Joeniel Jovero 1

1. Describe how each stage of the caring process was depicted in “Tuesdays with Morrie”.
Compare and contrast caring in meaningful social relationships and professional nurse
caring in the health care setting. If Mitch is a registered nurse, what can be considered as
the therapeutic aspects of his interactions with Morrie and Morrie’s family? Give three
specific examples of these therapeutic interactions.
The stages of the caring process were depicted dividedly between Mitch’s attendance at
the college and sixteen years after graduation. Attachment and assiduity stages transpired during
freshman year. Attachment stage initiated on the first day of class when Morrie asked if Mitchell
if he preferred to be called Mitch or Mitchell. Another example of the attachment stage is when
Mitch began calling Morrie “coach”. Mitch respected and adored Morrie very much that he took
all the sociology class that Morrie taught. This led to collaboration to create a thesis paper, which
also deepened their bond. They met after class to discuss not only the thesis paper but also about
different topics of life. This is a depiction of assiduity.
Intimacy and confirmation attained peak in the remainder of Morrie’s lifespan. Mitch
began visiting Morrie every Tuesday at his home. They talked about the world, feeling sorry for
yourself, regrets, death, family, emotions, fear of aging, money, how love goes on, marriage,
culture, forgiveness, the perfect day, and saying goodbye. This depicted intimacy because they
had very close “physical, mental, and social association,” and they both were able to express
themselves without reservation. Depiction of confirmation stage can be seen when Mitch was
comfortable enough to assist Morrie with his activities of daily living like moving his head when
it tilted to one side, or to transfer Morrie from bed to chair. The ultimate depiction of
confirmation is the creation and publication of the book.
Mitch’s weekly visit to Morrie’s household is very therapeutic to Morrie and his family
as well as the nursing staff that care for him. Mitch’s visits provided Morrie’s family and
caretakers the opportunity to take a breath and relax a bit. Mitch’s visits also brought plenty of
happiness to the dying “coach” because he was able to impart knowledge and discussed his
innermost fears, ideas, and philosophy. It gave Morrie a sense of purpose. Mitch’s occasional
therapeutic touch was very valuable to Morrie. The slightest human contact left a smile on his
face. Also, bringing Janine, Mitch’s wife, was very therapeutic for Morrie. Bringing Janine was
an acknowledgement of how much Morrie meant to Mitch. Also, Janine sang a song that left him
with tears running down his cheeks..
2. Develop a plan of care for Morrie based on your knowledge and understanding of his
health condition. Do not use a table.
Problem: Impaired gas exchange related to atelectasis secondary to impaired
cough/sneeze reflexes and/or hyperventilation and ineffective breathing pattern related to
progressive loss of mobility/paralysis. Inadequate oxygen perfusion to the tissues leads to
inability to generate energy; therefore, this is an energy problem.
Goal: Patient will perform deep breathing and coughing exercises three to five times a
day before meals and snacks to encourage lung expansion. Patient will utilize incentive
spirometer three to five times every hour to encourage lung expansion. This goal is to maintain
airway and encourage lung expansion; therefore, this is a maintenance goal.
Interventions: Elevation of the head of the bed to ease shortness of breath and provide
comfort during sleep. This will fall on the category of energy because this will increase energy
production by increasing oxygen tissue perfusion. Assess changes from baseline respiratory rate,
depth, pattern, chest expansion, adequacy of respiratory exchange and effort; retraction of
intercostals spaces; abdominal breathing; diaphragmatic breathing; nasal flaring and use of
cervical accessory muscle of respiration; color (cyanosis); cough, gag, and swallow reflexes.
This is a nursing process category. It is gathering data, evaluation, and plan implementation.
Usage of incentive spirometer will promote lung expansion. This will be a teaching category
because we need to educate the patient about the proper use of the device to effectively promote
proper lung expansion and tissue perfusion.
3. Except behavioral theories, consider one of the groups of teaching and learning theories.
You are the visiting nurse attending to the learning needs of Morrie and/or his family
regarding his health condition and care needs. Identify a specific aspect of his care that
needs to be taught to his caregiver and/or family. Develop a teaching plan:
Charlotte is Morrie’s dedicated wife. She is primarily a tactile learner but she also learns by
visualization and can follow directions very well. She will be taught how to transfer Morrie from
the bed to his chair. Her objective is to demonstrate successful transferring of Morrie from bed to
his wheelchair while maintaining proper body mechanics to prevent injury. I will utilize the
application of cognitive theory. First, I need to identify Charlotte’s learning style, which is
primarily tactile and visual. Then, I need to assess her knowledge of proper body mechanics as a
way to establish rapport, identify her readiness to learn, to identify her body of knowledge, and
prevent possible injuries. Afterwards, I will verbalize instructions as well as demonstrate transfer
techniques because she can follow directions very well and she is a visual learner. She will
demonstrate transferring techniques utilizing proper body mechanics with me as the patient. We
will use her husband’s equipment to become familiar with how they work and this helps to
establish the mood. This will also enforce her knowledge because she is primarily a tactile
learner.
4. Review the characteristics of the critical thinker. Describe how you have demonstrated
four of these characteristics. Substantiate these characteristics with actual interactions
and/or situations.
I believe that I have the following four characteristics of the critical thinker: intellectual
humility, intellectual courage, intellectual empathy, and intellectual integrity. Intellectual
humility is an understanding to the limitation of one’s knowledge and the possibility of having
incorrect information or assumptions (Cresia, & Friberg, 2010). I have this characteristic because
I am a nursing student and I constantly double check that I have the correct information or that
my thinking is accurate about nursing concepts by asking my instructors and peers. Possessing
intellectual courage denotes the eagerness to listen and observe different ideas, including those
that oppose own beliefs (Cresia, & Friberg, 2010). I am open to correction and criticism as long
as they are constructive for me or for my patient. For example, when we had our foley check-offs
Eileen suggested that I should place a blanket over my patient before positioning my sterile field.
I was bemused but listened to her reasoning behind the idea. Intellectual empathy is the ability to
understand another person’s viewpoint by placing oneself in other person’s place or shoes
(Cresia, & Friberg, 2010). I was a math tutor for the college a couple years ago. I explained
mathematical concepts to my tutees in simpler and direct approach applying different techniques
for different learning styles such as visualization where I perform the calculations on the green
board for visual learners. For kinesthetic learners, I would take a problem from their homework
and have them solve it at the board. I also talk about the steps and the rational for each step for
audio learners. Intellectual integrity is the ability to admit fault and the application of standards
(Cresia, & Friberg, 2010). Last semester I had to tell my nurse that I incorrectly labeled one of
tubes for the blood and I was able to correct my mistakes before it was taken by lab.
 5. What advantages do you see to consumers having access to health care information from
the Internet? What challenges does this present to practitioners? How do you recommend
practitioners deal with the challenges?
The greatest advantage of Internet is convenience. Due to the rise of the Internet, health
issues and questions about anything from illnesses to medications can now be acquired in
seconds. This commodity allows for more informed healthcare consumers. There are plenty of
websites such as WebMD or Mayo clinic that provide easy to understand information on
illnesses, treatment, signs and symptoms, and causes. It also saves consumer time and money
because they do not have to wait in the doctor’s office and pay for the visits. Information from
the Internet is virtually free of charge. Also, if a consumer has a question regarding medications
he/she can search them in the Internet without leaving his seat or house. You can even access
them on your phone.
Misinformation is a major disadvantage of having access to health care information from the
Internet because not every website is credible. This misinformation can lead to poor healthcare
choices and poor relationship between patients and doctors. Some patient’s would probably
argue with the doctor regarding their treatment because the Internet says an alternative treatment.
Practitioners can deal with these problems by suggesting credible websites for the patients to
visit. Practitioners also need to spend adequate time with the patient to answer all their questions
and concerns. We need to empower them to advocate for their own health. In other words, great
customer service goes a long way.
 Reference:

Cresia, J, & Friberg, E. (2010). Conceptual foundations: the bridge to professional nursing

practice. Mosby.