Caring can be defined as having compassion, empathy or a feeling of concern for others. According to Jean Watson Caring is “the model ideal of Nursing whereby the end is protection, enhancement, and preservation of human dignity. Human caring involves values, a will and a commitment to care, knowledge, caring actions, and consequences”. Caring goes beyond human to human person-centred care as it involves the act of caring, action and upholding values of caring.
In the nursing literature, caring behaviours can be described as actions concerned with the well-being of a patient, such as sensitivity, comforting, attentive listening, honesty, and nonjudgmental acceptance Journal of Caring Sciences 2014. In the case study video of Mrs Palmer, a number of behaviours relate to providing comfort. As one example, it was observed in Mrs Palmers video that the nursing student gave Mrs Palmer a heat pack to relieve pain, for her to rest comfortably without a lot of pain and putting a pillow for her under her head and pulling the blanket for her to ensure she is warm.
We also see in the case study video one of the nursing student attentively listening to Mrs Palmer when he saw her crying by talking to her with an open body, eye contact and lowered himself to the same level with her. Attentive listening gives the patient a sense of comfort that, they are being heard and it also gives an opportunity for caring nurses to know the patient more. The nursing students consistently addressed Mrs Palmer by name, as we see them referring to her by her name when they administered medication and as they were getting her out of bed to go and have a shower.
The nursing students gave Mrs Palmer vital information to enable her to make informed decisions, as one of the nursing student suggested for her to talk to a social worker for an ideas that might help her with her children and a dietician to help with a diet plan. The nursing students exhibited therapeutic communication as they talk to Mrs Palmer, asking her how she is feeling? How is the pain in the rating scale of 1-10? In the case study we also observed nursing students administering Medication to Mrs Palmer at the exact time they communicated to her indicating that they can be trusted as they were honesty in providing care as required by the nursing code of conduct.
The nursing students exercises personal hygiene by sanitizing their hands before they could touch the patient and asking for permission from the patient before they could touch them as a form of respect, as one example we observed the students asking the patient so they can have a look at her leg. The nursing students made Mrs Palmer their responsibility by checking on her and positioning the bed and patient to reduce exertion required by nursing staff and making sure she has an access to the patient buzzer. As Mrs Palmer was crying one of the students managed to talk to her showing empathy and asking why she was crying. By showing empathy to her, it made Mrs Palmer to tell him some of the sensitive issues in her life and even opened up about her weight and that she is looking after her children by herself. The nursing student was Patient as he was talking to Mrs Palmer allowing her to express herself and allowing her time to respond on some of the suggestions he had regarding her weight and caring of the children.
According to Secure Health Care Solutions on 11 July 2016 “nurses operate on six core values which are commonly known as the 6 c’s. Nurses who operate on these values ensure that the job gets done in an effective and efficient manner and that patients are safe and treated well”. The six C’s as described by Jean Watson are compassion, competence, confidence, conscience, commitment and comportment.
Providing comfort is considered a key caring behaviour of nurses. Comfort is a broad term which can have many meanings, for example the Porto Biomedical Journal Volume 2 January to February 2017 views comfort as characterized by the satisfaction of one’s needs, by the person feeling strong, safe, supported and cared for. Within the 6C’s of caring, providing comfort is seen as a component of compassionate care. In the nursing literature there are many examples of the importance of providing comfort to ensure quality care and enhance the patient experience. For example, patients often perceive nurses as caring when they engage them in the necessary steps to take for them to get well quickly.
Compassionate goes beyond comfort and empathizing with patients. Providing kind and considerate treatment all times. As a result of this nurses may receive an inspirational sense of human connection and confirmation of the meaning of their work. For example, as observed in the case study video we saw students nurses being compassionate towards Mrs Palmer when one of the nurses saw her crying, the student nurse took time to seat down and talk to Mrs Palmer that she does not have to worry about her children or her being obese as they are professionals who can help her.
Responsibility by the nursing staff towards patients is seen as an act of conscience which is to put yourself in the patient’s shoes and continued focus on empathy. According to Sister Simone Roach 2002 views conscience as “working consistently on another’s behalf and representing the concerns of the patient”. Respect is a component of comportment as nurses are to treat patients with respect and being non-judgemental, thus respecting their beliefs and dignity. This enables the patients to trust nurses to provide a high level of personal caring. As observed in the case study video we saw student nurses asking Mrs Palmer before they can touch her or before administering medication to her if they can touch her.
As observed in the case study we saw Mrs Palmer confident to share her personal problems with the student nurse. The student nurse was attentively listening to Mrs Palmer as she was talking which made her to have confidence in sharing the personal challenges that she was facing. As nurses exhibits high levels of commitment to their work, requires them to possess higher levels of patience, as they may be over-stretched with little financial growth for their efforts. Patients have a wide range of needs and treatments requirements and come from different sphere of life hence nurses should possess high levels of commitment and patience in order to make sure that their patient needs are met.
A number of nursing theories include the core concept of caring. One such theory, the Theory of Human Caring and according to Jean Watson is that, “humans cannot be treated as objects and that humans cannot be separated from self, other, nature, and the larger workforce.” This theory describes caring as “the centrality of human caring and on the caring-to-caring transpersonal relationship and its healing potential for both the one who is caring and the one who is being cared for” (Watson 1996).
In this theory there are 4 major concepts that Watson outlined which are human being, health, environment or society and nursing. One key idea that is of interest is the Theory of Transpersonal Caring. According to Watson’s theory of Transpersonal Caring “Nursing is concerned with promoting health, preventing illness, caring for the sick, and restoring health.” This idea could be incorporated into nursing care by ensuring that information such as preventing illness is provided to patients after they are discharged.
As observed in the case study video we saw one of the nursing students encouraging Mrs Palmer to talk to a dietician for a healthy diet to manage her body weight thereby promoting health for the patient. Promoting health of patients should not be a once of thing, personal care centre facilities should have different professionals on site to help in some of the cases. For example, having a dietician on site to talk to Mrs Palmer to provide her with a diet plan. We also observed in the case study video the nursing students making sure that Mrs Palmer is well taken care of by providing the information so that the patient make an informed decision in the care that she is receiving. Such information is important to nurses for caring for the sick in helping them to restoring their health.
Caring is broad and it goes beyond having compassion, empathy or human to human person – centred care. It also involves behaviours which define how we offer person-centred care to our patients. Behaviours such as touch, respect and addressing the patient by name helps the patient to recover quickly. The 6C’s which include among them compassion, confidence and conscience gives a clear picture of quality care to our patient and enhancing their experience. Jean Watson gave us an insight that Theory of Human Caring, humans cannot be treated as objects and cannot be separated either from self or nature.