1. How would the nurse practicing from Nightingale’s theory, begin her home visit? What would be the priority for the nurse in this situation?
Home visits provide an opportunity for the nurse to access the situation of the client at their home. Based on this assessment, the nurse can make decisions, and plan her care activities. In this given client, she has two children who are been taken care, along with a cat. Considering the situation of the room in which the children spend are raised, there is poor ventilation, and potential source of contamination like the cat, the litter box, soiled diapers and unmade bed, which suggests that the house is not neat and tidy. The nurse should therefore begin by addressing issues related to hygiene and sanitation. The nurse can educate Isabelle or any other responsible person in the house, on how to control and prevent the outbreak of disease at home.
As a priority, the nurse can determine the health needs of Isabelle and her family. People are willing to cooperate only when they feel a need for it. Keeping the children’s room clean, disinfected and well ventilated is important in promoting health. This is also an opportunity to determine the children’s vaccination status. Understanding the client’s needs will help to make recommendations that will be effective. The priority of this visit is to promote behavioral patterns that will promote health.
2. How might Nightingale’s understanding of sanitation and environment guide the nurse in her home visit?
Florence Nightingale’s definition of nursing, focuses on the triad formed by the individual, environment and health. These three component are interconnected. Change in one can affect the other two components in the triad. Nightingale defined the nurse’s role in optimizing the environment and enabling healing (Shaner-McRae, McRae, & Jas, 2007). Through her statistics work, Nightingale was able to demonstrate the association between disease and sanitation. She stressed the importance of improving sanitation and healthcare, as to promote and preserve people’s health. Nightingales theory of sanitation and hygiene has far reaching efforts in transforming the society. Prior to her era, the workhouses in her country was in a sorry state of affairs. She was asked to provide a plan to improve the situation in workhouses that were crowded by sick paupers, mentally ill, young children, criminals and other healthy paupers. Death rates were high among women and children in these workhouses and infirmaries. She concluded that overcrowding, unsanitary conditions and lack of hygienic practices, were at the core of these outcomes. She used to send nurses to these places, to educate and promote practices that will improve sanitation and hygiene. (Nightingale & Skretkowicz, 2010)
3. How could the nurse develop a relationship with Isabel and return as a welcomed visitor in Isabel's "home"?
The relationship between the nurse and Isabelle is based on care. Having a caring attitude will help the nurse to enter into a workable and friendly relationship with Isabelle, thus enabling a warmer welcome and cooperation of the client and the family in the subsequent visits. Through caring relationship, nurse will consider the genuine healthcare needs of the individual. Knowing these need, nurse can act to facilitate health and healing (Walivaara, 2013).
In a healthy nurse -client relationship, there is trust and confidence. Such a relationship is built only through conscious effort and choice of action. A trusting relationship is a reciprocal relationship and is satisfying (Walivaara, 2013). It influences the client experience with the nurse. There are different levels and boundaries to this relationship, which helps to make the interaction more meaningful and comfortable.
References
Nightingale, F. & Skretkowicz, V. (2010). Florence Nightingale's Notes on nursing (1st ed.). New York: Springer Publishing Co.
Shaner-McRae, H., McRae, G., & Jas, V. (2007). Environmentally Safe Health Care Agencies: Nursing’s Responsibility, Nightingale’s Legacy. Nursingworld.org. Retrieved 15 January 2017, from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No2May07/EnvironmentallySafeHealthCareAgencies.html
Walivaara, B. (2013). Caring Relationships in Home-Based Nursing Care – Registered Nurses' Experiences. The Open Nursing Journal, 7(1), 0-0. http://dx.doi.org/10.2174/1874434620130516003
