Unit 5 – Theory & Education
Article Link – Patient evaluation of a discharge program following a radical prostatectomy
The article I chose this week is “Patient evaluation of a discharge program following a radical prostatectomy.” The article goes through many methods of doing discharge teaching for a patient who recently had a prostatectomy for prostate cancer. It includes not only the moments when the patients leave the hospital, but discharge education days prior, and in follow-up care. This area of nursing is especially important because it is where the nurse can get a lot of teaching experience. The nursing theory used in this article relates to Betty Neuman’s system model. Neuman’s model focuses on protection and prevention from stress (McEwen & Wills, 2019). Neuman’s model states that if stress is not prevented, the nurse should protect the patient’s health and wellness (RN Central, 2011). The article’s emphasis on informed discharge instructions from the nurse will prevent stress on the patient when they go home, as there are many aspects of care following a prostatectomy.
The curriculum design utilizes theory-based teaching strategies. Operational teaching strategies are used and using visual aids in teaching the patient is very effective in this situation (McEwen & Wills, 2019). One of the biggest concerns after a prostatectomy is urinary incontinence after the urinary catheter is removed. During the patient’s clinic follow-up, we tell patients they will have stress incontinence up to 6 months post-op, so we teach Kegal exercises for this. We teach patients how to perform these in the clinic, and also provide visual aids in order for them to get a better idea of what muscle they are utilizing. Patients become frustrated easily when they continue to have incontinence, so that is why Neuman’s model is important in striving to reduce this stress. Another concern that patients have is going back to ‘normal life’ after the cancer is gone. A prostatectomy has a very long recovery period, and sometimes patients feel completely better but are not completely healed until about 6 months afterward. I had a patient who felt better about 4 weeks after his surgery. It was summer, so he went on his riding lawn mower. Unfortunately, the vibration from the machine opened up some stitches and he ended up back in surgery. This teaching was perhaps not enforced, and this caused more stress on the patient.
Davison, B. J., Moore, K. N., MacMillan, H., Bisaillon, A., & Weins, K. (2004). Patient evaluation of a discharge program following a radical prostatectomy. Urologic Nursing 24(6), 483-489.
McEwen, M. & Wills, E. (2019). Theoretical basis for nursing (5th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
RN Central. (2011, September 12). 7 nursing theories to practice by. Retrieved from http://www.rncentral.com/blog/2011/7-nursing-theories-to-practice-by/