Professional Presence and Influence
Professional presence is something of a nebulous concept. Before this course, I honestly never considered what it was and how my nursing practice was defined by it. During my journey through this course I discovered what it truly meant. “Presence is an intersubjective encounter between a nurse and a patient in which the nurse encounters the patient as a unique human being in a unique situation and chooses to spend her/himself on the patient’s behalf’’ (Wingate, 2007). Presence defines how a person interacts with those around them, and particularly in the healthcare field, it’s incredibly important.
A1. Two models of health and healing
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d.). They did not grasp that feelings like stress or fear could impact a person’s health. As a result, physicians and nurses alike, may have failed to treat the whole person that was ill. They very likely only treated part of a disease or illness.
Another model of health that evolved over time is the physical-mind model. This model purports that a person’s overall state of health or ability to heal can be affected on how or what they think. For instance, that depression or anxiety can negatively impact a critically ill patient’s ability to heal. It also recognized that feelings or emotions can physically manifest as illness. For example, someone who is extremely anxious can give themselves an ulcer, without doing something to physically harm themselves. Simply being under significant stress can cause a physiological response to stimulate the creation of more stomach acid and wears a hole in the lining of the stomach, creating an ulcer. When using this model of health, doctor and nurses can treat a person, mind and body, when they have an illness.
Recently there was a patient on my unit that perfectly demonstrated this. Ms. B came in for an aortic valve repair. Her surgery went well, but shortly afterwards stopped participating in her care. She became apathetic towards physical therapy, to getting out of bed, and even so far as eating meals. When this happened, she started to physically decline and started getting complications. She got pneumonia, ended up on a ventilator and in the critical care unit 3 times in one month. She eventually became quite depressed about her outlook. She left our hospital on hospice care, which is unfortunate because most of Ms. B’s problems stemmed from the fact that she had been apathetic towards her care.
A2 – Differences between a model of health and my professional presence
The physical body model and my professional presence differ greatly. As previously discussed, the physical body model maintains that every illness or disease has a physical cause and solution. It fails to take into acknowledge the brain as something that can negatively impact your health. My belief is that the mind can have a significant impact on how a person recovers from illness and generally stays healthy. Depression, stress, or apathy can seriously decrease your general state of health and can significantly extend your recovery time from a severe illness or injury, if not make it completely impossible.
When I have a patient, I focus on the physical and mental aspects of their health. After a patient has had open heart surgery, it is important to get them up and moving as much as possible in order to get their body back on track. It is important to have them take their new medications and have them understand why they need them. It is equally important to nurture their mental health. Many patients after surgery have a feeling of helplessness and loss of control. When they do this, I feel it is important to find things to give them...