Constructivism and Personalized Nursing Care
Constructivism is a learning theory that is based on evidence on how people learn (Brandon & All, 2010) and this tends to vary among individuals (Hunter & Krantz, 2010). This approach to learning is learner-centered (Gray, 1997) requiring constant evaluation from the learner (Paiget, 1977) or “ongoing personal-professional development” (Parker &Smith, 2010, p.357). Knowledge is accumulated through practice and experience; thus, no two individuals will have the same construct of knowledge to apply to the solution of a given problem. When applied to healthcare, constructivism translates into a personalized approach to nursing.
Evidence-based nursing is constructivism in practice where nursing is patient-centered and not disease oriented; that is, the focus of care is on the patient as a whole, not on the disease (Brandon & All, 2010, Parker &Smith, 2010). This means, that in addition to the treatment of a medical condition, the healthcare provider must also consider any psychological and environmental conditions that might impact the quality of life and wellbeing of the patient.
In the case of Buddy and Grace, Buddy had an extensive medical history that included serious co morbidities such as gout, osteoarthritis, squamous cell carcinoma, melanoma, hypertension, congestive heart failure, and a history of multiple falls. On the other hand, although his wife Grace suffered from Alzheimer’s, she has no known co morbidities of serious medical concern. Thus, from a medical perspective, the management of Buddy’s health represented the greater challenge. Nevertheless, it was Grace and not Buddy who died first of a massive heart attack. While medications had been successful in the management of Buddy’s various diseases, Buddy’s tendency to fall remained the largest concern, and in the end contributed to the death of his wife.
A personalize approach to nursing requires the use of evidence to provide and maintain the health of a patient and to help the patient cope with medical problems and to improve quality of life, regardless of the disease or disability (Parker &Smith, 2010).The purpose of a nurse practitioner is to promote health by managing a patient’s current diseases while preventing new diseases or injuries. In Buddy’s case, a history of falls and a deteriorating condition placed Buddy at high risk of incurring new falls. However, although it was foreseeable that Buddy would suffer a fall in the near future, it was not foreseeable that his fall would lead to the death of his wife and not to his own death.
One of the duties of nursing it to select intervention modalities that would empower the patient, either by offering protection or by helping them gain independence (Parker &Smith, 2010). The main focus of nursing is a holistic approach that should take into account every aspect of the person and not just the pathological conditions (Parker &Smith, 2010).Buddy and Grace’s unsafe living conditions had a great impaction the overall quality of health and wellbeing of the couple. An alternative solution to moving to an assisted living facility would have been some form of daily home care or electronic medical alert systems.
But perhaps the most important aspect of nursing is that a nurse works in collaboration with the patient, other members of the health team, and members of the patient’s family (Parker &Smith, 2010).More important, the nurse-patient relationship is an ongoing relationship, from the first intervention until the death of the patient (Parker &Smith, 2010) and is centered around a caring attitude and deeply grounded on interpersonal relationships. In the Buddy and Grace story it was clear that the nurse-patient relationship was central to the wellbeing of the couple, to such extent that it was the nurse’s help the husband sought and relied upon at the time of his ultimate crisis.
Brandon, A. F., & All, A. C. (2010). Constructivism theory analysis and application to curricula. (ACTIVE LEARNING). Nursing Education Perspectives, 31(2), 89-93.
Gray, A. (1997). The road to knowledge is always under construction. (Master’s thesis, University of Saskatchewan). Retrieved fromhttp://saskschoolboards.ca/research/instruction/97-07.htm
Hunter, J., & Krantz, S. (2010). Constructivism in cultural competence education. Journal of Nursing Education, 49(4), 207-214. doi:10.3928/01484834-20100115-06
Parker, M.E. & Smith, M.C. (21010). Nursing theories & nursing practice (3rd ed). Danvers, MA: F.A. Davis.
Piaget, J. (1977). The development of thought: Equilibration of cognitive structures. (A. Rosin, Trans). New York,NY: The Viking Press.