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Use of Travelbee’s Theory in Practice
Considering the following scenario that is typical in psychiatric care delivery. It deals with the issue of depression and suicide. You are working on the afternoon shift as a nurse at the local mental health unit. You have been informed that a new admission has just been triaged form the emergency department and has been cleared for admission to the unit. You are assigned this person as part of your caseload. You prepare the room as the patient is brought to the unit by the emergency department staff.
Applying Travelbee’s model you know that the original encounter will occur the moment you greet the patient. You may have some preliminary information about the patient (54-year old Caucasian female diagnosed with depression who is suicidal) and she may have some preliminary information about nurses (are generally nice and caring).
The patient arrives on the unit and you and the patient are now alone in the room as you begin the admission assessment. You are now entering the emerging identities phase. You are getting to know the patient as a human being and she is getting to know you as a human being. You hear her story and the circumstances leading to her admission and you may begin to feel something emotionally toward the patient. She, too, is mentally forming an impression of you, for example, based on how you are asking the questions, the tone of your voice, your body posture and your attitude. She is deciding if you are trustworthy, caring and competent.
You skillfully navigate the sensitive issues around suicidality, which allows the patient to feel comfortable enough to disclose information. Details of the emotional pain leading to her suicide attempt have touched you and you recognize that you have now entered the empathy phase of the relationship. You may actually experience a brief sense of your own mood shifting as you navigate this phase.
You return to the nursing station to document your assessment and begin the plan of care. As you put the information together and start your work, you may next experience sympathy. Developing a plan of care with goals of safety, restoration of internal control, reduction of depressive symptoms and instillation of hope indicates that you desire to provide nursing interventions that alleviate the cause of the patient’s illness and reduce her suffering. It may also occur to you that this patient was probably experiencing at least prolonged extreme anguish or likely despairful not caring, as viewed by Travelbee’s continuum of suffering.
As the days pass, you and the patient meet regularly during your shift. You have meaningful conversations that allow her to express her feelings and explore solutions to the circumstances that led to her admission. She uses her time with you productively and you have been able to relate to each other, human being to human being. Subsequently, you have now established rapport. This is where the bulk of the work and healing is done in the nurse-patient relationship.
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