[ANSWERED] Mrs. Franklin-Jones was admitted from the Emergency Room to Cardiac Intensive Care one week ago with a diagnosis of acute myocardial infarction. She has recovered as expected

Written By: Dan Palmer, RN

Mrs. Franklin-Jones was admitted from the Emergency Room to Cardiac Intensive Care one week ago with a diagnosis of acute myocardial infarction

Mrs. Franklin-Jones was admitted from the Emergency Room to Cardiac Intensive Care one week ago with a diagnosis of acute myocardial infarction. She has recovered as expected

Mrs. Franklin-Jones was admitted from the Emergency Room to Cardiac Intensive Care one week ago with a diagnosis of acute myocardial infarction. She has recovered as expected and is moving to the cardiac step down unit today. She is talking with Nurse Julie Hernandez, as she gets settled in her new room, \”I was really surprised when I got that bad pain in my chest! I knew I had high pressure but I just didn\’t think it was that bad. I try to take my medicine like they told me to in the clinic but sometimes I forget.

I guess that I need to study those papers they gave me about what foods I should eat and not eat. I better take care of myself! Momma had bad pressure and it killed her! Who knows—I may even have to learn to cook different than I was taught in Jamaica! I may have to let Tomas do the cooking. He\’s got more time at home now than I do since he lost his job. There isn\’t too much time between my shifts at the school cafeteria and my new housecleaning job. You know my sister is coming up from Jamaica to see me. I think she is bringing me some bush tea. That\’ll set me right!\”

  • Using Leininger\’s Culture Care Model, what factors in the story shared by Mrs. Franklin-Jones should be considered by Nurse Hernandez when planning for the patient\’s discharge?
  • Why is the theory of Culture Care Diversity important in the delivery of nursing care for all patients?
  • Using Leininger\’s Theory of Culture Care Diversity and Universality, develop a plan of care for Mrs. Franklin-Jones.
  • Discuss the strengths and limits to Leininger’s Theory.

Case Study #2

Claude Jean-Baptiste is recovering from post-hip replacement surgery and has been transferred to the Rehabilitation Institute adjacent to the hospital. When he enters the unit, he sees welcoming signs written in several languages including his own, Creole. Since there are no nurses on that shift that speak Creole, they use a language line to ask for translation services.

During this initial nursing assessment, the translator informs Mr. Jean-Baptiste that the nurses invite him to have a relative at his side so that they can be sure to understand and meet his needs. He is asked about Haitian customs and beliefs that they might honor. Mr. Jean-Baptiste is encouraged to bring food and spiritual care items, and to share the warmth of his culture with the nursing staff.

  • Discuss assumptions of the Transpersonal Caring relationship. What is the nurse\’s role?
  • How is love, as defined by Watson, evident in this caring moment?
  • How can the nurse creatively use self to create a healing environment?
  • Discuss the strengths and limits to Watson’s Theory.

Expert Answer and Explanation

The transcultural Nursing Theory and the Transpersonal Caring Relationship Theory

Case Study One

The transcultural Nursing Theory or Cultural Care Theory is a nursing theory developed by Madeleine Leininger in 1995. The theory involves understanding and knowing different cultures considering healthcare and nursing illness caring activities, values, and beliefs to offer efficacious and meaningful nursing care services to individuals according to their health-disease context and cultural values (Busher Betancourt, 2016). According to the theory, different cultures across the globe have different values and beliefs about health and illness and have different modes of caring. This part of the assignment uses a case study to apply the theory in nursing care.

Factors to Consider When Planning Mrs. Franklin-Jones’ Plan 

According to P. Sagar and D. Sagar (2018), Leininger developed various factors that should be considered by nurses when planning care. These factors include economic, educational, political, cultural beliefs, values, and lifeways, social and kinship, religious and philosophical, and technological factors. Based on the model and the case, Nurse Hernandez should consider various factors when planning to discharge the patient. The first factor the nurse should consider is the educational factor. Mrs. Franklin-Jones tells the nurse that “she needs to study the papers they gave her about what foods she should eat and not eat.”

Therefore, the nurse should educate the patient about the foods to eat before discharging her to avoid readmission. The nurse should also factor in the patient’s kinship characteristics. The patient noted that her mother died of HBP, and thus the nurse should provide the interventions that should prevent her from suffering HBP (Busher Betancourt, 2016). The nurse should also consider the patient’s economic factors. Information about the patient’s economy can help the nurse recommend interventions that suit her financial status. Information about economic status can also help the nurse plan care that will not interfere with her job schedule and prevent her from forgetting to take her medications.

Importance of the Theory 

The theory of Culture Care Diversity is so vital in care delivery. This theory can help a nurse understand the patient’s culture under his or her care and deliver care based on the patient’s values and beliefs. For instance, in the case, the theory has helped Nurse Hernandez identify that Mrs. Franklin-Jones lacks education about the foods to eat and not to eat. As a result, Hernandez effectively plans an intervention to improve the patient’s knowledge. Another importance of this theory is that it can be used to improve the relationship between nurses and patients.

When nurses understand patients’ values and beliefs, they will provide care that respects their values, hence improving their relationship (P. Sagar & D. Sagar, 2018). Lastly, the theory is significant because it can improve patients’ satisfaction. Patients who feel that caregivers respect their norms, beliefs, traditions, and values will be highly satisfied with the services (Albougami et al., 2016).

A Plan of Care for Mrs. Franklin-Jones

The first step of the care plan is health assessment. The health assessment will be done by analyzing the patient’s personal and medical history and physical, sexual, cultural, and emotional factors. Assessment results will be used to provide a diagnosis. The second step is outlining the expected outcomes of the plan. Third, interventions to solve the problem to be highlighted and rationale for interventions provided. Lastly, the plan should be evaluated to find whether it met the proposed outcomes and the improvements to be made where necessary. Overall, the care plan should involve assessing, diagnosing, and outlining expected outcomes, nursing interventions, and evaluation.

The Strengths and Limits of Leininger’s Theory

The first strength of the theory is that that the Sunrise model was well-developed and has logically demonstrated how the concepts in Universality and Culture Care Diversity interrelate. Second, the theorist organized her concepts clearly and well, and this has made it easy for people to apply the theory in different settings (Albougami et al., 2016). The third strength is that the theory can be generalized and applied in many distinct situations. Lastly, the theory seems hard in terms. However, it can be understood easily upon the first contact. The weakness of the theory is that its terms are not simple.

In conclusion, nurses should provide care that considers the patients’ cultural beliefs, values, and practices.

Case Study Two

The Transpersonal Caring Relationship is a theory developed by Jean Watson. The theory’s concern in how caregivers provide care to their patients and how they progress care into better plans to restore health by promoting wellness and health and preventing illness. According to the theory, nursing is concerned with preventing diseases, caring for the sick, promoting wellness and health, and restoring people’s health (Tonin et al., 2019). The focus of the theory is health promotion and disease treatment. This part of the assignment uses case study two to apply the theory in nursing care.

Assumptions of Transpersonal Caring Relationship Theory 

The theory made several assumptions, including the following. First, caring can be demonstrated and practiced effectively through the interpersonal approach only. Second, caring includes the carative elements that can lead to the satisfaction of certain human wants. Third, effective caring promotes family or individual development and health (Pajnkihar et al., 2017). The fourth assumption is that responses to caring accept patients in their current situation and what they will turn out to be after treatment.

Fifth, a caring environment is the one that allows the patients to grow and, at the same time, give them opportunities to decide the type of actions they should undergo. The sixth assumption is that the science of curing corresponds with the science of caring. Lastly, the theory assumes that the central practice in the nursing profession is caring (Maniago & Albougami, 2019). From these assumptions, the nurse has the role to provide care to patients by considering the patients’ wants. For instance, in this case, the nurses should provide Claude Jean-Baptiste with the care that comprises his Haitian customs and beliefs.

Evidence of Love in the Case

According to Maniago and Albougami (2019), Watson defined love as the practice of providing care in a respectful, nurturing, and understanding manner. A nurse can show love by valuing the patient as a whole. The following are ways to love, as defined by Watson, evident in this caring moment. First, love can be seen where the nurses have welcomed Claude Jean-Baptiste with signs written in different languages, including Creole, his own language. The action shows that the unit values the patient’s presence in the hospital.

Second, love has been shown by the nurses when they provide the patient with a translator. The nurses have accepted the patient by providing him with a translator, which is a sign of love. Third, respect is one of the elements of love, as described by Watson (Pajnkihar et al., 2017). The nurses have respected the patient’s culture by allowing him to bring food and spiritual care items. Lastly, leadership has been shown when the nurses allowed the patient to be accompanied by a family member.

Using the Sub-concept to Self to Create a Healing Environment 

The concept of “self” comprises of the perceptions of the features of the “ME” or “I” the perspectives of the connection of “ME” and “I” to various aspects of life and others. In other words, “Self” is a concept that highlights how one views herself or himself (Pajnkihar et al., 2017). Nurses can use this concept to create a healing environment in the following ways. First, the nurse can make the patient environment as quiet as possible. Lastly, the nurses can use the Self-concept to take the patients outside the room after ambulating them.

The Strengths and Limits of Watson’s Theory

The first strength of this theory is that it is easy to understand and can guide and improve nursing practices in a healthcare organization. Second, the language used was not sophisticated; rather, it is evolutionary and fluid. Third, the concepts of the theory have been clearly and comprehensively. Another strength is that the theory’s assumptions are logical and can be effectively applied in the healthcare environment (Tonin et al., 2019).

Lastly, the theory’s scope comprises the majority of aspects of the phenomena of health and illness. The weakness of the theory is that it has not clearly highlighted the direction nurses should take to achieve authentic healing and caring relationships. Nurses who need concrete guidelines may feel insecure using this they alone.

Conclusion

Watson’s theory can help nurses make caring the center peace of nursing practice. Through this theory nurses can create a healing environment.

References

Albougami, A. S., Pounds, K. G., & Alotaibi, J. S. (2016). Comparison of four cultural competence models in transcultural nursing: A discussion paper. International Archives of Nursing and Health Care, 2(3), 1-5. https://pdfs.semanticscholar.org/f1b7/48b664e1236fc0841a6c33259403e3f4f5e9.pdf

Busher Betancourt, D. A. (2016). Madeleine Leininger and the transcultural theory of nursing. The Downtown Review, 2(1), 1. https://engagedscholarship.csuohio.edu/tdr/vol2/iss1/1/

Maniago, J. D., & Albougami, A. (2019). A national survey of transpersonal caring competency among emergency room nurses in Saudi Arabia. https://doi.org/10.21833/ijaas.2020.01.015

Pajnkihar, M., McKenna, H. P., Štiglic, G., & Vrbnjak, D. (2017). Fit for practice: Analysis and evaluation of Watson’s theory of human caring. Nursing science quarterly, 30(3), 243-252. https://doi.org/10.1177%2F0894318417708409

Sagar, P. L., & Sagar, D. Y. (2018). Current State of Transcultural Nursing Theories, Models, and Approaches. Annual review of nursing research, 37(1), 25-41. https://connect.springerpub.com/content/sgrarnr/37/1/25

Tonin, L., Lacerda, M. R., Favero, L., Nascimento, J. D., Rocha, P. K., & MO, N. (2019). Transpersonal caring model in home-Care nursing for children with special care needs. Journal of Nursing Education and Practice, 9(1). URL:https://doi.org/10.5430/jnep.v9n1p105

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FAQs

What are the key assumptions of Leininger’s culture care theory?

Leininger’s culture care theory assumes that culture significantly influences individuals’ health beliefs and practices. The theory posits that understanding diverse cultural perspectives is vital for providing effective and culturally competent healthcare. This assumption stems from the belief that culture shapes individuals’ values, behaviors, and healthcare expectations, emphasizing the need for healthcare professionals to incorporate cultural considerations into their practice for improved patient outcomes.

What are the three major contributions that Madeleine Leininger made to transcultural nursing?

Madeleine Leininger, a pioneer in transcultural nursing, made significant contributions, including:

  1. Cultural Competence Emphasis: Leininger highlighted the importance of cultural competence in nursing. She advocated for healthcare professionals to understand and respect diverse cultural values, beliefs, and practices to provide more effective and sensitive care.
  2. Culture Care Theory: Leininger introduced the Culture Care Theory, emphasizing the impact of culture on health and healthcare. This theory guides nurses in providing culturally congruent care, considering patients’ cultural backgrounds to enhance health outcomes.
  3. Transcultural Nursing Education: Leininger played a pivotal role in developing and promoting transcultural nursing education. She advocated for integrating cultural competence training into nursing curricula, ensuring that future healthcare professionals are well-prepared to work in diverse and multicultural environments.

Why is the theory of culture care diversity important?

The theory of Culture Care Diversity, a key component of Madeleine Leininger’s Culture Care Theory, holds significance for several reasons. Firstly, it recognizes the diversity in healthcare practices among various cultural groups, emphasizing the need for individualized and culturally congruent care. This approach ensures that healthcare professionals consider and respect diverse cultural beliefs, values, and practices, ultimately leading to more effective and patient-centered care. Additionally, by acknowledging and addressing cultural diversity, the theory contributes to reducing health disparities and fostering improved health outcomes within multicultural populations.

What are the benefits of culture care theory?

The Culture Care Theory, developed by Madeleine Leininger, offers several benefits in the field of nursing and healthcare.

  1. Culturally Competent Care: The theory promotes culturally competent care by recognizing and integrating cultural values, beliefs, and practices into healthcare delivery. This leads to more personalized and effective care, fostering positive patient experiences.
  2. Improved Patient Outcomes: Considering cultural factors in healthcare decision-making enhances patient understanding and compliance. This, in turn, contributes to improved health outcomes as care aligns with patients’ cultural preferences and expectations.
  3. Reduced Health Disparities: By addressing cultural diversity, the theory helps reduce health disparities among different cultural groups. Culturally congruent care ensures that individuals from diverse backgrounds receive equitable and accessible healthcare, promoting overall health equity.
  4. Enhanced Nurse-Patient Relationships: Integrating cultural considerations builds trust and rapport between healthcare professionals and patients. This strengthens the nurse-patient relationship, creating a supportive environment for effective communication and collaboration in the care process.
  5. Cultural Sensitivity in Education: The Culture Care Theory has influenced nursing education, emphasizing the importance of cultural sensitivity training. This prepares future healthcare professionals to navigate diverse cultural landscapes, fostering a more inclusive and empathetic healthcare workforce.

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