Application of Caring to Practice

 by Teresa Agtuca  

I am assigned to Ms. Fatma Abdulla, 36 y/o Female Qatari, 85 kg. She is admitted due to persistent vomiting and both lower limbs weakness. She was discharged 3 weeks ago from the hospital for gastric sleeve procedure for her morbid obesity, 120 kg. 

Before entering her room, I briefly scanned her medical record to know more about the
history, what has been done and given to her. She was my patient from her previous admission. Upon entering, I greeted her, “how are you Fatma, I am Teresa.” She smiled but I did not see any brightness from her eyes. She lost weight a lot. I touched her hands and I assured her that I will be back to her as soon as I received my other patient. She just nodded. I agree with Ms. Balabagno that CF1,2,3 are very important in interacting with patients and promoting their self-worth. A genuine concern to others is always seen by our actions or body language. Just be with the client even without word could make a big difference to those who are in need of physical, psychological and spiritual support. I can also add CF 4 here, I found out that as nurses, we can gain respect and trust from our patients when we introduce ourselves to them before any interaction and address them by their first name, this will make them comfortable and at ease when communicating with us. 

As I promised, I went back to her without delay. She can still remember me. CF 4. Established rapport is very important foundation for the healing process. She told me she has leg pain. Before exposing her, I drew the curtain to provide her privacy. I examine her leg, positioned and elevated to pillow and applied some light massage. CF 8, C9. Provision of comfort, safety and privacy are major aspects of this carative factor. She asked me, do you think I could still walk? She showed her hands, you see even my hands are also so weak now. I should have not done the operation. I lost weight but I am also losing my independence. CF5,8,10. She is showing concern about her environment, how she can perform her activities of daily living, how she can help her family, how she can enjoy jamming with her friends. In this situation, as nurses, our aim is focused on how to strengthen her coping abilities, to increase self-worth and dignity. A caring environment should be provided for her, thus including other health care disciplines, and moral support from her family and friends. 

Before answering, I clarified what the attending physician said about her condition, in order not to give misleading information to her. She said I have a severe nutritional deficiency secondary to my operation. So I told her that she is lacking some vitamins and nutrients in her body that could lead to her weakness in both upper and lower extremities, and that after replacing or restoring those vitamins and essential nutrients in the body, gradually her weakness will be improved and her strength will be regained, slowly she will be recovered. CF2, 6. Now, I can see some hope and smile in her eyes. I started educating her about the safe and effective use of her medications, medical equipment and some assistive devices in coordination with the Occupational/Physiotherapist, fall prevention measures, importance of skin care. CF7,8,4,9,10. Although, I instructed her to call whenever she needs assistance, I did not wait for her to call, I often visited her and anticipate her needs. I encouraged her to gradually perform her usual activities of daily living starting from the simplest task, for example wiping her lips with tissue after drinking water, covering her hair with her veil or tarha. 

All carative factors are interrelated with each other. Unconsciously, we nurses are applying the Watson’s theory of care in our day to day encounter with our patients.