Strength-Based Nursing and Healthcare Plan for Emma | Desklib

The nursing practices that should have been promoted to ensure Emma regained her old lifestyle are; implementing the principles and values of SBN, administration of physical and speech therapy exercises, post-surgical care, plan of care, and collaboration with family. | Desklib

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STRENGTH-BASED NURSING AND HEALTHCARE PLAN FOR EMMA
Student’s Name
Student ID
Code + Course Name
Professor’s Name
University Name
City, State
Date

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Table of Contents
Strength-Based Nursing and Healthcare....................................................................................3
Overview................................................................................................................................3
Comprehensive Understanding of Strength-Based Nursing Care..........................................3
Principles and Values of SBN (Gottlieb, 2014).....................................................................4
SBN Intervention on Emma’s Healthcare Journey....................................................................6
Transition Point: Post-surgical Care and Plan of Care...............................................................7
Post-Surgical Care..................................................................................................................7
Plan of care.............................................................................................................................7
Holistic Approach, Focus on Emma’s Family and Collaboration with Emma..........................8
Summary of SBN Practices and Outcomes................................................................................8
Conclusion..................................................................................................................................8
References................................................................................................................................10

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Strength-Based Nursing and Healthcare
Overview
Strength-based nursing is a care approach whereby certain fundamental principles and
values direct nurses’ actions thus enhancing the promotion of empowerment, hope and
self-efficacy (Gottlieb, 2014). SBN focuses on a person and family’s inner and outer
strengths and resources to facilitate health promotion and creation of suitable conditions
for healing (International Family Nursing Association, 2015). This enables nurses to
effectively deal with problems that may arise as well as minimize the discrepancies.
This discussion therefore seeks to outline the SBN care plan that should have been and
those that were implemented throughout Emma’s healthcare journey. Emma’s
healthcare story evidently informs health professionals that love, optimistic mindset and
support can incredibly improve a person’s health and life (Gee, 2018). A further outline
on the SBN care for a patient after going through a surgical operation will be discussed.
Emma went into a stroke after going through a complex surgical procedure. Therefore,
the immediate post-surgery care while Emma was in a stroke will be discussed as well.
A holistic approach, focus on the family and cooperation with Emma will also be
presented. A summary on the SBN care practices will also be discussed before a
conclusion is drawn.
Comprehensive Understanding of Strength-Based Nursing Care
SBN is an evidence-informed practice that ensures that people have support in their
healthcare outcomes and personality (Australian Medical Student Journal, 2018). SBN
appreciates the importance of the environment and sociocultural frameworks in the
realization of an ideal healthcare result. The objectives of healthcare promotion,
facilitation of healing and easing the suffering of patients by making the environment
suitable to the patient’s conditions are endorsed in this care plan (Nursing Centre,
2018). Therefore, SBN supplements the medical care provided, the nurses’ input to the
patient and family’s health and healing and the empowerment of the patient and
family’s control over their health and healing. It not only focuses on the prevention,
well-being and person-centred care but also on the patient’s shortfalls. The patient’s
deficits are analysed based on pathophysiology, paying attention to the unusual and
dysfunctional characteristics with an aim of solving the problems.
The remarkable changes in the healthcare provision services have roused modifications
in economic, political and social environments thus making healthcare managers to
provide new ways of maintaining and improving the delivery of services Trajkovski,

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Schmied, Vickers and Jackson, 2013). The involvement of patients and their families in
the care and policy making decisions has increasingly become one of the new strategies
used by healthcare managers. Involving patients and their families enhances the quality
of services provided as well as meets the requirements of the government in service
production (Tambuyzer, Pieters, and Van Audenhove, 2014). There are eight principles
and values that guide nurses in their actions. These include; health and healing, holism
and embodiment, uniqueness, subjective reality and created meaning, self-
determination, learning timing and readiness, person and environment are fundamental
and collaborative partnership (Gottlieb, 2014). These values and principles enhance the
provision of SBN healthcare and quality healthcare service delivery.
Principles and Values of SBN (Gottlieb, 2014)
Collaborative partnership: This principle states that the relationship between the
nurse, the patient and the family is collaborative. Each of the party incorporates its own
knowledge, skills and experience to the relationship. The nurse possesses the medical
knowledge of the patient’s health and healing conditions. On the other hand, the family
and the patient have the facts about their health background and vulnerabilities. When
the nurse is cooperative and open to the patient and the family, a collaborative
relationship is created. The patient and the family feel respected by the nurse when their
strengths are appreciated and recognized.
Health and Healing: SBN endorses health and healing as the fundamental objective of
nursing care. Health enables the patient to flexibly adapt to the challenges in life.
Healing restores a person’s wholeness and during this process people develop different
abilities that are capable of improving and sustaining their health. Nurses enhance the
promotion of health by assisting people in the development of new skills that will
enable them to cope with life. Nurses support the patient’s healing capacities through
encouraging them to sleep, ensuring proper nutrition and controlling the patient’s pain
(Byrne, Barry, and Petry, 2012). The nurses also ensure that patients recover from
physical and social issues by availing healing environments.
Holism and Embodiment: Holism identifies that the parts of a person are intertwined
and each part affects the functioning of the person. The presence of symptoms, for
instance, signals that there is a problem with the person’s functioning. The symptoms
that cause dysfunction in a person should be treated or rather eradicated to enable the
healing process to reinstate a person’s sense of completeness. The nurse’s role
according to SBN is to assist the patient in achieving their objectives. The nurse should

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also work with the patient in order to come up with solutions to the medical problem
and thus fix the problem.
Learning, Timing and Readiness: Learning is central to a person’s continued
existence, development and transformations as it involves psychological processes.
Humans are able to traverse the environment through learning. Learning also entails
being ready to participate in a new action altogether. According to SBN, timing
involves coordinating the outcome anticipated with the proficiencies of the body and
the willingness of the mind. The nurse should be accustomed to the patient in order to
know the exact and perfect moment of administering intervention. This principle is
necessary for healing as people learn how to care for their health. The timing of the
intervention focuses on a person’s knowledge and circumstances.
Person and Environment are Integral: The environment physically and socially
affects a person and the family. A person may portray strength in a certain environment
while on the other hand; he or she may be vulnerable in some environments. People
develop and thrive in a suitable environment. Suitable environments enable people to
maximize their strengths and seize the opportunities for healing and transformations.
Self-Determination: SBN ensures that a person’s self-determination, knowledge and
choice of values are respected and upheld. However, the choices available are limited to
a certain degree as the person’s knowledge and situation affect his or her ability to act
in accordance to his or her interests. Majority of the living acts entail making a choice
on what way to react to certain situations and restrictions in healthcare and the
interventions that should be undertaken. SBN views the role of nurses as attentively
listening to patients and providing clarifications and not making choices for them.
Subjective reality and created meaning: Understanding shapes experiences since
they hold precise meanings. A person’s understanding of events is directed by emotions
and experiences which then affect their reactions. SBN requires nurses to recognize and
enhance patients’ communication.
Uniqueness: SBN identifies that people are different genetically and in terms of
specific dispositions. The variation between people is determined through strengths and
weaknesses; how they affect their physical reactions and behaviours. In order to
identify a person’s uniqueness, the strengths and flaws should necessarily be
understood. A patient’s strength could be in the effective exercise of autonomy; being
able to make appropriate decisions. The family’s strength can also be visible in the

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proper implementation of autonomy. Different people make different choices therefore
they cannot be identical.
SBN Intervention on Emma’s Healthcare Journey
In 2005, Emma experienced a left-side paralysis which kept worsening (Gee, 2016).
This was one of the symptoms of an impending stroke that Emma suffered after a
complex surgical procedure. Nurses should have practised exercises and physical
therapies for Emma so that movement would be regained the area affected. Restoration
and strengthening of the neural pathways that regulate movement in the brain is an
important stroke recovery method brought about by rehab exercises (Flint Rehab,
2017). Nurses should have carried out language exercises with Emma to help her regain
her speech and writing skills. Exercises in speech therapy helps patients like Emma
recover from the stroke and improve their language. Emma was barely able to mumble
words out of her mouth even though she wanted to. But the nurses did not initiate any
speech therapy exercises on her that would have helped in regaining her speech. Emma
also lost the ability to swallow. This made it difficult for nurses to help in the nutrition
of Emma as well as administration of medicine. This was a side-effect to the speech
loss and could only be regained through speech therapy.
Emma suffered a stroke after going through a surgical procedure. A stroke takes place
when the supply of blood to the brain is interfered with (Disabled World, 2018).
Strokes can be recognized and prevented once the patient has gone through a surgical
procedure. The risk of perioperative strokes is high among the female gender as well as
surgeries pertaining to head or brain injuries or tumours Based on this knowledge,
nurses should have been able to anticipate the stroke that Emma suffered. Emma had
blood clots and internal bleeding and swelling in the brain thereby causing the stroke.
Ultrasound should have used in order to break the blood clots so as to reduce the risk of
a stroke.
Emma was diagnosed with Arteriovenoces Malformation (a knot of the blood vessels in
the brain) and therefore a surgery was necessary. Emma consented to the surgery; the
doctors were aware of the risks but they did not enlighten her or her family. The
surgery aggravated the internal bleeding thus leading to a stroke. The principles of
collaborative partnership, readiness and timing were not adhered to in this case.
Emma’s intervention timing was poor that is why she suffered a stroke. The doctors and
nurses should have first dealt with the blood clots and internal bleeding before
performing a surgical procedure to remove the AVM.

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Transition Point: Post-surgical Care and Plan of Care
Post-Surgical Care
After the surgery, a post-surgical recovery nurse should have been placed in charge of
Emma. What happens at the initial phase after post-surgical or anaesthetic operation,
patients are assessed and managed closely for a better recovery. (Nursing, 2017). It is
the duty of post anaesthetic recovery unit nurses to make sure that patients like Emma
go through the whole process safely after surgeries for a better and efficient recovery in
the transition to this type of care, Emma should be assessed regularly, making sure she
is careful monitored and her information about recovery is appropriately documented.
In this type of care also, the major systems of the body are evaluated, like, respiratory
systems, cardiovascular and renal systems. (Akhtar, 2013). Emma’s comfort from pain
is primary and it should be prioritized as she seemingly has a brain swelling that could
be a confirmation of infection.
Plan of care
Emma went into a coma after going through a difficult surgical procedure. Internal
bleeding in the brain and blood clots were the core reason she suffered a stroke. Nurses
had to device plan to deal with her during the stroke and after she regained
consciousness. Emma lost her speech after the stroke therefore nurses could not involve
her in the planning of her care. Her twin sister, Bec, was called on in order to assist in
the communication with Emma. Bec went with a red magnetic letter board that finally
enabled the doctors and nurses to communicate with Emma. However, Speech therapy
exercises would have greatly assisted in the communication with Emma. Emma also
had trouble swallowing after the stroke (dysphagia) and she therefore needed tubes
jostled down her throat in order to swallow. Emma thus became vulnerable to deficits
such as ataxia, diplopia, dysarthria, nystagmus, mobility and sensory deficits after the
stroke. A nurse had to be assigned to her to help her in controlling her bowels as well as
find solutions to the deficits she suffered.
Holistic Approach, Focus on Emma’s Family and Collaboration with Emma
The administration of care during critical health situations should be guided by the
principle of holism (Iglehart, 2013). The nurses were aware that each part of Emma’s
body would affect her general condition. Emma has a blood clot and swelling in the
brain but the doctors still went ahead with the surgical procedure to remove the AVM
in Emma’s brain. IN the end Emma went into a coma due to internal bleeding in the

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brain. The doctors were aware of the risks associated with performing a surgery on
Emma in her state but they still did not inform the family or Emma. The principle of
collaborative partnership was also not adhered to as well as the doctors agreed on a plan
of care after Emma suffered a stroke without consulting the family. The main objective
of nurses and doctors should be to relieve Emma of her pain and treat her effectively.
Summary of SBN Practices and Outcomes
The nursing practices that should have been promoted to ensure Emma regained her old
lifestyle are; implementing the principles and values of SBN, administration of physical
and speech therapy exercises, consulting Emma and her family before drawing out a
plan of care and giving attention to the risk factors surrounding the patient.
The anticipated outcomes in Emma’s healthcare situation are; enhancement of sense
and mobility, family’s contentment, regaining of Emma’s former lifestyle,
empowerment of Emma and regaining of speech-language by Emma.
Conclusion
Love, support and empowerment can assist in the SBN care of patients. Collaboration
between the nurses, family and the patient can lead to the achievement of the desired
outcomes. This is possible through the safeguarding of the principles and values of
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References
Akhtar, A. (2013). Pre-Operative Assessment and Post-Operative Care in Elective
Shoulder Surgery. The Open Orthopaedics Journal, 7(1), 316-322.
doi:10.2174/1874325001307010316
Australian Medical Student Journal. (2018). Forget everything you thought you knew:
how your assumptions are impacting the health outcomes of your patients. Available at:
http://www.amsj.org/archives/5550 [Accessed 18 Oct. 2018].
Byrne, S., Barry, D. and Petry, N.M., 2012. Predictors of weight loss success. Exercise
vs. dietary self-efficacy and treatment attendance. Appetite, 58(2), pp.695-698. doi:
10.1016/j.appet.2012.01.005
Emma Gee (2018). The Book | Emma Gee. Available at: http://emma-gee.com/the-
book/ [Accessed 18 Oct. 2018].
Flint Rehab. (2017). Left Side Stroke Recovery: 5 Things Everyone Must Know – Flint
Rehab. [online] Available at: https://www.flintrehab.com/2017/left-side-stroke-
recovery/ [Accessed 18 Oct. 2018].
Gee, E. 2016. Reinventing Emma. The inspirational story of a young stroke survivor.
Gottlieb, L.N., 2014. CE: Strengths-based nursing. AJN The American Journal of
Nursing, 114(8), pp.24-32. doi: 10.1097/01.NAJ.0000453039.70629.e2.
I., News, P., News, R., News, E. and Newsletters, I. (2015). Strengths-Based Nursing
(SBN) - International Family Nursing Association. International Family Nursing
Association. Available at: https://internationalfamilynursing.org/2015/01/30/strengths-
based-nursing-sbn/ [Accessed 18 Oct. 2018].
Iglehart, J.K., 2013. Expanding the role of advanced nurse practitioners—risks and
rewards. New England Journal of Medicine (368) 20 pp. 1935-41 doi:
10.1056/NEJMhpr1301084
News-Medical.net. (2013). Strokes that occur during or shortly after surgery can be
devastating. [online] Available at:
https://www.news-medical.net/news/20130212/Strokes-that-occur-during-or-shortly-
after-surgery-can-be-devastating.aspx [Accessed 18 Oct. 2018].
Nursing, A. (2017). Post-anaesthetic Recovery Unit Nursing - Australian College of
Nursing. Australian College of Nursing. Retrieved 19 October 2018, from
https://www.acn.edu.au/education/single-unit-of-study/post-anaesthetic-recovery-unit-
nursing

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Publications (2018). Stroke: Symptoms Causes & Treatment. [online] Disabled World.
Available at: https://www.disabled-world.com/health/neurology/stroke/ [Accessed 18
Oct. 2018].
Tambuyzer, E., Pieters, G. and Van Audenhove, C. (2011). Patient involvement in
mental health care: one size does not fit all. Health Expectations, 17(1), pp.138-150.
Trajkovski, S., Schmied, V., Vickers, M. and Jackson, D., 2013. Using appreciative
inquiry to transform health care. Contemporary nurse, 45(1), pp.95-100.