Magazine article American Nurse Today

Introducing the Quantum Patient

Magazine article American Nurse Today

Introducing the Quantum Patient

Article excerpt

ASA YOUNG VISITING NURSE working in Cincinnati, I was asked to go to the home of a woman who was "not compliant." This woman, who had a history of high blood pressure and blood clots, was pregnant for the seventh time in 5 years. Her doctor had prescribed a diaphragm with spermicide. She and her husband lived in the attic of her parent's home; it had one bathroom on the first floor where she kept the birth-control "equipment." Her husband strenuously objected to the interruption a trip to the bathroom required, so she put in the diaphragm every evening before he came home from work. The diaphragm would become dislodged as she fixed dinner, cared for the children, and did other chores. No healthcare provider in those 5 years had asked her about her living conditions. Pregnancy was dangerous for her, so they prescribed something, which, as it happened, was inappropriate for her situation.

A patient is a person: indivisible; one. Quantum means small, tiny, one. Irreducible. Simple. Indivisible. So totally interconnected that no part of her being can successfully be isolated A quantum patient is one, singular, whole, indivisible human being who is suffering--in this case, from high blood pressure, blood clots, and too many pregnancies too quickly. The Cincinnati woman could have told us what the problem was, and it wasn't willful noncompliance. The problem involved her whole life situation.

During the past century, great success was achieved through specialization. Experts resolved distinct problems within well-defined fields--and no field has been better defined than medicine. The organizations in which doctors and nurses worked, primarily hospitals, also became specialized; even the departments within hospitals became highly specialized--so much so that many hospitals instituted "product line management," which formally created specialized organizations within the specialized hospital.

The success of specialization resulted in a daunting progression of unintended consequences, not the least of which was widespread fragmentation. We divided humans into discrete bodily systems, neglected anything outside the body, and ignored the interrelated nature of the body itself. We know now that problems no longer fit within strict medical specialties, and effectively treating them no longer supports traditional specialization. We know it, but we frequently disregard it.

Effective treatment and disease management exist in between the specialties, fields, disciplines, and categories that evolved over the last century. …

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