Nursing: Discussion Postings - Comfort Care for All

I am listing three discussion postings and i need you to provide constructive and insightful comments that go beyond that of agree or disagree. 1)This first post is by Carolyn: The term "comfort measures" usually does refer to end of life issues, but in all actuality we use comfort measures in our everyday life, with ourselves as well as most people we come in contact with on a day to day basis. Causing loved ones or acquaintances discomfort is not a natural part of our being. Therefore, comfort measures should be a basic part of everyday nursing care throughout a lifespan. In regards to patients, every patient's comfort needs can vary depending on patient specific needs, expectations, and diagnosis. When assessing a patient you must be aware of non verbal cues, grimacing, rolling of the eyes, shrugging shoulders, and eye contact as well as verbal when asking questions to ensure a patient comfort. Being knowledgeable on culture, religious beliefs and specific diagnoses will aid in developing a care plan for impaired comfort. Comfort related care plans have basic focuses for every patient to apply to make it patient specific: pain, respirations, sleep, coping, safety, and education are just a few examples. It is the nurses responsibility to ensure the patients comfort is being met. If you are unavailable to preform the intervention to maintain comfort then you can delegate interventions as long as the delegee is practicing within their scope of practice. Forming a trusting relationship with your patient is important so if you can do it, do it. "Given the current emphasis on health promotion and the importance of comfort to the process of healing, comfort is an indispensable element of holistic, culturally congruent human care" Malinowski, A., Stamler, L. (2002) 2) This postings is by Marita: Comfort care should be a substantive need in all aspects of life. In my paper last week I defined discomfort as mild pain or an inconvenience. Have you ever had a splinter in your finger or hand from splitting wood? It does not cause pain, but it is very inconvenient and occupies my mind until I can get it out. Patient care is about many things and comfort is one of them. Comfort is defined by the individual and the needs will vary from one person to another. Comfort is a holistic state and if comfort is impaired the patient may have anxiety, disturbed sleep pattern, fear, inability to relax, social isolation and many other characteristics. Management of discomfort can be better managed by addressing comfort needs. Physical comfort include pain relief, fluid/electrolyte balance, regular bowel function and adequate oxygen saturation. Psychosocial comfort include cultural customs, ability to connect with friends and family and enhanced family/friend support. Spiritual comfort is the internal awareness of self and include accommodating religious practices, increase relaxation, enhance independence and maintain/improve self-esteem. Environmental comfort include temperature, noise, light, color, views from the room and access to nature. The nurse should assess the comfort needs of the patient and develop a plan according to the assessment. Nursing interventions could include teaching relaxation techniques to promote sleep and reduce anxiety, provide a quiet and relaxing atmosphere, encourage active exercise to increase feeling of well-being, provide pain relief, provide distraction techniques, build trust between the patient and nurse and any intervention to enhance comfort for the patient. Can care of discomfort be delegated and should it be? Interventions are not always comfortable and may cause pain such as reducing a dislocated shoulder or knee. The intervention causes discomfort at first but the end result is relief. If the patient is going to have a nursing intervention that causes discomfort I believe the nurse that has built a trusting relationship should be the one to carry out the intervention. Enhanced comfort readies the patient for healthy behavior and can assist them in attaining optimal health and function. 3)This postings is by Nash: I agree with the author that comfort care is closely associated with end of life care, and I also agree that comfort care should be a substantive need in all aspects of life. Comfort needs for individuals are not all the same, many different people respond to different types of care and comfort treatments. Some different types of comfort treatment can range from aromatherapy, humor, to meditation or chiropractic medicine (Lillis, Taylor, Lemone & Lynn, 2011). The RN will have to discuss with the patient the necessary comfort needs of each individual patient during their interview process. During this time would be the best to discuss culture and comfort needs in a comfortable environment. The RN will also need to use past experiences and educational references to better assist the patient and their needs, whether they are known or not to the patient. I believe comfort is a core of nursing care. Today, we have gone away from it, except with end of life care, but it needs to be incorporated in every aspect of nursing, whether acute, chronic or emergency. This can be done easily if the RNs communicate with their patients and families. Discomfort is often the intervention but the benefits of the intervention usually outweigh the discomfort caused by the intervention.