Strengths-Based Nursing Care: A Review

This assignment requires a critical analysis of strengths-based nursing care. Students must examine theoretical frameworks, evidence-based practices, and real-world applications of this approach. The focus is on understanding how strengths-based nursing empowers both patients and families within the context of various health conditions.

Running head: NURSING ASSIGNMENT
Nursing assignment
Name of the student:
Name of the University:
Author’s note

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Introduction (Overview of Emma’s journey):
The report focuses on a strength based nursing care (SBNC) plan for Emma Gee, a 24
year old girl who was vibrant young children with active lifestyle in childhood. However, her life
changed all of a sudden when she started experiencing disturbing symptoms and was diagnosed
with stroke. There were several transition points in her life associated with great challenges and
sufferings at those point of life such as revelation about the diagnosis of stroke, going for the
surgery and remaining coma, the life after regaining consciousness and struggling with activities
of daily living after stroke (Gee 2016). This report mainly focuses on the transition point of
nursing care following Emma regaining consciousness after coma and analyzes the usual care
provided to her. Based on evaluating experience of Emma in that period, a SBNC plan is
developed for Emma to promote her empowerment by following eight principles of SBNC.
Overview of implementing strength based nursing care for Emma
The strength based nursing care (SBNC) is an innovative approach to care that
emphasizes on a new set of values to promote empowerment, self-efficacy and hope in patients.
Unlike the medical model of care which is focused on treating the disease and not the person, the
SBNC model is similar to patient centered care model where focus is on healing of patient
(Gottlieb, Gottlieb and Shamian 2012, pp. 38-50). In case of patient-centered care, healing
occurs within the relationship between staffs and the participant, and the SBN focus on creating
an environment that enhances the patient’s capacity for health and innate mechanism of healing
(Gottlieb 2014, pp.24-32). Unfortunately, all the above elements were missing in the usual care
provided to Emma after coma. The use of SBNC care plan is important for Emma during the
transition point of Emma regaining consciousness after coma because in the usual care provided

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to her, the specific needs of Emma and her strength was not considered for care planning. For
example, just after she regained consciousness, she wanted the medical team to talk to her,
however they were in a conversation among themselves. The review of the usual care revealed
no action to identify what treatment of care option is working well or it will work best for Emma.
With the use of SBNC, the main plan is to work with strength of Emma to overcome her
problems and deficits. The strategies followed to implement SBNC for managing her care after
regaining consciousness will focus on the principle of holistic personalized care, empowerment
of patient, family/person centered care, context based care, collaborative partnership and self-
care (Gottlieb, Gottlieb and Shamian 2012, pp. 38-50).
After regaining consciousness after coma, Emma relied mainly on medical staffs for her
daily life activities like cleaning, washing, feeding and rolling. She always felt like poked and
prodded and missed seeing the familiar faces like her family members in front of her. She failed
to communicate with her family member after the black mask on her mouth. To implement
SBNC for Emma, the immediate strategy is to engage in a therapeutic communication with
Emma first to identify her strength and weakness and then develop care plan for her. The nursing
behaviors like active listening, assessing patient’s understanding and preference of treatment
option, validating their participation in decision making and communicating with empathy (both
verbally and non verbally) is likely to enhance patient centered communication while caring for
(Emma Elwyn et al. 2014, pp.270-275). While providing her support in daily life activities, all
considerations will be made to respect her dignity and find out Emma’s preferences in receiving
support. In addition, including family members in care planning will be very crucial as they can
give lot of information about strength and coping skills of Emma. Based on family strength
assessment, their family member can also be involved in care so that Emma does not feel

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intimidated and develops the positive motivation to accept the treatment and this approach would
accelerate her pathway towards recovery and healing (Smith, Swallow and Coyne 2015, pp.143-
159).
Family functioning and relationship in nursing practice
As it is planned to engage family members in planning and addressing health care needs
of Emma, it will be important for nurse to conduct family strength assessment to identify any
family strength factor that can promote recovery of Emma and a positive experience in care. This
exercise would help to gain knowledge about patient’s relationship, level of attachment with
family members and any specific family strength that promotes recovery of patient
(Svavarsdottir, Sigurdardottir and Tryggvadottir 2014, pp. 13-50). The narration by Gee (2016)
showed that Emma was closely attached to her mother, Lyn and after regaining consciousness,
Emma always wanted to see her family members in front of her, however she was always
surrounded by hospitals staffs. Therefore, understanding family strength is important so that her
mother could also be involved in care. Hence, interview with her mother can give information
related to support, togetherness, communication, shared activities, acceptance and resilience in
Emma’s family and this information can be used to enhance both physical as well as spiritual
well being of Emma (Gottlieb et al. 2012, pp. 38-50).
Another important consideration for nurse to promote healing and recovery of Emma
according to SBNC plan is to develop a therapeutic and caring relationship with the patient.
This is importance to promote inclusiveness in nursing practice and make patient accept and
trust the treatment provided to them (Tobiano et al. 2015, pp. 1107-1120 . The narration by
Emma after gaining consciousness mainly revealed she felt poked and prodded and no care being

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taken while shifting her from one bed to another during any medical activities. Hence, this means
in the usual care provided to Emma, no communication or feedback was taken from Emma to
understand her concern. This issue will be addressed by engaging in therapeutic communication
with Emma and always interacting with her at all point of care to take feedback for any care
implemented or find out any issue faced by Emma while going forward with any treatment. This
will facilitate collaborative nursing practice and nurse can develop the resilience skill of Emma
to cope with any difficulties at any point of care. Offering assistance to Emma during her stages
of anxiety and clarifying the importance of certain treatment for her recovery may also address
feelings of disgust experience by Emma (Feo et al. 2017, pp.54-63). This will ensure that
effective and caring nurse patient relationship is developed with Emma.
Strength based nursing care for one critical transition point in Emma’s journey
Goal of SBNC care plan for Emma after regain consciousness-
 To provide SBN approach to support her in activities of daily living such washing,
dressing and feeding.
 To involve Emma’s mother in basic activities like dressing and feeding to develop
resilient and spiritual well-being in patient.
 To be vigilant to respect patient’s dignity and respect while implementing care
 To take regular feedback from Emma to understand what will work best for her and
reduce her sufferings during the treatment.
SBNC plan for support in activities of daily living:
 Collect subjective data (S)- The first plan is to collect subjective data of level of difficulty
in activities of daily living after coma. Emma was having trouble in speaking and

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communication with others due to dysphagia. Although she tried to say things, but no
could understand her. She also lost the ability to normal movement and could not even
wriggle her toes after regaining consciousness after coma. Other issues that severely
affected her activities of daily living included double vision, inability to swallow foods
due to dysphasia (nurse asked her to open her while feeding a fluid, but Emma’s brain
could not support her to complete the action), inability to use the communication board,
comb her hair and dress herself. She was also found to experience great psychological
stress and trauma during the process due to the absence of therapeutic communication
and presence of family members in care (Gee 2016). Collect objective data (O)- The level of deficits in the area of mobility, speech and gait
will be measured by use of appropriate tools. This would help to understand the level of
support or assistive device Emma might require during ADLs. Assessment (A)- Bases on the collective and objective data obtained, the nurse can assess
the difficulties faced by Emma in nursing care and support for ADLs. Treatment plan (P)-
1. SBNC for ADLs will be provided by being respectful towards Emma and preserving her
dignity during feeding, dressing and washing activities. As she faced difficulty in
speaking, it will be necessary to communicate with Emma to understand whether she can
express her thoughts and feeling through non-verbal signs. Teaching her non-verbal
communication skill is also likely to address her struggle during speaking with others
(Lutz and Green 2016, pp.e263-e265).
2. As Emma’s family remained with her for a very short time in the usual care provided, it
is planned to at least allow her mother, Lyn to meet and support Emma at least during

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feeding so that she gains some warmth and familiarity in the hospital environment. This
would also address her feelings of social isolation and lack of support from family
members during difficult times (Address psychological stress and anxiety in patient)
(Carman et al. 2013, pp.223-231).
Reflection on Emma’s experience in actual health care received and SBNC
The usual care provided to Emma after gaining consciousness mainly revealed that there
was a focus on just completing specific medical task assigned for patient, however no care was
taken to preserve the dignity of patient. Therapeutic means of communication was always
missing as hospital staffs talked among themselves and paid no attention to the issues that Emma
faced while speaking or feeding or shifting her to another room. Use of such approach to care de-
motivate patients and diminish their will power and hope for recovery. Patients also distrust such
system and develop feelings of aggression and psychological stress in the procedure. On the
other hand, the SBNC plan is mainly focused on effective communication with patient
throughout the stage of treatment. This ensures that patient’s preference and issues can be
identified and the most optimal environment is provided to patient to enhance their resilience
skills and feelings towards healings (Spence Laschinger et al. 2010, pp.4-13). By the use of
SBNC, it is expected that Emma may develop a sense of familiarity and inclusiveness in care and
respond well to the treatment provided. The inclusion of her family member is also likely to
reduce her psychological distress.
Conclusion on role of SBN for patient and family empowerment
The main conclusion from developing the SBNC care plan for Emma is that SBN is a
unique approach to care and must be actively implemented in nursing practice to promote

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patient/family empowerment and engagement in decision making. The SBN approach of
focusing on patient and family strength creates an environment for their empowerment and
developing positive attitude towards the care process. Use of such approach is likely to reduce
the burden of nurses in their practice as it reduces conflicts, errors and any dissatisfaction with
the care provided and accelerates recovery and healing of patient.

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Reference
Carman, K.L., Dardess, P., Maurer, M., Sofaer, S., Adams, K., Bechtel, C. and Sweeney, J.,
2013. Patient and family engagement: a framework for understanding the elements and
developing interventions and policies. Health Affairs, 32(2), pp.223-231.
Elwyn, G., Dehlendorf, C., Epstein, R.M., Marrin, K., White, J. and Frosch, D.L., 2014, ‘Shared
decision making and motivational interviewing: achieving patient-centered care across the
spectrum of health care problems, ‘The Annals of Family Medicine, 12(3), pp.270-275.
Feo, R., Rasmussen, P., Wiechula, R., Conroy, T. and Kitson, A., 2017, ‘Developing effective
and caring nurse-patient relationships’ Nursing Standard, 31(28), pp.54-63.
Gee, E. 2016, ‘ Reinventing Emma’, Retrieved 23 October 2017, from
http://file:///C:/Users/User00/Downloads/1801246_440436544_emma%20(1).pdf
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patients’, Stroke, 47(12), pp.e263-e265.

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