Thinking in Wholes

The world extends far beyond the walls of a hospital where patients go to receive treatment. For the workers within those environs, however, those walls can lead to feelings of pressure as large volumes of patients are processed and discharged. In spite of the task-oriented demands of the profession, nurses are expected to meaningfully contribute to the life of the global patient, not just the momentary patient. In doing so, they can foster an environment that encourages big picture focus and engenders trust in the role between patient and caretaker.

One pattern of change in thinking that I could immediately address lies in a shift from the realm of thinking in pieces to thinking in wholes - or, critical thinking. Another way to state it would be to highlight the difference between singular focus and a global approach. Within a singular focus, people concentrate on the immediate task at hand. Rubenfeld and Scheffer (2010) model a metaphor of studying the intricacies of a single tree only to miss the beauty of the composite of the forest (p. 300). With the unavoidable value of completing tasks within the nursing profession, it remains facile to neglect the totality of the patient, especially in intensive care units where turnover occurs at a rapid rate (Rubenfeld & Scheffer, 2010, p. 300). Why is the patient in the hospital in the first place; what is the root cause of the issue? Such questions left undefined may render task-oriented services as mere band-aids rather than contributing factors to long-term solutions.

The big picture in nursing is an idea that transcends all nationalities to strike a resonating chord at the heart of the profession. In Denmark, Sørensen and Hall (2011) examined the value of this matter as a source of human and professional pride, stating "seeing the big picture indicates a desire to do good for both patients' and staff" (p. 2284). In this case, thinking of wholes concerns broader elements of providing leadership in the workplace and looking out for the needs of co-workers who may be in difficult moments (Sørensen & Hall, 2011, p. 2284). By considering the needs of all individuals within a caretaker unit, effective nursing leadership can promote a caring atmosphere worthy of the nursing profession.

In the course of my work, many opportunities exist to begin thinking of wholes and implement big picture thinking in my professional development. No matter where I am or how much time I have with a patient, I realize I have an important responsibility to care for the whole person. In doing so, I will think ahead in anticipation of opportunities where I can teach "little things" to patients and family members succinctly and with clarity (Rubenfeld & Scheffer, 2010, p. 300). In my practice environment, I recognize that tasks center around the careful execution of details and provide the crux of my job position. However, acting in a task-oriented way can often cause situations where the patient themself is actually overlooked. To address this, I will also examine end-of-shift reports and work to maintain track of how many the patients' exterior world is mentioned (Rubenfeld & Scheffer, 2010, p. 300). In this way, I may apply my tasks to the broader scope of their life.

In my current position, I have the potential to act as a leader. By seeing the bigger picture, I must learn to focus on the now of the moment by addressing immediate health needs and have the foresight to extrapolate known issues and make them relevant for the patient in anticipation of future events (Sørensen & Hall, 2011, p. 2284). By adopting a caring attitude in all of my professional interactions, I can take initiative to ensure a positive work environment.

Acting to think in wholes ultimately yields situations where the big picture comes under consideration. When the lives of patients come into play, nurses must act to promote environments that attend to routine responsibilities as well as to thinking ahead for the needs that may occur after discharge. Coupled with an attitude that strives to promote the well-being of colleagues, a harmonious interaction can become reality.

References

Rubenfeld, M. G., & Scheffer, B. K. (2010). Critical thinking tactics for nurses: Achieving the IOM competencies (2nd ed.). Sudbury, Mass.: Jones and Bartlett.

Sørensen, E. E., & Hall, E. O. (2011). Seeing the big picture in nursing: A source of human and professional pride. Journal of Advanced Nursing, 67(10), 2284-2291.