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Emerging Standards of Care


Globally, health care systems have changed to provide quality care to patients but conversely, nurses have had increased workloads and responsibilities all together. Today, nurses have to contend with the fact that patients have an increased acuity and are more complex with regard to their health conditions. Due to these reasons, nurses are forced to be more creative in preserving their health care provisions and Jean Watson’s caring theory is one way through which this goal can be easily accomplished (Cara, 2010, p. 1).

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This study will use this theory as a guideline to developing the best nursing practice for the care of veterans in Las Vegas, Nevada. Through this pragmatic study, the Watson caring theory will outline the details of how we can develop a culturally competent health care program that will be exclusive to caring for veterans in their specific locality. Comprehensively, the Jean Watson theory together with the patient centered care approach to nursing will be used to develop a quality nursing system that will meet high quality nursing guidelines.

Culturally Competent Care

A culturally competent care for my workplace would be that which cares for the specific needs of the patients. Patients often fall into different demographic patterns, but based on culture, patient care should be tailor made such that it is appropriate to the cultural identities of the patients. A culturally competent patient care program is however reliant on the principle of good patient to nurse relationship and the ability to care for patients’ wellbeing. These initiatives should however be undertaken comprehensively because they are to incorporate the input of all stakeholders including the hospital, partners and the community in general.

Usually, standards are often upheld so that institutions can secure funds from the federal government or for the standards to be adopted by interested agencies or within the organization. However, the most important function for adoption of these culturally sensitive standards is for patients to get the best care and be comfortable in the entire healing process. Their safety during the health care provision process is also guaranteed in this process.

Health care providers should be sensitized to provide patients with care that is in tandem to their cultural health beliefs. This therefore means that the health care provider should ensure he/she upholds high levels of respect and understanding towards the patient’s cultural beliefs (Office of Minority Health, 2007, p. 5). Health care organizations and institutions should also ensure they recruit personnel who are diverse and flexible. They should also be recruited from the demographical area to which the patients come from because they will relate better to the patients.

In the context of this study, health centers should recruit and retain staff who have a significant experience with veterans or who have knowledgeable on their unique needs. A diverse staff which can relate to the patients’ unique needs is therefore very crucial in ensuring that patients feel their needs are well accommodated. In addition to recruiting and retaining staff who are versant with unique patient needs, it is important that health centers ensure health care providers undergo continuous training in linguistic and upheaval of culturally appropriate practices (Office of Minority Health, 2007, p. 5).

The hospital administration should also make adequate arrangements to cater for patients who may not be proficient in the English language by providing translation services or employing bilingual staff who are well versant with the patient’s language (at no cost). These services should be communicated to the patients in both verbal and written forms. However, some patients may be lured to incorporate translation services from a family member although this should be highly discouraged, let alone tolerated. However, an exception should be made when the patient specifically requests that a family member translate the information. In close relation, the health care providers should be in a position to avail patient friendly materials like brochures to the patients in their native languages.

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The hospital’s administration should also undertake the initiative of benchmarking various aspects like accountability, operations plans, policies and procedures which are related to culturally sensitive practices to ensure health care is maintained at high levels. This should be outlined within the context of a strategic plan (Office of Minority Health, 2007, p. 9). In the same regard, they should also ensure evaluation processes are undertaken periodically so that the efficiency of the health care workers is maintained.

Population Served and their Vulnerability

This study is aimed at providing the best health care services for veterans. Veterans are a population group that have underwent prolonged years of war in other countries and most often have a high chance of physical injury or increased exposure to environmental diseases (considering the nature of their work). Most of the people in this population group are male but it should not be mistaken that female veterans are few.

Considering veterans have served most of their lives in service of their country, they usually retire with very little savings and most often find it difficult to engage in other types of gainful employment. Moreover, this population group is most often aged and has a family to take care of; without much financial assistance. Due to their ages, veterans are highly prone to diseases associated with diabetes, reproductive health disorders, cardiovascular complications and others. In this regard, more emphasis should be made to these types of complications; meaning health centers should employ physicians who are experienced in dealing with such types of complications.

Considering the difficulty of engaging in other types if gainful employment, veterans are more likely to find it difficult financing their health care costs than any other population group. It is therefore important that health care facilities provide cheap and affordable health care for them. Most importantly, this population group is highly vulnerable to physical injuries they may have sustained during war and many of the patients usually find it difficult coping with their new condition if such eventualities lead to disabilities. It is therefore important that health care facilities offer some form of therapy or counseling services to help the patients recover from their conditions.

Standards that Appear to be Met or Unmet

Standards Met

A friendly environment for healing is met in this criteria because, it is easy for the veterans to feel at home due to language conformity with the health care workers in Las Vegas and from the fact that health care workers can understand their profession was aimed at fighting for their country. The health care workers are also likely to respond positively towards the needs of the veterans through continuous training to be provided by the health facility in a periodic basis. This will enable the health care providers to be well acquitted with appropriate health care services (Georgetown University, 2007, p. 2).

Benchmarking standards are also effectively met especially with proper allocation of funds to staff improvement initiatives and periodic evaluative procedures to ensure programs aimed at incorporating a cultural sensitive environment is in place. All forms of communication have also been undertaken in verbal and written forms especially through the use of brochures, such that patients are well informed of the health care services they will be subjected to.

With regard to community partnerships, a lot has been done to ensure enough participation of all relevant stakeholders is incorporated. Currently, there is no sense of abandonment given to veterans by the government as was previously noted and the general community at large is very supportive of the work veterans have done for the country. The government has especially improved its health care policies regarding veterans and a lot has also been done by the community to provide emotional support to ailing veterans.

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Unmet Standards

Though health care provision has been improved over the past few years, there is still a lot to be done to ensure health care gets a personal touch. Currently, health care providers are providing basic services by the book, as opposed to giving their services a personalized touch that conforms to the needs of the patients. A lot therefore needs to be done to expand the perceptions health care providers currently have regarding provision of effective and basic health care.

Implications of met and Unmet Standards

Met Standards

A benchmarked process of health care delivery is bound to maintain high standards of health care provision. It will ensure the health care facility has the highest most acceptable health care quality in the market which is also bound to imply faster healing of patients because the healthcare provided will be comprehensive in nature. In addition, the maintenance of good channels of communication between the patient and the health care service provider is likely to improve patient-nurse relationships in the long run and will also increase the level of trust and honesty the patients and nurse can accommodate (Dossey, 2009, p. 371). Finally, the maintenance of an all-stakeholder partnership is bound to ensure the health care facility gets enough support from the community and partners; whether it is in terms of financial or emotional support.

Unmet Standards

Unmet standards of basic health care provision without a personalized touch may later lead to the development of more health complications because patients may suffer from psychological complications. When the patient’s psychology is not in tune with healing, the patient may take a longer period to recover than expected. Patients are also never comfortable with their surrounding and may exhibit withdrawal symptoms because of a lack of emotional support. It is therefore important that nurses provide a comprehensive form of health care provision.

Solutions to improvement of Unmet Standards

For health care givers to provide a personalized and patient oriented form of health care delivery, it is important that the perception of health care be opened. These principle is supported by Jean Watson’s theory which bases an ideal care on there principles of carative factors, transpersonal caring relationship, and the caring moment between health care givers and patients. An ideal health care service delivery will therefore be reliant on the above principles and are detailed as follows:

Carative Factors

Carative factors are often perceived as a pillar to the profession of nursing. Typically, carative factors have been used in contrast to contemporary curative factors. Distinctively, carative factors appreciate an important core of nursing which is the humane component of nursing. In other words in the development of a culturally competent nursing care for veterans, the ideal system would have to identify with their inner world and the experiences they have gone through in the course of their profession.

The carative factors to be considered therefore have to be built on specific elements including an altruistic system or values, an emphasis on appreciation of unique patient values, sensitivity to self values and patient values, building a sense of trust, careful expression of positive and negative sentiments, tactful problem solving techniques, interpersonal learning and teaching, support in spiritual and physical development and supplement of patient needs. These attributes are essentially aimed at giving personal care and showing love to the patients (which practically involves being physically present for the patient whenever he/she needs the nurse).

Interpersonal Care and Relationship Nurturing

Interpersonal relationships are based on the nurses’ willingness to nurture a unique kind of human care that is based on the nurses’ moral commitment to exhibit human values and dignity as well as uplifting personal and patient values. This should be observed in the context of embodying the human spirit and not just merely maintaining the moral status of a patient, like an object. This kind of care therefore needs to be administered at a conscious level because there is interplay of experience, perception and intention, all at the same time (Miller, 2008, p. 24).

In essence, this level of commitment requires the nurses to go beyond their usual job task fulfillment and cater to the patient’s subjective and deeper need; other than the surface need to get better. This requires that the nurse engages her caring consciousness so that she can relate to the unique perspectives of the patients. In this study, this will involve the experiences of the veterans at war and the deep perceptions and convictions towards the same. Interestingly, this experience will highlight the differences that may exist between the caregiver and the patient but will also expose the mutuality between them.

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This is a core pillar towards the strengthening of the relationship. In other words, the health care giver and the patient are all engaged in a process to discover their wholeness and meaning through the relationship. Interpersonal relationships therefore transcend the ego of an individual because it goes into spiritual connection or cultural identification that fosters the patient’s healing and comfort (McCormack, 2010, p. 27). The ultimate goals for the nurturing of this kind of relationship rests in the fact that patients will be protected, healing enhanced and the dignity, humanity and wholeness of the patient will be preserved if not improved.


Research studies have observed that it is important for the nurse or the caregiver to be in tune with why he/she has to be in the caring moment with the patient so that they may achieve personal motivation (Basavanthappa, 2003, p. 8). In addition, both the patient and the caregiver can all benefit from the influence of the caring moment through the decisions chosen and actions that follow. This therefore has an impact in the overall life history of both parties. The caring moment between the two individuals becomes a form of transpersonal relationship especially when it allows for the engagement of spiritual and cultural concepts because it allows for the expansion of honesty and trust between the patient and the caregiver (Peterson, 2008, p. 194).


The Jean Watson theory enables nurses to identify deeper with their professional roots and values which are essential in the provision of high quality nursing care. Moreover, it helps nurses develop an archetype of an ideal nursing system that can be used to endorse professional identity in a field that fails to meet humanistic values expected of specialized nursing care. Its success can be pegged on the fact that the theory enables nurses feel gratified instead of just perceiving their career as just a job. In this manner, nurses, will not only provide the best care but show compassion to the patients; such that their dignity is exemplified and their healing accelerated. In most cases, nurses often achieve a sense of actualization.


Basavanthappa, B. T. (2003). Fundamentals of Nursing. London: Jaypee Brothers Publishers.

Cara, C. (2010). A Pragmatic View of Jean Watson’s Caring Theory. Web.

Dossey, B. (2009). Holistic Nursing: A Handbook for Practice. New York: Jones & Bartlett Learning.

Georgetown University. (2007). Cultural and Linguistic Competence Checklists for MCH Training Programs. Web.

McCormack, B. (2010). Person-centered Nursing – Theory and Practice. London: John Wiley and Sons.

Miller, C. (2008). Nursing For Wellness in Older Adults. Michigan: Lippincott Williams & Wilkins.

Office of Minority Health. (2007). National Standards on Culturally and Linguistically Appropriate Services (CLAS). Web.

Peterson, S. (2008). Middle Range Theories: Application to Nursing Research. Michigan: Lippincott Williams & Wilkins.

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