Nursing Role in Helping Burn Patient’s Coping Abilities with Body image and Self-esteem
NU201: Family Focused Nursing
November 16, 2012
Part I: Clinical Narrative and Clinical Question:
It was my 2nd pediatric clinical weekend; I was still trying to cope with my first clinical experiences at Shriners. I couldn’t sleep the night before, checked on my daughter several times (more than usual) to make sure she was safe. It was an overcast, dark, very quiet Saturday morning as I made my way into Shriner’s Hospital. All the way to the hospital from my home, the only thing on my mind was “who is waiting for me today”? Is the ...view middle of the document...
Her mom was at the bedside. I introduced myself as a student nurse and I informed her that I was going to take care of her for that weekend. I asked her how she slept, if she had any pain. She replied “I slept well and I don’t have any pain.” I also asked her whether I could take her vital signs. She replied, “yes”. She primarily speaks Spanish but speaks English as well. She goes to school here in 6th grade as she got visa through Shriners Hospital. Once I was done taking her vital signs, I told her that I would be back when she was done with her breakfast to do a head to toe assessment, help her take a bath, transfer her from bed to go-cart, and change the bed linen. She said “ok” with smile.
I went back to her room after a while to check whether she had finished eating. I was glad to see that she finished all of her breakfast. I completed the head to toe assessment. Her whole body had scars except her head, even though it was 70% TBSA burn. Scars were all over face, back, chest, upper and lower extremities, burn deformity of fingers, thick banding along the anterior aspect of her thighs bilaterally. My patient had undergone numerous reconstructive procedures at Shriners hospital. This time, she was admitted for a surgical procedure called release and graft of the right knee, the left thigh was the donor site.
After the assessment I decided to help her with the bath. When I took off her socks, I was shocked to see that all of her toes were missing. My mind was flooded with emotions, thoughts, and so many questions. What had happened to her? How does she feel about herself? How does she cope with this horrible disfigurement? How does her mom feel about her? Will she be alright? Will she be able to lead a normal life in the future?
To hide my emotion from Flora, I changed the topic and started talking about her hobby, what she wants to be when she grows up. She told me that she had a cat in Guatemala, she loves animals. When she grows up wants to be a veterinarian. She also asked me how far I am in my nursing school, if I wanted to stay at Shriners. She wanted me to work at Shriners because she liked me; she thought that I will be a great pediatric nurse. By the end of my shift when I went to say bye to her, I became emotional when I wished her good luck and she wished me good luck by saying “I wish you good luck with your school and be a successful nurse.” I left her room with tears in my eyes. This experience made me wonder how do the nurses help their patients cope with their altered body image and accompanied struggles with the self esteem? It is critical for nurses to emphasize that the patient’s improvement depends on both physical as well as psychological recovery. A nurse’s awareness of a patient’s unique feelings and needs related to their injury can put the patient in a position to be able to more readily accept life in their new body.
Part II: Investigation of the Literature
Investigation of the...