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The primary role of medical staff is to provide necessary medical help and ensure that the patient receives necessary patient care. However, in the circumstances, when doctors need to save lives, perform serious surgeries and find diseases in numerous patients on a daily basis, it can be often very hard to recognize each patient’s psychological and physiological needs beyond the scope of their base needs. At the same time, it can be quite easy to “lose sight of the total person”, in the words of Price, Frey and Junge (2004), since the focus is often on a particular disease and body organ (p. 44). Still, patients remain, first and foremost, ordinary humans with a broad spectrum of needs, interests and concerns, and a truly professional healthcare specialist needs to be able to recognize and address them effectively and in a timely manner in order to fulfil his moral, ethical and professional duties. While the aforesaid idea is applicable to all patients, the surgical patients are among the most susceptible to stress, since every surgical intervention they have to undergo because of the absence of acceptable alternatives puts their lives at risk (Price, Frey, & Junge, 2004, p. 44). For this reason, in order to understand and meet even the most complex of their needs and, thus, to relieve their stress, healthcare professionals often use Maslow’s hierarchy of needs as a guide to surgical patient’s needs in the patient-centered care.
The widely-applied hierarchy developed by Abraham Maslow is a complex structure of human needs that reflects the dependence of higher-order needs on the satisfaction of the more basic ones. According to Maslow, the fulfilment of physiological needs forms the basis of human existence, and, for this reason, they are the most important needs. They include the necessity to maintain body processes that ensure human existence, including breathing, nutrition, thermoregulation, mobility, rest and elimination (Fuller, 2010, p. 15). Since these needs are so vital, a surgical technologist or a nurse needs to make sure that the patient has access to free breathing, and his respiratory tract is safe from accidental injuries or penetration by anything but air (Fuller, 2010, p. 14). Other physiological needs to be monitored by the technologist are the need in nutrition and rest, which are needed for the repair of cells and tissues; for this reason, a healthcare professional needs to check the patient’s fluid balance and how much fluid was infused during a surgery, as well as to ensure that the patient has enough rest in order for his body to recover from stress (Fuller, 2010, p. 14). Since the body needs to maintain a certain temperature to stay alive and healthy, technologists need to check it constantly and take measures to maintain the needed temperature during patient care and surgical procedures. Finally, since the patient’s mobility is restricted during hospital stay and surgeries, technologists or nurses need to take steps to protect the body from injuries, when the patient cannot do this because of immobility. As the patient cannot control elimination of body fluids during surgeries and when his mobility is restricted in general, professionals need to ensure timely elimination to prevent health risks.
The focus of the next set of needs is the patient’s safety and security. According to Poston (2009), these needs may often be of psychological nature (p. 350). However, in surgical setting, the primary concern of many patients is their physical security, so it is a technologist’s work to control all processes and devices that may endanger the patient’s well-being beyond normal expectations, and to ensure necessary protection from infections. Psychological needs, on the other hand, may include the necessity to know that anesthesia will work, that the patient will survive the surgery, that he will be able to continue normal living after the surgery and after the treatment of his disease, including being able to maintain financial security and stability. Many patients fear the loss of job and family because of the illness, and healthcare professionals need to recognize such fears and relieve them.
The next level of needs consists of needs to love, feel loved and have good relationships with others, also known as the needs of social belonging. In hospital setting, satisfaction of these needs can be achieved both by care and attentions from medical staff, as well as by granting relatives and friends with access to the patient, who may otherwise feel isolated because of his condition. Before and after surgeries, patients need to feel care, respect and recognition of them as human beings, not simply as patients, by medical staff. Also, since the surgical patients often fear that surgeries and diseases may leave them disfigured, many fear social isolation and losing the feeling of belonging to their social groups. Unfortunately, patients may not voice their concerns and fears, while such anxiety fuels stress and may impede the recovery process. Professionals have to remember about such fears and talk them out with the patient.
Esteem needs follow the previous level and respond for the patient’s self-esteem. Patients may grow to lose self-esteem and loathe their own bodies because of the onset of a disease. As Fuller (2010) perfectly points out, self-image is often dependent on the body image, and if the body becomes ill and imperfect, and the patient starts to feel helpless and dependent, his self-esteem may plummet, and if medical staff mistakenly fails to recognize such feelings, the patient may develop the feeling of worthlessness, anxiety and the fear of rejection (p. 16).
Finally, the last set of needs is self-actualization, which is a person’s need to fulfil own life purpose and achieve own goals, whatever they may be. Because many patients’ ability to reach own full potential can be impeded by the disease and surgery, patients may feel frustration and grief (Fuller, 2010, p. 15). The surgical patients may, in addition, connect such inability with the image of their bodies changed by the surgery, and they may grow to believe that their surgery is a sign of disability. It is the task of medical staff responsible for patient care to communicate with the client regarding these concerns and together find out if the patient’s goals are truly in danger because of the surgery and disease.
The hierarchy of needs is a good practical tool for assessment and understanding of patients’ needs. It can be used as a guide and help address the needs one by one from the bottom to the very pinnacle of the pyramid. The application of the hierarchy to the surgical patients as a group especially susceptible to additional stresses and dangers is especially important, since this group of patients often suffers from medical staff’s disregard of their psychological, emotional and spiritual needs, which not only creates additional stress, but can also contribute to the patients’ slower recovery.
References
Fuller, J. K. (2010). Surgical technology: Principles and practice (5th ed.). Maryland Heights, MO: Saunders Elsevier.
Poston, B. (2009). An exercise in personal exploration: Maslow’s hierarchy of needs. Retrieved March 12, 2016, from http://www.ast.org/pdf/308.pdf
Price, P., Frey, K. B., & Junge, T. L. (2004). Surgical technology for the surgical technologist: A positive care approach (2nd ed.). Clifton Park, NY: Thomson-Delmar Learning.
