Stage 3 Questions

Reflect on your answers to the Part I of the case study. Did Jean’s desire for independence stand out to you as important? If the staff knew Jean valued her independence, how could they have used this information to promote safety?
Explain how clinical forethought is used to predict potential complications and what it means to you as a future nurse.
Describe the value of seeing healthcare through the patient’s eyes. How can nurses have an impact on the lives of patients like Jean?
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Unfolding Case Study Stage 3

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ANSWER

Unfolding Case Study Stage 3

Jean’s desire for independence stands out as important for many reasons. Primarily, in stage 1 case study, Jean is described as an independent woman who lived alone as a widow for 35 years, after the death of her husband. This primary instance shows the desire for independence in Jean’s life. Secondly, throughout these years, even at 88 years, Jean took care of herself by performing daily chores, activities and even paid her bills without hesitation or struggling. Despite having four older sons and several grandchildren, she did not ask for their assistance or employ an assistant to help with daily chores. Thirdly, she enjoyed being at home, as she opted to stay at home even after her diagnosis and worried being taken away from her home when it was discovered that she fell in her house. All these instances show Jean’s autonomy desires, as she had developed a home-based routine that worked for her effectively.

If the nurses understood the value of Jean’s independence to stay in her home, they could have implemented and integrated a home-based treatment plan and home routine that integrated her home routine and medical specification. Independence, in this case, means Jean could achieve, make decisions, and initiate actions confidently. However, to some point, she needed dependence, which could have been approached and addressed using a balance between independence and dependence through the staff (Lister, Hofland, & Grafton, 2020). The response to developing a home routine and treatment plan should have been long-term, including defining nutrition, meal plan, home functionality, and mobility such as taking baths and visiting the restroom. In this case study, she called for assistance when trying to use the restroom, but even after waiting for 20 minutes, no help was given, which resulted in tripping and falling on the carpeted floor. This shows that the nurses and staff did not understand or take Jean’s value for independence seriously; hence, a home routine treatment plan was not implemented. Understanding this information would have helped promote self-management approaches, initiate a balance between dependence and interdependence, which could have been possible through a partnership, and eventually, Jean’s safety promoted.

Clinical forethought among nurses requires the utmost critical thinking, clinical imagination, and experiential learning. It allows nurses or medical practitioners to anticipate likely clinically oriented eventualities among patients through which nurses can take feasible actions. Through the development of clinical forethought, nurses develop and create a mind habit of thought and action in their practice and in the treatment or medication prescription. This way, they think of a patient’s disease, treatment history, recovery trajectories, and their implications in treatment (Linsley, Kane, & Barker, 2019). It maximizes nurses’ ability to predict potential complications if a certain patient is treated using a particular treatment plan, hence taking prior and warranted actions to manage and control the associated risks. Clinical forethought enables nurses to see the unexpected, react effectively to specific patients, and future think to help in predicting and anticipating future risks when treating a patient. In response, good treatment plans, sound, and appropriate decisions are taken when preparing the milieu to respond rapidly to anticipate patient risks (Linsley, Kane, & Barker, 2019). For instance, using Jean’s story, a nurse’s forethought would have predicted possible home falls as her health kept deteriorating. In response, the nurse would have prepared rapid and timely intervention strategies that would have been implemented, such as home improvements and rails for walking support, which could have prevented the fall she encountered.

As a future nurse, I will acquire critical thinking, clinical imagination, and experiential learning skills. They will equip me with the ability to see the bigger picture, anticipate, and predict clinical signs associated with patient treatment plans. This way, I will be confident to make essential clinical judgments and decisions to prepare timely interventions and increase my assertiveness to patients. This way, I can predict and effectively manage potential complications through exemplary mitigation strategies tailored to meet the patient’s needs.

Nurses and medical practitioners are mandated to provide quality healthcare, which should integrate patient preferences and communicate patient satisfaction (Kuipers, 2019). Primarily, seeing healthcare through the eyes or lens of patients helps medical practitioners become aware of patient’s culture, beliefs, and experiences with the healthcare systems, in return, they understand external forces better guiding patients’ decisions or preferences and issues that show a lack of control over their health and how they feel. Having this knowledge helps medical practitioners and nurses understand the framework through which patients see healthcare, developing, and tailoring treatment plans incorporative of patient preferences and decisions. The ultimate value is that quality healthcare providence is attained, patient satisfaction achieved, and patient-centered care enhanced. Patient satisfaction is integral in measuring and indicating quality healthcare, which requires seeing through the patient’s eyes. Research shows that satisfied patients easily comply with physician’s prescriptions or nurse’s instructions, hence, improving healthcare and treatment outcomes (Carretta, Bond, Cappiello, & Fantini, 2017). When nurses practice and learn to see through the eyes of patients such as Jean, they understand and feel their experiences. Thus, more treatment opportunities are presented to provide quality care and patient satisfaction. As nurses, we can impact patients by providing an amicable, satisfying, and healing environment characterized by engagement, empathy, and compassion from nurses.

References

Carretta, E., Bond, T. G., Cappiello, G., & Fantini, M. P. (2017). Looking Through the Patients’ Eyes: Measuring Patient Satisfaction in a Public Hospital. Journal of Patient Experience, Vol 4(3), pp; 121-128.

Kuipers, S. C. (2019). The importance of patient-centered care and co-creation of care for satisfaction with care and the physical and social well-being of patients with multi-morbidity in the primary care setting. BMC Health Serv Res, Vol 19(13). https://dio.org/10.1186/s12913-018-3818-y.

Linsley, P., Kane, R., & Barker, J. H. (2019). Evidence-based Practice for Nurses and Healthcare Professionals. New York: SAGE Publications.

Lister, S., Hofland, J., & Grafton, H. (2020). The Royal Marsden Manual of Clinical Nursing Procedures. New York: The Royal Marsden.