Thank you for your blog, and the words you use to instruct and encourage new nurses. I love reading what you have to say, and I have already used your advice when paging a physician during night shift! Definitely helped me prepare and keep my confidence. My question is this: how do you balance your physical, emotional, and spiritual care for patients? This has been on my mind a lot lately, and I’m frustrated at my apparent inability and lack of time to provide good, holistic care.
– thered-gisterednurse via Tumblr
I think finding the right way to holistically care for your patients is to first identify their needs. And you can do that within the first 15 minutes of being around them.
Sometimes, patients have very good support systems, are emotionally secure, spiritually satisfied, and just really need their physical/medical needs to be attended to. These patients honestly need you less.. and that’s okay. That’s everyone’s idea situation when they go into the hospital, but I’m sure you’re well aware that many people are not so blessed.
Attention and time
I can tell which patients need a lot of emotional support. I can just feel that they need more attention and time. With these patients, just sitting in there, listening to them talk or just even being physically in the room is way more important to them than getting their meds given on time. When I identify this need, I’ll chart in the room with them. We don’t have to talk, I just want them to know I want to spend time around them. I ask them about their family, spouse, life, home, or even just simple stuff like the weather. These patients just want someone to want to be around them. I linger in the room as long as possible (but being careful that I’m not neglecting other patients). I save more time for them. I take extra time explaining things.
These patients also benefit from physical reassurance/touch as well. A hand on the back when they start telling you something and get tearful. Sometimes I’ll reassuringly hold their hand when they get emotional or are having a hard time talking. These patients really need your patience.
Little things are victories (finally pooping, standing at the side of the bed for the first time, keeping all of their pills down, sitting in the chair for 15 minutes today instead of the 5 minutes yesterday, eating half of their meal, etc.) I make a big obnoxious deal about these things because it really means a lot to them to have someone encouraging them. These are the patients that put on their call light just to tell you that they finally pooped and feel so much better. Someone consistently encouraging them makes them feel like they can do anything.
Emotional and spiritual support
You kind of have to feel around to identify their spiritual needs. Some people are very outright about their spiritual life and identity and some people don’t acknowledge that part of their life. It usually takes a little longer into the relationship to understand their spiritual needs if they don’t just outright tell you. This can be very, very personal so some don’t feel comfortable sharing it with you until they know they can trust you and you won’t judge them. And some never will, and that’s okay too. I’ve had a few share with me their personal beliefs without me asking first (it’s very important to let them tell you this stuff, not to pry it out of them!) and if I shared the same beliefs and they expressed a need for prayer and didn’t feel comfortable with our chaplain, I prayed for and with them. It’s quite an amazing experience.
So, in short.. I believe the key to properly supporting patients holistically is first appropriately identifying their needs (physical, emotional, spiritual) and filling in the gaps. Be able to interact with someone and see that they just need someone to listen to them. Or maybe they just need encouragement. Or maybe they need some prayer. Or maybe they need to just know you won’t/don’t judge them. Or maybe they just need to know and feel that they are important to you.
Honestly though, if you’re asking this question.. I know you’ve got to be a good nurse. Clearly, it’s about more than documenting correctly, giving meds, and doing procedures perfectly. You’re off to a fantastic start and I am sure your patients are very thankful for you. Thank you for what you do.