Using Leininger's Culture Care Model, what factors in the story shared by Mrs. Franklin-Jones should be considered by Nurse Hernandez when planning for the patient's discharge?
The model provides a basis for transcultural nursing, which provides a cultural-specific and globally acceptable nursing care in a bid to promote patients’ well-being. This includes providing the necessary help during death or illness through the provision of ways that are culturally meaningful to them (Leininger, 2016). This case calls for significant flexibility among the nursing staff especially at a time when they are designing and creating care policies and programs to ensure that it meets the concerns and demands of the patient who in this scenario is Mrs. Franklin-Jones hailing from a divergent culture.
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The nurse handling Mrs. Franklin-Jones case, Nurse Julie Hernandez need to possess effective and the appropriate intercultural communication skills as well as a good awareness as far as Mrs. Franklin-Jones cultural needs are concerned. The aim should be developing and implementing the appropriate strategies that are culturally acceptable as per Mrs. Franklin-Jones needs to provide adequate nursing care. Additionally, the nurse should be conversant with the patient’s social and cultural reality as this will allow him/her to prepare and plan well for the patient needs (Smith and Parker, 2015). The nurse should take into account the patient social status and her inability to adhere to her medication schedule in terms of timely intake of the medication. The cultural values of the patient prohibit her from letting Tomas help her prepare the food and as a result, she does not get enough rest or relax. Furthermore, there is no much time between her shifts at her new housecleaning job and the school cafeteria. Mrs. Franklin-Jones also clearly does not appreciate the nutritional strategies that were recommended for her at the clinic in regard to her condition, especially in terms of what to take and not take. These represent some of the important factors that the nurse needs to put into consideration as she plans for Mrs. Franklin-Jones’ discharge.
Why is the theory of Culture Care Diversity important in the delivery of nursing care for all patients?
This theory is crucial in delivering nursing care to all patients for a number of reasons. It provides a clear base for the development of a better understanding and respect for all patients regardless of the patient’s diversity in beliefs, values, culture, and spirituality in regard to the illness, its cause, treatment as well as the patient outcome (Smith and Parker, 2015). In this case, the theory is important due to the fact that there is a constant increase in population that translates to an increase in multicultural. As such it promotes the provision of holistic and personalized nursing care. It makes it necessary and enables nurses to understand and appreciate the existing differences in terms of health care values, beliefs, customs and culture among people from diverse backgrounds. It allows nurses to acquire the necessary knowledge and skills as far as cultural competency is concerned. This places them in a better position to ensure the realization of positive patient outcomes as well as help in the achievement of patient satisfaction. In addition, the theory also is important as it strengthens the nurse’s commitment towards relationship-centered nursing which pays more attention to the care of the sick individual rather than the disease and its pathophysiology.
Using Leininger's Theory of Culture Care Diversity and Universality, develop a plan of care for Mrs. Franklin-Jones.
The care plan will be developed based on the following; the nurse is required to determine the existence of any patient health beliefs that might have contributed to the condition. In this particular case, Mrs. Franklin-Jones believes that her current condition, myocardial infarction has something to do with bad pressure which she believes to be the cause of her mother’s death. As a result, she believes that it may kill her. The plan of care should be designed in such a way that it will make her believe that it will help reduce her pressure (Leininger, 2016). The nurse should gather all relevant information in regard to any home based remedy taken by the patient to treat the symptoms associated with the disease. In this scenario, such remedies include bush tea and it is appropriate that the patient is advised accordingly.
It is also imperative that the nurse gets to understand how ethnicity, culture, and race affect the patient’s social relationship as well as the attitude of the patient towards their health. For instance, this case shows how much Mrs. Franklin-Jones who is the patient, in this case, involved herself in all her duties and this stressed her even more. Her diet also aligns with her culture (Leininger, 2016). Therefore the care plan should put into consideration so as to the nutritional strategies according to her culture. The patient needs to be advised to avoid or reduce the intake of chunk meals and ensure she gets a little rest after meals. The nurse should make her understand the basis of her restricted intake of cholesterol and saturated fat from her diet. She should be instructed to reduce her intake of eggs, milk fat, trans-fatty acids, and meat fat. The nurse should recommend that she opts for vegetable oil instead of palm or coconut oil while preparing her meals. She should frequently make use of cooking methods such as microwaving, steaming, baking, and broiling in place of frying.
Nurse Hernandez should also ensure that she collects information on the socioeconomic status of Mrs. Franklin-Jones as this information may have a bearing on the patient health by impacting the promotion of her health as well as her well-being. From this case, it is evident that the patient did not have time for rest between her work shifts, thus the plan of care should be designed with this in mind. The nurse needs to suggest that the patient begin her work with alternate have days and then resume the normal routine within 3 weeks. During this time, she should involve herself with less challenging (Smith and Parker, 2015) duties at the beginning while ensuring that she has more rest time in her working shifts. This should be followed by frequent rests over four to eight weeks following her discharge. She should also stay away from various activities which may involve lifting or pushing heavy objects when on duty. This should also include activities which may lead to dizziness, shortness of breath, weakness, extreme fatigue, and palpitations.
Discuss the strengths and limits of Leininger’s Theory.
Leininger’s theory has several strengths as far as the provision of nursing care is concerned. It focuses on patients’ culture to ensure better patient outcomes and satisfaction. It provides the nurse with adequate support as it enables him/her to the art of being culturally sensitive promoting the nurse consciousness as far as different cultures are concerned (Leininger, 2016). This enables them to act appropriately while accommodating patients from diverse cultures. It puts more emphasis on patient care as the basis of nursing practice in comparison to other existing theories which mainly revolve around people, health, nursing, and the environment. The benefits of this theory are highly beneficial as it conceptualizes nursing as a practice enabling nurses to utilize it as a model in different settings in their daily practice. The theory can be generalized as the concepts and the relationships provided in the theory are applicable in several and different cases or scenarios. It is easy to understand and apply. Moreover, it is the first theory that prioritizes the discovery of diverse and universally acceptable cultural care.
However, the theory has the following limitations. It may be used as the reason for errors in clinical decisions which include outcome misinterpretation. Data based taken based on this theory may not be useful for all patients as every individual is unique in a way. Despite the importance of holistic nursing care, according to the theory, the nursing concept is fully focused on the culturally consistent kind of care (Leininger, 2016). The main demerit is seen in that it does not focus on the illness and its symptoms. The theory may make it difficult for nurses to adapt to the other cultures leading to cultural shock among nurses. The static culture framework that is based on this theory faces limited applicability as it lacks focus as far as structural context is concerned. The cultural framework suggested by the theory renders many health care strategies inappropriate.
Case Study #2
Discuss assumptions of the Transpersonal Caring relationship. What is the nurse's role?
The transpersonal caring relationship existing between the nurse and the individual patient is based on care, love, affection, and concern they show to each other away from the clinical care. It is assumed that this relationship is effective in promoting not only the health of the patient but also that of their family as this care directly impacts the family in a positive way. The nurse’s role in this type of relationship is to show a genuine desire to be part and at the center of their interactions with patient/s (Prayer, Culture, and Evidence-Based Practice, 2016). The nurse’s focus is to help the patient in achieving a complete sense of satisfaction and harmony.
How is love, as defined by Watson, evident in this caring moment?
As defined by Watson, love is evident during this caring time when the nurse makes the patient regain their self-power and this will serve to promote the patient’s confidence and health. The creation of such a caring environment makes the patient feel more important and encourages him/her to take care of themselves as caring for the patient is the center of nursing as a practice.
How can the nurse creatively use self to create a healing environment?
The nurse can creatively use self in the creation of a healing environment by helping with basic needs of the patient sacred acts, touching the patient body, mind, and spirit. Additionally, a healing environment can be created through the sustenance of humanistic-altruistic values practicing loving-kindness with self as well as others (Prayer, Culture, and Evidence-Based Practice, 2016). The nurse can also promote this environment via being sensitive to others and self.
Discuss the strengths and limits of Watson’s Theory.
Watson’s theory has a number of strengths. In addition to promoting quality care, it also enhances soul satisfaction. It allows nurses to fully participate in the encouragement of the patient to attain self-actualization (Prayer, Culture, and Evidence-Based Practice, 2016). It also prioritizes the patient rather than the technology. However, the theory just like all the others has weaknesses. The differences in thought sometimes lead to a mismatch between the transpersonal caring relationship assumption and the patient needs. It is difficult to develop and apply concepts such as affection and care for patients who stay in the hospital for a short time.
References
Leininger, M. M. (2016). Theoretical Foundations of Nursing. Retrieved from https://nurseslabs.com/madeleine-leininger-transcultural-nursing-theory/?fbclid=IwAR2BQXR2UM-eWs6-KexixjVU55TUAJIkoIeZ0dOv10Dfn2UxnHT5t8k0n7s
Prayer, Culture, and Evidence-Based Practice. (2016). Medscape. Retrieved 06 June 2019, from http://www.medscape.com/viewarticle/561760_3
Smith, M. C., & Parker, M. E. (2015). Nursing theories and nursing practice. FA Davis. Fourth Edition
