Professional Presence and Influence 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.
A1. Two models of health and healing
In the history of modern medicine, practitioners have evolved
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As a result, physicians and nurses alike, may have failed to treat the whole person that was ill. They very likely only treated part of a disease or illness.
Another model of health that evolved over time is the physical-mind model. This model purports that a person’s overall state of health or ability to heal can be affected on how or what they think. For instance, that depression or anxiety can negatively impact a critically ill patient’s ability to heal. It also recognized that feelings or emotions can physically manifest as illness. For example, someone who is extremely anxious can give themselves an ulcer, without doing something to physically harm themselves. Simply being under significant stress can cause a physiological response to stimulate the creation of more stomach acid and wears a hole in the lining of the stomach, creating an ulcer. When using this model of health, doctor and nurses can treat a person, mind and body, when they have an illness.
Recently there was a patient on my unit that perfectly demonstrated this. Ms. B came in for an aortic valve repair. Her surgery went well, but shortly afterwards stopped participating in her care. She became apathetic towards physical therapy, to getting out of bed, and even so far as eating meals. When this happened, she started to physically decline and started getting complications. She got pneumonia, ended up on a ventilator and in the critical care unit 3 times in one month. She eventually
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
Florence Nightingale, considered the founder of modern nursing, first began to establish nursing as a profession during the Crimean War. Since then, nursing theorists have continued to expand on the thought that patients are made up of more than just the symptoms they present with, Abraham Maslow, Carl Jung, Dr. Larry Dossey and Dorothy Johnson, but none more so than Jean Watson. She developed a theory of human caring that contained several core concepts, these concepts lay forth the ground work for how we, as nurses, should care for a patient. These concepts included transpersonal caring relationships (going beyond ego to higher “spiritual” caring
I have witnessed a “burned out” nurse simply say to a client who is refusing a medication due to a side effect the client does not care for, ‘okay, I will just put refused and tell the doctor.’ This client needs educated about his/her choice. Most of the time, the client does not realize how refusing the medication can have a negative effect on his/her body overtime.
Biopsychosocial model this describes that we all take things differently when experiencing mental health. When someone has experienced physical illness they can also experience mental health issues
Healthcare, and Medicine is advancing more and more each day. As healthcare workers, our understanding of health and healing has improved and changed in the way we care for our patients. Dossey believed in the three eras of medicine. Era 1 began in the 1800s and its focus was solely on the body. The belief that healing and overall health are totally physical. The therapies and treatment were either medications or surgical procedures. The thought that healing all humans based on bodily functions, and how they can be treated will change as time changes. Era 2 began in the 1950s and it focused on the mind and body. Health care providers realized that
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”
My professional presence is more mind/spirit rather than all three combined. As I stated earlier, I rely on my relationship with God to help me make professional as well as personal decision. I work in community nursing, where there’s not a lot of critical care to be given, but I still have to use critical thinking skills in some situations. Minsky observed the most important thing in life is to grow-beyond our current state, to become more our essential authentic self. This is the grand opportunity called “life”. When I worked in the hospital setting, the first model of health, concentrating on stabilizing physical ailments, and overlooking the need to assess the patients for emotional, spiritual or cultural factors are generally practiced. I agree that western medicine as a whole has really evolved and with the integration of technology into the health care setting has been a positive move. I have often seen patients come in with physical illnesses and soon realized that some of the patients have mental illnesses as well. However, the doctor would only focus on the physical illness and prescribe medicines or surgery to only address
Since the mid-19th century, there have been three distinct models of health and healing. The first era began in the mid-1960s and dealt primarily with the physical body. It is known as the mechanical model and focused solely on the anatomy and physiology of the body. It was physical in nature, and gave no consideration to the mind or spiritual side of the human being.
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).
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
In our practice, professional presence is the foundation on which we establish what it means to be human and to care for our fellow man. To be a nurse and choose the many sacrifices it takes to spend one’s life caring for others requires knowledge of one’s own personal beliefs and values. Our own past experiences with life and how they have shaped us also influence how we relate and treat our patients. These things work together to create our mindful presence. Throughout our years of practice, our experience with patients, coworkers and physicians as well as a growing knowledge base help us develop a road map which we follow in our everyday
One of the causes is that unless an absolute miracle happens, the fatally ill people will be dead no matter how they are treated. Moreover, the only
Professional asscoiation is "a body of people, formed usually to controll entry into the profession, maintain standards, and represent the profession in discussions with other bodies"(Dictionary.com). I feel that a college student might want to join a professional association for three reasons---1. it allows a student to "get their feet wet", they will get use to what it's like in their certain field, this experience will help them know what it takes, or even if they are in the right field and maybe should find a new major, and new career path.---2. it allows a college student to build their resume, being apart of a professional association just looks good to an employer, because professional associations help build a students work skills,
Community of Inquiry model, involving the components of social, teaching, and cognitive presence, was significantly experienced since my first term at Frontier Nursing University. The teaching presence during my didactic course was superb, utilizing variety teaching methods, such as power points, group interactions, videos, books, and power points. The didactic class then guided the teaching presence in clinical with use of the provided books, resources provided, and guidance of my regional clinical mentor. My preceptors attributed great deal to teaching presence, sharing their depth of knowledge and expanding my own skills and knowledge.