Five Attitudes toward Quality Nursing Care

The attitude and approach of the nurse in the health care sector is the most important factor in the life of any patient who wants to be with treated with care, compassion, respect, empathy and more than that as a human being.

Nursing profession is a most noble profession from a humanitarian angle and apart from various skills it requires some traits or attitudes to be cultivated to fulfill the cause for which this profession is known.

Florence nightingale was perhaps the first nurse in human history in true sense to possess the traits for which she was known at that time. She showed to the world that generous nursing attitude can make a lot of difference in the life of the patient. During the Crimean war, she visited military hospital at Turkey along with some women nurses and made terrific changes in the hospital. The mortality rate, which was at 40% when she entered the hospital, came down to just at 2%. That was the first recognition to the nursing profession that became an integral part of the medical treatment as an intimate care taker. Nightingale became a role model for future generations in nursing profession. (Quan, Kathy)

http://www.netplaces.com/new-nurse/what-is-a-nurse/a-brief-history-of-nursing.htm

Since then medical science has made a lot of progress in terms of facilities and modern equipments but importance of nurse has never diminished.

Attitude of Professionalism:

As the ICN code of ethics for nursing describes, “The nurse’s primary professional responsibility is to people requiring nursing care.

Professionalism is a foremost and important attitudinal requirement for nurses. The work attitude or professionalism in discharging the duties is important for patient’s care and well being. Talking about professionalism implies sticking to the rules as per the medical guidelines without bringing any emotional factor in between. Among all medical staff, nurses are nearest to the patient and their role is that of care taker and service provider, which makes essential for them to learn the entire nursing task and be proficient in it. Breaching professional behavior means negating a duty of care and that may have serious consequences even in legal context.

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The process of communicating to the patient and obtaining consent regarding a course of treatment through patient’s signature on a form is one of the important requisite as a frontline caretaker and this forms a part of professional attitude for the nurses. The patient’s consent is sacred and must be protected while undertaking any nursing procedure; however, when patient is incompetent for physical or mental handicap, due to age or unconscious state then consent is required from legal guardians in the best interests of patient.

By virtue of nurse’s profession, they hold patient’s confidential information and nurses use judgment while sharing them. In order to form a bond of trust between the patient and health care professional including nurses, it becomes imperative to maintain the confidentiality on part of nurses in all the circumstances.

Nursing attitudes what is desired and what is not desired at times could be subjective but having listened one real life incident of one of the patient, it can certainly be outlined in more authentic way.

The patient belonged to a big town in US where she was born and brought up. She was well aware of nodules in right breast but she assumed that they were merely benign cysts and that will go away after some time and she didn’t pay much attention on it. When she went for her annual well women visit she was asked to go for immediate mammogram and surgical consultation. She listened to the heed and fixed the appointment for a mammogram two weeks later.

As she narrated, mammogram checkup was her distasteful experience. “Do these technicians and nurses really care?” that is what her first experience was. She was alone, unsure, afraid, and a bit confused. Professionals go through all this as per the daily routine and they become so impersonal-having no need to inform what they are going to do. One of the nurses was handling her as an unanimated item; perhaps, she had been used to the atmosphere. She kept waiting for long hours uniformed about the procedure. Radiologist conveyed her to consult a surgeon as soon as possible and was looking upset. She assured him that she will not die and she has lived a full and wonderful life. As per the advice, she went to the surgeon.

After arrival to surgeon’s outpatient clinic, she was waiting for her call being highly concerned and unsure of the outcome. A kind and wonderful nurse from the clinic office took over her case. The nurse listened her patiently what she narrated about her experience at the radiologist’s clinic. According to her this nurse was positive, organized and efficient and she helped her feel better. It did not take her longer to understand patient’s situation and emotional trauma that she had passed through at the radiologist’s clinic. This nurse took her time to explain everything, which was necessary for the patient to know and organized the meeting with the surgeon much ahead of the time than it would have taken her to go through the regular appointment process.

As per the patient the attitude that she liked in the nurse was her Tidiness in organizing the things swiftly.

The patient was at her next nursing encounter where abnormal mammograms led to biopsy at outpatient surgery center. The nurses were indifferent and unconcerned. She was escorted in and out frequently from one place to another and handled like a bundle. They informed her that it will be open breast biopsy. She was on local anesthesia but throughout neither she was informed about the procedure, likely complications nor anybody tried to soothe her feelings. Of course, on discharge they did provide her an instruction sheet to follow and advised to contact the clinic in case of any contraindications or any other concerns.

The biopsy report was with her in next 48 hours and it was time for her to go for bilateral mastectomy but the crucial decision for her was whether to go for reconstruction or not. She was referred to a plastic surgeon so she went to discuss some disturbing details. She was lucky to have some pleasant encounter with a nurse who was full of empathy and knowledgeable on this topic. According to the patient, she touched her heart and made her forget her real problem. She gave her a book to read which was about those women who in their life did not go for reconstruction after the breast removal operation. She was honest to her profession.

This nurse was truly amazing! She did not take much of the time to explain regarding the pros and cons of the reconstruction procedure. While explaining, she continued with her important tasks. She had full empathy with the patient; she was imparting the details in the manner as if she was taking a decision for her own self. At the end, the patient had full trust in this nurse. Finally, the patient decided in favor of the reconstruction. This nurse helped the patient in taking one important decision at this crucial juncture. She was there at each step of the operative procedure and always provided her the tips to manage the pressure and pain. She was more like a friend then a nurse.

Empathy and Friendliness are two other important attitudes that a good nurse should have in nursing care.

When the patient entered the hospital for breast removal operation, luckily she found her friend in the role of nurse. Her friend was not only a seasoned nurse but performed her duties of caring in the night of her surgery. She provided emotional comfort and the care that patient requires after the operation. This nurse knew precisely what to do and when to do – to help her up, to control the room temperature, to move a tube, control the drip to avoid shivering, adjust the light and so on very small things but very important for the comfort of the patient. She cared and cared for the patient. The patient felt it by heart and soul.

Next day during day time, it was not a pleasant experience with new nurse arrived at the duty. When the patient got discharge after 72 hours, she was escorted by a nurse and not a very pleasant experience as she was literally pushed in a wheelchair and then to the hospital car without due consideration that her body was not really ready to take any jolt neither physically nor emotionally-yes, emotionally too because she had lost her two breasts. No special instructions for future care or any advice in the event of any contraindications.

She literally cried for hours as she went through the episode of all nursing experiences in the process. She realized nursing is a sacred act. Nurse comes in the life of a patient at most crucial and critical time as a caring human being-a very intimate caring at the most critical juncture of patient’s life.

Intimate Caring is an attitude which any patient will always seek during his or her difficult times.

From this anecdote, the following attitudes surface as most critical requirements for nursing care.

Professionalism

Tidiness

Empathy

Friendliness

Intimate Caring

It may happen that some of the attitudes or traits come naturally in the nurse and some needs to be cultivated by experience. It is a profession of deep caring physically and emotionally. It is an adventure of self-discovery and deep learning.