Creating safe and healing environments: Innovative curriculum to support team members during patient and family escalations in a quaternary care pediatric hospital.

Workplace violence in healthcare settings is at a crisis point. Healthcare organization have almost as many serious injuries from violence then all other industries combined (OSHA, 2013; Phillips, 2016). The costs of workplace violence have reached a crescendo provoking a response from several leading healthcare organizations including the Center for Disease Control, Occupational Safety and Health Administration, American Organization of Nurse Executives, American Nurse Association, and the Joint Commission who have all prioritized workplace violence initiatives. To address the issues of workplace violence our hospital embarked on a systematic change to improve the physical and psychological safety of faculty and team members. A multidisciplinary curriculum team developed the Creating Safe and Healing Environment course that introduces concepts to honor the unique demand on team members as they manage the intricacies of caring for others in a hospital setting. The team revisited the complex nature of the relationships and partnerships that are formed in healthcare between the team member, patients and families. The focus of this paper is to discuss the complex issue of workplace violence and review the development of curriculum that focuses the complexities of caring for pediatric patients, introduce the concepts of healing environments and teaches the skills and knowledge needed to co-create safe and healing environments for both care providers and their patients. This paper will also highlight the how a curriculum of this type is informed by the expertise of nursing theories including revisiting Nightengale ideals and incorporating Jean Watson's "Philosophy and Science of Human Caring".

Increasing the capacity to provide compassionate care by expanding knowledge of caring science practices at a pediatric hospital.

BACKGROUND: The emotional aspects of patient care affect care givers' capacity to remain present, safe and caring. As demands increase and capacity decreases care providers are at risk for compassion fatigue (CF). LOCAL PROBLEM: Our organization treats children with complicated diagnoses. Nurses carry a heavy emotional burden due to prolonged exposure to suffering with chronically ill children, ethical dilemmas, and an onus to also care for the parents. METHODS: Our program highlights theory guided practices that honor the complexities of caring for others and creates opportunity for the care giver to slow down and prioritize how they care for themselves. INTERVENTIONS: Caritas Circles, a small group intervention program, was developed to offer a deeper exploration of Jean Watson's Caring Sciences practice and theory using intentional practices to pause, be present and find peace in the midst of caring for sick children. RESULTS: Quantitative and qualitative measures show improvement in care providers' ability to prioritize their own needs as they care for others. Care providers noted the need to have organizational support for resiliency, a connection to purpose as a care provider, and opportunity to let go of the emotional residue found in their role. CONCLUSIONS: Organizations can no longer afford to ignore the emotional labor that care givers experience. This program highlights the need for hospitals to prioritize this type of experiential intervention and offer time during work hours where providers are honored and cared for, so they can continue to care for patients and families.

[Nursing Experience Using Watson's Caring Theory to Mitigate Suicidal Behaviors in a Homosexual Male].

This report describes our experience providing nursing care between 7th October and 7th November 2016 to a homosexual male who repeatedly engaged in stress-related suicide attempts and self-harm. Information was collected using comprehensive nursing assessment, observation, and interviews and the health problems of ineffective coping and disabled family coping were identified. Because of affection-related distress and the lack of recognition of his gender orientation by his family, the client engaged repeatedly in self-harm and attempted suicide on several occasions in order to cope with the self-perceived unbearable stress and stressful situations. The authors provided nursing care based on Watson's theory of human caring. We fulfilled the nature of caring, prompted respect and acceptance, and established a therapeutic, interpersonal relationship. We also adopted the concept of suicide intervention, and used the protective factors as the main coping strategies. These approaches allowed the client to acknowledge the events and reactions that may trigger his suicidal ideas, to develop better self-reflection and impulse control, and to mitigate the ideas and behaviors related to suicide and self-harm. Because constant conflicts between the client and his parents hampered a harmonious family relationship, we adopted family-centered care in order to enhance family resilience, which created room for mutual learning and development and reconstructed a healthy family relationship. Our successful results with this case encouraged our writing this paper in order to share this nursing experience with caregivers facing similar client situations and needs.

A descriptive study on holistic nursing education: Student perspectives on integrating mindfulness, spirituality, and professionalism.

BACKGROUND: Mindfulness has gained prominence in education as a method for enhancing student well-being and learning, yet its integration into nursing curricula remains underexplored. Student lived experiences are essential to understanding the potential benefits and challenges of mindful nursing practice. AIM: To explore the lived experiences of undergraduate nursing students who practice mindfulness as it relates to nursing education. METHODS: This was a qualitative descriptive phenomenological study. Data was collected using semi-structured Zoom interviews. Recruitment used word of mouth and snowball sampling. Out of 80 applicants, 17 undergraduate nursing students were interviewed until data saturation was achieved. Data were analyzed using Edmund Husserl's approach to descriptive phenomenology, supported by Jean Watson's Theory of Human Caring and Abraham Maslow's hierarchy of needs. RESULTS: Seven main themes emerged: Interpersonal and Transpersonal Connections, Spiritual Beliefs and Practices, Faith in the Future, Feelings of Peace, Barriers to Mindfulness in Nursing Education, Integrating Mindfulness Across the Curriculum, and Mindfulness Models in Building Professional Patterns. CONCLUSION: Data indicate nursing educators have a significant role in guiding students to mindfulness practices for the well-being of the nursing profession.

A Spiritual Well-Being Model for the Healing Arts.

This article presents a theoretical model based on a synthesis of psychological (the word psyche means soul) theories regarding components of the human spirit, human spirituality, and the development of spiritual well-being, with a focus on the relationship between stress and human spirituality. These components include an insightful relationship with both oneself and others, a strong personal value system, and a meaningful purpose in one's life. Additional aspects include a model for spiritual growth (seasons of the soul) and various aspects of one's life experience that hinder or promote greater spiritual growth. Based on this model, holistic nurses may integrate these concepts into their world view of holistic healing and include the health of the human spirit as a greater part of the holistic wellness paradigm.

Evaluación de los Comportamientos de Cuidado Humano de las enfermeras: perspectiva de personas adultas hospitalizadas / Evaluation of Caring Behaviours by nurses: A perspective by hospitalized adult persons

Objetivo: evaluar los comportamientos del cuidado humano brindado por profesionales de Enfermería desde la perspectiva de personas adultas atendidas en un hospital de especialidades en México. Método: estudio descriptivo transversal realizado entre septiembre y diciembre de 2020. Se efectuó muestreo por conveniencia en los servicios de cirugía, traumatología y medicina interna. Se midieron variables sociodemográficas, clínicas y la escala Caring Behaviors Assessment en su versión validada al español. Esta incluye 63 comportamientos de cuidado humano brindado por los enfermeros medidos con escala Likert (de 1 nunca a 5 siempre). Se llevó a cabo estadística descriptiva y bivariante. Resultados: participaron 103 personas con una media de edad de 45,3 años. El 50,5% era hombre y el 72,8% tenía escolarización secundaria o menor. Evaluaron que las enfermeras mostraban comportamientos de cuidado humano casi siempre o siempre (X= 4,28; DE 0,46) en la escala global. La subescala de Asistencia a las Necesidades Humanas obtuvo el mayor promedio (X= 4,73; DE= 0,46) mientras que la de Enseñanza/Aprendizaje obtuvo el más bajo (X= 3,54; DE= 1,13). Trato respetuoso, individualizado y manejo de equipos fueron los comportamientos de cuidado mejor evaluados. Las visitas en los traslados, el hablar sobre la vida fuera del hospital, la planificación de metas de salud, el tacto para el consuelo y la consideración de necesidades espirituales, los peor evaluados. Conclusiones: los comportamientos de cuidado mejor evaluados fueron los relacionados con las habilidades instrumentales de los enfermeros y el respeto al paciente. El contacto físico, la conversación con el paciente y la consideración de las necesidades espirituales fueron algunos de los comportamientos pendientes de desarrollar.(AU)

Objective: to evaluate the caring behaviour provided by Nursing professionals, from the perspective of adult persons managed at a Tertiary Care Hospital in Mexico. Method: a descriptive cross-sectional study conducted between September and December 2020. There was convenience sampling at the Surgery, Orthopaedic Surgery and Internal Medicine Departments. Sociodemographic and clinical variables were measured. The Caring Behaviours Assessment scale was used in its version validated in Spanish, which includes 62 caring behaviours provided by nurses and measured with the Likert scale (from 1: never to 5: always). Descriptive and bivariate statistic was applied. Results: the study included 103 persons with 45.3 years as mean age; 50,5% were male and 72.8% had secondary or lower schooling. The evaluation confirmed that nurses showed caring behaviours almost always or always (X= 4.28; SD 0.46) in the overall scale. The Assistance to Human Needs subscale obtained the highest average (X= 4.73; SD= 0.46) while Teaching/Learning obtained the lowest (X= 3.54; SD= 1.13). Respectful and individualized treatment, and equipment operation were the best scored caring behaviours, while the ones with worse scores were visits during transfers, discussing life outside hospital, planning health goals, tact for comforting, and the consideration of spiritual needs. Conclusions: the caring behaviours better scored were those associated with the instrumental skills of nurses and respect to patients. Physical contact, conversation with the patient, and consideration of spiritual needs were some of the behaviours still pending development.(AU)

Enfermería: Teoría de Jean Watson y la inteligencia emocional, una visión humana / Nursing: Jean Watson's theory and emotional intelligence, a human vision

Introducción: a lo largo de su evolución como ciencia, uno de los problemas de la enfermería ha radicado en comprender los fundamentos ontológicos del cuidado y sus componentes teóricos para darle un sentido coherente y consistente como una ciencia humana. Objetivo: describir los elementos cualitativos que se presentan entre la teoría de Jean Watson: Filosofía y Ciencia de la asistencia y la inteligencia emocional. Métodos: partiendo del principio de que los conjuntos conceptuales son racionales y, por tanto, analizables desde el pensamiento lógico, por lo que el objetivo se logró por métodos teóricos, inductivo-deductivos específicamente histórico-lógico, de análisis-síntesis y sistémico-estructural-funcional. La búsqueda se realizó en las bases de datos: Medline ­ Lilacs ­ DARE y Biblioteca Cochrane. Se analizaron 10 factores que componen la teoría de Jean Watson y su vinculación con la inteligencia emocional; o sea, cada uno de estos factores tiene un componente fenomenológico dinámico relacionado con las personas a las que se les brindan los cuidados. Conclusión: cada uno de los elementos que se relacionan, en la Teoría de Jean Watson y la inteligencia emocional al ser contextualizado, implica la presencia de un proceso reflexivo, sistemático, controlado y crítico de su objeto, basado en el método científico que responda siempre a la búsqueda, planteamiento y solución de los problemas surgidos en la vida de los hombres. Cada uno de estos factores tiene un componente fenomenológico dinámico relacionado con las personas a las que se les brindan los cuidados(AU)

Introduction: along their evolution like science, one of the problems of the nurse has resided in understanding the ontological foundations of the care and their theoretical components to give a coherent and consistent sense to the nurse like a human science. Objective: describe the qualitative elements that are presented among Jean's Watson theory: Philosophy and Science of the attendance and the emotional intelligence. Methods: for the making of this article the theoretical method was used, of the principle that the conceptual groups that occupy us are rational and, therefore, analyzable from the logical thought, for what the achievement of the proposed objective was consummated specifically by theoretical, inductive-deductive methods the historical-logical one, of analysis-synthesis and systemic-structural-functional. The search for the making of this article was carried out in the following databases: Medline - Lilacs - Library of the Collaboration Cochrane. The 10 factors are analyzed that compose Jean's Watson theory and their linking with the emotional intelligence. In summary, each one of these factors has a component dynamic phenomenological related with people to those that are offered the cares. Conclusions: each of the items listed in the Theory of Jean Watson and emotional intelligence to be contextualized, implies the presence of a thoughtful, systematic, controlled and critical process of the object, based on the scientific method that always respond to search, analyze and solve the problems in the lives of men. Each of these factors has a phenomenological dynamic component related to the people who are providing care(AU)

Algunos aspectos esenciales del pensamiento de Jean Watson y su teoría de cuidados transpersonales / Some essential aspects of Jean Watson thought and her transpersonal caring theory

En este trabajo se realiza una síntesis del pensamiento de Jean Watson a partir de dos perspectivas fundamentales a saber: su filosofía de cuidados y su teoría de cuidados transpersonales. El análisis se centra, por una parte, en los fundamentos filosóficos del cuidado que derivan del existencialismo y de la teoría de la alteridad levin-asiana y, por otra, en los 10 factores de cuidado que caracterizan su teoría. El artículo además rescata aspectos de la utilización de su teoría de cuidados en diferentes contextos de enfermería. Las autoras del artículo valoran el significado y trascendencia de cada uno de ellos para la disciplina, y la oportunidad que supone aplicarlos en la praxis del trabajo cotidiano y en el desarrollo de una vida buena.

A display of Jean Watson's thoughts, based on the understanding of her philosophy and theory of transpersonal care is undertaken. On one hand, the analysis is centered in her philosophical assumptions which are based on Existentialism and Levinas theories. On the other hand, the analysis is centered on the ten factors of caring defined on her theory. Beside that this article described the benefits of applying her theory in different contextual nursing situations. The authors make reference to the meaning and transcendence of each one of her ten factors for nursing, and the improvement opportunities coming from their implementation on the way that nurses provide care today as well as on their own personal leaves.