NI406 Essay: Assessing Kai's Needs with Fawcett's Metaparadigm

This essay provides a detailed analysis of Kai's case study, a 60-year-old man experiencing anxiety and depression, admitted to the hospital with physical symptoms. The essay begins with an introduction to nursing care plans and the significance of holistic assessment, referencing Fawcett's metaparadigm. It then delves into Kai's specific case, outlining his physiological, psychological, sociological, spiritual, and cultural needs. The assessment incorporates Fawcett's four metaparadigms (person, health, environment, and nursing) to frame Kai's care. The essay also discusses the role of nurses within a multidisciplinary team in meeting patient needs. The work of Jackson is also discussed, comparing and contrasting the theories. The essay concludes by summarizing how the frameworks of Fawcett and Jackson apply to Kai's situation, reflecting on the learning gained through the assignment. The essay highlights the importance of equality and diversity in holistic assessments and emphasizes the need for nurses to consider all dimensions of a patient's life to provide comprehensive care. The essay also provides a reflection about the learning from the assignment.

PLANNING AND WRITING
THE NI406 ESSAY

TABLE OF CONTENTS
Introduction......................................................................................................................................1
Holistic nursing assessment and Fawcett’s metaparadigm..............................................................1
Assessment of Kai with reference to holism and Fawcett...............................................................3
Jackson’s work.................................................................................................................................5
Conclusion.......................................................................................................................................7
Reflection.....................................................................................................................................8
REFERENCES..............................................................................................................................10
Appendix........................................................................................................................................11

Introduction
Nursing care plan can be defied as a kind of direction that helps in fulfilling needs of a
patient and their family members through different kinds of nursing care (Stai and et. al., 2018).
There are various kinds of nursing care and many theories or metaparadigms has been developed
using which a proper and appropriate nursing care plan can be developed (Lavdaniti, 2017). It is
extremely important to identify needs and requirements of patients so that nursing assessment
can be carried out accordingly and care needs of patient can be covered or fulfilled in nursing
care plan of patient. This essay will be focusing upon discussion of holistic assessment of a
patient named Kai with reference to metaparadigms of Fawcett and nursing work nature outlined
by Jackson. This assessment will further analyse where metaparadigms of frameworks to
Fawcett’s and Jackson’s work fit. In order to discuss holistic assessment of Kai first of all
Holistic nursing assessment and Fawcett’s metaparadigm will be discussed and ways in which
these assessments can be applied to kai will be discussed. Then discussion of Jackson’s view of
nursing work will be discussed and ways in which it can be applied to Kai’s assessment. Lastly
all the areas covered in the essay will be summarized in order to conclude ways in which all the
three above mentioned frameworks fit into Kai’s case study. In this essay both Fawcett or
Jackson’s theories work will be compared and analysed in order to identify which f the following
theories will be working better, whether both of them are same or different. Not only this, lastly
in this, reflection of what has been learnt by one by doing this essay will also be discussed or
reflected.
Case study of Kai: Kai is a 60 years old man who lives with anxiety and depression. Kai
lives all alone as both the children of Kai are married and settled in other city and his wife died
an year ago. Due to this is unable to take care of is care needs and requirements. Kai already has
a mental condition but recently he is feeling unwell because of which he has been admitted to
nursing care area of XYZ hospital. According to the reports it has been identified that Kai has
been feeling unwell from past seven days. When he was admitted he had high fever with high
temperature. He reported that from past seven days he had high temperature, was feeling tired
and lethargic, was not able to maintain proper diet or it can also be said that he had a poor
appetite from past seven days. Due to this he was unable to take care of himself and required
medical addition where his care needs will be fulfilled.
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Holistic nursing assessment and Fawcett’s metaparadigm
Holistic nursing assessment
Holistic care can be defied as provision of care to patients that are completely dependent
upon mutual understanding of patients about their physical, psychological, emotional, and
spiritual needs or dimensions (Cohen and Boni, 2018). It is a kind of approach which is provided
to support physical and mental needs of a person. For provision of holistic care to patients it is
extremely important to conduct Holistic nursing assessments helps in understanding unique
challenges, goals, strengths of patients in a proper manner (Renton, 2020). This assessment helps
in providing various kinds of benefits such as: it helps in establishing proper communication
between nurse and patients, it further helps in making patients feeling valued by respecting their
beliefs and values, and it further helps in helping patients in achievement of improved outcome
so that patients can gain more control over their healthcare outcomes.
Holistic nursing assessment helps nurses in gaining more information about diagnosis of
patients, planning care plan and implementing care plan in a proper manner. It further helps in
showing respect to patient’s preferences as well as to their dignity. Holistic assessment of a
person helps inn assessing needs of patient in six main dimensions that are:
 Physiological: In this complete physical assessment of overall health of patient is done
(Thornton, 2016).
 Psychological: In this, potential stressors that can worsen health issue or illness is assessed
and identified.
 Sociological: In this discussion of family network is done of who can help patient at home is
assessed.
 Developmental: In this analysis of psychosocial and cognitive development is done in order
to identify ways in which it can affect response of patient to health issue.
 Spiritual: In this, religious and spiritual practices of patient is asked so that it can be
identified whether nursing care is required to be altered or not.
 Cultural: In this, diet, cultural values related request is considered of patients.
Importance of equality and diversity when conducting a holistic assessment of a person’s need
In holistic approach equality and diversity is extremely important especially when needs
and requirement of a person is being assessed (Chapireau, Bashir and Fan, 2020). Maintaining
importance of equality and diversity helps in eliminating changes of racism, offending someone
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or treating someone unequally. Treating every patient equality from diverse culture helps in
offering proper learning to nurses, address racism or differences by providing proper and helps in
provision of appropriate payer by layer training to employees.
Fawcett’s metaparadigm
Metaparadigm is a concept that focuses upon central issue in discipline. According to
Fawcett there are four main concepts of nursing that are required to be comprehensively defined.
These four main concepts are: person, health, environment and nursing. These four
metaparadigms of Fawcett are known as metaparadigm of nursing (Southard, 2020). These
concepts helps in guiding nurses to perform critical thinking and in nursing process in everyday
experience in clinical settings.
 Person metaparadigm says that person is the recipient of nursing care and can include
individuals, patients, families, communities etc.
 Health metaparadigm focuses upon degree of wellness of well- being which is experience by
person. It may be different for patient to patient.
 Environment metaparadigm focuses upon internal and external surrounding that affects the
patient. It includes both positive and negative conditions of physical environment of patient
like family, friends or healthcare settings.
 Nursing metaparadigm focuses upon actions and characteristics of nurses who provide care
to client. Its major goal is to bring improvement in patient care (Bender, 2018).
This Fawcett’s metaparadigms are evident in nursing framework of holistic assessment
and fits with assessment of Kai. This Fawcett’s metaparadigms clearly help in understanding that
each person experience different feeling and these four concepts of nursing differs from person
to person. These Fawcett’s metaparadigms can be used to understand nursing care needs of
patients and can be easily used for holistic nursing assessment. It is an important and useful tool
in assessment process because using this tool positive changes within overall attitude of nurses
can be brought. Using these Fawcett’s metaparadigms holistic engagement of two parties can be
done that can help in building trust and confidence within people (Kalogirou, Olson and
Davidson, 2020). So, it can also be said that Fawcett’s metaparadigms can be used for assessing
needs of Kai and building trust worthy relationship of Kai with nurses so that desired outcome
can be achieved. Using this tool nursing care for Kai can be developed in an appropriate manner
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such that enhanced outcome can be achieved on the basis of six main dimensions that impact
overall health of Kai.
Role of the nurse as a member of the multi-disciplinary team in assessing a person’s needs
Nurses plays a vital and important role in multi-disciplinary team especially in terms of
addressing needs and requirement of patients (Punshon and et. al., 2017). Nurses of
multidisciplinary team take change of patients, support them during whole course of
investigation, focuses upon providing them with proper and adequate treatment and care so that
they feel comfortable during their diagnosis and treatment. Not only these nurses are also
important because they help in maintain discipline and coordinating with others during whole
procedure.
Assessment of Kai with reference to holism and Fawcett
Holistic assessment of Kai
Holistic assessment is beyond nursing documentation of vital signs of patient. It pinpoints
needs of patient, recommend type of care which is best for them (Subrata and Phuphaibul, 2019).
It includes patient’s self- assessment, patient’s history, patient’s ability to communicate, patient’s
preference to the delivery of care, cultural and regional beliefs of patient, language and need for
an interpreter. Assessment of Kai’s needs through holistic nursing assessment has been explained
below:
 Physiological: Nurse is required to assess physiological needs of patients in order to assess
whether patient is in good physical condition or not. Physiological condition of Kai is not
good as he is feeling very unwell, with a high temperature and has felt tired and lethargic
with a poor appetite from past seven days. Due to high temperature poor appetite, he was
feeling extremely unwell, his energy level was also low and require nursing care.
 Psychological: Kai is having mental condition and is suffering from anxiety and depression.
Due to his poor physical condition his anxiety level is increasing and is getting depressed he
requires psychologist who will explain it to her how he will be supported with proper nursing
care and how his overall health will be improved.
 Sociological: As kai’s wife is already dead and he is living all alone he wishes for both of his
children and other family members to be close to him throughout his treatment or till the time
he does not get cured. He also wishes to connect with patients who are also suffering from
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anxiety and depression so that he can get to known ways in which they tackle with their
anxiety and depression and do not let both of these factors affect his overall health.
 Spiritual: Kai is catholic and wishes to receive visit from hospice chaplain. This requirement
of Kai can be included by nursing care staff members as a part of holistic care so that he can
cope up with his condition.
Fawcett metaparadigms assessment of Kai
It is a kind of theory that helps in explaining ways in which nursing discipline should
function. Four basic concepts of Fawcett’s metaparadigms can help in addressing Kai, his health
and wellbeing, Kai’s environment and nursing responsibilities. These nursing Fawcett’s
metaparadigms points to holistic view of care where patient and his wellbeing is connected to all
the four main components (Nikfarid and et.al., 2018). Four main components of Fawcett’s
metaparadigms for assessment of Kai are:
 Person metaparadigm: Kai is the main recipient of care for whom nursing care plan is
required to be developed so that his overall health can be improved. in order to bring
improvement within desired health outcome of Kai both of his children should be contacted
and asked to be with him till his recovery. Psychological, Physiological, social and spiritual
needs of kai identified within holistic assessment will be fulfilled by nurses so that his overall
health can be managed and positive personal connection between nurse and Kai can be
developed.
 Health metaparadigm: Self care needs of kai will be provided by nurses so that his appetite
can be maintained and proper nutrition’s can be provided to him, he will be provided with
primary health care so that his high temperature and low wellness level can be reduced as
well as his stress and anxiety can also be reduced.
 Environment metaparadigm: as Kai lives all alone so it is impacting his overall mental
health is not only increasing his anxiety and depression but it is further increasing his stress
level. His family members including his children will be asked to participate in this nursing
care plan so that this anxiety, depression and stress problems can be treated and health
outcomes can be enhanced.
 Nursing metaparadigm: Safe and caring care environment will be provided to Kaiso that
optimal and desired health outcome can be delivered. Nurses will be provided with training
so that care process can be carried out in a proper manner.
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Jackson’s work
There are various models in the nursing work which helps in assessing the case of the
patients. This research does not happen in vacuum instead it is impacted and influenced by the
understanding and attitudes of the time. Jackson identified different areas of nursing in order to
gain deep insight about it and 4 types of labour which includes emotional labour, physical
labour, organisational labour and cognitive labour. Jackson stated that these areas need to be
analysed in any case of nursing as it helps in gaining in-depth insight about the case and helps in
assessing it. According to Jackson, the nursing labour is divided into various areas and nursing
can be better understood by combining all these areas. Nurses strive hard to play the role in every
area and also add the value to the settings of healthcare. IT also helps in connecting the nurses in
different areas and practice domains (Jackson, 2018). This is why it is a framework for the
purpose of understanding. The four areas of the theory of Jackson can be incorporated with the
case of Kai as follows:
Figure 1: Nursing Labour by Jennifer Jackson
Source: Jackson, 2015
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Physical labour: This is considered as the oldest type of labour which makes it easy to track the
case which is why it is divided into two parts i.e., technical and basic labour. Basic labour
describes the basic needs of all the people like feeding, bathing etc. and the technical labour is
depended upon the issue of the particular illness of the patient such as managing the chest tube
etc. This helps in sorting the activities which needs to be done for the well being of the patient.
According to the case of Kai who is a 64 year old woman who feels unwell along with the
temperature being high and felt tired with poor appetite and also was living with depression and
anxiety. The physical labour to be done by the nurses here can be involving the patient in
meditation, breathing exercises along with the regular exercises. For fever it can be providing
extra fluids, raising the room temperature etc.
Emotional Labour: This includes the caring and compassion role of the nurses. This deals in
controlling the emotions of the nurses and creating such an environment which is desirable for
the patients. The nurses have to maintain a calm demeanour do that the patient does not become
scared and remain mentally and emotionally stable. In the case of Kai, this can be provided by
the nurse by arrange the talking session for the patient with the family members and friends, do
not make the patient realize about the loneliness, talking to the patient regarding the good times,
making the patient feel comfortable and many more.
Cognitive labour: This deals in analysing the things which are right for the patient as these are
influenced by the emotional and social factors (Ryan and et.al., 2020). The nurses have various
thoughts about different patients and this becomes challenging to keep all the things cognitively
stacked. In the context of the case of Mrs. Kai, providing self health materials by the therapist,
scheduling the relaxation technique for the patient, providing oral hygiene to the patient,
changing of clothes, changing of position in the healthcare setting and many others must be
clearly stacked for improving the condition of the patient.
Organisational labour: This is considered as the invisible labour which describes the hard work
done by the nurses for improving the critical condition of the patient. This can include booking
the appointment, ordering the blankets for the ward, charting or documentation etc. The
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organisational labour in the vase of Mrs. Kai could be keeping the appropriate documents for
ensuring the schedule of the medicines, therapies, exercises etc. (Jackson and et.al., 2018).
Ordering the extra blankets in order to keep the temperature of the patient’s body normal at the
time of fever, ensuring no sound and peaceful room as it can increase the level of anxiety can be
included in the organisational labour.
This is how, the theory of Jackson proves to be the best theory for assessing the condition of the
patient. It helps to evaluate the condition from all the aspects, whether physically emotionally or
any other aspect. This helps the nurses also to provide the treatment in a systematic manner and
also increases the efficiency of the treatment and improves the quality of life of the patient.
Conclusion
From the above study it has been summarized that nursing holistic approach plays a vital
role in improving health of patients with anxiety and depression. This care of approach helps
nurses in improving overall quality of care given to patients. Main focus that has been discussed
in this study as per the holistic approach of nursing is: respect, dignity and empathy in nurse.
Patients are being respected by holistic nurses that improves relation of nurses and patient. It has
also discussed importance of improved relation with patient and continuous communication in
improving health patient with anxiety and depression. Holistic nurses engage patients in their
treatment options as well as in healthcare choices. Further, this study has discussed main
components or metaparadigm concepts of Jackson and Fawcett theory in nursing. It has shown 4
aspects of each theory in which Jackson’s theory consists of emotional, physical, cognitive and
organizational labour. All these main aspects, labours and metaparadigm make nurses efficient or
successful. In addition, this study has discussed other main 4 metaparadigm of Fawcett in
nursing such as: environmental, person, health and nursing component. Conclusion of aspects of
both theories are similar to some extent.
Meaning of all aspects or metaparadigm concepts are same. All these components refer
qualities that nurses should posses such as: emotional factor and attachment towards patients.
Nursing component according to which nurses’ main priority should be getting effective
outcomes or improving health of patients in an effective and timely manner. All these types of
labour like cognitive, emotional, organizational and physical in nurses helped in knowing that
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how nurses add value to healthcare setting. It has also discussed impacts that race, religious, age
and gender have on quality of care of patient. Jackson’s theory fit in the case of Kai, suffering
from anxiety and depression. The main factor of delaying in improving health is age of the
patient that has been discussed in the above study.
Reflection
I learned several things while conducting this study on Kai. I found that race, religion,
ethnicity, gender does play a vital role in nursing assessment. It affects ways people respond or
behave to interventions given by nurses and health care professionals. I also learned important
metaparadigm concept in this study related to Fawcett theory. All main components that can help
nurses in improving health by implementing them according to situation are: person
component, environmental component, nursing and health. I learned more about patient
component in which metaparadigm of Fawcett theory is being focused on receiver of care (Disler
and et.al., 2019). It helps patients in improving their health. Health component also fit to Kai’s
situation so, I also learned about this in which wellness access is being given to patient to the
great extent. Along with this I found importance of holistic approach and Jackson’s theory of
nursing. As per the Jackson’s theory of nursing I learned different types of labour that are
included in nurses. All these main aspects make nurses perfect and help out in completing their
roles. All main aspects that I learned in this study are: cognitive, emotional, organization and
physical labour.
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