The Plastic Surgery Office Nurse...
Transcript of The Plastic Surgery Office Nurse...
Running head: THE PLASTIC SURGERY OFFICE NURSE EDUCATOR 1
The Plastic Surgery Office Nurse Educator
Georgia Elmassian
Ferris State University
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Abstract
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The Plastic Surgery Office Nurse Educator
A patient educator is an individual who works in the healthcare industry. Often, the
educator is a registered nurse or an allied health professional who communicates directly with
patients and families regarding health and illness across the continuum of care. The patient
educator is a intermediary and or connection between the physician and patient. This paper will
focus on the specialized role of the plastic surgery nurse educator.
Current Practice
As a current nurse educator in the plastic surgery field, my role encompasses many facets
of responsibility. Not only am I a teacher of information, I am the liaison between the patient
and the surgeon; the multidisciplinary medical team; the hospital; community services; and
family members. I define, inform, demonstrate, execute, coordinate, mentor, encourage, and
support the patient who is contemplating, as well as engaging in plastic surgery, whether
aesthetic or reconstructive. I also help to create a plan; objectives; and achievable goals for the
patient from the initial consult all the way through and including post-operative recovery care.
To further appoint my role as a plastic surgery nurse educator, the following sections will detail
the knowledge, skills, and attitudes one needs to be a successful educationalist.
Knowledge
In accordance with the standards of nursing practice, the American Nurses
Association (2010) states “the registered nurse employs strategies to promote health and a safe
environment.” (p. 41) Keeping in alignment with this standard, my current position as a nurse
educator in the plastic surgery office does subscribe to this criterion of practice. I venture to
identify and employ teaching tactics that need to be cognizant of sound, clear, and empathetic
communications which are necessary to ensure a healthy and trusted environment that is vital to
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effective patient education. As a nurse educator, I need to know the phases of life span growth
and development, and utilize learning approaches both physically and psychologically when
educating patients for surgical procedures and optimum recovery care. I fully utilize methods of
personal nursing knowledge, where I am aware of the patient’s situation, and I quickly build a
trusting and working relationship with the patient, and patient’s family.
I readily engage my patient in a comprehensive perioperative education that is not merely
a rhetorical question and answer guidance. Rather, I employ effective constructivist concepts for
patient education whereby I advise the patient to build upon his or her earlier knowledge of the
procedure and surgery. I then expand their foundation, and prompt them for effective plastic
surgical expectations and outcomes. In fact, according to nursing research, “when patients are
adequately prepared psychologically and physically, and policies and guidelines have been
followed, the risk of postoperative complications should be low, leading to a quick recovery.”
(Liddle, 2012, para. 21) Hence, plastic surgery patients who engage in a learning connection
with a nurse educator end up with better surgical outcomes than those patients who did not have
any instruction.
Equally significant for the nurse educator to keep in mind is that each member of the
family is at a different developmental and emotional time in the road of life. Therefore, all
family members are influenced by one another either simultaneously or independently, as well as
positively or negatively. With this in mind, it would be relevant for the nurse educator to
understand human growth and development, as well as identify family and ecology systems
when preparing patients and their families emotionally and physically for surgery. In fact,
Bronfenbrenner’s ecology system theory contends families are not isolated systems; rather
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families and individuals within one system are influenced by, or themselves, influencing another,
sometimes much larger system of life (Lewthwaite, 2011). Therefore, the plastic surgery
nurse educator, when preparing a patient for a surgical event, should respect the concept families
are part of a much larger body.
Skills
As an existing nurse educator in the plastic surgeon’s office, it is my primary
responsibility to surgical patients, to instill a trusted environment dedicated to providing valuable
perioperative information and implementation. This is accomplished by collecting appropriate
health and assessment data from the patient during the consultation phase, analyzing the data,
identifying outcomes, and executing a plan of action. In so doing, the first five standards of
nursing practice, assessment, diagnosis, outcomes identification, planning and implementation
(American Nurses Association, [ANA], 2010) have been clearly instituted, and the strength of
my practice elevated.
Accordingly, sound and basic foundational skills, and understanding in general and
plastic surgical nursing, patient communication, critical thinking skills, pathophysiology, and
pharmacology are employed by the nurse educator. For a consultation to be successful, it is
necessary for the educator to have an understanding of psychosocial, communication, and
interpersonal skills. These are needed, to adequately assess and respect a patient’s body
dysmorphia or perceived body image, and promote reasonable expectations/outcomes of
aesthetic or reconstructive surgical procedures such as face-lifts and liposuction.
Moreover, as a nurse educator in a busy plastic surgery office, it is necessary to create a
constructivist environment for learning in which patients become engaged in activities that build
around their previous experience ("Constructivism," 2004). This entails encouraging patients to
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problem solves and acquire more awareness surrounding their surgical procedure. Subsequently,
we will discuss their pending surgery and how their understanding of the procedure has
modified. These building blocks of information will ultimately develop an optimal peri-surgical
experience.
Attitude
The plastic surgery office where I now serve as patient educator is a practice that is quite
unique in the plastic surgery field. The current trend in the medical-business subspecialty market
is to have separate reconstructive and aesthetic practices. However, this surgeon’s practice
model welcomes diverse individuals across the entire life span and provides services for both the
aesthetic and reconstructive patient. We see a plethora of patients all across the spectrum for
something as simple as in-office Botox treatments, to office based surgery mommy-makeovers
("Mommy Makeover," 2013) and facelifts, to the complex staged-surgical procedures for the
cleft lip/cleft palate patient, to the multifaceted hospital in-patient bilateral breast reconstruction
and flap surgery. Thus, it is necessary for the plastic surgery nurse educator to use thoughtful,
therapeutic, and effective communication. As well as, culturally appropriate and practical
instruction, utilizing constructivist teaching methods across the continuum of care for the
aesthetic and reconstructive patient.
Reflection
In summary, a successful plastic surgery nurse educator who works with individuals and
patients across the human growth life cycle, will have an understanding of the foundations of
human growth and development and will successfully engage the surgical patient both
psychologically and physically (through demonstration). Furthermore, the educator will have the
ability to explain the pending surgery, assess the patient’s needs, and identify expected outcomes
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plan and implement patient care, and evaluate the patient’s overall perception regarding
procedure, potential complications, and recovery care, all to ensure patient satisfaction and rapid
therapeutic recuperation after surgery.
Philosophy
My philosophy of nursing is strongly linked to my philosophy of being a nurse educator.
As a plastic surgery nurse educator, my mind long since merged nursing practice with nursing
education. As a nurse educator, I consider the patient teaching role to be an extension of my
nursing practice where I look at the whole person in order to assess, evaluate, and plan for their
needs. Plastic surgery nursing is an increasingly challenging and changing environment. Nurses
in this subspecialty are assuming more responsibility and expanded roles. Comprehensive
assessment, intervention, and therapeutic communication skills are essential to plastic surgery
education, and promoting optimal surgical outcomes. Therefore, the role of the plastic surgery
nurse educator encompasses more than a nurse-patient relationship. It combines the science of
education with the art of nursing. The following sections will provide the reader with a succinct
overview of my understanding of the nursing metaparadigm’s: person, health, environment, and
nursing concepts that I find helpful for the patient, and their relationship to plastic surgery.
Person
The person metaparadigm concept in nursing, as I believe it, refers to a vast interrelated
system much like the aforementioned Bronfenbrenner ecology system. The person
metaparadigm includes the human system, or layer, which includes family, peers, friends and
neighbors, faith, and community, and interconnects with that of the nurse. The groundwork of
the person metaparadigm is the basis of the larger system that is continually interacting and
benefiting from the nurse and nursing care.
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Betty Neuman, a nursing theorist of the Systems Model, believes the person
metaparadigm refers to all aspects of the person interconnecting with other larger systems.
Neuman’s philosophy states “nurses should not only view the individual holistically, but should
also take the family, friends, and the community into consideration.” (Mercer University College
of Nursing [Mercer, CON], n.d.) Neuman’s theory also believes the person and nurse
interconnect to regain balance amidst the physiological, psychological, socio-cultural, spiritual
and developmental subsystems (Tourville & Ingalls, 2003).
The plastic surgery educator fully utilizes the person metaparadigm concept on a daily
basis with patients. Promoting optimal surgery outcomes is one of the primary challenges of
aesthetic and reconstructive education. Therefore, the educator recalls the psychosocial outcome
of surgery is contingent on the patient’s developmental stage and influence of family and
resource support; thus integrating Neuman’s principles into practice. Additionally, knowledge of
the patient’s emotional and psychological characteristics, and body image perceptions is essential
to providing compassionate care for the plastic surgery patient from the first pre-operative
consult and assessment through the postoperative recovery period (Hotta, 2007; Carper, 1978).
Health
Succinctly defined, the health metaparadigm concept in nursing is the measure of
physical, emotional, and social wellness or illness that is experienced by an individual. Tourville
& Ingalls (2003) finds as nursing has evolved; the profession looks at the patient’s position on a
health spectrum and simply defines health as “the absence of disease.” (p. 22) Sister Callista
Roy, another theorist of the systems model, further finds “health is a process of becoming
integrated and able to meet goals of survival, growth, reproduction, and mastery.” ("Roy," 2013,
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para. 25) Clearly, internal and external factors within the patient’s larger system shape the
nurse’s assessment of, and plan for, the patient’s comprehensive continuum of health.
The plastic surgery nurse educator, unmistakably understands that aesthetic and
reconstructive patients are in need of education regarding wellness and disease throughout the
range of plastic surgical care. Therefore, the patient educator provides patients with the skills
needed to contribute to improving health, as well as enhancing recovery.
Environment
The environment metaparadigm concept in nursing, as I believe it, refers to everything
that surrounds, influences, and affects the person whether internal or external in nature. The
environment system of a person is continually changing and is constantly interconnecting and
interrelating with other larger systems. The environment as it relates to nursing includes any
factors that would indicate a physical or psychosocial need, or would be beneficial in nature.
Callista Roy, nurse theorist, as mentioned previously, bases her nursing theory on the
open systems model. Her adaptation model “focuses on the constant interaction between the
person and the environment, and how the person adapts to his/her environment.” (Tourville &
Ingalls, 2003, p. 27) Her theory includes developmental stages, family, and culture; as well as,
three types of systems influencers- focal, which are individual needs, contextual, as in resources
and support, and, residual, which comprises the family. All of which are not conclusive, but
continually interact with the patient, nurse, and environment (Boston College William F. Connell
School of Nursing [Boston College SON], 2013). Thus, the nurse, patient, and the environment
are all interconnecting and affecting behaviors.
As a nursing educator in plastic surgery, the patient’s environment as described by Roy,
must be taken into consideration at all times, and factor into the strategy in which to establish
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goals for perioperative and recovery care. Thus, the education plan that the nurse educator puts
forth for the surgical patient is contingent upon the surgical procedure, access of caregivers, the
patient and family’s interpretation of the perioperative teaching and post procedure care, as well
as, the preparedness and compliance of the patient to be involved in their treatment.
Nursing
The metaparadigm concept of nursing encompasses the nurse-patient relationship, the art
of care, and the meeting of needs. Moreover, in accordance with the six American Nurses
Association Standards of Practice, nursing is the assessment, diagnosis, outcomes, plan of action,
intervention, evaluation, education, and empathetic interaction between the nurse and patient
(ANA, 2010). The nursing concept not only refers to the delivery of care and health, it is
meeting the psychosocial needs of the person, family, and community. Nursing is a
particularized art where the needs of the individual is met and provided in a professional and
effective manner (Carper, 1978).
Nurse theorist Dorothea Orem, also a uses a systems model for her Self-Care Theory.
Orem’s support for the nursing metaparadigm positions that individuals should be independent
for their own care and the care of their family members. Masters (2014), states the nursing
metaparadigm as defined by Orem as “therapeutic self-care designed to supplement self-care
requisites. Nursing actions fall into one of three categories: wholly compensatory, partly
compensatory, or supportive-educative.” (p. 60) Therefore, in alignment with Orem, the plastic
surgery nurse educator’s goal should be to increase the patient’s self-care ability in the best way
possible.
Much in correlation with Orem’s metaparadigm of nursing, not only does the nurse
educator support the plastics patient; but the patient has an obligation to contribute to their own
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care decisions, pre and post-surgical instruction, and treatment plan. Therefore, it is essential for
the plastic surgery nurse educator to disseminate relevant knowledge in which to teach patients
how to care for themselves, have an understanding of their surgical procedure, and be
comfortable in handling their own care. Thus, patient education is a key component of nursing
practice.
Nursing Theory
Florence Nightingale, a statistician, and social reformer was the founder of the
profession of nursing and the first nursing theorist (Tourville & Ingalls, 2003). Her teachings on
care were based on statistical evidence and the principles of caring for, and about the patient.
Continually evolving from Nightingale’s basic philosophy, three classifications of behavioral
theories-interactive, system, and development have been expanded over the years and integrated
into current nursing theories and practice today (Tourville & Ingalls, 2003).
When we consider the concepts and assessments of the leading nursing theorists as
described above and add them to the metaparadigm’s of nursing, we get a more narrow view and
understanding of the larger range of nursing as science. Therefore, if we combine nursing
knowledge with theory, evidence based research, and the insight of nursing we have the
necessary components of art and science that identify the discipline of nursing (Carper, 1978;
Dudley-Brown, 1997; Tourville & Ingalls, 2003).
Conclusion
As we can conclude from this discussion, nursing focuses on the whole of the
person/patient, the environment, and health experiences. It is through the utilization of nursing
theories and metaparadigm’s that the nurse-patient relationship, systems, and developmental
theories and concepts merge. Plastic surgery educators involve both the science and art of
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nursing in that we combine principles, research, and art/care into the domain of practice on a
daily basis.
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References
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