Care vs Health Care (existential discussion)

[TraumaTwo]

I just thought I'd start a discussion if there are like-minded out there. Sorry if it's not "professional enough" for this forum. I won't be offended if it gets deleted.

I struggle with this weekly nowadays... providing "Care" vs what today's economy considers "healthcare".

As a caregiver, I always wanted to and strive to provide care for the individual, not their "health". My client is a person, not an organism. My clients have problems maintaining good health, but these days a large part of that is spiritual. Not "religious" but spiritual. They are down, depressed, anxious, concerned, worried, stressed, and quite frankly, it is killing them from the inside out.

I know... pot calling the kettle black. But I am not complaining nor concerned about my own adoption of a burden (stress etc of a care giver's vocation). I am concerned when patients complain of not-being-well, and it is clear that the problem is not as biological as Modern Health Care wants us to believe.

Do you deliver "care" or "healthcare"? Do you help maintain a healthy biological stasis, or do you concern yourself with more of a humanity aspect of "caring"?

I'm not looking to get all metaphysical... I work in Modern Healthcare. And as a modern healthcare worker, wanting to actually care for people, it is seemingly more and more difficult every day. Almost to the point of career re-evaluation.

Anyone else?

[RNperdiem, RN]

I can help a patient maintain a healthy biological stasis, but when they are discharged home, their choices are their own. Some things people have to do for themselves. Mental health providers and counseling can help people achieve things like peace, joy, a sense of worth etc, but these things are worked for, not passively given. Nurses, like everyone else have limits to what we can do.

[JBudd, MSN]

I work in an ER, so mostly what we treat is immediate and acute. The chronic ones, we try to refer to social services or get hooked up with a good PCP or clinic.

The truth is, some have used us for loneliness, some for refusal to acknowledge a chronic condition and wanting us to "just fix it" over and over. One in particular was simply an attention seeker, it took years to get him out of our system and into a program. An ER is just not a good place for psych care, especially on the night shift.

There are times when I've just stopped running and talked someone through things, especially scared kids going to the OR, or getting stitched up. One 8 or 9 year old girl was freaking out about a hand lac, the doc put up a drape so she couldn't see what he was doing. I talked to her while we were waiting for the numbing to kick in and just kept it up until the sutures were all in. She knew the doc was there and to hold still, but suddenly asked when we were going to start? Told her she was done, and she couldn't believe it until the doc smiled and pulled down the drape. She was in total disbelief, just kept staring at the stitches, but was very happy about we hadn't lied about not hurting.

Stopping the tasks and talking to the person is sometimes a luxury, but I try to talk while doing the tasks as well.

[SHGR, MSN, RN, CNS]

OP, you sound like the kind of person who enjoys the Nursing Theory courses. The holistic theorists are my favorites...Jean Watson, Martha Rogers, Porifice...

I do try to maintain a holistic viewpoint. I work with adults with multiple chronic conditions and barriers to self-care. So using a holistic mindset is necessary for me to maintain a buoyant attitude.

[OnlinePersona, LPN]

OP, you sound like the kind of person who enjoys the Nursing Theory courses. The holistic theorists are my favorites...Jean Watson, Martha Rogers, Porifice...

I do try to maintain a holistic viewpoint. I work with adults with multiple chronic conditions and barriers to self-care. So using a holistic mindset is necessary for me to maintain a buoyant attitude.

i agree with the holistic viewpoint.... and by the feel of this, i think the OP has such a warming heart :)

in regards to the discussion at hand. I honestly don't know what to say to it considering if i say what i really feel; people get all mad and start bashing each other on this forum.

eh. just by you caring, i feel you are at least maintaining emotional integrity.

[TheCommuter, BSN, RN]

With nurse/patient ratios of 7 to 10 patients at my workplace, I end up providing coldly efficient 'healthcare.' Humanistic 'care' and compassion simply are not efficient with the time constraints I have.

[xoemmylouox, ASN, RN]

I provide what extra care I can. I try to make time to really listen and hear my patients. Sometimes it can be such a relief for them to vent to you about whatever is bothering them. From the fear of the future, the distress of their current illness, or family dysfunction. I also try to offer guidance and use these as teachable moments if appropriate. I don't have the time to provide the care I want to, but I try to make time for the important things (which is not always possible).

[firstinfamily, RN]

I guess it depends on what my patient load is like. If I have the time to give a little more TLC I do so. Sometimes the patients just want someone to talk to and I try to provide this as well. It is difficult to be therapeutic when you are spending your time getting stuff done and tethered to a computer. I try to see what each patient needs just to make them feel better. It is part of being a nurse to provide holistic care, but it is not always possible.

[Despareux]

I wish I had more time to BE with my patient, to sit with them and really hear what they're telling me, but sadly, acute care just doesn't seem to allow that. By the way, Margaret Newman was my favorite nursing theorist. I really want to know how to interject her theories into my own practice. I'm hoping going into hospice care (eventually), I will be able to do that with the patient and their family.