique. Psychologically, physically, intellectually, financially, emotionally, culturally…name it, we all are different. In a given moment of time each one of us are in a different stage or phases in our lives. Thus, careful analysis and data gathering is very crucial in approaching nursing care.
According to Dr. Susan S. Blum who is an Assistant Clinical Professor in the Department of Preventive Medicine at The Icahn School of Medicine at Mount Sinai, Holistic means looking at the whole person when evaluating their health status. This means to think about their family, work, stress, environment, childhood, emotions and trauma as part of the work up and when making a treatment plan.
So putting that into a nursing perspective, I would like to share suggestions and ideas in ways of approaching nursing care Holistically.
A patient from Saudi Arabia came to America to get a second opinion. He and his family decided to go to this big world renown hospital here in the States. He was diagnosed in Saudi Arabia with Pancreatic cancer that has metastasized to his colon, liver and then bones. The patient was in so much misery and was young. He was only in his late 50s. He has a beautiful wife and 5 children in which the eldest son luckily was able to accompany them.
Patient and the wife did not speak any English but the son was able to with some difficulties. So most of the time they needed someone to translate for them especially when doctors were making rounds. Oh and by the way, the patient was a retired army in his country as well.
It was obvious that they are well off and distinguished in their country because of the way they dress and move (nothing is wrong with that). The patient’s wife mentioned that they have quite a few maids in their house in Saudi Arabia as well.
The wife served cookies, pastries and tea for nurses, doctors and other staff member to take with when they leave the room. On few occasions that I visited the patient I obliged by sipping this cardamom tea and tried this mouth watering pastry as I felt that it’s rude to turn down the wife’s offer.
Why did I mention all these informations that pertains to the patient and his cultural customs? Most of the time as healthcare personnel we mostly focus on their physical and medical histories, it’s either we are rushed or just don’t believe that those informations play a big part in caring for them.
Going back to our patient… … Even though he is in the late stage of cancer, he hasn’t given up at that time especially his wife and son. They opted for all the treatments to be done and the patient agreed to take whatever medicines that are required with the treatment plan.
But after how many weeks when the patient completed his course of radiation therapy, due to the stage of his cancer and his physical condition, the doctors were not willing to pursue other treatment. So it was time to tell the wife and the patient their decision. Sadly ‘though, one of the doctor forgot to observe the holistic approach. He didn’t take into consideration the background of the patient and family and also forgot their cultural standing…he just blurted it out with less tact that they were not going to pursue other course of treatment and that he will be discharged soon. Some medications were also stopped without proper explanation as to why.
Lo and behold, the wife became so upset and asked the doctor to step out and immediately was fired! She reported him to the top and decided to get another doctor for another opinion. The doctor that got fired most probably mean well and didn’t want the patient’s misery to be prolonged. He also probably didn’t want him to be exposed to a lot of infections in the hospital being that he is immunocompromised. There’s a lot of reasons surrounding the doctors decisions but due to the fact that his manner of conveying those informations and plans were not in support to what they feel and their backgrounds, it was not taken well thus conflicts arose.
That occurrence could have been prevented if only holistic approach was taken into consideration because our psychological/ mental and emotional well-being plays a big part in wellness and healing. Yes, he was a terminal cancer patient but he could have been in peace with the prognosis and so as the family member if the discussions between them and the doctor was done in a manner that are gentle, calming, respectful and with a lot of tact.
It would have been an easy transition to where patient and family could just focus on the now… be more relaxed and be more prepared in planning realistically. But due to stress and fear, because of the inability of other healthcare personnel to support them, their expectations and stress level became unrealistically high therefore they caused more trouble to the hospital and staff member rather than cooperating.
How To Improve Hollistic Approach
1. Listen to the patient and be open to any information they have to share.
2. Try as much as possible to know them..it may not be right away but during the shift. That will make a big difference. And it will be good to start with patient’s name or their preferred name.
3. Be patient. Some of us with different cultural backgrounds has different mind set. We all process information differently. Some patients that are going through a lot may take processing on a much slower pace.
4. Offer an interpreter or get a translation app on your phone. Some hospitals now has tablets that staff members can use.
5. Be open to diversities and or other cultural backgrounds.
6. If patient is unable to speak, contact the family to get more insights about the patient.
7. Be mindful with ways of communicating. Some patients maybe going through mental or psychological stress or trials. And some might have just came from a different background. As, to avoid misinterpretation.
8. Provide care with dignity.
9. Be respectful of their choices and or gender.
10. Practice empathy. As, it will show that you sincerely care.
11. Make it a habit to smile.
12. Avoid making patients feel rushed.
13. Don’t insinuate or assume..it’s best to always ask or clarify to avoid wrong judgment or misinterpretation.
14. Always practice the habit of explaining everything to patients or family members in layman’s term. It is best not to assume that everybody knows our terminologies as healthcare workers, in that way we are sure that we got our message across clearly.
15. Be mindful of body language.
16. Awareness of different religious practices is very important too.
17. As much as possible be knowledgeable of each and every cultural diversities that are common in your areas as that will save you the time and trouble of trying to understand them.
In A Nutshell
Connecting or dealing with different kinds of people poses great amount of challenges. Day in and day out our lives are intertwined with each other. We deal with our partners, children, friends, coworkers etc. We deal with each individual accordingly and with careful attention if we want a symbiotic and harmonious relationship with them. The way we treat Joe will not be the same with Tracy as they are both unique individual. Sure we would like to treat people fairly but we mostly need to treat each and everyone accordingly. And that is the same in nursing profession. So….
What Are The Advantages Of Holistic Nursing Approach
1. Happy patient, happy life..just like happy wife, happy life. Patient’s will be compliant and will make your life as a nurse easier.
2. A better well-being for patients.
3. Less psychosomatic discomfort.
4. Fewer medications will be needed especially pain and anti anxiety medications.
5. Better nurse patient relationship.
6. Better outcome.
7. The length of hospitalization will be lesser.
8. The chances of rehosptalization will also be lesser.
9. Medical costs will be lower.
10. Hospital beds will be available to those that are in need of acute care.
11. And as a staff member that are affiliated with a certain hospital, we are not going to be worried or bombarded with post discharge complaints from patients that were not happy during their hospital stay thus patient satisfaction score is up.
Those approaches that I have mentioned are just a few. The advantages are going to be a lot. I am sure that you all have more to add. So please add those thoughts and leave your comments down below. Thank you.