Strength Based Nursing: Principles, Care Plan, and Outcomes

Strength based nursing is founded on eight core principles that foster hope, healthy behavior, and quality life. This article discusses the need for health care education, nursing care plan, promotion of resilience, and outcomes of strength based nursing. It also emphasizes the importance of preserving the dignity of patients and developing hope among them.

STRENGTH BASED NURSING 1
STRENGTH BASED NURSING
By; Student’s name
Student ID
Code + Course Name
Professor’s Name
University Name
City, State
Date

STRENGTH BASED NURSING 2
Table of Contents
Introduction......................................................................................................................................3
Need for Health Care Education......................................................................................................4
Transition point: nursing care following regaining consciousness..................................................5
Suffering experienced during care...............................................................................................5
Strength based nursing care plan.................................................................................................6
Promotion of resilience................................................................................................................7
Outcomes of strength based nursing................................................................................................7
Conclusion.......................................................................................................................................8
References........................................................................................................................................9

STRENGTH BASED NURSING 3
Introduction
Strength based nursing is based on the idea that interactions with others is imperative in
the healing process. (Gottlieb, 2014). This concept recognizes that the human beings consists of
more than the just the physical and for one to recover they must be well in all aspects of
themselves. Florence Nightingale describes the role of nurses as creating an environment that
would best enable the patient’s body to recover. (Nightingale, 1946).
Strength based nursing is founded on eight core principles. Health and healing. The
primary goal of nursing is to foster the recovery and healing of the patient. Nurses work towards
promotion of healing of the patient through such processes as sleep, nutrition, and pain control.
Uniqueness: SBN acknowledges that all people are different; everyone is genetically
unique and has a certain disposition. Furthermore, the most condusive environment for recovery
is different for different people as people thrive in different environments. Nurses must therefore
center their care plan along the patient’s individual strengths.
Holism and embodiment: Martha Rogers (1970) explains that people are unitary beings
who react to their surroundings as integrated wholes. (Iglehart, 2013). Patients should be
regarded as a whole and treated as more than just the disease they are suffering from. Care
provided should take into account the physical, mental and social aspects of the patient.
Subjective reality and created meaning: An individual’s perception of their reality
affects their response to it. Nurses should therefore be aware of all their actions and words as
though they could affect how the patient views themselves as well as their recovery process.
Person and environment are integral: For complete patient recovery the patient must
be placed in an environment where they thrive best. Nurses ought to ensure that they create an
environment where patients feel supported and safe. This involves allowing them to personalize
the place where they are recovering and creating a rapport with the patient.
Self-determination: SBN recognizes that patients have the freedom of choice to make
decisions regarding their health. It emphasizes the need for nurses to give patients the leeway to
decide what they want with the help and guidance of the nursing staff.
Learning, timing and readiness: It is essential for patients to learn about the illness
which they are suffering from. This enables them to mentally prepare for the tasks ahead of them
and helps to put in sync mental willingness with their bodies’ capabilities. (Gottlieb, 2014).

STRENGTH BASED NURSING 4
Collaborative partnership: A partnership ought to exist between nurses and patients
where nurses bring their expertise in the medical field while patients bring knowledge about
themselves as individuals. This enables the patients to receive quality care that is tailored
towards them as ensured by their involvement in all aspects of their care through consultation.
(Delaney, 2018)
Need for Health Care Education
The discovery of ones’ illness particularly an illness that could have a fatal ending is
petrifying for patients.
Emma describes experiencing increasing anxiety over her cerebral angiogram as she
awaits surgery. (Gee, 2016). The situation was aggravated by her lack of knowledge on her
disease as she imagines all the things that could possibly go wrong. After being diagnosed she
meets a team of doctors who discuss the various treatment plans for her yet fail to engage her in
conversation, explain to her clearly the different plans and why they wouldn’t work or even ask
about her concerns over her disease.
As a result of this information deficit, Emma remains largely ignorant of the difficulties
that await her after her surgery. She is for the most part disillusioned that her life will remain the
same. This disillusionment affects her recovery later on. (Klonoff, 2010).
One of the core aspects of strength based nursing is learning, timing and readiness.it is
imperative for patients to be thoroughly educated on the disease they are suffering from, the
available treatments, the implications of the treatments and the effect that their illness will have
on the quality of their life. Such education needs to be delicately handled and the goal of passing
information to the patient is to ensure that they have clarity about their situation. (Adams, 2010)
The nurses ought to have taken time to give all necessary details to Emma regarding her
illness after her diagnosis. They ought to have explained to her what lifestyle changes she ought
to have implemented and any warning signs that would indicate her state was deteriorating. This
would serve to alleviate her anxiety and help her focus simply on her recovery.
During her recovery Emma is often disheartened by her progress as throughout the
process she maintains an idea of what her life will be like upon recovery. She is certain that she
will be just as she was prior to the onset of her illness. Throughout her rehabilitation at Royal
Talbot Rehabilitation Centre she strongly believes that she will leave the center with the ability
to run even though from all practical medical perspectives this is unlikely.

STRENGTH BASED NURSING 5
Nurses have the responsibility to create awareness to patients on the implications of their
conditions in a sensitive way that does not dishearten them. They must depict to patients,
realistically, what they should expect their lives to turn out to be post recovery.
The nurses dealing with Emma after her stroke ought to have taken time to inform her of
the implications of her stroke on her body. While all persons are unique and they extent of their
recovery varies, the nurses have a responsibility to paint a picture to their patient of the realities
that her future would likely entail.
Transition point: nursing care following regaining consciousness
Suffering experienced during care
Upon regaining consciousness, Emma describes her situation as one in which her life
depended on the graces of the hospital staff. She states that she feels like “a child” an indicator of
the powerlessness she is overcome by in her situation. She is unable to perform the most menial
of tasks and is dependent on others to do everything for her such as feed her. (Gee, 2016).
Her inability to perform the most basic of tasks is aggravated by the fact that she feels as
if she has lost all dignity as a result of the actions of the people who she relies on to perform
tasks for her. One of the nurses feeds her while playing what she describes as the ‘airplane game’
which is belittling for Emma who is a twenty four year old woman and not an infant. (Gee,
2016).
Also, Emma is overcome by the feeling of loss of self-determination. Unable to speak the
nurses make all decisions for her and fail to seek her approval and sometimes even fail to inform
her of an action they are taking. When Emma messes her bed, the nurses come to attend to her
and clean her up. As they do this they roll her over without speaking to her or addressing the fact
that this is a matter of great embarrassment to her. (Gee, 2016).Patient choices are vital to their
self-worth and respect and are of utmost significance in upholding medical ethical principles.
(Ewert, 2013).
Furthermore, Emma describes often being in immense amount of pain which was not
dulled in the least bit by pain killers. She is forced to identify what is aggravating her pain and
attempt to avoid it. A difficult task given her situation where she is unable to speak and has little
control over the movement of her body.

STRENGTH BASED NURSING 6
Strength based nursing care plan
Upon the regaining of consciousness, the nurses should have taken conscious steps to
ensure that Emma received patient centered care.
Emma and her family ought to receive health education on her situation. The nursing
staff would explain to Emma that she had suffered a stroke and as a result she would not be in a
position to perform certain tasks for a period and that the staff would assist her in all that she
requires. The nursing staff could then educate the family on all the tasks she required help in so
that they could be in a position to help her if the situation required it. This would prepare Emma
mentally for the process that lay ahead.
The nursing staff would then establish a relationship with Emma and in particular her
family, who knew Emma well as she could not speak at the time, based on collaborative
partnership. Upon discovering a problem that would create a challenge for Emma’s comfort the
staff could ask the family to help them come up with a solution that served all parties. This
would be practical in problem solving as a number of her family members are health
professionals. This would also create a power balance between those involved.
In their interactions with Emma, the staff ought to recognise her as the twenty four year
old woman that she is. Hence, they needed to treat her in such a manner that befitted her age.
Though the patient requires assistance like a child does, the staff ought to acknowledge that she
is not a child but an adult. She needs to be treated as more than just her deficits.
The staff ought to appreciate the freedom of choice of individuals especially when there
are limits to the choices they can make. Nurses ought to grant to Emma an opportunity to make
choices even over trivial things. When the time came to remove staples out of Emma’s head she
ought to have been asked about the timing. Reinforcement of self-determination in patients
enhances self-efficacy.
The strength based nursing approach requires the staff to be mindful of the patients and
sensitive to their needs. When dealing with matters which would generally cause embarrassment
to the patient, the nurses ought to offer reassurance to the patient and make sure they understand
what steps are being taken to deal with the matter.

STRENGTH BASED NURSING 7
Assessment Nursing
Diagnosis
Patient outcomes Interventions Rationale
Chronic pain Nerve damage
from stroke
Patient will:
Inform the nurses
of any actions
that aggravate
her pain
Administration
of pain killers
Painkillers will
help ease patients
burden.
Speech
impairment
Damage from
stroke
Attend speech
therapy once a
day.
Use of a
communication
board
Observation of
patient gestures
and non-verbal
skills
Nursing requires
collaboration
between patients
and nurses.
Therefore, nurses
need to give
information and
understand
patient needs and
demands.
Inability to move
body
Attend physical
therapy
Assist patient
with task that
require body
movements such
as feeding.
Inform patients
of all the tasks
they will be
performing on
their bodies
before moving
any part of their
body.
Patient needs
help with the
tasks.
Preserve the
dignity of the
patient by giving
them a chance to
decide what they
want.
Promotion of resilience
Patients constantly need to be encouraged to work through all the challenges they are
facing and remain positive throughout their recovery. Nurses ought to help patients focus on
overcoming any challenges that arise during recovery as opposed to fearing their challenges.
Outcomes of strength based nursing
Strength based nursing is founded on principles which foster hope, healthy behaviour and
quality life. (Williams, 2013). Patient outcomes in terms of the extent of recovery as well as
recovery time are bound to increase when the strength based approach is applied.
Strength based outcome is beneficial to the patient as it enhances self-efficacy. Patients’
willingness and belief in their ability to meet the targets set to ensure their recovery increases

STRENGTH BASED NURSING 8
when the care given to them is centered on their needs. (Byrne, et al., 2012). In order to create a
mindset in the patients that motivates them to succeed nurses must tailor their care to the areas of
strength of their patients.
Preservation of the dignity of the patients while in hospital. The experience of a patient is
often described as demeaning as they are often treated as less than human (Lattimer, et al., 2010).
Strength based nursing emphasizes on patients as a whole being hence focuses on the fact that
they are ill while taking into account their needs and rights as people.
Development of hope among patients is enhanced. With the nurses’ guidance, patients are
able to envision their own recovery within realistic bounds. Nurses should be in a position to
encourage patients to attempt different action plans to achieve the set goals and such
encouragement must be based on hope.
The family members of the patient also feel empowered. Undertaking education of family
members on the health problems faced by the patient encourages them to take a proactive role in
the recovery process. They are quick to offer assistance to the nurses in simple tasks such as
feeding a patient who cannot feed themselves and they can also prove essential in problem
solving.
Strength based nursing is of greatest impact on the nursing staff who became aware of
their vital role in the recovery of patients by actively assisting patients particularly in non-
medical areas of challenge. This enables them to fulfill their job as health practitioners by
enabling them to ensure health and healing in a manner that is best suited for each individual
patient and often more economical. (Browne, et al., 2012)
Conclusion
Patient care is the primary duty of nurses. This requires nurses to ensure the health and
healing not only of the physically incapacitated part of the patient but also of the patient as a
whole. (Hansen, 2016).Nurses must ensure that while performing their duties they take into
account the physical, mental and psychological health of the patients.
Patients and their families ought to be involved in the development of a health care plan
so as to ensure that all their reservations, fears and questions are handled by the nurses.
Strength based nursing prioritizes the needs of the patients and the members of their
families over economic and political factors. This establishes a system where individuals are
valued over bureaucratic systems. (Gottlieb, 2014).

STRENGTH BASED NURSING 9
References
Adams, R., 2010. Improving health outcomes with better patient understanding and education.
Risk management and policy, pp. 61-72.
Browne, G., Birch, S. & Thabane, L., 2012. Better Care: An Analysis of Nursing and Healthcare
System Outcomes, s.l.: Canadian Foundation for Healthcare improvement.
Byrne, S., Barry, D. & Petry, N. M., 2012. Predictors of Weight Loss Success: Exercise vs.
Dietary Self-Efficacy and Treatment Attendance. appetite, pp. 695-698.
Carey, B., 2005. Archives: New York Times. [Online]
Available at: https://www.nytimes.com/2005/08/16/health/in-the-hospital-a-degrading-shift-
from-person-to-patient.html
[Accessed 3 October 2018].
Delaney, L. J., 2018. Patient-centred care as an approach to improving health care in Australia.
The Australian Journal of Nursing Practice, Scholarship and Research, pp. 119-123.
Ewert, B., 2013. Patient Choice Has Become the Standard Practice in Healthcare Provision: It is
Time to Extend its Meaning Comment on “Is Patient Choice the Future of Health Care
Systems?”. International journal of health policy and management, pp. 227-228.
Ford-Gilboe, A. B. M., 2004. Hope, health work and quality of life in families of stroke
survivors.. journal of adv. nurses, pp. 322-332.
Gee, E., 2016. Reinventing Emma. s.l.:Emma Gee.
Gottlieb, L. N. P. R., 2014. Strength based nursing. American Jouranl of Nursing, pp. 24-32.
Hansen, E., 2016. Whole person care, patient-centred care and clinical practice guidelines in
general practice. Health sociology review.
Iglehart, J. K., 2013. Expanding the role of advanced nurse practitioners-risks and rewards. New
England Journal of Medicine.
Klonoff, P. S., 2010. Psychotherapy after brain injury: principles and techniques. s.l.:Guilford
press.
Lattimer, et al., 2010. Problematic hospital experiences among adult patients with sickle cell
disease.. J Health Care Poor Underserved, 21(4), pp. 1114-23.
Lattimer L, Haywood C Jr, Lanzkron S, Ratanawongsa N, Bediako SM, Beach MC., 2010.
Problematic Hospital Experiences among Adult Patients with Sickle Cell Disease. JOurnal for
the healthcare of the poor and undeserved, pp. 114-123.

STRENGTH BASED NURSING 10
Nightingale, F., 1946. Notes on nursing : what it is, and what it is not. Philadelphia: J.B.
Lippincott Company.
Rogers, M., 1970. An introduction to the theoretical basis of nursing [by] Martha E. Rogers.
s.l.:Philadelphia F. A. Davis Co. 1970.
Williams, B., 2013. Strengths-Based Nursing Care: Health and Healing for Person and Family.
Journal of neuroscience nursing, p. 177.