Coaching patients to self-care: a primary responsibility of nursing

Aim.  To explore the process nurses use to guide and support patients to actively re-establish self-care.
Background.  The movement of hospitalized patients from less to more independence is primarily a nursing responsibility. Studies of nursing practice in inpatient rehabilitation settings have begun to shed some light on this, but as yet there is limited understanding of the actual skills nurses use to support patients to re-establish self-care.
Method.  This study used grounded theory. Microanalysis and constant comparative analysis of data collected during interviews with, and observation of, registered and enrolled nurses during everyday nursing practice in five inpatient rehabilitation units facilitated open, axial and selective coding. Relevant literature was woven into the final theory.
Findings.  To facilitate patient transition from the role of acute care patient to rehabilitation patient actively reclaiming self-care, nurses engaged in a three-phase process known as coaching patients to self-care. The three phases were: easing patients into rehabilitation, maximizing patient effort and providing graduated assistance.
Conclusion.  Coaching patients to self-care is a primary activity and technology of rehabilitation nursing.
Relevance to clinical practice.  Patients in a variety of settings would benefit from nurses incorporating coaching skills into their nurse–patient interactions.     

Caring and nursing: a dilemma

The history of caring is intertwined with the history of women and thus with nursing Although nurses have a professional mandate to provide care, the significance, meaning and function of care and caring remains undefined and intangible within nursing Many factors contribute to a dilemma that requires the professional responsibility to care while withholding recognition from those who provide such care Caring is often hailed as the hallmark of nursing This paper considers some of the questions and permutations related to the concept of caring in nursing     

Dietary advice and heart disease: a nursing dilemma?

This paper reviews the debate concerning the relationship between dietary fats and heart disease. The paper also addresses the questions “should nurses persuade patients with heart disease to follow a low-fat, low-cholesterol diet?”, “If so, will patients be less liable to a heart attack?” and “are such recommendations based on valid scientific evidence?”. The author examines the recent evidence which is critical of such dietary regimens, and claims that much of the dietary advice given by nurses to these patients is biased, misleading and scientifically unfounded.     

Pain management: a practical approach to nursing education

This article describes a program that provides a practical approach to educating staff nurses in pain management. The content is appropriate for adult patients across all clinical specialties. Pain assessment and commonly used analgesic and adjuvant medications are provided in nine educational sessions lasting 10 to 20 minute. Each presentation topic is prepared in Microsoft Power Point in three versions: slides, notes, and handouts.