Introduction
Rosemarie Parse’s Theory of Human Becoming is a nursing theory that emphasizes the unique and individual nature of each person’s experience and views health as a process of continually being made. The theory suggests that individuals are co-creators of their health and well-being and that nursing care should focus on facilitating the patient’s unique journey toward their desired state of health (Bunkers et al., 2021). Utilizing nursing theories in practice is essential to guide nursing care and improve patient outcomes. Nursing theories provide a framework for understanding the complex nature of healthcare, including the patient’s experience, the role of the nurse, and the interplay between various factors that influence health and wellness. By utilizing nursing theories, nurses can provide evidence-based care tailored to patients’ needs and promote active participation in their care. Furthermore, nursing theories can improve the quality of care nurses provide and enhance their professional development.
Case Scenario
Patient Information
Name: Mrs. M
Age: 65 years old
Medical History: Hypertension, Type II Diabetes Mellitus, and Chronic Kidney Disease.
Mrs. M was admitted to the hospital with shortness of breath, leg swelling, and weight gain over the past few days. On examination, she was found to have fluid accumulation in her lungs and legs, and her blood pressure was elevated. Further tests revealed that her kidney function had declined significantly. The patient reported feeling overwhelmed and anxious about her condition and treatment plan. The principles of the Human Becoming Theory guided the nursing care plan for Mrs. M. The nursing interventions aimed to promote the patient’s active participation in her care, considering her unique perspective and values.
Assessment
Assessment is a crucial component of nursing care, and utilizing the Human Becoming Theory can guide the assessment process and promote patient-centered care. The assessment focuses on understanding the patient’s perspective, values, and beliefs about their health and illness experience. By gathering this information, nurses can develop a holistic understanding of the patient and use it to guide care planning and decision-making. In the case scenario of Mrs. M, the nursing assessment was guided by the principles of the Human Becoming Theory. The nurse conducted a thorough interview to identify the patient’s goals and expectations related to her care. The nurse also gathered information about the patient’s family and social support system. This information helped the nurse to understand Mrs. M’s perspective, values, and beliefs related to her health and illness experience.
Understanding the patient’s perspective, values, and beliefs is essential in nursing practice as it allows nurses to provide patient-centered care tailored to their needs. By understanding the patient’s unique perspective, nurses can collaborate with patients to develop care plans that align with their values and goals. This approach promotes patient autonomy and encourages patients to participate actively in their care and decision-making. In the case scenario of Mrs. M, the assessment information was used to guide care planning and decision-making. The nurse collaborated with the patient to identify strategies for coping with the illness and adapting to the treatment plan. The care plan also included interventions to address the patient’s physical symptoms, such as administering diuretics and blood pressure medications and implementing dietary modifications.
Diagnosis
The nursing diagnosis for Mrs. M was “Risk for decreased cardiac output related to fluid overload as evidenced by elevated blood pressure and edema.” This nursing diagnosis was derived from the assessment data that showed Mrs. M had elevated blood pressure and significant edema, which indicated fluid overload. The nursing diagnosis also considered the patient’s history of hypertension and diabetes, which put her at increased risk for cardiovascular complications. The Human Becoming Theory guided the nursing diagnosis by considering the patient’s unique perspective, values, and beliefs related to her health and illness experience. The nurse understood that Mrs. M strongly desired to remain independent and maintain her quality of life. Therefore, the nursing diagnosis focused on addressing the patient’s fluid overload to prevent complications that could impact her independence and quality of life.
Planning
The planned nursing interventions addressed the nursing diagnosis’s underlying cause: fluid overload. The interventions included administering diuretics, implementing a low-sodium diet, monitoring fluid intake and output, and assessing vital signs frequently. The nurse also planned to collaborate with the patient to develop strategies to manage her fluid intake at home and cope with the illness. The Human Becoming Theory guided the care plan by considering the patient’s unique perspective, values, and beliefs related to her health and illness experience (Narayan & Mallinson, 2021). The care plan was designed to be patient-centered, promoting autonomy and active participation in the care process. The nurse collaborated with the patient to identify strategies aligned with her goals and preferences. The care plan considered the patient’s values and goals, promoting autonomy and active participation in the care process.
Implementation
The nursing interventions included administering diuretics, implementing a low-sodium diet, monitoring fluid intake and output, and assessing vital signs frequently. The nurse also collaborated with the patient to develop strategies to manage her fluid intake at home and cope with the illness. The Human Becoming Theory guided the implementation of nursing interventions. The Human Becoming Theory was used to guide the implementation of care by considering the patient’s unique perspective, values, and beliefs related to her health and illness experience. The care provided was patient-centered, promoting the patient’s autonomy and active participation in the care process. The nurse ensured that the patient was fully informed and engaged in the care process, encouraging her to ask questions and express her concerns.
Evaluation
Evaluation involves assessing the outcomes of the care provided and determining whether the goals of the care plan were achieved. In the case of Mrs. M, the care plan was evaluated to determine the effectiveness of the nursing interventions implemented to address the nursing diagnosis of “Risk for decreased cardiac output related to fluid overload as evidenced by elevated blood pressure and edema” (Stickel et al., 2019). The care outcomes were positive, and the nursing interventions effectively addressed the underlying cause of the nursing diagnosis. The patient’s vital signs stabilized, and the edema decreased. The patient reported feeling more comfortable and could manage her fluid intake more effectively.
The Human Becoming Theory was used to evaluate the care plan’s effectiveness by considering the patient’s unique perspective, values, and beliefs related to her health and illness experience. The nurse assessed the patient’s level of satisfaction with the care provided, ensuring that the care plan aligned with the patient’s goals and preferences. Based on the evaluation, some changes were made to the care plan. The nurse modified the patient’s medication regimen to ensure the diuretic effectively managed fluid overload. The nurse also provided additional education on the importance of adhering to a low-sodium diet and managing fluid intake to prevent future episodes of fluid overload (Riegel et al., 2019).
Conclusion
The case scenario of Mrs. M highlights how the Human Becoming Theory can be utilized in nursing practice to guide the assessment, diagnosis, planning, implementation, and evaluation of patient care. The theory emphasizes the importance of understanding the patient’s unique perspective, values, and beliefs to provide care that aligns with the patient’s goals and preferences. Through the assessment process, the nurse thoroughly understood Mrs. M’s health status and beliefs about managing her health. The nursing diagnosis of “Risk for decreased cardiac output related to fluid overload” was derived from the assessment. The care plan was developed based on the Human Becoming Theory to address this diagnosis. The nursing interventions implemented were tailored to the patient’s unique needs, preferences, and values, and Mrs. M was actively involved in the care process. By utilizing nursing theories, nurses can provide evidence-based care tailored to individual patient’s unique needs and preferences, improving patient outcomes.
References
Bunkers, S. S., Bournes, D. A., & Mitchell, G. J. (2021). Rosemarie Rizzo Parse: Humanbecoming. Nursing Theorists and Their Work E-Book, p. 370. https://books.google.com/books?hl=en&lr=&id=usg5EAAAQBAJ&oi=fnd&pg=PA370&dq=rosemarie+parse+theory+of+human+becoming&ots=a_WQrraFE-&sig=DA62MxBuScPbjbn-BT_AoKNhk5Y
Narayan, M. C., & Mallinson, R. K. (2021). Transcultural nurse views on culture-sensitive/patient-centered assessment and care planning: A descriptive study. Journal of Transcultural Nursing, 33(2), 150–160. https://doi.org/10.1177/10436596211046986
Riegel, B., Lee, S., Hill, J., Daus, M., Baah, F. O., Wald, J. W., & Knafl, G. J. (2019). Patterns of adherence to diuretics, dietary sodium and fluid intake recommendations in adults with heart failure. Heart & Lung, 48(3), 179-185. https://doi.org/10.1016/j.hrtlng.2018.12.008
Stickel, S., Gin-Sing, W., Wagenaar, M., & Gibbs, J. S. (2019). The practical management of fluid retention in adults with right heart failure due to pulmonary arterial hypertension. European Heart Journal Supplements, 21(Supplement_K), K46-K53. https://doi.org/10.1093/eurheartj/suz207
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