INTERPERSONAL ASPECTS OF NURSING THEORY By: Joyce Travelbee According to Travelbee, nursing is accomplished through human-to-human relationships that

begin with the original encounter that progresses thorough a series of stages of emerging identities, developing feelings of empathy, and later on, sympathy until such time that the nurse and patient have attained rapport in the final stage. The establishment of a nurse-patient relationship and the experience that is rapport is the end of all nursing endeavor. Rapport is that which is experienced when nurse and patient has progressed through the four interlocking phases preceding rapport and the establishment of a nurse-patient relationship.

Before we started our duty in the clinical area, we were trained and taught on the importance of communication and building of rapport not only to the client, well or ill, but as well as with the family. Therapeutic communication was our vehicle through us, student nurses, and patient relationship were established. We provided positive approach, during our initial interaction with him, since the patient has body malaise and irritable because of his present condition. Proper communication through good listening and proper asking of questions are done so that we were able to identify one another with respect to his condition and for our ability to offer assistance. Rapport was easily built which helped us to gain his cooperation and compliance in providing nursing care to him, and to receive further information about his present condition.

Self-care deficit theory of Nursing of Dorothea Orem The main focus of this theory is the enhancement of the clients ability for self-care. When individual is unable to meet his own self-care requisites, a self-care deficit occurs. A persons self-care deficits are the result of environmental situations. The appropriate system that exist within nursing practice is the partially compensatory system wherein the student nurse and the patient help each other to perform self-care measures. It is shown below: Partially Compensatory System The nurse is responsible in: Performing some self- care measures for the patient Compensating for self-care limitations of the patient Assisting the patient as required

For the patient to: Performs some self-care measures Regulates self-care agency Accepts care and assistance from nurse

When an individual is unable to meet his own self care requisites, a self care deficit occurs. It is in the duty and obligation of the professional nurse to recognize and identify these deficits in order to define a support modality or intervention.

This theory is applicable to our patient during the time of our 3 days nursing care to him, due to his present condition. As we observed him, hes been a bed ridden for 3 days due to muscle weakness and difficulty of breathing. Self care deficit occurs, because he wasnt able to meet his own self care requisites like eating, bathing, changing clothes, defecating etc. It is our duty and obligation to recognize those deficits in order for us to define a support modality and interventions. As assigned students nurses to him, it is our responsibility to provide total patient and holistic care to our patient. We performed self-care measures to him like providing bed bath; help him to compensate for self-care limitations through assisting during going to the bathroom to defecate; and assist him in his daily routine. It is clear in this model, the importance of emphasizing on education and supportive measures to our client. We provided health teachings like the importance of withdrawal from alcohol to prevent further liver damageand to increase intake of protein to compensate to the decrease albumin.

HELPING ART OF CLINICAL NURSING By Ernestine Wiedenbach Wiedenbach defined nursing based on her field of maternity nursing. According to her, there are four elements in the art of nursing: philosophy, purpose, practice, and art. She viewed clinical nursing as being directed toward meeting the patients perceived need for help. The following are the major concepts and sub-concepts of her philosophy. 1. Patient- need for help 2. Nurse- purpose, philosophy, practice and art. In order for nurses to fulfill the nurses helping role, they should be able to identify patients need for help through: 1. Observing behavior consistent or inconsistent with their comfort

2. Exploring the meaning of their behavior 3. Determining the cause of their discomfort or incapability 4. Determining whether they can resolve their problems or have a need-for-help In her theory, she believes in the four elements to clinical nursing. In her first element, which is nurses philosophy, it is described as the attitude and belief about life and how that affected reality of them. As female student nurses who are spiritually molded by our institution, we were able to apply nursing care with respect for his dignity and worth as a male patient. Secondly is the nurses purpose. We traditionally visit our patient, a day or hours prior to our duty, so that we could formulate proper and accurate nursing care plan to him. We set plans or goals on what do we want to accomplish to our patient through our nursing interventions. We planned the activities directed toward the overall good of our patient based on the formulated nursing diagnosis. Next are the practice and art. Practices are the observable nursing actions that are affected by beliefs and feelings while art includes, understanding patients needs and concerns and doing actions to enhance patients ability. We became very sensitive to our patients need during our nursing care. We tried to foresee possible things/complications that could happen to our client so that immediate nursing actions could be establish. We also became his advocate, even though his subjective data didnt match the objective data that we assessed, still we did accurate and proper interventions and referrals to the staff nurses and clinical instructor.

Advised client to eat high protein, high carbohydrate, moderate fat and low sodium diet Encouraged the client to eat small frequent meals Instructed the client to avoid drinking alcohol beverages to prevent further fibrosis of liver from scarring Instructed client to use soft toothbrush for oral care Advised client to avoid strenuous activities that may cause injury Encourages client to increasefluid intake Instructed the client to be in semi Fowlers position when eating Instructed client to avoid suppositories Advised the patient and relatives to do proper handwashing especially relatives when touching the clients body parts

Encouraged client to eat foods rich in potassium, folic acid, vitamin C and vitamin B complex such as Instructed the client to avoid fresh foods like vegetables and raw shellfish