Comfort Theory: An Overview

In the light of current nursing shortage, health care system should find the means to address this problem in order to continue achieving the goal, which is to provide the optimum level of health of a person or client. 

During the 1900’s, comfort is considered the goal of both nursing and medicine because it is believed that comfort will lead to recovery. Comfort is a complex term and titled as one of the distinguishing characteristic of the nursing profession yet, it has never been conceptualized, studied and researched in the field.

In this part of the blog, you will notice that we include certain terms about the theory in which you may get confused of but don’t worry because each will be discussed further as you read the other posts in this blog.

Pioneering the work on theory of comfort in nursing is Dr. Katharine C. Kolcaba PhD, RN, an American nursing scholar, a clinical nurse specialist who attained several scholastic awards and achievements. With her collated readings, knowledge, experiences and researches... she was able to provide a holistic definition for comfort not only in nursing but for the whole health care team.

The theory of comfort is one of the many middle range nursing theory because it is focused on a limited dimension of the reality of nursing. It is formulated to provide guidance for everyday practice and scholarly research rooted in the discipline of nursing. 

Comfort Care in Various Healthcare Disciplines

Kolcaba’s comfort theory is not relevant only in the nursing field, but also engages the other healthcare disciplines. When providers of health care are driven to the same goal of making comfort available, the needs of the patient is adequately met. Furthermore, improvements in health seeking behaviors as well as institutional integrity is experienced. The following case sample illustrates comfort care continuity across the various healthcare fields.

Mr. S. is a 45-year-old Canadian man who has just been admitted to the ICU postoperative cardiac surgery. He has had an uneventful coronary artery bypass graft with no complications in the operating room. He is intubated and placed on complete mechanical ventilation. His vital signs are: blood pressure (BP) 150/90 mm Hg, heart rate 86 beats per minute, respiratory rate 12 breaths per minute, and temperature 35.3[degrees]C.

The surgeon caring for Mr. S. is familiar with Kolcaba's comfort theory and structures the orders accordingly. The target systolic BP for Mr. S. is less than 130 mm Hg and the surgeon's postoperative orders include BP medications and intravenous morphine sulfate for pain. In addition, the surgeon prescribes an nonsteroidal anti-inflammatory drug, ketorolac, to be administered to the patient once it has been determined that they are not bleeding excessively and have acceptable renal function. This close attention to treatment of pain represents a comfort intervention instituted by the surgeon that not only addresses a particular healthcare need of the patient but also recognizes the importance the surgeon has placed on of the relief form of comfort. There is a standing order in place for warming patients postoperative coronary artery bypass graft.

NARS

This personal blog entry was made way back December 08, 2007... It may be out of place here, but my primary reason of re-posting it is for us to see where we have been through before. It is in our formative years as nurses (student nurses) when our clinical instructors and professors shared to us that nursing care will truly be appreciated once we provide comfort to our patients. Anyway, we all started developing our comfort caring attitude as nurses during our college years. Now, take a glance at our memory lane! 

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Last Friday I applied for my SSS and TIN numbers to finally complete my UST Hospital staff nurse position candidate requirements. I am not yet qualified for the position because I'm still for interview and still a lot more processes and qualifying stuffs to hurdle before making it there. I passed the requirements and my objectives for the day were met. So just to kill the time I decided to pass by SM Manila to take a good look at what they offer during their Friday sale. Only to realize that I'm broke. Huhu.. And I barely have enough money for fare to get home. Oh I just miss my college days... Thinking of my bum status just makes me so devitalized... Edi nag-window shopping nalang ako... :p

While strolling I saw a movie poster featuring some nurses.. So to satisfy my curiosity I went on the 4th level to examine the movie poster. It was Jennelyn Mercado on the title role and some local artists as nurses. It was produced by Carl Balita. And to shorten it all.. I watched the movie.. Haha.. Then the desire to learn about the movie was satisfied.. Take note.. Only the desire to know about the film was satisfied but I'm not claiming that the film satisfied me. (?!)

NARS featured the lives of a group of nursing students on their last year of college on their way to the board examination. The language used was simple but they also used some technical terms in which only individuals in the medical field could relate to such as petechiae, TAHBSO, Billroth, IMCI, etc. Technically, the film making was not so good yet not so bad. Although problems with blocking, lighting, and picture quality were obvious.

Theme-wise, I was so able to relate with their struggles as nursing students, the sleepless nights, the patients hesitant to cooperate with the students, the chismisan in the nurses' station, an inconsiderate clinical instructor, and a lot more. The movie featured numerous issues in the nursing education today but not much effort was given to tackle the issues in profundity. Acting-wise, okay lang...

Each character in the story presented their reason for taking up nursing and believe me you could relate to their reasons. As in I could see my classmates back in college in them especially when answering the question, "Why nursing?" and surely you'd get varied responses.  

I believe I saw a classmate, a board topnocher, Jaimie Mislang, in the movie. It was a clip of the Oath Taking last October 2, 2007 at the Araneta Coliseum. Nakapasa kasi yung mga nursing students ng story sa board exam kaya pinakita yung Oath taking. Eh nakita ko si Jaimie. Ahehehe. I'm uncertain if it really was her with her right hand raised.

Since I was able to relate to some points in the lives of the nursing students and I saw a classmate in the movie, I give 3 out of 5 stars for NARS.

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As of re-posting this entry, July 04, 2010, the DVD version is still available at the PNA Center at Ermita, Manila. 

- Heherson Morales, RN

You Make A Difference

Be moved. Take some minutes off and see and feel how our patients value us. Thank you, nurses.