Introduction
As part of the work with this patient, Jean Watson’s theory was used, which is that caring is the central aspect of the nurse practitioner’s work since it allows focusing equally on health promotion and patient treatment. Initially, it was an attempt to give a new meaning to the nursing profession as a field of knowledge and practice with its system of values, ethics, and mission in society (Pashaeypoor et al., 2019). This is a way to pay attention to nursing care as a new discipline for individual medical areas. Watson believes that the time has come to develop the science of care – a new field of knowledge and skills that is not limited to nursing care (Constantinides, 2019). It also includes other branches of scientific knowledge, such as education, ecology, philosophy, ethics, humanities.
From the point of view of J. Watson, the values of nursing care, knowledge, and skills aimed at a person in need of care are a unique art of healing that complements conventional drug therapy. All this is carried out in conjunction with the internal subjective processes that each individual experiences during life, especially in a state of illness (Pashaeypoor et al., 2019). At the same time, with this new philosophy and theory of human care, Watson seeks to balance the therapeutic orientation of medicine (Constantinides, 2019). Thus, nursing stands out as a unique disciplinary, scientific, and professional branch concerning nursing care and public health.
Nurse practitioners’ empathic connections with hypertension patients can improve their blood pressure and their quality of life and life expectancy. It is critical that persons impacted get nursing care that matches their requirements and improves their quality of life and the best possible medical therapy (Vujanić et al., 2020). Watson’s Caring Model is a nursing method specialized to the requirements of people with hypertension and was utilized to provide services to Mr. Washington.
Reason for the Theoretical Application
First of all, it should be noted that this theory contributes to the best indicators of patient satisfaction. This is due to the various essential characteristics that nurse practitioners exhibit towards patients. Importantly, it should be mentioned that this theory leads to the strongest patient satisfaction statistics (Constantinides, 2019). According to the study, blood pressure may be reduced, and the need for pharmaceutical medication reduces when people are taught about healthcare and lifestyle changes, such as weight reduction, aerobic activity, and nutritional therapies (Constantinides, 2019). It is worth paying attention to the fact that various ways of changing his lifestyle were proposed as part of Mr. Washington’s treatment plan. In addition, each treatment method was explained in detail, and the patient was asked to discuss all issues related to his problems.
In addition, another important aspect of this theory is that it is inherently very practical, simple, and logical to use. This, according to the researchers, is because the model evaluates people holistically, including their physical, psychological, and social environments, and improves problem-solving abilities (Vujanić et al., 2020). The approach may be integrated into direct patient-family care, and it encourages patients to take charge of their health. Consequently, when drawing up a treatment plan for Mr. Washington, much attention was paid to his education. Explaining in detail the method of application and the principle of action of medicines, we provide the patient with the opportunity to maintain their health independently. A detailed description of the actions makes it easier for the patient to understand what is required of him. In this case, it becomes psychologically and technically much easier to independently maintain the order of the treatment plan.
The approach emphasizes that nursing care may be offered rationally, and that nursing science and art are coherent in nursing practice, and it supports nurse practitioners with their caring-healing knowledge. Using Watson’s Caring model, nurse practitioners may deliver comprehensive care in their practice (Pashaeypoor et al., 2019). Watson’s paradigm may also be viewed as a philosophical and ethical basis for professional nursing and a disciplinary priority for nursing (Vujanić et al., 2020). This caring concept contains a call for both art and science; it establishes a methodology that integrates and combines new dimensions of mind, body, spirit medicine, and nursing, developing freely as vital to the human phenomenon of nursing practice (Drevenhorn, 2018). Various studies show how this theory has been applied to different patients. These studies have demonstrated that the general condition of patients improves due to a more attentive attitude to them.
Theoretical/EBP Application
When drawing up a treatment plan for Mr. Washington, it is necessary to consider various aspects concerning his socio-economic situation and the general conditions for the development of this disease in the country. Based on recent research, it should be noted that blood pressure tends to appear predominantly in the African American inner-city community (Waldron et al., 2019). The study emphasizes the significant frequency of hypertensive crises and emergencies in the predominantly African American urban population, five times higher than the average level (Waldron et al., 2019). In individuals with already highly increased blood pressure, the race is not a predictor of the development of hypertensive crises or acute target organ damage (Shen et al., 2018). Consequently, the use of Jean Watson’s theory makes it possible to better consider the psychological and social condition of the patient. When drawing up a treatment plan for Mr. Washington, it was necessary to discuss in more detail with him the factors that may not depend on him but affect the possibility of maintaining health. Thus, considering this specificity, general recommendations were identified that the patient could follow to change his lifestyle effectively. Mr. Washington is always allowed to discuss his socio-economic situation to adjust the plan.
Aside from challenges of cultural diversity, efficient communication, in general, is necessary for implementing Watson’s Ideas into action. Authentic communication is an essential part of executing altruistic processes, mainly when aiding and developing trust in relationships, both of which are essential in nursing (Pashaeypoor et al., 2019). Cultural variations and attitudes toward communication, educational background, social level, and demographic features all impact the nurse-patient interaction, which nurses must understand to give appropriate care to patients (Pashaeypoor et al., 2019). Thus, there may be possible obstacles to maintaining the health of Mr. Washington. The fact is that even though he tries to maintain a certain level of a healthy lifestyle, it still needs to be changed a lot. Therefore, building a trusting relationship with a patient can be problematic.
Within Jean Watson’s theory framework, the education aspect of the patient and his family is very important. In the case of Mr. Washington, it was necessary to make a plan for his follow-up visits and explain in detail what the patient should not do and what he should describe his condition. Counseling is described as a process in which one person assists another in clarifying his or her life circumstances and deciding on the next steps. To take action, the patient must be able to recognize what he has to do, stop doing, continue doing, and accept. Using Watson’s counseling approach in a consultation helps maintain patient-centeredness, empathy, and autonomy (Drevenhorn, 2018). Additionally, impacts on weight characteristics, physical activity, perceived stress, and the proportion of patients who achieved blood pressure management have been reported.
Ethical Theory Underlying Decision Making
Dr. Watson’s Theory of Caring is characterized as a moral ideal that encompasses mind, body, and soul interaction with another, and it was one of the first conceptual frameworks in nursing. Care ethics is based on the premise that caring for others is fundamental to human life and that it links individuals into a web of relationships (Pashaeypoor et al., 2019). To maintain a reliable, caring connection with the patient, the nurse must be self-aware of any judgmental sentiments or feelings that would encourage them to go over the line into intimacy.
Ethical Principles
Truthfulness and confidentiality
The rules of truthfulness ensure the partners’ openness in social interaction – the doctor and the patient. The rule of confidentiality is designed to protect them from unauthorized intrusion by direct participants from the outside (McDermott-Levy et al., 2018). These aspects are completely related to Watson’s theory, which is based on a direct trusting relationship between a patient and a nurse practitioner. While building relationships within the framework of this approach, medical professionals receive much personal information from the patient. In the case of Mr. Washington, it was possible to find out how he spends his free time, what alcoholic beverages he uses, and other personal aspects of life. Thus, this is important to get more extensive information about the patient to change the way of life in the best way, which was done in the case of Mr. Washington.
Autonomy and informed consent
Expressing respect for patient autonomy means recognizing that decision-making patients have the right to make decisions about their medical care, even if such decisions would contradict the recommendations of their attending physicians (McDermott-Levy et al., 2018). It is necessary to understand that Watson’s theory is determined by the desire to provide care to the patient. However, certain principles may stand above the aspirations of nurse practitioners and doctors. In the case of Mr. Washington, there were no contradictions in the views on the treatment plan. The patient trusts specialists’ opinions to a sufficient extent; therefore, he did not express a refusal of medicines. Such a result depends on the patient’s well-conducted education so that he clearly understands why and for what medicines are provided to him.
Code for Nursing
The ethical basis of a nurse’s professional activity is humanity and mercy. The most important tasks of a nurse practitioner’s professional activity are:
- comprehensive care for patients and relief of their suffering,
- restoration of health and rehabilitation,
- promotion of health promotion and prevention of diseases (McDermott-Levy et al., 2018).
A nurse practitioner must respect the inalienable rights of every person to the highest attainable standard of physical and mental health and receive adequate medical care. They are obliged to provide the patient with high-quality medical care that meets the principles of humanity and professional standards (McDermott-Levy et al., 2018). These principles of activity are inextricably linked with Watson’s theory, which is built precisely on the desire of nurse practitioner to provide comprehensive care to patients. Analyzing the case of Mr. Washington has taken all necessary measures to ensure his health. His complete examination was carried out, and it was also possible to obtain the personal information necessary to build a treatment plan. Based on the characteristics of Mr. Washington’s age and socio-economic conditions, the most optimal options were selected to cope with his diseases effectively.
Policy and Ethical Issues
Mr. Washington is an African American whose job involves optimal commitment and engagement. However, he is stressed since the economic lockdown during the COVID-19 pandemic reduced customer influx and minimized corporate operations. The income disparity poses optimal difficulty to afford healthy foods, prioritizing cheaper variants. The affordability of food is an essential factor across the global population due to the significant influence of it on the patient’s diet. According to the research by Buonomo et al. (2019), a family’s unstable or poor socio-economic status leads to poor nutrition patterns and catalyzes both obesity and weight loss. Even though such extremes of Mr. Washington’s situation are unlikely, it is necessary to take into account this risk factor of job loss. An important point is to constantly check the patient’s condition and socioeconomic situation to better interpret the treatment plan.
Another aspect that can cause ethical problems for accessing treatment is the philosophy of the clinic. A nurse practitioner needs to be fully immersed in the patient’s treatment process based on Watson’s theory. This is reflected in the fact that it is necessary to spend much more time working with each person. At this stage, the problem arises that each medical institution has some features that consist of the principles of its employees’ activities (Pashaeypoor et al., 2019). In the case of Mr. Washington, all his interests were considered, and the necessary assistance was provided. However, problems with other cases may arise in one way or another in the course of work.
NP Clinical Decision Making and Practice Responsibilities
To manage patient care and encourage professional practice, the nurse practitioner combines the scientific method, current evidence, and national standards of care with a systematic perspective. Together with the patient and family, the nurse practitioner develops an evidence-based, mutually accepted, cost-conscious, and effective plan of care that optimizes health potential or supports end-of-life decisions (Constantinides, 2019). Mr. Washington’s case revolved around prescribing or ordering the proper pharmacologic and non-pharmacologic treatments. It was also required to create a patient education strategy that considered the patient’s health literacy skills and learning requirements.
One of the important aspects of the nurse practitioner’s work is the maintenance and improvement of skills and knowledge. This is determined by the fact that each patient requires an individual approach, which complicates the workflow due to time constraints (Pashaeypoor et al., 2019). That is why it is necessary to constantly learn about various trends in the field of medicine and healthcare to provide patients with the most optimal solutions for their treatment.
In the case of Mr. Washington, Watson’s approach was used to work closely with the patient. Even though this patient had widespread hypertension, it was necessary to learn about other related diseases. To do this, it was necessary to research various studies that were conducted on other patients with similar cases. Moreover, it was the scientific work of colleagues that allowed us to justify the application of Watson’s theory in the treatment of Mr. Washington. This is manifested in the fact that various articles describe how an attentive and caring attitude to the patient can significantly reduce blood pressure and the risk of developing concomitant diseases. That is why it is necessary to constantly develop the skills and knowledge necessary to work as a nurse practitioner
References
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