Healing Environments: Professional Presence

Society has progressed both socially and technologically as has medicine. This includes our understanding of health and healing as evidenced by Dossey’s three eras of medicine. Era 1, beginning in the 1800’s, reflected the prevailing view that health and illness are totally physical in nature and therapies included surgical procedures and drugs. Era 2, starting in the 1950’s, related to the mind and body. Practitioners began to realize that emotions and feelings can impact health. Era 3, still developing today, began in the 1990’s and builds on the previous eras by adding the spirit and proposes that consciousness is not confined to one’s

When you meet someone for the first time every detail is being noticed; from your entrance, wardrobe, handshake, etiquette, and voice quality and speech (Center for Professional Communication, 2014). First impressions are lasting ones and the first step in building long lasting relationships. A person must be aware of their presence and understand themselves to have a confident professional presence.

The medical model “is a perspective of scientific materialism and the dominant perspective in biological psychiatry. This perspective uses scientific method to explore observable, measurable aspects of the individual”(Elliott Ingersoll, 2016, p. 346). The psychological perspective is “the perspective that represents the subjective experiences of the client. This includes thoughts, feelings, and worldviews as well as such things as mystical or intuitive experiences” (Elliott Ingersoll, 2016, p. 348). The medical model and the psychological model resemble each other by focusing on the brain such as the mind and behavior.

What does it mean to be human, and how do we as nurses provide care to our patients? According to Jean Watson “The future of nursing is tied back to Nightingales sense of calling guided by a sense of commitment and covenantal ethic of human service; cherishing our phenomena, our subject matter and those we serve. It is when we include caring and love in our work and our life we discover and affirm that nursing, like teaching is more than just a job but a life giving and life receiving career for a lifetime of growth and learning” (Watson, J. 1978). There have been many different

• “Guardians are concerned citizens who trust authority, join groups, seek security, prize gratitude, and dream of meting out justice”

A1. Models of Health and Healing- The candidate provides a logical discussion, with substantial detail, of the differences between 2 models of health and healing as they relate to what it means to be human.

Professional presence is something of a nebulous concept. Before this course, I honestly never considered what it was and how my nursing practice was defined by it. During my journey through this course I discovered what it truly meant. “Presence is an intersubjective encounter between a nurse and a patient in which the nurse encounters the patient as a unique human being in a unique situation and chooses to spend her/himself on the patient’s behalf’’ (Wingate, 2007). Presence defines how a person interacts with those around them, and particularly in the healthcare field, it’s incredibly important.

Hospice care is a model of care that focuses on relieving symptoms and supporting patients with a life expectancy of six months or less (Altshuler, 2013). For most nurses, caring for a dying elder (individual aged 65 years and above) is a discrete, time-limited experience that begins with first contact, often in a hospital, emergency room, or long term care facility, and ends with the death itself (Phillips & Reed, 2008).

The first component speaks of a healing environment. This is an environment that is restful to the patient and the patient‘s family. There are no overhead paging, no sweepers going down the hall at night, promotion of a calming stress free environment for staff and patients to connect with their internal spirituality. The implementation of something as simple as a relaxation garden or massage treatment can go far in helping a patient rejuvenate so that they can move forward.

1. Era I – “Mechanical Medicine” began in the 1860’s. Its focus is on surgical procedures and drugs. The thought was that health and illness are only physical in nature and consciousness is equated to functioning of the brain. Era I thinking in displayed in review of psychiatric care in the early 1900 with the use of frontal lobotomies to cure hysteria. The thought was that performing a surgical procedure on the brain will remove the area that is causing the Hysteria. Era I focuses on performing a procedure or providing a medication to fix the body physically, while Era III takes into account the patients perception of health, their stats of mind and their support

When considering this the color of the environment plays a big part of the healing environment. The use of chromotherapy, color healing, is essential when considering a healing environment. Green is considered the universal color for healing (Stefanidakis, 2001). Using colors appropriately in the hospital environment can encourage emotional responses to enhance healing. If the incorrect colors are utilized the patient may present with symptoms of irritability instead of peacefulness or cheerfulness which could inhibit healing. Furthermore, the hospitals interior plays a major role in the healing process. Spirituality will be promoted if the interior reflects the hint of a religious atmosphere such as exercising specific religious artifacts spirituality will be promoted. Hospitals can also incorporate unrestricted visiting, decorative fountains, fireplaces, skylights and healing gardens to help provide a relaxing environment which decreases stress for their customer population.

The founder of the Planetree is Angelica Thieriot (Sharrow & Durand, 2012). Thieriot made Planetree symbolize a sycamore tree. The sycamore tree was the location where Hippocrates taught his medical students the art and science of healing. “Wherever the art of medicine is loved, there is a love of humanity,” Hippocrates once said. Planetree is bringing back the healing principals that Hippocrates believed in. (Planetree: An Introduction – Huelat Davis | Healing Design (Formerly Huelat Parimucha), n.d.). PPlanetree creates standards to make sure that healthcare centers deliver patient-centered care. This includes all aspects of care (Ingersoll, 2013). Planetree's concept is that care needs a plan based on the needs and expectations of the patient and family.

Through the Professional Presence and Influence course, I realized that I have much room for improvement and growth. I learned how to examine my personal inner and outer environments, investigate my personality preferences, participate in mindful practices for improved patient safety and satisfaction, establish goals with achievable outcomes, and lead others in the nursing profession with an improved professional presence. Professional Presence A professional presence includes more than simply being present in a designated work area for a designated amount of time.

Roger S Ulrich argues the importance of healthcare facilities creating a supportive surrounding that aids in the patient's ability to cope with stress. This can be achieved through providing patients with a sense of control over their environment, access to social support, and access to positive distractions. There is room for improvement in healthcare facilities, and these improvements might not cost too much. Research has shown “that supportive design can be credibly related to dollar savings in healthcare costs. (Ulrich 104). Elements of supportive designs have shown to reduce medications for patients and even reduce the patient's time in the hospital. These cost saving details would come close, if not fully cover, the cost of creating a

As a result of growing evidence regarding the effects of environmental characteristics on the health and wellbeing of people in healthcare facilities, more emphasis is being placed on, and more attention being paid to, the consequences of design choices in general hospitals. A general hospital is a large medical facility where patients with many different types of ailments are given care. In the United States there is a movement to improve the interiors of medical facilities by basing planning and design decisions on this evidence of beneficial features to achieve the best possible patient, staff and operational outcomes constituting evidence-based design. As a result these constructed or renovated hospitals will serve patients and be a workplace for personnel for decades. The impact of the physical environment of general hospitals on the health and wellbeing of the patients as well as staff has received accelerating academic attention. Although, the question still remains whether healthcare design and its enormous cost is worth it. A major factor is that no amount of interior design can make up for experienced staff, state of the art technology, and medicine. It is important to know where medicine stops working and where the environment starts to influence healing. Would it be better for the medical community to invest more of their money, time, and resources into the interior environment or to medical advancements? Therefore, the goal of this research is to find