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Front Matter Pages i-viii.
Pages Routine and Emergency Bedside Equipment Setup. Vital Signs: Cardiac Medications: Dosages, Preparation and Administration. Fluid and Electrolyte Balance. Nutrition Management: Parenteral and Enteral Nutrition and Oral Intake.
The Interaction between Physiotherapist, Nurse and Parent. An Overview. Nursing Care at the Pediatric Cardiology Ward. Nursing Care in Cath Lab. Nursing Care in ICU. Nursing Care for Patient with Heart Failure. This ac- tive listening, in nursing, allows to establish relation- Starting point in this approach is represented ships of trust, to understand each other, to share the by a radical attack of the reductionism supported by meanings of experiences and to construct a common neo-positivist medicine and a need to overcome mind- cure and care pathway.
Everyone lives experi- ences where he is really and intentionally included. According Socio-anthropological approach is based on the to Heidegger 31 , the phenomenological perspective application of social sciences, sociology and anthropol- of things must be overcome through an understanding ogy to the study of medicine. According to him, not only an epis- by the patient. The word disease focuses attention on organic le- of language and life must be performed too, a choice sion, which is an objective measurable event; the word that Heidegger had previously rejected, by making an illness focuses attention on subjective experience based immediate shift from comprehension to ontology.
According to this approach, fessionals and patients. For this If the hermeneutic phenomenological approach reason, patients and professionals bear a moral respon- focuses on different points of view, the socio-anthro- sibility related to how the narrative is expressed and pological approach refers to the plurality of actors the subsequent choices.
Some Israeli researchers 34 involved in clinical encounter physicians, nurses, define a narratological distress, which is marked by the healthcare professionals, patients, caregivers who have internal dispute between two narratives: Instead of focusing on inter- of physicians and other professionals, who tend to re- preting their meanings, this approach concentrates on duce and ignore the experience of pain, as it is not de- cultural contents expressed by patients, according to tectable from a diagnostic point of view; and the narra- their different social roles.
The illness-disease-sickness tive of the patient himself, who acknowledges the pain triad becomes the main instrument to overcome the A new model of narrative nursing 17 The threefold division of narrative proposed by who take part to this process, according to their dif- Frank represents an example of how narrative can be ferent skills.
Each professional has his own point of studied according to social settings He divides view on the disease, which is related to different per- narratives into three models: An English research tient, disease with reference to healthcare profession- 38 puts this kind of classification into practice, fo- als and sickness with reference to other social subjects cusing on the idea that narratives do not only involve involved.
These three different perspectives produce patients past experiences but can be useful to create and express three different types of knowledge: For this reason, we can produce equally different types of narratives; all of consider narrative as a social action and the act of nar- them are rightful and complementary; from their in- rating as a social activity which involves not only the teraction, clinical encounters stem and develop in their narrator but all those who listen.
This approach based on holistic compre- is to create a therapeutic plot. Therapeutic emplotment hension, putting into action a hermeneutic dialogue comes out from interpretive activities during therapeu- which allows the enhancement of the different skills tic encounter between healthcare professionals and involved, in order to integrate them, to create a proper patients. This approach requires a narrative skill by ten, understand, interpret and co-create stories of dis- healthcare professionals.
The humanistic narratologi- ease, must be necessarily supported by narrative prac- cal model suggests that narrative practice must entail tice, intended as skill to set up care pathways based on a high degree of skill narrative skill , which leads to narrative competence.
Moreover, it is possi- dividual narrative structure 39, Usefulness of narrative approaches to nursing: Towards a new paradigm for health: Taffurelli the effort means to combine two models that seemed based interviews as preferential technique in the three incompatible: Evidence-Based Nursing Model and phases of nursing: Narrative-Based Nursing Model.
The first one is ca- 1. The second model is 2. This model was for example effectively healthcare aimed at keeping multidimensional health used in the cardiovascular setting Integrated narrative nurs- diagnosis. The integrated use of cases and narratives ing means an assistance methodology that supplement highlights three increasing steps of diagnostic defini- quantitative data, already normally detected on the pa- tion: Indeed, the integrated narrative nursing plore traditional information; in the third step, narra- makes use not only of quantitative tools evaluation tive information play a paramount role in understand- scales and scientific evidence , but of qualitative tools ing the problem, a result that traditional assessment too narrative interviews, autobiographies, therapeutic would not reach To achieve a global Within this perspective, the integrated model and bio-psycho-social approach to the person and of makes use of a bio-psycho-social approach.
Environment is not only intended as external, physical, objective entity, but also as rela- tional and subjective entity gained through experience.
What future for the integrated narrative nursing? Health gets both a clinical and a psychosocial dimen- sion because, next to the disease, we meet a patient As previously explained, narrative nursing means who lives a subjective and personal experience illness , new ways of offering care in all of the three different and this experience is socially acknowledged sickness.
The benefits coming from the use of narrative In this sense, the goals of integrated narrative nursing are different and, among them, at three levels.
In which employs narrative interviews to implement fact, this integrated model would be useful: The narrative approach in a best-quality organizational environment, which must be improved through a specific educational path- allows to devote the right time to narrative nursing; way, by integrating the bio-medical with the psycho- to create a working team with co-workers and staff at social nursing in the professional practice They represent the first topic and a special educational pathway, which until level of negotiation, by giving them more freedom of now has been too much underestimated.
In the wide Italian healthcare setting, a significant Therefore, at third level, the narrative nursing omission must be recorded in the use of this method; integrated represents a high-added value to nursing, nevertheless, the biomedical model, which has not yet because of positive effects on outcomes of patient care been integrated, remains the main reference model Patients and their for an important cultural change.
In Italy, a high de- relatives defined narrative as a kind of support in or- gree of interest for the narrative approach is recorded. The and practice this healthcare approach. Even the use References of pictures during narration, together with the exami- 1.
Quaderni di Medicina de Il Sole24Ore Sociologia della malattia. An introduction]. Fran- 2. Medicine, Rationality and Experience: An An- coAngeli, Cambridge Univer- The political role of illness narratives. J Advan sity Press, Nurs ; 31 6: The need for a new medical model.
A challenge Aiutare a vivere: Science ; Narrative based medicine e medicina di genere Knowledge to nursing care]. Sorbona, Medicina Dalla raccolta dei dati al colloquio infermieristico: Narrativa ; 1: When the Hospital Becomes Home: J Contemp Ethnogr ; to the nursing interview: Nursing oggi ; 6.
Nursing science: Major paradigms, theories, and science]. Nursing oggi ; 3 8: Psicologia della salute: Carocci Faber, Narrative Medicine: Form, Function, and Ethics. UTET, Ann Intern Med. Patients and healers in the context of culture: The narrative in neurology and psychiatry. Neu- an exploration of the borderland between anthropology, ropsychiatry ; University of California Ready to listen: J Pain Symptom Manages ; 43 3: Concepts of practice.
New York: Meaning Construction in McGraw-Hill, Palliative Care: The Use of Narrative, Ritual and the expres- Guide to Nursing Management and sive Arts. Am J Hosp Palliat Care ; 23 4: Mosby, Narrative and medicine. N Eng J Med ; Cento modi per guarire.
Enciclo- 9: Una rassegna completa, chiara e Narrative Evidence Based Medicine.
Encyclopedia of the other medicine. The marriage of evidence comprehensive review, clear and accessible to all methods of and narrative: J care unofficial]. Red Edizioni, Eval Clin Pract ; 17 4: Modello assistenziale tradizionale e integrato a Heidegger and meaning: Nurs Philos ; 1: Paul Ricoeur e il fondamento del filosofare model and integrated compared: Lo social-relational outcomes of patient with acute coronary sguardo - Rivista di filosofia ; Unpublished PhD dissertation.
Charles Taylor, phronesis, and Parma, Ethics and interpretation in illness narrative.
Chronic pain Milano: Ambrosiana, A phenomenological study. Narrare la malattia. Nuovi stru- Chronic Illn ; 8 3: Narrative possibilities: Carocci, Perspect Biol Med ; 48 1: The illness narratives: Storie di cura. Medicina narrativa e medicina delle the human condition. Basic Books,