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NUR 700 Discussion 4.1: Story Theory and Clinical Comfort in Nursing NUR 700 Discussion 4.1 Story Theory and Clinical Comfort in Nursing NUR 700 Discussion 4.1: Story Theory and Clinical Comfort in Nursing Story Theory The story theory presents a framework where the nurse and person can develop an intimate relationship critical in improving the quality of care. The practitioner has a favorable understanding of the perspectives of the patient regarding the treatment process and its cultural implications; thus, they are uniquely placed to tailor the plan to the required specificity for the realization of positive health outcomes. Connecting with self-in-relation involves the practitioner identifying with the needs of the person. The nurse engages in hypothetical speculation through intentional dialogue to create ease (Brodziak et al., 2017). The practitioner endeavors to explain the treatment plan in relation to the medical condition by immersing themselves in a story to make it relatable and expedite movement towards a resolution. The professional seeks to create a feedback channel where the patient can participate in the provision of care by offering insights and other critical information required to achieve improved recovery prospects. Specific Example/ Duffy’s Quality Caring Model Duffy’s (2008) quality caring model explores the value of empathetic nursing within the modern context of evidence-based practice. Patient care is segmented into a variety of satisfaction indicators that, if met, significantly improves the prospect of achieving positive health outcomes. The theory advocates for relationship-centered professional encounters between practitioners and patients to relish a sense of being cared for, thus, expedite recovery prospects and enhance the subject’s well-being. One particular case that resonates with me the that of Mrs. M, a 76-year-old female who was not responding to treatment. I noted that the patient’s poor response was primarily caused by immense psychological stress caused by increased financial uncertainty. Being an immigrant and a low-income earner, she was ineligible for Medicaid and was unable to afford private insurance. The patient’s daughter had lost her job during the pandemic. Mrs. M was worried she might not be discharged from the facility after receiving treatment. I assisted her by informing her of the available facilities for persons in her situation. The patient was grateful that someone had expressed genuine concern for her plight and recovered soon after. References Brodziak, A., Wolinska, A., & Rozyk-Myrta, A. (2017). The story theory is a key element of many holistic nursing procedures. J Gerontol Geriatr Res, 6(454), 2. https://www.longdom.org/open-access/the-story-theory-is-a-key-element-of-many-holistic-nursing-procedures-2167-7182-1000454.pdf Duffy, J. R. (2008). Quality caring in nursing: Applying theory to clinical practice, education, and leadership. Springer Publishing Company. Story Theory and Clinical Comfort in Nursing Story theory, a middle-range nursing theory, can strengthen the care that nurses provide to their patients. Stories are a vital facet of human experience and nursing practice. Story theory depicts a narrative event that transpires through intended nurse-person dialogue (Liehr & Smith, 2018). It strengthens nursing care by improving the bond between practice and research (Liehr & Smith, 2018). Story theory is comprised of three correlated ideas: intentional dialogue, connecting with self-in-relation, and creating ease (Brodziak et al., 2017). Intentional dialogue is the pivotal action between the nurse and the patient that animates the story (Liehr & Smith, 2018). It allows for the nurse to question what is most important about a complex health issue (Liehr & Smith, 2018). Connecting with self-in-relation happens with insightful mindfulness on one’s own experiences (Liehr & Smith, 2018). It is a dynamic course of identifying self as linked with others in an emerging story plot revealed during intentional dialogue (Liehr & Smith, 2018). Creating ease is recalling fragmented story instances to encounter flow all while establishing a grasp on the complete story (Liehr & Smith, 2018). When the different parts of a story come together in a noteworthy way, there is frequently advancement in the direction of solving and answering a health issue. Story theory also brings about listening and true presence (Brodziak et al., 2017). Using story theory with my rehabilitation patients strengthens the care I provide by permitting my patients to transition to further independence. This is achieved by allowing myself to question what it is about the patient’s current diagnosis that matters most to them, reflect on past events that may have contributed to this new diagnosis, and linking those different parts together to create ease of resolving the health issue at hand. I can engage in intentional dialogue about the effects of the patient’s new diagnosis to see if it is the newfound need to rely on others, the inability to express themselves appropriately, or maybe the change in body image that is largely bothering them. I can help them determine which aspect they want most to correct. I can assist the patient to reflect on past decisions and choices that may have led to this key moment in their life, and help them determine new care methods and positive changes they can make to prevent something like this from happening again. NUR 700 Discussion 4.1 Story Theory and Clinical Comfort in Nursing Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERR 700 Discussion 4.1: Story Theory and Clinical Comfort in NursingS:NU I can recall a specific instance in which I could have used Kolcaba’s Theory of Comfort to care for a patient. The patient was a younger male who was recovering from COVID-19. He spent two months in the intensive care unit prior to being transferred to the rehabilitation hospital that I work at currently. The patient had a tracheostomy, a gastrostomy tube, a stage 3 sacral pressure injury, an unstageable pressure injury to the occipital area, and ‘COVID rash’ covering both lower extremities. The patient also suffered an acute kidney injury now requiring hemodialysis. Kolcaba’s Theory of comfort entails assessing the patient’s comfort requirements, creating and executing suitable nursing care plans, and evaluating the patient’s comfort after the care plans have been carried out (Bice & Kolcaba, 2020). Comfort occurs in three ways: relief, ease, and transcendence (Bice & Kolcaba, 2020). Relief is meeting a patient’s specific physiological comfort needs (Bice & Kolcaba, 2020). Ease addresses comfort in a state of tranquility (Bice & Kolcaba, 2020). Transcendence is described as the state of comfort in which patients are able to overcome their problems (Bice & Kolcaba, 2020). For relief, I helped the patient achieve this through medication administration for pain management. I could have improved his relief by adding extra pillows or an air mattress topper to help reduce pressure on his sacrum. For ease, I helped the patient achieve this by answering questions to decrease his anxiety of the unknown. I could have done a better job on this aspect by holding the patient’s hand, sitting with him so that he did not feel alone, providing a communication board to help him communicate needs due to the inability to speak as a result of the tracheostomy, or by helping him video chat with his family. For transcendence, I do not recall helping the patient achieve this level of comfort. Reflecting back, I could have begun to teach him how to manage his own bolus feeds through his gastrostomy tube, which would have assisted him with overcoming a new challenge in his life. However, I just did the feedings myself, but I now realize, that should have been a teachable moment as well as a moment of transcendence for him. Adding all of these things to my interventions would have improved this patient’s quality of care.   References Bice, A. A., & Kolcaba, K. (2020). Katharine Kolcaba’s comfort theory. In M. C. Smith (Ed.), Nursing theories and nursing practice (5th ed., pp. 371–381). F. A. Davis. Brodziak, A., Wolinska, A., & Myrta, A. (2017). The story theory is a key element of many holistic nursing procedures. Journal of Gerontology & Geriatric Research, 6(6). https://doi.org/10.4172/2167-7182.1000454 Liehr, P. R., & Smith, M. J. (2018). Story theory. In M. J. Smith & P. R. Liehr (Eds.), Middle range theory for nursing (4th ed.). Springer Publishing. https://doi.org/10.1891/9780826159922.0011 Story Theory and Clinical Comfort in Nursing Story Theory Story theory provides an opportunity for patients and caregivers to address health-related challenges, allows patients to reflect on perceptions of their current health, and allows caregivers to encourage positive thinking (Chuang et al., 2018). In addition, the use of story theory allows nurses to establish what is most important to the patient. As we identify what is most important to the patient, we can develop a plan of care that promotes a higher level of healing. The story theory consists of three concepts: intentional dialogue, connecting with self-relation, and creating ease. Intentional dialogue centers around purposely engaging with the patient to determine what matters most regarding their complicating health challenge. Connecting with self-relation includes individuals being aware of others and connecting the relationship between the past and present health challenges. This can consist of high points, low points, and turning points. Finally, providing or creating ease for the patient does not always imply that it will be permanent. This can be a fleeting moment, but it is still a step toward recovery and healing (Smith, 2020). The story theory will strengthen my care towards clients through the implementation of these three concepts. As a recovery nurse, I have to repeatedly assess what current health issue is most pressing to my patient. This could be nausea, pain, thermoregulation, fluid intake, circulatory issues, or education. I must never assume what is most important to the patient, but if I am willing to listen and have a purposeful engagement, I will establish how to best provide for my patient’s needs. Many individuals recovering from anesthesia have previous experience, or it is their first time, and is unsure what to expect. As I promote reflection of past experiences or fears, I can foster awareness and ease the patient. By implementing intentional dialogue, I can determine their greatest health challenge, allow for reflection and self-evaluation of past experiences, and foster a positive mentality for themselves. Comfort Theory Comfort is defined as being strengthened by meeting the three types of comfort and the four contexts of the human experience. The three types of comfort are relief, ease, and transcendence. The four contexts of the human experience are physical, psychospiritual, environmental, and sociocultural (Coelho et al., 2016).  Relief is meeting your comfort needs. Ease is a care experience that promotes calm and contentment. Transcendence is an experience that allows the patient to rise above the pain (Vo, 2020). As I reflect on my nursing experience, I think of a patient I cared for when I was a new graduate. I was working in a Cardiovascular Thoracic Unit caring for a middle-aged female who had stage four lung cancer and had recently undergone a lung decortication. The patient had a double lumen chest tube and was in agonizing pain. I could have provided relief through the physical context and addressed her pain more frequently. I attempted to provide some psychospiritual relief in telling her about the pain relief from the chest tube removal, but I see that this only provides hope and does not address current pain. This patient expressed her religion as catholic and carried a small statue of the Virgin Mary. She needed it visible at all times. I could have provided psychospiritual relief by addressing her anxieties and making sure that her statue was visible to her at all times. I attempted to address environmental factors such as lighting and temperature, but I could have addressed noises in her room and potential odors. I could have addressed her sociocultural needs by sitting with her and establishing her support system, performing more thorough teaching, and discussing her barriers to healing. As I reflected on providing her with ease, I attempted to address questions and pain to the best of my ability at that time. However, I now know the care I provided did not provide transcendence. If I could care for this patient again, I would readdress my patient’s needs, add this theory to my practice, and provide a higher quality of care. References Chuang, H. W., Kao, C. W., Lee, M. D., & Chang, Y. C. (2018). Effectiveness of story-centered care intervention program in older persons living in long-term care facilities: A randomized, longitudinal study. PloS one, 13(3), e0194178. https://doi.org/10.1371/journal.pone.0194178 (Links to an external site.) Coelho, A., Parola, V., Escobar-Bravo, M., & Apóstolo, J. (2016). Comfort experience in palliative care: A phenomenological study. BMC palliative care, 15, 71. https://doi.org/10.1186/s12904-016-0145-0 (Links to an external site.) Smith, M. C. (2020). Nursing theories and nursing practice (5th ed.). F.A. Davis. Vo T. (2020). A practical guide for frontline workers during COVID-19: Kolcaba’s comfort theory. Journal of patient experience, 7(5), 635–639. https://doi.org/10.1177/2374373520968392 Edited by Jarin Loveday on Sep 16, 2021 at 7:07am Order Now