When patients arrive to the ER, they present with a “chief complaint”, or the reason that they came to the hospital. We, of course, identify the problem and treat the diagnosis based on evidence based practice. But, we don’t just stop at the diagnosis, nurses identify other needs and even warning signs. We ask about a safe home environment, access to medications, assess health literacy, and even screen for suicidal ideation. This is called holistic care, or treating the whole person rather than just their chief complaint.
Holistic care involves ensuring each patient has the capability to understand their medical history and have access to the resources they need to stay healthy. It is easy to document that the patient refused or is noncompliant, but often their reasoning is quite innocent. Asking questions, and more importantly listening to our patients provides so much more useful information that helps to tie up their story. Doctors are often in and out of a patient room within 15 minutes (if that). I have seen doctors simply ask the nurse how the patient is doing without even laying eyes on them theirselves. Nurses have the opportunity to thoroughly identify each patient need and educational level.
Holistic care can be overwhelming if the patient requires many resources or additional time for teaching. I often remind my patients to take it one step and one day at a time. It is too much to think about everything that needs to be fixed or mended. Start with day one and one change then gradually add in additional disciplines. It all starts somewhere.
Until next shift,
Shania