Care of a patient with breathing difficulties

Abstract

Emily is a 75-year-old woman with congestive cardiac failure and chronic obstructive airways disease. Before she became ill and was admitted to hospital, her GP had changed her medications. Emily had been confused by the change, and had taken the wrong tablets at the wrong time in the wrong quantity. This had caused her to have too much carbon dioxide and not enough oxygen in her blood, as a result of which she developed myoclonic jerks. At the time she was admitted to hospital, Emily's family were told that she might not survive 48 hours.

An integrative review of the use of the concept of reassurance in clinical practice

“…Verbal forms of reassurance noted in the data included offering words of encouragement (Al‐Mutair et al., 2014; Barr, 1992; Hermann et al., 2019), and demonstrating professional competence (Gibb & O’Brien, 1990; Gregg, 1955; Hermann et al., 2019; Karlsson et al., 2012). Other forms of reassurance were communicating adequate, clear, honest and accurate feedback (Al‐Mutair et al., 2014; Boyd & Munhall, 1989; Cossette et al., 2002; Gibb & O’Brien, 1990; Gustafsson et al., 2018; Jones et al., 2007; Usher & Monkley, 2001); and keeping the patient and family informed and encouraging them to verbalize their concerns (Blackhall et al., 2011; Fareed, 1996; Wocial et al., 2014).…”

“…Also, the choice of reassurance technique depends on the culture (Chauhan & Long, 2000), geographical settings (Cossette et al., 2002; Hicks et al., 2014) and religious affiliation of patients (Diggins, 2012). The nurse provides appropriate, acceptable and effective reassurance by demonstrating cultural and religious sensitivity or awareness (Barr, 1992; Chauhan & Long, 2000; Diggins, 2012). For instance, therapeutic touch may not be appropriate in certain cultural contexts especially when delivered by the opposite sex (Chauhan & Long, 2000).…”

“…Through this connectedness, nurses avail themselves emotionally to connect with the patient (Boyd & Munhall, 1989; Gregg, 1955; Jay, 1996; Teasdale & Kent, 1995; Wocial et al., 2014) within an enabling environment (Fareed, 1996). Emotional connectedness and compassion facilitate the sharing of each other's lived experiences through which the nurse can recognize and accept the patient's emotions (Barr, 1992; Wocial et al., 2014). The nurse comes to the level of the patient and shares with the patient personal stories that resonate with him/her (Gustafsson et al., 2018; Usher & Monkley, 2001).…”

“…The forms were broadly categorized as verbal and non‐verbal. Non‐verbal forms of reassurance included therapeutic touch, maintaining eye contact, active listening, calm voice (Al‐Mutair et al., 2014; Barr, 1992; Boyd & Munhall, 1989; Chauhan & Long, 2000; Cossette et al., 2002; Karlsson et al., 2012); being nice (Beaver & Luker, 2005); being authentically present with the patient and family (Fareed, 1996; Monk, 2019; Usher & Monkley, 2001); and demonstrating respect (Gregg, 1955).…”

“…Reassurance instils hope in patients and offers patients optimistic viewpoints of any emotional or physical challenges they may be facing (Al‐Mutair et al., 2014; Fareed, 1996; Teasdale, 1989). Moreover, reassurance helps to keep intact the patient's pre‐illness identity, dignity and self‐esteem (Barr, 1992).…”