I’m reviewing my notes from last year to make better sense of some nursing concepts that we learned. These aren’t literary terms, nor will you find them in the dictionary. These are Nursing Concepts. These concepts inform nursing foci, approaches, and so forth.
The Nursing Concept of Healing
Healing can loosely be described as a natural process of returning to wellness, although that isn’t always the case. It involves physical health as well as balancing of emotional, spiritual, and mental wellness. Healing is active, natural, multidimensional, and individual. Factors that can influence healing include personal attitudes, personal relationships, and body condition (Glaister, 2001). It can go without saying that having a healthy body condition prior to illness or injury will allow for quicker healing processes, but what is interesting is that having a positive attitude and positive, close personal relationships make the healing process more smooth. Bad attitudes often encourage bad outcomes.
Ways to support healing: Empowerment, creating or maintaining a support network, assess social determinants of health and assist in improving lacking areas, create a comforting physical environment, encourage proper nutrition and medication compliance; invite the patient to be the centre of healthcare decisions and care planning.
Nursing Concept of Confusion
We never fully defined this concept. Confusion is any alteration or deviation of a patient’s cognitive baseline. For some, not being oriented to person, place, or time is their baseline, such is the case with histories of traumatic brain injuries, strokes, multiple TIAs, dementias, and so forth. Confusion can present as fluctuating levels of consciousness, fluctuating sleep-wake cycles, fluctuating cognition, fluctuating body movements, visual or auditory hallucinations, exaggerated emotional responses that are unlike their norm, increased agitation, calling out, restlessness, inability to follow commands or requests, and so forth.
Causes of confusion are many. Urinary tract infections–or other body infections–can cause a delirium, presenting as acute onset confusion. Dementia can cause confusion and in those cases, it is important to have a solid baseline worked out for your patient or client so that you can be aware of if a delirium sets in. Often, dementia sufferers are older and are thus more prone to deliriums brought on by infections, medications, lack of sleep pain, and so forth. Some contributing factors include being elderly, alcohol abuse or drug abuse, severe pain, sleep deprivation, medications (this can be from drug sensitivities, reactions between other medications, reactions to the medication itself, overdose, inability to process the medication, toxicity, etc.), post-ictal state, mental illness, history of seizures, and so forth.
Some medications that are known to cause delirium in some patients include benzodiazepines, meperidine, narcotics, anticholinergics, atropine, scopolamine, and oxybutynin.
Nursing Concept of Stress
Stress is the subjective feeling of the inability to cope with internal or external experiences, often in response to a demand. Physiologically, stress causes the release of cortisol levels into the blood as well as adrenalin. As cortisol levels increase, it counteracts insulin, causing blood sugar levels to rise. It also suppresses the inflammatory response, weakening our second line of defence. Adrenalin increases our heart rate, so you can imagine that prolonged stress can have a poor effect on our overworked heart and blood vessels. Stress impedes the functions of white blood cells, decreasing our ability to heal. We release antidiuretic hormone, causing our blood pressure to rise and increasing our fluid retention. Also experienced is an increase in respiratory rate as a result of the catecholamines being released.
Chronic stress can lead to hypertension, irritable bowel syndrome, peptic ulcers, lupus, rheumatoid arthritis, and other immune-related issues due to our chronic immune suppression.
I will be reviewing the nursing concepts of transition, vulnerability, hardiness, resilience, guilt, shame, stigma, hope, loss, grief, spirituality, body image, sexuality, self-concept, and role changes.
References
Glaister, J. (2001). Healing: analysis of the concept. International Journal Of Nursing Practice,7(2), 63-68.