NURS 6341: Specialty in Clinical Nursing | Week 6

A common characteristic found in all great teachers is a love of their subject, an obvious satisfaction found in arousing this love in their students, and an ability to convince them that what they are being taught is deadly serious.

—J. Epstein

Think about what you see and what you note as you engage in clinical activities in your practicum setting. From your observations, how do the nurses who are regarded as “experts” provide quality care? In what ways do they bring both a telescopic and a wide-angle view of their patients and their specialty to their nursing practice?

This week you continue to advance your awareness in your specialty of interest by exploring how the physical, emotional, and social dimensions, also known as the “biopsychosocial science,” of illness and recovery are woven together in the application of highly skilled care. As a nurse with advanced knowledge, you reflect on how you negotiate these multiple dimensions and nuanced requirements, and as a nurse educator, how you will present or develop them in others.

Learning Objectives – Biopsychosocial Model Assignment

Students will:

• Analyze biopsychosocial strategies that improve patient care
• Analyze current research literature for applicability to specialty areas of interest
• Evaluate a practicum experience in the context of quality*
• Analyze opportunities for integrating quality measures into the nursing classroom*
• Construct a detailed practicum log**

* You continue working on the Assignment related to this Learning Objective, first introduced in Week 4 and submitted in Week 7.

** You continue working on the assignment related to this Learning Objective, first introduced in Week 1 and submitted in Week 7.

Learning Resources

Required Readings

Benner, P., Tanner, C., & Chesla, C. (2009). Expertise in nursing practice: Caring, clinical judgment, and ethics (2nd ed.). New York, NY: Springer.

• • Chapter 4, “Proficiency: A Transition to Expertise” (pp. 103–135)

The authors continue to present the stages of nursing practice development by outlining the characteristics of proficiency and how the leap from competent to proficient nursing is transformative in six major ways. As with the previous stages, consider this process from your own experience and observation of nurses in your practicum setting.

• • Chapter 5, “Expert Practice” (pp. 137–169)

This chapter completes the presentation of the stages of nursing practice. As you read, bring to mind expert nurses in your specialty area of interest and characteristics of their skilled performance.

• Chapter 1 is one of three chapters in Expertise in Nursing Practice written by contributors other than the authors. Hubert and Stuart Dreyfus are brothers who have developed a model of skill acquisition. In this chapter they explain their model and its five stages—novice, advanced beginner, competence, proficient, and expert— and its application and implications for development of nursing practice. Note the conclusion that experiential learning is essential for progressing from novice to expert in any field and consider how this practicum may advance your nursing practice.

Sadigh, M. R., Phd. (2013, April 01). Development of the Biopsychosocial Model of Medicine. Retrieved April 05, 2017, from http://journalofethics.ama-assn.org/2013/04/mhst2-1304.html

This brief presentation explains the concept of the biopsychosocial model—how physical, psychological, and social factors interplay in both the development and treatment of disease.

Discussion: Applying Biopsychosocial Science to Improve Patient Quality of Care

“We had a patient that was in the OR, and I’d gotten word that he had been … in the CCU beforehand, had a really poor heart….I was coming into work that evening and had received word that his family was sitting … in our waiting room. So I thought I’d go out and meet them.… They were like stressed to the max … [and] proceeded to tell me this whole story about what this poor man had gone through….[I]t was like they were just looking for this release valve and I gave it to them, and they seemed to appreciate that, and I think at that point we kind of clicked.”

—(Benner, Tanner, and Chesla, 2009, p. 142)

In this excerpt taken from your course text, the nurse describes her interactions with the patient’s family as a significant aspect of providing quality patient care. From her first interaction with both the family and the patient, she has an intuitive grasp of what is needed to calm the worries of the family as a system.

Consider examples such as these from your course text, practicum setting, and previous clinical experiences. Also reflect on your own experiences or observations of nurses engaged in patient care in which the larger impact on the family, or the community (the clinical staff or a broader group) was not as strongly considered or not acknowledged at all.

In this Discussion, you exchange views with your colleagues on the concept of quality patient care that is based on biopsychosocial knowledge.

To Prepare

• Review the article, “Biopsychosocial Model” and examples from the text reading that demonstrate its application. Reflect on your previous clinical experiences or those during your current practicum, and identify situations in which you used biopsychosocial knowledge when working with a patient.
• Reflect on your practicum experience through the lens of the biopsychosocial knowledge. How have you applied your advanced skill and knowledge when working with patients, families, or communities (clinical or others)? What specific biopsychosocial strategies have you used or could use to ensure or improve quality care in your practice?
• Conduct further research to locate evidence-based biopsychosocial strategies that improve quality care for patients, families, and communities.

By Day 3 Biopsychosocial Model Assignment

Post an explanation of three biopsychosocial strategies* you use or may use to improve quality care for a patient, a family, and community. Explain how each strategy aids the individual/group by describing specific examples from your practicum and current literature.

* To meet the requirements of this Discussion, you must identify at least three strategies: one for the patient, one for the family, and one for the community.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using one of the following approaches:

• Ask a probing question, substantiated with additional background information, evidence, or research.
• Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
• Validate an idea with your own experience and additional research. Biopsychosocial Model Assignment.

ADDITIONAL INFORMATION;

Biopsychosocial Model

Introduction

The biopsychosocial model is a concept of medicine developed by psychiatrist George L. Engel at the University of Rochester in 1977. According to this approach, any health-related event, be it illness or injury, involves biological, psychological and social factors. This model was developed because there are many factors that can impact someone’s health status. It also claims that medical doctors are not only responsible for health issues’ biological causes but also their psychological and social effects on the patient’s life. However, the biopsychosocial model does not consider whether mental health problems are caused by illnesses or vice versa; instead it focuses on how these things impact each other in order to improve treatment outcomes as well as patient care overall

The biopsychosocial model of disease (BPS) proposes that any health-related event, be it illness or injury, involves biological, psychological and social factors.

The biopsychosocial model of disease (BPS) proposes that any health-related event, be it illness or injury, involves biological, psychological and social factors. It was developed by psychiatrist George L. Engel at the University of Rochester in 1977.

This model was developed by psychiatrist George L. Engel at the University of Rochester in 1977.

This model was developed by psychiatrist George L. Engel at the University of Rochester in 1977. He was a professor of psychiatry and medicine at the University of Rochester, where he worked for more than 50 years.

He was an expert in the field of psychosomatic medicine and a pioneer in the study of stress. The model was developed as an alternative to Sigmund Freud’s psychoanalytic theory, which Engel believed did not adequately explain how emotions affected physical health.

Engel argued that a holistic view of disease could lead to better treatment outcomes.

Engel argued that a holistic view of disease could lead to better treatment outcomes. The biopsychosocial model is holistic, as it considers the biological and psychological aspects of a person’s health. In contrast, many biomedical models focus solely on biology and ignore social and environmental factors that influence health outcomes. This can lead to misdiagnosis or ineffective treatment plans because they are based on incomplete information.

A 2009 study found that the presence of two or more comorbid disorders increased the risk for poor clinical outcomes in patients with chronic obstructive pulmonary disease (COPD).

He also held that medicine should be a broad approach based on biology, psychology and sociology.

He also held that medicine should be a broad approach based on biology, psychology and sociology. Medicine is holistic, meaning it covers all aspects of health care including mental health issues such as depression or anxiety.

The doctor-patient relationship is also a key component of medicine. A physician must listen to their patients and take into account their history and physical symptoms when making diagnoses.

The doctor-patient relationship is also a key component of medicine. A physician must listen to their patients and take into account their history and physical symptoms when making diagnoses. Doctors often spend a lot of time getting to know their patients, which can help them understand how best to treat them.

The biopsychosocial model claims that medical doctors are not only responsible for health issues’ biological causes but also their psychological and social effects.

The biopsychosocial model claims that medical doctors are not only responsible for health issues’ biological causes but also their psychological and social effects. This approach is a holistic approach to disease, which looks at the whole person, not just the biological. It looks at the environment in which he or she lives, as well as his or her internal state of mind.

That means the doctor should act as a psychologist or sociologist when necessary.

Biopsychosocial model doctors are trained to understand the patient’s psychological and social needs, as well as the illness itself. They can help patients cope with the illness, adjust to it, and most importantly understand what they’re going through so they can make informed decisions about treatment options.

The BPS approach sees the patient as part of a whole environment consisting of both internal & external factors which impact his or her health status.

The BPS approach sees the patient as part of a whole environment consisting of both internal & external factors which impact his or her health status.

The patient’s internal environment includes things like thoughts and feelings, moods, beliefs, attitudes etc.; while the external environment includes family members, friends & work colleagues who influence his or her behaviour.

However, it does not consider whether mental health problems are caused by illnesses or vice versa.

However, it does not consider whether mental health problems are caused by illnesses or vice versa. This is a glaring omission that has been the source of much debate among researchers.

Some argue that mental health problems can lead to physical diseases and vice versa, but others disagree with this notion. For example, in some cases (like bipolar disorder) people may be genetically predisposed to developing certain types of illnesses such as cancer or diabetes later on in life—but they may also have suffered from symptoms like depression before they became ill with these other conditions as well. It’s important to look at the big picture when trying to understand how biopsychosocial factors play into our lives: if you take care of yourself mentally and physically enough then your chances of getting sick will decrease significantly!

Looking at the big picture helps determine causes and impact of an illness

When diagnosing, a doctor will consider the whole person. This includes looking at their overall health and well-being as well as any coexisting conditions such as heart disease or alcohol abuse. The doctor will also look at their environment: what kind of food they eat, whether they have access to healthy foods and if there are any barriers in place (i.e., no transportation). Finally, he or she will consider the situation surrounding this patient’s illness: does he live alone? Does she work full time? Does someone else handle most of her responsibilities for her children?

This approach can help you determine why someone has depression or another mental illness such as anxiety disorder or bipolar disorder; however, it can also help us understand how these disorders impact our society more broadly–and what we might do about it!

Conclusion

The biopsychosocial model offers an effective way of looking at the patient’s health status in order to determine causes and impact on the overall patient. It also helps doctors to develop better treatment plans, as well as being able to predict outcomes better than traditional medicine alone would be able too. In conclusion, this approach has been shown time and time again by many researchers who have conducted studies on how it affects people with mental health problems or other medical issues