Holistic care – seeing the patient as a physical, spiritual and psychological whole – is an example.
A community nurse clarified it for me with a case study.
Claire was the youngest child in a family of seven. From the age of 10,Claire was sexually abused first by her father, then by her brother.
At 14, she mysteriously went missing from home and returned, just as suddenly, six weeks later. Burdened by the need to provide for her large family, the mother grumbled at Claire’s ‘selfishness’ but would hear nothing of her reasons.
An elder sister, who had herself managed to fight off the attentions of the brother and father, tried to tell the mother what was going on but she was told to ‘mind her mouth’ or she could leave and take her troublesome younger sister with her.
Intra-familial tension grew, and Claire began to feel she was the cause. Her health declined and she always seemed to be ill. When one ailment cleared up, another replaced it.
She also made a habit of leaving home without explanation for weeks at a time.
She made three attempts on her life and spent long periods in a psychiatric unit, confiding to her sister that all her problems would be solved if only her mother would listen to her story, accept that she was telling the truth and forgive her.
Eventually, she died. The official cause of death was pneumonia. ‘But that,’ the community nurse told me, ‘is a simplification. No doubt it was the final cause of her physical demise.
But who knows? If her mother had just listened to her, Claire might still be with us. You need a holistic grasp of a case to understand that.’
Lesley McHarg is a third-year student nurse in Scotland
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