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Nursing Concept and Skills
In hospital settings, the key role of a nurse is to provide nursing care to ensure that a
hospitalized patient meets his/her basic needs. Caring is showing concern and empathy to other
people. It has 5C’s that are applicable to the nursing profession: commitment, conscience,
competence, compassion and confidence (Koutoukidis, 2016). Hygiene is the science that deals
with promotion and preservation of health. Hygiene is also those conditions and practices
promoting or preserving health (McCormack, 2014). The aim of this work is to discuss how a
nursing concept will be used while undertaking a nursing skill. The selected nursing concept is
caring and the nursing skill is hygiene requirements. This work will discuss how caring would
influence the way hygiene is undertaken. Lastly, it will discuss how caring and hygiene supports
significance as a sense of relationship centred care. Significance is a sense of feeling that one
matters as a person (Koutoukidis, 2016).
Care, Hygiene Requirements and A Sense of Significance
Caring is feeling and showing concern and empathy to other people; it is showing or having
the compassion to other people. The caring feeling also requires action. This means that just
sitting and showing empathy is not enough to be called caring, but a nurse makes an extra step to
do actions that help the patient to recover. Caring helps a patient to understand and adjust to
illness (Koutoukidis, 2016).
Caring is made up of five main features. When nurses apply these features in the workplace,
this helps to improve the work relationships, patient relationships and increase the likelihood of
the nurses to advance in their careers. Grasping meanings of these features is fairly
straightforward, but nurses should take time and effort to ensure these features are consistently
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applied in the workplace. The five main features of caring include commitment, conscience,
competence, compassion and confidence (Sloan, 2013).
Caring is important in the nursing practice especially to those patients with mental illnesses
who could not care for themselves. There are challenges of having mental problems, and these
patients may end up doing dangerous things that affect their health or eventually cause death.
Caring helps to avoid such problems. Illness has the power of striking down even the mightiest
individuals because there is no person who is immune. Through caring, a nurse sees the patient
as the whole person, not just as a patient or diagnosis (Smith & Turkel, 2013). The importance of
holistic nurse caring is that it heals the patient's mind, body, and soul. In this care, nurses think
how they could assist patients with illnesses in the body, mind, emotions, spiritual and religion
(Woods & Keady, 2016). With caring being important in nursing practice, nurses need to learn
more about it and the kind of attitudes they should have to achieve it safely and with dignity for
every person involved.
Hygiene is the science that deals with promotion and preservation of health. Hygiene is also
defined as the conditions and practices promoting or preserving health (McCormack, 2014).
There are two types of hygiene: hygiene in the workplace and personal hygiene. The key features
of hygiene in the nursing profession include sterilization of equipment for healthcare services,
hand washing, personal hygiene for patients and providing sanitation services to patients (Sie,
The reason for choosing hygiene is because this skill can greatly reduce the spread of
infections among nurses, patients and between patients and nurses. Spreading of infection is in
most cases caused by poor hygiene requirements and most of the diseases spread through direct
contact (Koutoukidis, 2016). While nurses spend time with patients in close proximity, it
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becomes difficult to avoid transfer of bacteria. Routine care by nurses often involves
administering drugs and injections to patients and determining patients’ physiological states.
Without high hygiene standards and infection control, this adds to the transmission of infections.
Diseases such as E. coli, Norovirus, coughs, colds and respiratory infections are spread through
poor hygiene, thus it critical to observe good hygiene requirements if the spread of these diseases
is to be avoided (McCormack, 2014). The other reason for selecting this skill is because it can be
used as an indicator of mental illness. Poor hygiene accompanies certain mental illnesses such as
dementia and psychotic disorders. By using hygiene as a mental illness indicator, measures can
be taken early enough before the illness becomes detrimental.
Hygiene requirements are one of the most important practices all nursing professionals
should always observe. Hygiene requirements are highly valued by intensive care unit patients
and are indicators that affect the perceptions of families about the quality of attention (Woods &
Keady, 2016). Hygiene involves providing comfort and well-being while serving as a preventive
measure against diseases and infections. To apply the caring concept, patient independence will
be observed, their privacy ensured and be treated with respect. Additionally, the focus would be
on looking for ways to involve patients in their own care and promote their comfort. This
concept will be applied while undertaking hygiene for instance by assisting in the maintenance of
the patients’ personal hygiene needs. This is because maintaining hygiene makes patients feel
more comfortable, safe and improves their wellbeing. Maintaining dignity also makes patients
emotionally comfortable thus facilitating their recovery (Sie, 2012).
Undertaking hygiene while at the same time practicing care may not be easy as caring
influences hygiene in one way or the other. One of the features of caring is conscience. To
deliver the best possible care to patients, this requires a nurse to have at all times a sense of
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moral responsibility which can be achieved by having a strong conscience. Conscience guides
nurses to undertake certain actions when stress and personal matters challenge the way they
could deliver best practices. Nurses are required to adhere to their conscience as this will always
help to put them on the right course (Watson, 2015). Hygiene needs vary across individuals and
cultures because maintaining hygiene habits is a function of cultural and socioeconomic factors,
the patient's health, age and physical state (Sie, 2012). While nurses believe that hygiene is
mandatory and adhere to this conscience by imposing their requirements of hygiene, this
compromises the values, beliefs, culture and mental state of some patients. Nurses should,
therefore, take into consideration the cultural and socioeconomic factors surrounding the patient
of interest before imposing hygiene standards.
A good relationship between a nurse and a patient is built through the consistent interaction
of the two. Because of care, a nurse is not able to delegate some hygiene activities to young or
newly qualified nurses. Otherwise, this will be acting against caring. In spite of nursing
professionals prioritizing hygiene, the nurses perform hygiene care in a sanitary and mechanical
way without understanding patients’ conditions and contexts (Koutoukidis, 2016). In most cases,
nurses intervene to their professional routines and services but do not appreciate the needs of
patients. Nurses delegate these tasks to assistants, young or newly qualified staff. According to
Koutoukidis (2016), some aspects of nursing care are unattractive since they are repeatedly done
and are physically demanding. As a way of showing compassion and empathy to patients, nurses
may not even delegate the task of bed bathing (an activity that supports hygiene and comfort) to
auxiliary team members. Delegating bed bathing may deter a nurse from getting enough
information about patient care and miss an opportunity of improving her relationship with the
patient (Sloan, 2013). Bed bathing conducted by nurses is seen as a "sacred" activity that
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encourages intimacy between a nurse and a patient and is one way of showing compassion to a
patient. Therefore, caring dictates the kind of hygiene activities undertaken by nurses.
Having compassion which forms the basis of caring is vital for all nurses. A nurse is
considered to be compassionate when she shows empathy to her patient and always provides
treatment in a kind and considerate manner. A nurse is rewarded by receiving an inspiring sense
of human connection and affirmation of the importance of her work. Showing compassion
stretches to doing actions taking into account the patient’s preferences. In spite of hygiene
requirements being of the highest priority in nursing, it is imperative to understand the stability
of a patient. Disrupting sleep, hemodynamic stability and temperature should be observed as a
sign of empathy towards patients (McCormack, 2014).
Bath taking is one the periods at which most negative events occur in the patient, mainly
during bathing or a few hours later. This is the reason it is imperative for nurses to prevent and
report incidents and make improvements to reduce deaths of critically ill patients that result from
such a practice. Some of the effects resulting from this practice include changing the patient’s
blood pressure, causing desaturation and mechanical ventilation problems, cardiac arrest and
abnormal heart rate (Watson, 2015).
A study by Sie (2012) reported that the time allocated for bed baths varied across nurse
professionals and healthcare organizations. Therefore, there is no standard time and duration of
the bath. There is also no documentation of the negative effect this practice will have on a
patient. In some organizations, nurses bath patients during night hours while others do so in the
morning because of the workload and organizational factors that support this practice. This may
be against needs and preferences of patients and does not contribute to the building of a positive
nurse-patient relationship. As a sign of empathy, nurses should take into account the negative
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consequences that may arise by bathing patients at a certain time of the day. They should also
consider their needs and preferences because this forms the basis of good caring. Therefore, good
caring affects the time of undertaking certain hygiene practices to patients such as bathing (Sie,
The concept of caring and the nursing skill hygiene requirements support significance sense
of relationship centred care. A sense of significance feels that you matter as a person
(Koutoukidis, 2016). Illness, care, and healing occur in a relationship. This relationship may be
of a patient with self and with others. Significance is the center of patient healing and the broader
health care delivery. When patients feel that they matter, this contributes to their healing process.
Similarly, when nurses feel that they matter in their workplaces, this motivates them to provide a
wide range of health care services aimed at facilitating recovery of patients (McCormack, 2014).
There is a strong relationship between caring and significance. Nurses have to deal with
patients who fall into sadness and no longer feel that they matter in this world. Practices such as
poking, prodding, testing, and scanning may make patients feel they are no longer special,
unique or important. Caring makes them feel more human. Showing compassion to patients such
as looking in their eyes, taking their hands and not talking about them, but by talking to them can
be a great way of giving them a sense of significance (Woods & Keady, 2016).
Having identified that there is a relationship between the concept of caring and a sense of
significance, we can now look the relationship between hygiene and a sense of significance.
Hygiene involves promoting and preserving health. Sterilizing equipment before using them for
another patient, hand washing and provision of sanitation services gives patients a feeling of
safety against infections. It makes patients feel that nurses are concerned about their health. This
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makes a patient feel he/she matters as a person and the nurses are protecting his/her health
against infections (McCormack, 2014).
Providing care to patients is an essential practice in nursing professional that contributes to
patient recovery. Practices such as regular scanning and testing can be demoralizing and
sometimes may make a patient lose a feeling of being human. Caring helps to make a patient feel
more human. Hygiene, on the other hand, is a nursing skill that may facilitate or reduce the
spread of infections depending on the way it is conducted. Spreading of infection is more often
caused by poor hygiene requirements and most of the diseases spread through direct contact.
Therefore, it is imperative for nurses to ensure that they meet hygiene needs of their patients not
only at the expense of proper implementation of techniques but also by taking into consideration
the nursing procedures that are supported by nursing knowledge. These procedures should also
comply with the policies that promote patients' dignity and respect.
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Koutoukidis, G. (2016). Essential Enrolled Nursing Skills for Person-Centred Care. New York:
Elsevier Health Sciences.
McCormack, B. (2014). Person-centred Nursing Theory and Practice. New York, NY: John
Wiley & Sons.
Sie, I. (2012). Personal- and environmental hygiene in Norwegian nursing homes. Journal of
Nursing Education and Practice, 5-17.
Sloan, G. (2013). Psychology for Nurses and the Caring Professions Psychology for Nurses and
the Caring Professions. Emergency Nurse, 8-8.
Smith, M., & Turkel, M. (2013). Caring in nursing classics: an essential resource. New York:
Springer Pub. Company.
Watson, J. (2015). The Attending Nurse Caring Model ®: Integrating theory, evidence and
advanced caring-healing therapeutics for transforming professional practice. Journal of
Clinical Nursing, 360-365.
Woods, R., & Keady, J. (2016). Involving families in care homes: a relationship-centred
approach to dementia care. London; Philadelphia: Jessica Kingsley Publishers.