Using the six dimensions model of the relationship-based care is highly essential to the quality of patient care. Discuss.
The existence of healing hospitals is not a new ideology. “Historically, hospitals were often founded and funded by religious orders” (Encyclopedia Britannica, 2014). Hospitals of yesteryear were built on the premise of healing and fulfilled several of the requirements of institutions established for healing. As early as 4000 B. C. many religions identified and associated some of their deities with healing powers. However, the modern concept of hospitals dates from 331 C E, when Roman emperor, Constantine the Great, converted to Christianity and abolished all pagan hospitals, thus creating the opportunity for a new foundation of healing arts hospitals grounded on Christianity.
Prior to this event, the sick person was isolated from his/her community. The Christian tradition stressed the close relationship of the sick to the members of the community, who were obligated to provide the care. This lead to the ideology that sickness was a concern and obligation of the Christian Church (Encyclopedia Britannica, 2014).
Spiritual or compassionate care involves serving the whole person in all the dimension we use to describe the essence of our being, the physical, emotional, social, and spiritual self and how we establish relationship with individuals with whom we come in contact. Such service is inherently spiritual acts.
As stated by Woolley et al.(2012), Using the six dimensions model of the relationship-based care is highly essential to the quality of patient care. Discuss.
The implementation of this model assist health care agencies to create caring, healing environments for the patients and staff especially those on the frontline. Woolley et al. (2012), states “the Relationship-Based Care Model (RBCM) is patient and family centered, surrounded by a framework of leadership, teamwork, professional nursing practice, patient care delivery, resource-driven practice, and outcomes measurement” (p.179).
The significant relationships the model speaks to are the relationships with the patient and family, relationship with self and, the relationship with colleagues. Other health care facilities are seeking to design healing environment. Eberst (2008), describes a healing organization as one that promotes the patient feeling of safety, comfort, and also serves as a reminder to the health care team why they chose to be in health care.
This author further explains that the “healing facility” must demonstrate compassion and loving kindness while at the same time being artistically appealing to the senses. The agency must also possess the ability to assist the patients and families manage the stressors of being sick and as such must be easily noticeable. Spiritual or compassionate care involves serving the whole person. Daring to be different comes with a price in today’s culture.
Religiosity and healing are not promoted in present day health care environment in the United States. Health care organizations, like any business is fraught with possibilities for failures and barriers for changing or implementing fundamentally different ideas instead of safely keeping it business as usual as in profit-driven and service-oriented. Implementing a healing or relationship- based environment in today’s hospital setting can be a challenging undertaking.
One of the most noted barrier is cost-related changes. Can the hospital afford to do this or more appropriately how can the administration not afford to make this change? Rolland (2011), states, “if a patient expresses an interest in praying before entering the operation room, the nurse offers a prayer for the patient’s safety, comfort and healing” (p.1). This took place on the Africa Mercy which is a floating hospital where professionals donate their time and talent in the service of people who cannot afford life-saving/changing surgeries.
On terra firma, stateside this could conceivably be frowned upon and viewed as the nurse delaying the procedure, tick tock we are on the clock, and time is money. If however, the hospital was faith-based such as those under the umbrella of Catholic health care, request for prayer is perfectly acceptable and in fact encouraged. Other barriers to creating a healing hospital setting according to Woolley et al. (2012) include leadership or lack thereof, availability of appropriate instruments for clinical decision making, technology, supplies and general administrative or operational systems blockades to implementing changes.
In the study undertaken by the above named researchers they found that nurses spent a mere 10% of their time engaged in patient support activities and another 40% in direct patient care. This simply means patients are not receiving enough supportive or compassionate care that they deserve from the professional that they most often see.
In terms of biblical appropriateness, the passage of scripture that comes to mind is Psalms 103:2-4 “ Praise the LORD, O my soul, and forget not all his benefits– who forgives all your sins and heals all your diseases, who redeems your life from the pit and crowns you with love and compassion”, (p.626).
I chose this psalm because it reflects on healing with compassion and love, the very thing that the health care industry needs to accomplish. Care providers come in contact with the patients and their families most often when they are most vulnerable and in need of not only our skills as practitioners to promote healing but also our compassion. Healing does not necessarily means disease free, it can mean being granted the peace and calmness essential to coping with illnesses whether they are of a permanent or temporary nature.
Patients and their families need to feel redeemed from the darkness or the pit of diseases. Eberst (2008), believes that in order for hospitals to promote healing the atmosphere must be conducive to rest and sleep for the patients. It is a known scientific fact that body tissue repairs best when the person asleep. At the Mercy Gilbert Medical Center a Catholic hospital they have instituted several measures to promote a healing environment. According to Ebert they administration has instituted a noise reduction policy to promote patients sleeping.
The hallways are carpeted, cleaning equipment have been outfitted with special silencers. Overhead paging was only permitted for emergencies, nurses carry wireless phones to maintain contact with the staff, patient and their families.
The advantageous corollary for this policy implementation was that the staff also experienced a calmer and less taxing working environment. Even better was the reduction in medication errors because there was less distraction for the nurses who were administering medications. Woolley et al. (2012) also believes that compassionate care involves coaching the staff, implementing relationship building skills among the inter-disciplinary team and hourly rounding by the nursing/nursing assistant staff.
These activities had the secondary benefits of also improved patient satisfaction with their care and reduced the noise levels from call light being activated by the patients needing immediate assistance. As previously discussed healing environment were religious- based but that situation has changed over the years.
The advances in technology in the past century, has brought a change in the focus of medicine from a caring to a service- oriented model. Health care is seen as a commodity for sale, therefore it must be profitable. The advent of the Patient Protection and Affordable Care Act (ACA), might change this culture in health care field but it will be a slow, painful, and tedious process. However, in recent years physicians have increasingly began to change their practice by incorporating spiritual care that involves our dimensions and complexities attributed to humanness, in efforts to balance their delivery of care.
They have accomplished this by the renewal of the ideology that prior to industrialization, spirituality was bonded to health care and that spiritual or compassionate care involves serving the whole person (Puchalski, 2001).
Compassion and healing were always attributes that nurses strive for in the delivery of care to their patients. If healthcare organization can view this compassionate care as a means to improving patient satisfaction survey scores, they need to first implement and measure these changes to see an improvement in patient care outcomes.
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