There is a lot of talk about holistic care in nursing circles but I can’t help but wonder just how many staff truly put the principles of such care into practice.
In my time as an occupational therapist and now as a manager, I reflect on my experience and think about how it has given me a rounded view of the system our patients travel through, and also helped me to empower patients to make decisions for themselves.
I wonder how many nurses working in an inpatient facility have ever worked with people in their own homes, seeing how they manage with everyday tasks that are often taken away from them when they go into hospital. You need to ask yourself how many patients could get to the bathroom and were doing so before admission. Are you limiting them and taking away their independence by washing them at their bedside and presenting them with meals from a trolley?
When doing a nursing assessment, you need to think beyond the hospital in terms of treatment-planning and intervention. Even though it is not always going to be you doing the intervention, comprehensive assessments should highlight both short and longer-term goals that go beyond the hospital door.
We have tried to address this at the hospital I work in. On two units, there is an area in each bay where patients can move away from their beds to sit at a table to eat their meals. On the other unit there is one large room where the patients eat lunch together, which helps with social interaction. Neither are ideal but we have made a start. The next step would be, where patients are able to do this, walking to the trolley to choose their food and walking back to the table with it.
If you haven’t had the opportunity to shadow community colleagues or go on home visits with therapy staff, I would encourage you to do so. It will give you vital knowledge about patient rehabilitation and help you to understand how people really manage in their own homes.
I am aware that the culture of where we work often inhibits this type of approach but shouldn’t we be thinking about how what we do affects our patients’ ability to live at home for as long as possible? This should be everyone’s ultimate aim.
Rehabilitation is a 24-hour, holistic approach and we should be constantly promoting and encouraging independence wherever possible, empowering our patients in the process.
Joanne Lowe is the operational manager for occupational therapists at Ellesmere Port Community Hospital, Cheshire