Week 7 Discussion: Nursing Theory Applied to Evidence Based Practice

Week 7 Discussion: Nursing Theory Applied to Evidence Based Practice Apr 14,2022 12:33am As a future family nurse practitioner, one of the issues related to this specialty track that will be dealt with frequently is pain. Pain is a frequent complaint and reason for visiting your primary care provider. Given that pain is very relevant and requires appropriate management, as a nurse practitioner, one would need to be holistic in creating a care plan that most appropriately treats pain. Specifically, one of the issues related to pain is the management of migraines and the appropriate treatment. In particular, the risks of treating migraines with opioid pain medication. Not only is there currently a major problem in the United States with opioids, but it is also a significant problem with providers prescribing opioids when it is not indicated. One of the nursing theories that can be applied to this concern is the comfort theory. The comfort theory was created by Katharine Kolcaba who defines comfort as the product of holistic nursing art (Puchi, Paravic-Klijn & Salazar, 2018). Kolcaba characterized comfort into three categories: relief, ease, and transcendence. She felt that people experience relief when they are given pain medication; for example, after surgical intervention. She referred to ease as a state of fulfillment; for example when the patient’s fear or anxieties are addressed, and the patient feels content. Lastly, she felt that transcendence in comfort came when the patient felt the empowerment to be above the challenge, or to complete the achievement. (Bergstrom, Hakansson, Stomberg, & Bjersa, 2018). Furthermore, Kolcaba felt that comfort existed in four different states: physical, psychospiritual, environmental and sociocultural. When looking at pain control and proper management, it is easy to understand how each one of these concepts applies and affects pain control. Pain is not just physical pain. One of the main factors contributing to pain often is psychosocial. Many times, someone’s spiritual and emotional wellbeing plan a role in someone’s physical pain. As nurse practitioners being holistic in care and treatment will promote viewing all aspects that dictate someone’s pain. Rather than just treating the pain itself, the issue may be multifaceted. When using the comfort theory to guide and manage proper pain control, we can reduce the amount of opioid pain medication given by addressing the other factors contributing to the physical pain. This is appropriate rather than throwing medication out to people that is a temporary solution to the permanent problem. From my experience as a nurse, pain is best controlled when the patient’s psychosocial component is addressed. Often times providers will prescribe medication after medication over and over and the patients’ pain remains uncontrolled. However, when you take the time to sit and talk to these people, there is more often than not, an underlying component to the problem. These people have emotional issues that have not been addressed. Once these are addressed or the patient receives counseling or other services that they need, things improve without medication changes. Pain is reduced because the person is feeling better about themselves and is no longer constantly dwelling on their pain. References: Bergstrom, A., Hakansson, A., Stomberg, M. W., & Bjersa, K. (2018). Comfort Theory in Practice-Nurse Anesthetists’ Comfort Measures and Interventions in a Preoperative Context. JOURNAL OF PERIANESTHESIA NURSING, 33(2), 162–171. Puchi, C., Paravic-Klijn, T., & Salazar, A. (2018). The Comfort Theory as a Theoretical Framework Applied to a Clinical Case of Hospital at Home. HOLISTIC NURSING PRACTICE, 32(5), 228–239. from Week 7 Discussion: Nursing Theory Applied to Evidence Based Practice Apr 15, 2019 1:08am Cassandra Moore Claire, Benner’s theory novice to expert is one of my favorite theories, truly I can see the value of this in the clinical setting. It is especially important and valuable as a nurse educator. In the clinical setting, it is always fun and impressive to watch as people grow through the stages. As a future nurse educator recognizing that each individual has their own learning style and learns differently is important. I personally am a visual learner. By hearing things, I do not learn, I need to see it or actually do something in order to learn it. While other of my co-workers listen to something once and are able to understand and retain it, I am not. Benner’s theory is so valuable in nursing because intuition is such an important piece of nursing. As we grow as nurses and advance from novice to expert we can begin to rely on our intuition and trust in our gut feelings more. I can remember when I was a novice nurse, and currently, I am far from an expert. However, I am no longer a novice and use my intuition on a daily basis. I have to say watching newer nurses grow in their own roles is very exciting. Nice job on your post. from Week 7 Discussion: Nursing Theory Applied to Evidence Based Practice Apr 16, 2019 1:50am Cassandra Moore Dr. Avery, I believe that reducing readmission rates as well as improving follow up care is a very important concept for patients. One of the reasons why this is so important is related to the cost associated with readmission rates. Not only is it costly to the healthcare system and the patient, but it is also not beneficial for the patient to be in a hospital. Studies have shown us over and over again that patients best recover in their home versus in hospital settings. Some of the interventions that can be done to improve follow up care is assure that the patient has the appropriate access to follow up care. Often times patients do not have the transportation or any means of getting to their appointments. Involving social work when you are able to help accommodate some of these things are helpful. Also putting some responsibility back on the patient for their own healthcare is important. As a provider empowering the patient to be responsible for their healthcare is important. Having programs such as mail pharmacies that send patients medications to their homes reduces some of the potentials for patients who otherwise do not have access to their medications. Another intervention is having home health services that are able to check in with patients to assure that they are following their instructions and taking the medications that they need to in order to prevent re-admission rates. There are many programs that are often underutilized that would be helpful if people would use them more.