Illness Modern Nursing Is Extremely

¶ … Illness

Modern nursing is extremely complex and much more patient oriented than ever before. Nursing theories abound, and are all useful in providing a toolbox of resources for the modern nurse. Theories are useful when usable, and when there are concepts that are part of the dynamic relationship in caring and advocacy that are some of the primary expectations of the modern nurse (Alligood, 2010). Because patients are often frightened and uncertain, one of the theories that can be used in both analysis and tactical application is Mishel's Uncertainty of Illness Theory. This theory is comprehensive and can be applied to any number of patient populations with divergent demographic characteristics, varying health concerns, and has no limits on age and ethnicity. Mishel tells us that interventions by the nurse can help calm the patient through gestures, words, symbolic references, behaviors, and empathy. The theory has many similarities to Watson's Theory of Caring, in that during uncertain times, empathy and care from the nurse can have a positive and proactive effect upon patient health, expectations, and ability to understand medical procedures. Indeed, clinical evidence supports that uncertainty in illness often increases fear to the point that it can make decisions about care and treatment options difficult for patients to make due to increased anxiety and a lack of ability to understand the decision making process (Mishel and Clayton, 2003).

Mishel's theoretical construct and quantitative scale may be used quite well during period of uncertainty, particularly when there is a potential life-threatening illness. For example, in a recent study focusing on the diagnosis of meningioma, researchers found that the patients' combined understanding of the illness along with a nursing intervention using Michel had considerable positive effects in helping women make informed decisions regarding treatment options, interventions, and procedures. Using this theory, nurses are able to be in a unique and powerful position to influence the process of understanding, informed decision-making, and ultimately, a co-role in support for patient's who face life-changing decisions (Guadalupe, 2010).

In the case of meningioma, age and gender are important variables: the illness tends to strike females older than 70 almost four times more than those younger. This is also a population that tends to be more anxious about healthcare, both in terms of cost and effects. It is also a population that often has limited resources and one that seeks to find others to help comfort and educate them. Modern technology has certainly improved both the diagnosis and treatment of the illness, but there are so many options that the patient is often left bewildered and frightened (Guadalupe).

A proactive and professional nursing approach to this illness takes Mishel's theory and uses it in four ways:

To combat ambiguity -- Patients are unaware of the progress and severity of their illness and often fill in with worst-case scenarios. Open and honest communication about that status of the illness will alleviate many concerns, or at least allow for uncoerced decision making.

To combat complexity -- Illness is complex and often based on statistical tables, not individual expressions. Using Michel, the nurse can simplify to the necessary degree both the illness and options.

To provide information -- More than anything, Michel can be used to educate and advocate for the patient. Patients have different levels of education and expectations, and therefore need information in different ways. Some patients, for instance, are aggressive about reading and understanding their illness, while others prefer to trust in medical science.