A Plan for Teaching Patients in S.D.A. Hospitals

Miss Maxwell here presents a suggestive plan to help nurses and all who minister to the sick to achieve a more effective ministry in the healing arts, particularly in the matter of bedside care.

R. MAUREEN MAXWELL, Associate Professor of Nursing, CME School of Nursing, Loma Lind

[Psychosomatic medicine emphasizes the interre­lation of body, mind, and soul, and indicates the patient's need of mental and spiritual healing as well as physical treatment. As one has observed 'Both the Bible and the blood say: 'Be a Chris­tian.'" Miss Maxwell here presents a suggestive plan to help nurses and all who minister to the sick to achieve a more effective ministry in the healing arts, particularly in the matter of bedside care.]

With the best-selling magazines carrying informative articles on healthful living, mental hygiene, disease conditions, and new drugs, the public is full of questions, and con­stantly becoming better informed regarding what at one time were thought to be medical matters. The professional nurse is in demand for talks in club meetings, in parent-teacher meetings, in churches, in schools, in homes. Nursing no longer consists of just the physical care of the patient in the hospital. When a pa­tient comes to a medical institution he no longer plans for a long two or three weeks' stay. The new mother takes home a three- or four-day-old baby, and when the patient who has had surgery four or five days earlier goes home he still has dressings to be changed. All need careful and detailed instructions on how to care for them­selves and their loved ones.

It is a well-accepted fact that the professional nurse must be prepared to help the patient mentally and physically in the home as well as in the hospital. But how about the Seventh-day Adventist professional nurse? How much more should she be prepared to teach the patient physically, mentally, and spiritually? Why do we have medical institutions except for the pur­pose of leading others to Christ; of breaking down prejudice; of helping people live fuller, healthier, happier lives?

Of course every employee of a Seventh-day Adventist medical institution has an important part in making this objective come true, but it is the nurse with whom the patient has the most contact. With so few nurses and so many pa­tients, how can the busy nurse possibly spend time in achieving her objective—the very rea­son why she is working in a Seventh-day Ad­ventist hospital! A happy, cordial atmosphere, the example set by serving vegetarian foods, the closing of the business office on Sabbath, all go a long way in helping others appreciate what we stand for. But there are those who have come to our institution because they have heard that it is different, because they want to understand us better, because they have definite questions they want answered. There are others who have been directed to come by the Holy Spirit, and they do not know why they came. Does not this busy nurse have a responsibility toward all these patients beyond that of creating the right atmosphere?

I. Objectives for Average Patient

Sometimes the busier a person is the more he accomplishes, provided there is a definite plan in mind! Is it possible to have a plan for teach­ing the patient? Before thinking about plans and methods the nurse must have in mind what she wants her patient to learn while he is in the hospital. What are the objectives for teaching the average patient who comes to a Seventh-day Adventist medical institution? Included among the objectives are:

A. To help the patient gain knowledge-

  1. of his own health condition and how it can be met.
  2. of the manner in which care of the body reflects in emotional and physical health.
  3. of good health principles, including the value of rest, exercise, deep breathing.
  4. of the harmful effects of stimulants and narcotics.
  5. of a well-balanced vegetarian diet and the ways in which it is superior to a flesh diet.
  6. of natural remedies such as water drink­ing and simple procedures that can relieve pain and disease.
  7. of community health agencies that might be of help to him in his particular need. S. of a loving heavenly Father, and the simple faith of Seventh-day Adventists.

B. To help the patient acquire abilities-

  1. that are necessary for the maintenance of health and that will meet his personal needs; e.g., administration of insulin, cal­culation of diabetic or reducing diet, care after a colostomy, et cetera.
  2. in simple hydrotherapy procedures that may assist in the care of himself or his family.
  3. in proper methods and procedures in per­sonal hygiene.
  4. to follow simple procedures for carrying out doctor's orders.

C. To help the patient develop attitudes-

  1. of cheerfulness toward life.
  2. of cooperation and tolerance.
  3. of being normal in spite of physical handi­caps.

D. To help the patient appreciate-

  1. the value of temperance in all things.
  2. the value of fruits and vegetables, and three regular well-balanced meals a day.
  3. the doctor and other members of the medi­cal health team.
  4. good reading and its value in promoting good mental hygiene.
  5. a philosophy of life that will help him ad­just to the world around, with his physical and mental problems.
  6. Seventh-day Adventists and their beliefs.
  7. prayer and faith in a Power beyond them­selves.

How can the student of nursing become aware of her teaching responsibilities?

At the College of Medical Evangelists, during the first semester of the sophomore year all students of nursing are asked to select, with guid­ance from instructors, a patient in whom they are interested. Objectives of what they would like to have this particular patient learn while he Is in the hospital, are prepared. Then by stimulating questions, or using casual oppor­tunities, the student endeavors to achieve these objectives during the patient's stay in the hospi­tal, without the patient's becoming aware that he is being taught. The student also prepares an evaluation of the success of her teaching in terms of patient reactions, opportunities used or missed, psychological principles used or mis­used. This teaching is not expected to deal with the patient's particular problem, as for example, giving insulin, for the student at this level is not yet prepared to instruct in such matters, but rather to cover the general principles of physi­cal, mental, and spiritual well-being.

Invariably, when this assignment is first dis­cussed with the students, there will be some who will say that they can't teach all these things while practicing in the hydrotherapy depart­ment, or their patient assignments are in the evening and there is no opportunity then, or they are too busy! But it is amazing how many, during the short two-week period, acquire the feel of an incidental teaching plan, adapting the plan skillfully to the needs of individual patients. And as they advance in their course, they use the plan in preparing nursing care studies. Many have expressed the satisfaction gained by putting the plan into practice.

II. The Plan Outlined

To teach means to help others acquire knowl­edge or skill. There are two ways that are usually thought of in connection with teaching: (1) where the student and teacher definitely plan a class period together; and (2) the inci­dental teaching that takes place as the need arises. A third method is suggested, which is a combination of the other two. That is, planned incidental teaching. In other words, the nurse will have a definite plan in mind that will enable her to be particularly alert to recognize teaching opportunities, and that will seem to the patient to have come up casually and in­cidentally.

In making such a plan for the hospital situa­tion a few things must be recognized and kept in mind. When a patient is acutely ill, "No word of creed or controversy should be spoken. Let the sufferer be pointed to the One who is willing to save all that come to Him in faith."—The Ministry of Healing, p. 120. So any plan that might direct a patient's thoughts to parti­cular principles—whether health or spiritual—should be for the convalescent patient. The nurse must recognize the fact that there will be times when she must stand by and give support rather than give information. In any learning situation the student is the most important fac­tor.

Some patients who come to our hospitals are highly educated, refined people, whereas there are others who need to understand such basic health needs as frequent bathing. Thus the content and method of teaching or any plan for instruction must be adjusted to meet the needs of the individual patient. Patients with conditions of diabetes, arthritis, obesity, colitis, et cetera, need special instruction in the area of their greatest need. A plan for in­cidental teaching can only be very general, and the special instruction included where it is most pertinent. This special instruction need not always be incidental, and in many cases would be more effective if the patient realized he was being given information that was pertinent to his condition, and that might prevent recur­rence or complications.

"In all your work remember that you are bound up with Christ, and part of the great plan of redemption. The love of Christ, in a healing, life-giving current, is to flow through your life."—The Ministry of Healing, p. 156.

The plan as outlined in the accompanying chart is for Mrs. Average Patient.

Age: 40

Religion: Protestant

Diagnosis: Rest and Treatment

Husband: Mechanic

Education: High school

(To be continued)

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R. MAUREEN MAXWELL, Associate Professor of Nursing, CME School of Nursing, Loma Lind

July 1957

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