Psychosocial Integrit

FOCUS REVIEW Psychosocial Integrity Psychosocial integrity is a basic health need for all patients. This usually focuses on promoting and support the emotional, mental and social well-being of patients experiencing stressful events, even as well as patients with acute or chronic mental illness. There are a lot of categories to be covered on the nursing actions. Therapeutic communication is one of them. Using therapeutic communication is one of the effective ways to contribute nurse-patient relationship. On chapter 4, I have learnt about nonverbal therapeutic communication techniques and verbal therapeutic communication. For nonverbal therapeutic communication, listening is a key and an acquired skill that is vital to the nurse-patient relationship. It requires full attention from the nurse to the patients. Sometimes, listening can be the most difficulty but it also is the most effective therapeutic. I have learnt that practice listening can convey the interest and caring and allow feedback to verify understanding of the message. For example, when dealing with upset patient, I have used the listening skill. I think I cannot solve the problem without listening to patient. So, I will give the floor to the patient to express about what made patient upset. And then I can take appropriate steps to resolve the problems. The second difficult therapeutic communication therapeutic will be silence. I have learnt that sometime, it is useful to not speak at all. Maintaining silence can give both nurses and patients an opportunity to think through and process what comes next in the conversation. Finally, using touch is a powerful way to communicate. It can relax or comfort a patient. However, nurses need to be sensitive to patients and ascertain whether touching is acceptable, since different patients have different culture. Some patients feel comfortable and some patients may feel threatened by it. For verbal therapeutic communication, asking questions help the nurses to fuller and deeper information from the patients and wants to know the patient’s feelings and beliefs about their current health situation. Open ended questions are a good way to obtain fuller information rater than a closed ended question that requires more than a simple yes or no answer. Restating is when the nurses repeat to the patient what the nurse understands to be the main point. It also can encourage patient to provide more information. Restating the patient’s message in nurse’s own words to verify that nurse is correct is called paraphrasing. Clarifying will be useful when patient’s message incomplete or confusing or does not go deeply enough to into the problem. Sometimes patients may tell the nurses the whole long stories and forgot the main point or patient is too vague, focusing elicits short and main point. Reflecting assists the patient to reflect and explore inner feelings and thoughts rather than seeking answers or advice. Patients may say that they do not have any pain but then their face is grimace so it doesn’t match with their verbal message. Then the nurse can use stating observation. I believe that offering information is the form of communicating that is used the most by the nurse. For example, the nurses give patient discharge instructions, diabetes education or how to use the blood pressure machine at home. Summarizing means review the main points covered in an interaction. It focused on key issues and allows for additional information. Use of humor provides a positive psychological and physiologic effect on the body. Humor can help the nurse and the patient relax and at ease. However the nurses must know that when is appropriate to use humor and when is inappropriate not to use the humor. Fundamentals Ability to apply fundamental nursing principles and skills to basic needs of clients. Topics include foundational client care concepts (ie: medical and surgical asepsis, infection control, physical assessment, therapeutic communication, medication administration, pain management integral to the delivery of safe, ethical, and legal nursing practice. Maslow’s hierarchy of needs is one of the most prominent psychological theories that explain individual motivation. Published in his seminal paper, “A theory of human motivation”, Abraham Maslow, an American psychologist and professor, depicted human needs as five hierarchical levels within a pyramid (Maslow, 1943). In this chapter, I have learnt that individuals must satisfy their lower-level needs before they can attend a higher set of needs. The first level is about physiological needs, is made of the most basic, biological needs, which represent the basic physical requirements of any individual. These requirements include the need for food, oxygen, shelter and water and form the basis for the pyramid. I think these needs are the strongest ones since if individual is deprived of all needs; they will strive to address the physiological needs in the first place. For example, without food and water, my body cannot function optimally. At this point, all other needs become of secondary important until my stomach is full again. Once, I get fulfill with the needs of food, the need for safety and security becomes prominent. For example, medical care, police, business, and education are amongst the things that allow us to fulfill our safety and security needs. Together, the first two levels of Maslow’s hierarchy of needs make up the basic needs. At third level in the hierarchy of needs by Maslow are involved feelings of love and belongingness. Examples of social needs include friendship, acceptance, trust and love. Similarly to first three levels of Maslow’s hierarchy of needs, esteem needs are attributed to deficiency needs, which arise because of deprivation. Self- actualization, according to Maslow’s classification, is a being or growth need. What distinguishes it from the lower-level needs is that it does not need stem from a lack of something. Instead, the need for self-actualization is driven by one’s desire to realize their potential to its fullest. This need can be developed and addressed only after all the aforementioned needs are addressed. Basic care and comfort The nurse contributes to the plan of care to promote comfort and assist client to perform activities of daily living. Basic care and comfort includes assisting with all activities of daily living (ADL). It also includes assistive devices, mobility/immobility, non-pharmacological comfort measures, nutrition and oral hydration, and post – mortem care. I have learnt that the nurse must have a good care plan that outlines the individual needs of the patient and the approach of the health care team to meet these needs. If patients receive good basic care and comfort, they are likely to recover quicker and have better health outcomes. A negative environment delays healing. I have learnt that when the nurse can use nonverbal and verbal therapeutic combines with Maslow’s hierarchy of needs which will make patient comfortable and better health. Also the nurse should help the patient deal with their symptoms by providing emotional support to patient. When the patient meets their physiological and emotional needs, they also improve the healing process and help patients feel safe and more empowered with managing their own recovery.