"A nurse does not only seek to alleviate physical pain or render physical care , she ministers to the whole person. The existence of the suffering whether physical, mental or spiritual is the proper concern of the nurse" - Joyce Travelbee  

 

Travelbee's phase of the nurse-patient-relationship is always seen in my nursing practice on a daily basis. It is innate, it doesn't even need deep analysis, it just comes naturally.   On admission to the unit for an elective surgery, while we are even receiving the patient to their room's door, we always smile and greet asking how they are without any prejudices and biases, and viewing them as a unique individual having unique personalities. After we made sure the patient is comfortable, we do the initial admission assessment/interview in a manner which make patient feel comfortable speaking about themselves and related information needed, being sensitive of their own pace, answers and questions. If available, we involve the family or significant others in the initial interview thereby gauging also how far the family are involved in the patient's care/needs.  And as the care progresses, we encourage the family to be involved in the patient's care preparing them for the possible results/conditions - may it be good or bad - of the hospitalization. Eventually, they would develop trust towards us, nurses, and make them verbalize whatever they are thinking or worrying with regards to their situation as the day of surgery approaches.   Pre-operatively, in our clinical experience, it is understandably seen that not only patients, but their families as well, are all anxious and feels somewhat fearful to the unpredictable changes and adjustments that is foreseen after surgery. In this regard, we reassure them and encourage verbalization of their concerns to at least alleviate feeling of fear and uncertainties.  We extend by offering them availability of spiritual services when asked - knowing their religious orientation on initial interview. We answer patient and family's questions to the best of our knowledge and experiences on the level of their understanding. They often ask about the same cases as theirs  or the success of surgeries done by the same doctors. We reassure them by citing previous patients (confidentiality preserved) who had undergone the same surgeries, their prognosis and what transpired on the course of their hospitalization. In this way, it would elicit further questions about their expectations and at the same time, we can also advice them on what to expect post operatively.   On the day of surgery, as expected, the patient is prepared for the procedure. The least we can do is to be with the patient and listen to them, comfort them and reassure them, for as the time of surgery comes close, they will be more apprehensive and nervous. We then bring them to the operating room with ease and assurance that they will be fine.   After the surgery, the patient is expectedly in much of pain. And in this stage, we tend to put ourselves in their shoes. We respond to their calls as soon as possible and act on their needs promptly. And as a surgical nurse, we somehow already know that the primary complaint of patient's would be post operative pain. Thus, administering pain medications even before they complain or giving analgesia regularly is already a practice. Other than pain, nausea, limited mobility, and bladder and bowel problems are also expected, hence, any nursing interventions geared in alleviating these signs and symptoms are also a priority.   As the course of the hospitalization progresses, the patient continuously and eventually regain their independence and generally their state of well-being after a day or days of assistive activities by the nurse.  The effective relationship which was developed since day one is a factor which made the patient gain trust and confidence to the nurse, and that which in turn helped the nurse to easily facilitate nursing care - involving the patient and their families - enabling them to accept and adjust around a major transition in their health.   Hospitalization is indeed a period where we take the responsibility towards our patients. It not only focus on the physical aspects or the illness itself, but the patient as a total  being taking into consideration the physical, emotional, psychological and spiritual experience of the patient. This in turn would be able to assist them towards wellness, recovery and also to be able for them to find meaning in their situation.