Phronesis of Home Nursing Care Severe Heart Failure Patients and Their Families to Continue Gentle Home Care:Analysis by ‘Case Study to Understand the Meaning of Care’

Abstract

This is a case study of a patient with severe heart failure who was discharged from the hospital based on his strong wish, and could continue receiving gentle home care.

Post-discharge, the nurse faced issues such as the patient’s “life crisis,” as well as the “crisis of being unable to decide on a treatment plan” due to a gap with the family’s wishes, and the “crisis of care by the wife.” However, the nurse was determined to provide unwavering support to him until the end. The nurse took actions before a crisis developed by reviewing the patient’s entire journey up to continued home care and continued to take an accepting approach to the entire home care.

The nurse listened to the true feelings of each family member at an appropriate time by becoming a part of the family without being intrusive, and connected the feelings of all family members without leaving anyone out; thus, gradually bringing them together, centered around the patient’s wife. She had been very anxious when he was first discharged from the hospital, therefore, the nurse assured her that there would be immediate nursing support in case of an emergency, and told her not to work too hard to prevent breakdown of the care. The nurse learnt what the wife could do independently and helped her gradually improve this. The nurse respected the patient’s wife, who is the specialist as far as knowing the patient is concerned, and worked closely with her to create the best possible care program for the patient.