TO BE OF SERVICE: Team E Utilizing

The Three C’s of Lydia Hall

(Introduction by Rose de Leon)

It was the 1st week of July 2008 when we had the chance to introduce ourselves in the group. It amazes me that we will have this actual grouping to be able to work together interactively, though a little bit hesitant at first, if this could really work for us and if we can really hang-on with each other. Thus, I grab this opportunity with a delightful heart to introduce my team members for our Group Blog, FMA 1 for N207. Most of my team mates are located in our beloved native land. Truly, one of the best countries where an excellent foundation for Nursing Education could exists nowadays. And also highly diversified in experience with each of us coming from different fields yet we shared one common vision…to come-up with a substantive output and to fulfill our nursing dream. The team, although far from ideal, showed their best efforts in putting the blog together, not minding the hindrances such as work schedules, family and personal lives. These are the talented and hardworking people of Team E:
ROSE: An offshore student who works as a Nursing Service Director, coordinates all group activities, and yes, even posting forums in MOODLE, just to keep everyone updated.
SHANDZ: Working as a CI in one of the nursing schools in Rizal, she took the challenge to become the group’s first Team Manager and formulated a questionnaire to help us ponder deeply into our assigned theory.
JOY: also an offshore student taking up graduate studies in London, through communication by far hinders, she made he way to make it up with the team through technical layout support and collaborative idea of its final picture that comes to reality.
ANNA: A bank executive from the South, she took the challenge of being the secretary, buzzing everyone in time for the conferences; and she does it even while working overtime!
CAYE: Despite working 2 shifts in the Neonatal Intensive Care unit of one of the country’s top hospital, took the challenge of being the team editor (in between naps).
DOC LOREL: A physician and a nurse, shared very clear and interesting point of view about the CURE model. Truly, she’s heaven-sent.
ELOISE: Shares with Rose the same operating room experiences, putting the theory to use in their perioperative patients.
JAN: A dialysis nurse on training, inspired the team to come up with the best that it can do, challenging the limitations to be able to present a blog that is short, concise and unique.
RANDULF: Together with Jan, he injected some masculinity in the predominantly woman team and encouraged everyone to come up with a personalized insight on the applicability and relevance of Lydia Hall’s theory in our practice.

These are the team members, and this is our TEAM BLOG.


ON LYDIA HALL AND HER THEORY: BY ANNA ESTOY and NHINA DE ROSAS

Lydia Hall was born in New York City on September 21, 1906 and grew up in Pennsylvania. She was an innovator, motivator, and mentor to nurses in all phases of their careers, and advocate for the chronically ill patient. She promoted involvement of the community in health-care issues. She derived from her knowledge of psychiatry and nursing experiences in the Loeb Center the framework she used in formulating her theory of nursing. These experiences might have given her insight in on the distinct roles of nurses in providing care for the patients and how the nurses can be of utmost importance in caring for these patients.
The theory of all, as they say, contains of three independent but interconnected circles—the core, the care and the cure. But what do these terms mean? According to the theory, the core is the person or patient to whom nursing care is directed and needed. The module has mentioned that the core has goals set by himself and not by any other person, and that these goals need to be achieved. The core, in addition, behaved according to his feelings, and value system. The cure, on the other hand is the attention given to patients by the medical professionals. The module has been explicit in stating that the cure circle is shared by the nurse with other health professionals. These are the interventions or actions geared on treating or “curing” the patient from whatever illness or disease he may be suffering from. Some interventions I can think of in relation to this are the surgeries performed to treat a tumors or other malignancies, prescribing pharmacologic therapies and performing diagnostic tests. The highlight, however is the care model. This is the part of the model reserved for nurses, and focused on performing that noble task of nurturing the patients, meaning the component of this model is the “motherly” care provided by nurses, which may include, but is not limited to provision of comfort measures, provision of patient teaching activities and helping the patient meet their needs where help is needed.
That means that if all three circles exhibit harmony and balance, the patient will be the one to benefit from it all since his needs are being put into priority but the meeting of it depends on which circle of the model is responsible for meeting such activities. It was hard not to see that in all of the circles of the model, the nurse is always presents, but the bigger role she takes belongs to the care circle where she acts a professional in helping the patient meet his needs and attain a sense of balance.


THE THEORY AT WORK: APPLICATION TO OUR INDIVIDUAL PRACTICE

ELOISE ENCARNACION AND ROSE DE LEON, Operating Room Nurses:
The theory can be applied in all the phases of the operative experience. The CARE can be utilized when providing patient care and teaching at each phase of the surgery, providing comfort both physiologically and psychosocially. The CORE model can be realized when he patient is able to express his feelings about the procedure and participates in exploring these feelings, helping him towards a faster recovery. The CURE model is used when we provided medication therapy to the patient, nurses assuming our roles as either scrub or circulating nurse.

CAYE ELLIMA, Critical Care/NICU Nurse: The patient with congestive heart failure usually has health problems related to the ineffective pumping mechanism of the blood, pooling of the blood in the lower extremities and a vast array of systemic symptoms. The cure model can be applicable in this case when the nurse would perform assessment and formulate care plans based on the patient’s needs and against limitations set by the physicians. The cure model will also require the nurse to closely monitor the patient’s response to the treatments and any untoward symptoms and relay these with the other members of the health team. In the care model, the nurse can help the patient or the family in accepting and adapting to the emotional and other stresses the condition may bring. It will be the nurse’s task to open channels of communication to allow expression of feelings and help the patient/family work out through it. It is also in this model that health teachings are imparted. The core model dominates when the patient and/or family are able to address the emotional concerns and issues related to the perception of the effects of the disease process such as activity restrictions. It will be, therefore, the sole role of the nurse to help the patient/family maintain or achieve his sense of balance.

NHINA SANDEEP DE ROSAS, Nursing Education/Clinical Instructor: The core, care and cure model can be applied into nursing education by utilizing its concepts in the mode of instruction given to students. The care model can be materialized in education by having clinical instructors provide “real-world” learning experiences to students. This would provide the students more opportunities for learning and encourages feedbacks about learning topics. Doing this would institute measures to further explore learning needs and help students develop confidence in assuming their roles as nurses. The cure model can be used by nursing educators when they plan for learning activities for their students. This can be done through implementation of diagnostic examinations to ascertain the students’ learning needs not only on nursing practice but also on other fields of science affecting the practice of nursing. The core model can be fully realized only when the clinical instructors are successful in helping the student meet his learning needs and thus providing him with an increased sense of accomplishment in terms of knowledge.

RANDULF ERGUIZA, Community Health Nursing/Clinical Instructor: Care becomes effective when we show sincerity and genuineness in out approach not only towards students but also to patients. We listen, we communicate and we make them feel a part helping the patients. Core is strengthened when we make them (students and patients) realize their potentials as individuals by reflecting not only on things that they can do but also on things that they were not able to do, and what things they still can do. Cure is provided when measures such as encouraging people in the community to utilize the services offered by the health centers and; and teaching them compliance to treatment regimens.

JAN STANLEY DIARESCO, Dialysis Nurse: Lydia Hall’s Care, Core and Cure theory can also be seen and identified in this kind of setting. Patients undergoing hemodialysis experiences problems such as physical vulnerability, feeling of being a burden to the family and being hopeless. Being a nurse one should use therapeutic communication when dealing with the patient, and family, provide proper care to the client as he or she undergoes dialysis and create an environment that would promote holism as the procedure is being done.

As soon as the patient arrives in our unit we explain the treatment and how would it benefit her and the risks involve so that he/she would be ready once the consent is being explained to her the physician. The therapeutic use of self of a nurse is shown here. As a practitioner in the Kidney Unit, we perform dual responsibility, one as nurse and the other as a technician. Being a nurse technician, we provide care to our clients by understanding the concept of dialysis with the use of the machine, how to troubleshoot technical problems, understanding water treatment, cannulation and priming the machine When priming the machine we wash out the renalin and residues present in the dialyzer to protect the client from its harmful effects that could lead to anaphylactic shock. Injecting innohep and heparinizing the tubings makes it safer for the client since clotting will be prevented, which could cause blood loss or wastage. Monitoring vital signs of the client 15 min for the first hour and 30 min thereafter to check for hypotension or hypertension (common complications during HD) would easily alert the nurse to provide initial interventions such as positioning, flushing and notifying the physician for medications to be given or any procedure to be carried out. Upon removal of the cannula’s from the patient site, the nurse should properly apply pressure dressing on the site so as to prevent blood loss and promote healing of the site. Educating the client not to scratch the site, exercise her are so that the fistula site would be bigger and prevent any injury to the site would be ways of preventing future complications to the site.

References:
Anonuevo, et al., Theoretical Foundations of Nursing; UP Open University Press; 2005
Potter and Perry; Fundamentals of Nursing, Fifth Edition; Mosby Publishers; 2001
George, J.B.; Nursing Theories: The Base for Professional Nursing Practice; 2000
http://www.napnes.org/practice/news/clinical_articles/care_of_the%20_congestive_heart_failure_patient.html

AND THIS IS OUR TEAM…

Shandz, Anna, Caye, Rhose, Eloise, Doc Lorel, Joy, Jan, & Randulf