Running head: BSN STUDENT LEARNING OUTCOME 4

BSN Student Learning Outcome 4:

Manage the Direct and Indirect Care of Individuals, Families, Groups, Communities, and
Populations to Promote, Maintain, and Restore Health
Megan J. Stucki
Dixie State University

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Abstract
The direct care of patients goes well beyond their individual person to include families and
communities. Care is emphasized in order to promote individual as well as community health
and long-term well-being. Commitment to healthy lifestyle practices is essential in a healthcare
provider who desires to instill that same dedication to patient and community alike.

BSN STUDENT LEARNING OUTCOME 4

BSN Student Learning Outcome 4:

Manage the Direct and Indirect Care of Individuals, Families, Groups, Communities, and
Populations to Promote, Maintain, and Restore Health
Direct care may be the hallmark or calling card of nursing. As such it deserves our full
effort and commitment, which in turn will produce the greatest benefit. As nurses care for
patients and families at the bedside, they are afforded a great opportunity. We have a duty to
promote health and well-being by educating our patients and the community about healthy
lifestyle choices. We have a duty to facilitate restoration of health in whatever capacity we find
ourselves. Lastly, we have a duty to advocate for our patients. We must recognize and seize these
opportunities if we are to see any change in the health of the people of this nation.
In an effort to understand what we are asking and often expecting of our patients it is also
my personal belief that we must practice what we preach. In doing so we are able to support our
patients in these changes. We may offer personal experiences when appropriate and perhaps
more importantly avoid hypocrisy, which tends to negate advice and potential adherence to
prescribed treatment plans and lifestyles. A sense of empowerment comes to each individual as
they feel supported and equipped to make changes.
Direct and Indirect Patient Care
Direct nursing care takes a specific form, which is understood using the acronym
A.D.P.I.E, a process learned during my associate nursing program. We assess each individual for
both subjective and objective symptoms. We use nursing diagnoses to then plan interventions
which are implemented; such as, patient procedures and education, and direct care. Finally, we
then evaluate the effectiveness of treatment and readjust as necessary. This process is continued
until the patients and primary physicians health care goals are met. Direct care requires

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communication between patient and provider, which is bolstered by and relies upon a trusting
relationship.
Indirect care is another vital part of health improvement. It requires knowledge of
information technology, the ability to document or chart patient information, and collaboration
with other people involved in the care process. As with direct care, while implementing indirect
care we practice patient advocacy. Interestingly, Mahlin (2010) notes that, patient advocacy
would achieve greater success if it was understood and expressed as a collective responsibility.
Mahlin goes on to state that part of our duty as a nurse includes protecting our patients
autonomy, protecting them from paternalism, and help bring about reform to patient care.
These efforts require a committed effort from individual nurses and groups of nurses to
implement change.
Personal Experience with Direct Patient Care
After obtaining a license to practice as a registered nurse I gained employment at a
treatment center for adolescents with a myriad of struggles. Some of these struggles include:
drug and alcohol abuse, truancy problems, running away, behavioral and psychological
disorders, and on occasion legal issues. On average I help care for ninety students who live, eat,
attend school, and spend their leisure time in this locked down facility.
This has provided me a unique opportunity to build great therapeutic relationships and
rapport with the students. As I do so I am better able to address their needs, which at times they
often struggle to explain given their limited life experience and presenting issues. We often
speak with parents or guardians regarding their childs health or incidents which occur on
campus. This has also afforded me the chance to develop advanced communication skills,
understand how to better help each student, and advocate for their health.

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Conclusion and Future Nursing Practice

A strong man cannot help a weaker unless the weaker is willing to be helped, and even then the
weak man must become strong himself; he must, by his own efforts, develop the strength which
he admires in another. None but himself can alter his condition.
- James Allen
Patient care, whether direct or indirect, is a vital portion of the health care process. As a
nurse I take pride in the part I play in providing exceptional care. In his book, As a Man Thinketh
(2010), James Allen postulated that the thoughts one entertains in the mind create the life one
lives. If this is true, then thoughts of health, vitality, and an ability to adopt healthy choices for a
lifetime are to be taught and encouraged of our patients.
A commitment to nursing excellence extends beyond the confines of the hospital, the
treatment center or community health center. It requires of medical professionals the ability to
think and do the same for themselves.
In conclusion, Allen (2010, p. 3), wrote,
A man's mind may be likened to a garden, which may be intelligently cultivated
or allowed to run wild; but whether cultivated or neglected, it must, and will,
bring forth. If no useful seeds are put into it, then an abundance of useless weed
seeds will fall therein, and will continue to produce their kind.
As a nursing professional I am superbly positioned to cultivate or nurture patients
suffering from disease due to neglect and/ or choice, and cultivate seeds of good health
which will produce future seeds of a like kind.

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References
Allen, J. (2010). As a man thinketh. Salt Lake City, UT: Bookcraft. Retrieved February 25, 2016
from http://www.nupathz.com/ebooks/As%20a%20Man%20Thinketh.pdf
Mahlin, M. (2010). Individual patient advocacy, collective responsibility and activism within
professional nursing associations. Nursing Ethics, 17(2), 247-54.
doi:http://dx.doi.org/10.1177/0969733009351949