I was reminded at church this morning of a central core concept to my personal view of nursing theory and that is inclusion. Inclusion should be the most important concept when we see a patient. I refer to this more as self worth of the individual. This is not a new concept in nursing, it is reflected in Jean Watsons theory of human caring, specifically “understanding the patient/client/family as a person” (Wagner, 2010). But I contend it goes further than that, until we meet that person at his/her level wherever it may be we will get nowhere with the healing process.
I am reminded of an incident not too long ago in my practice where a patient in my mental health unit had to be sent to the emergency room three times and then the last time refuse to be accepted back until proper care was gotten for him. He ended up in the ICU with not one but three different kinds of pneumonia. We, that work in this field know that if our patients go into the ER and mention their psychological diagnosis often times everything else they say means nothing. Everything becomes part of their psychological diagnosis. Or the patient with dementia or Alzheimer’s (and that is not a psychological diagnosis) goes into the ER and all of their claims are dismissed. We had a patient once who was a diabetic with a diagnosis of psychosis come to us from the ER and we did his sugar and found it to be 39. Once we got his sugar up, he was not psychotic any longer. Simple tests can be the difference between life and death. And here is the most simplest of things.
Ask how many people can state their psychological diagnosis without being ridiculed or looked down at. How many diseases other then psychological ones do people say you can do without the medication or basically snap out of it? Can you imagine saying that to a hypertension patient or one with diabetes? Just because you cannot see the effects, does not mean they are not real. Even in the hospital or other settings, psychological problems are ignored in many cases. And, if you combine the psychological illness with a substance abuse one then you can forget about being treated at all. And please do not Psychiatric Nursing mention it at polite human tables.
And last but not least, can we include psychological nursing as a specialty in the nursing field. When I was in orientation for my job at present I was asked “How did you get stuck in psych nursing?” I did not get “stuck” in psych nursing, I chose it. I have been 22 years a nurse, if I wanted to do something else I could have. You cannot ignore the persons psychological problems when you take care of them. That would be like you had a patient with a cardiac problem and a urinary tract infection and you ignored the urinary tract infection because you did not want to deal with it today. Or I do not have the knowledge so I will just simply not treat it. I am tired of having to justify my profession. If something tells you they are a cardiac nurse, do people argue that they need the specialty? Why do I have to argue just for my existence. There are a lot of unexplored areas in psychological nursing including the experience of pain that needs to be explored but we cut funding to these area to concentrate on other areas of nursing. When I tell other nurses or professionals I am a psychological nurse I either get sympathy or that I know nothing. Neither of which I want.
I am reminded of a song called “Come As You Are” by Crowder. Some of its lyrics are:” Come out of sadness from wherever you’ve been, Come broken hearted let rescue begin” (Crowder, 2014). Let us be inclusive both as nurses and in the public to let mental health come out and be acknowledged as a profession and as patients.
Crowder Come As You Are (2014) Retrieved from: http://www.newreleasetuesday.com/lyricsdetail.php?lyrics_id=86389 Wagner, A.L. (2010) Core Concepts of Jean Watson’s Theory of Caring/Caring Science Retrieved from: watsoncaringscience.org