NURS 2000: Problem Based Learning Nell Jones

Julie Tipping A00867116

Healthcare Support Services For Anna Hoffman

Health as defined by the World Health Organization (WHO) is “a state of complete physical,
mental and social well-being and not merely the absence of disease or infirmity” (1948). As
with this definition we can see that support services to promote health are just as broad and wide-
reaching. Support services can be any service performed, provided or arranged to help promote,
improve, conserve or restore the mental and/or physical well-being of a person. In Canada, it is a
fundamental right to have access to healthcare and with that we have systems in place, both at
institutional and grassroots levels, to provide a plethora of healthcare services. It is important as
nurses that we begin by knowing how to talk and discuss support services with our patients, and
understand the difficulties some may face in accessing these services.

When treating a patient in the hospital we are expected to be able to connect them with multiple
types of support systems from admission to recovery well after they have left the hospital. It is
important to have an idea of what support systems the patient may already have and those they
may wish to seek out.

Informal supports are generally those family and friends who are already in the social network
for the patient. They can be either children, spouses, neighbours, colleagues, people from their
church or other community groups. They already have some degree of relationship with each
other. Formal supports are typically individuals that come from agencies or organizations to
provide a service or type of care.

In the case scenario of Anna Hoffman, we will be focusing on support services we can introduce
to her as we discuss discharge planning. Priority problems we will focus on this week will be
spiritual distress, chronic pain and disturbed self image. Here are a couple theories to know
when thinking about how we can best support our patient and in creating nursing care plans.

Maslow’s Hierarchy of Need

Maslow’s theory developed in 1948,

postulates that people are motivated to
achieve certain needs and that there is an
order to which these needs must be met
(McLeod, 2016). In this model, the bottom
of the pyramid indicates the most basic
level, our ABCs, water, warmth, and these
needs precedes over any other needs. Not
until we have met those basic needs are we
then motivated to achieve the next level of
needs and so on. The original hierarchy of
needs has five levels, physiological needs,
safety, belonging and love, esteem, and self-actualization (McLeod, 2016). Maslow’s hierarchy
NURS 2000: Problem Based Learning Nell Jones
Julie Tipping A00867116
was expanded in the 1970s to also include cognitive and aesthetic needs and then transcendence
needs (McLeod, 2016). This hierarchy of need is what we as nurses use to determine our priority
problems as we assess our patients

“1. Biological and Physiological needs - air, food, drink, shelter, warmth, sex, sleep, etc.
2. Safety needs - protection from elements, security, order, law, stability, etc.
3. Love and belongingness needs - friendship, intimacy, trust and acceptance, receiving and
giving affection and love. Affiliating, being part of a group (family, friends, work).
4. Esteem needs - self-esteem, achievement, mastery, independence, status, dominance, prestige,
managerial responsibility, etc.
5. Cognitive needs - knowledge and understanding, curiosity, exploration, need for meaning and
predictability.
6. Aesthetic needs - appreciation and search for beauty, balance, form, etc.
7. Self-Actualization needs - realizing personal potential, self-fulfillment, seeking personal
growth and peak experiences.
8. Transcendence needs - helping others to achieve self actualization. “ (McLeod, 2016)

Self-Care Deficit Theory of Nursing

The self-care deficit nursing theory was developed by Dorothea and overarches three of her
theories, the theory of self-care, the theory of self-care deficit and the theory of nursing systems
(Gonzalo, 2011). Very broadly this theory philosophies that all “patients wish to care for
themselves”. The main assumptions of this theory are that all people are distinct individuals that
should be viewed as self-reliant and responsible for their own care (Petiprin, 2016).The level of
care a patient needs is based on a set of self-care requisites, which include basic human needs,
maturational progress, situational prevention, and any needs that relate to the condition of the
patient (Petiprin, 2016). If a patient is unable to meet certain self-care requisites, the nurse should
rate their patient’s dependencies on a scale consisting of total compensation, partial
compensation, and educative/supportive and be able to adjust their care according.

Nell’s take on how to talk to our patients about accessing support

- Talking about and implementing support services should start from the very first interaction
with the patient.
- Be open and receptive to the patients needs and wishes
- Understand that your role is to support the patient in their needs. Although your education and
skills may take precede when one can cannot achieve basic level care, when we look at the
higher needs described by Maslow there is a change in our role.
NURS 2000: Problem Based Learning Nell Jones
Julie Tipping A00867116
References
Gonzalo, A. (2011). Dorothea E. Orem. Retrieved September 25, 2017, from Theoretical
Foundations of Nursing: http://nursingtheories.weebly.com/dorothea-e-orem.html

Government of Canada. (2008, June 6). Chapter 4: The Chief Public Health Officer's report on
the state of public health in Canada 2008 – Access to health care. Retrieved from
Governement of Canada: https://www.canada.ca/en/public-
health/corporate/publications/chief-public-health-officer-reports-state-public-health-
canada/report-on-state-public-health-canada-2008/chapter-4i.html

Gulanick, M., & Myers, J. (2014). Nursing Care Plans. Diagnoses, Interventions, and Outcomes.
Philadelphia: Elsevier.

McLeod, S. (2016). Maslow's Hierarchy of Needs. Retrieved September 25, 2017, from Simply
Psychology: https://www.simplypsychology.org/maslow.html

Petiprin, A. (2016). Nursing Theory. Retrieved from Self Care Deficit Theory:
http://www.nursing-theory.org/theories-and-models/orem-self-care-deficit-theory.php

Williamson, D. L., Williamson, M. J., Stewart, K., Hayward, N., Letourneau, E., Makwarimba,
J., . . . Rootman, W. D. (2006). Low-income Canadians’ experiences with health-related
services: Implications for health care reform. Policy Health, 106-121.

World Health Organization. (1948). Constitution of WHO: principles. Retrieved from World
Health Organization.