Sick Role

1. INTRODUCTION
The patient and nurse meet as two strangers. The patent/family have a need for help therefore professional assistance is needed and the nurse in this phase needs to assist the patient and family in healing what’s happening with or to the patient. It’s important that the nurse works together with the patient in analyzing the situations so that the can clarify and recognize the condition.

2. BODY
2.1 The identical phase
The patient reacts or responds selectively to people who can meet his or her needs so each patient responds differently to the sick role. The patient might actively need the nurse out or wait until the nurse professional seeks him/her out so the patient response is three folded so she may participate with and be independent with the nurses (ii) be autonomous and independent from the nurse (iii) be passive and dependant on the nurse. Throughout the identification phase, both the patient and nurse must clarify each other’s perceptions and expectations, post experiences of both the patient and nurse will have a bearing on what their expectations will be during this interpersonal process. The initial attitude of the patient and nurse are important in building a working relationship for identifying the problem and deciding on the appropriate assistance. (PEPLAUI’S PHASES IN NURSING) 2.2 Expressive role of a nurse

During the illness role, the patients may make more demands than when they were seriously ill. They apply minor requests as other attention seeking techniques depending on their individual needs. These actions become difficult if not impossible for the nurse to completely understand. The nurse must deal with the unconscious forces causing the patient’s actions. The principle of interviewing techniques must then be used in order to explore, understand and adequately deal with the underling problems. It is very important that the nurse explores the possible causes for the patient’s behaviour.

A therapeutic relationship must be maintained by practicing an attitude of acceptance, concern and trust. (HENDERSON V) The nurse should encourage the patient to recognize and explore feelings, thoughts, emotions and behaviours by providing a non-judgemental atmosphere and a therapeutic emotional climate. The expressive role is more concerned with the establishment and maintenance of any extensive and effective therapeutic environment and assisting the patient to become receptive to therapeutic intervention. As a nurse, you should accept the person as if he/she is with full recognition of his/her individuality, fears, hopes and recovery potential. Supporting him/her through basic nursing care demonstrates the concern of the nurse for the patient (GOLDSMITH J & JOHNSON E). 2.3 The instrumental role

This role is more concerned about practical involvement of the nurse to the patient, her knowledge and skills, the evaluation of such knowledge and the utilisation of this knowledge. It involves observation, diagnosis, therapeutic planning and intervention and the selection on scientific grounds. The role of the nurse is primarily expressive and to a lesser extent instrumental except where she functions in the role of the doctor or pharmacist n the absence of one or both. (CHARLOTE SEARLE) The instrumental role involves the training of student nursing professionals; delegation of administrative aspects of patient care also monitor the patient holistically and be involved in emergency actions. (DU TOIT & VAN STADEN) Some patients may take an active interest in and become involved in self-care. Such patients will become more self-sufficient and will demonstrate initiative by establishing appropriate behaviour for goal attainment. The nurse may take the initiative of reminding the patient scheduled exercise actively. (JULIA B.GEORGE) There are many challenges when taking care of the patient. Patients may be in denial of his/her condition and become frustrated, anxious and leads to the phase whereby a patient refuses treatment and leads to slow recovery and a nurse hers to play a parental role to nature the patient’s emotions and feelings prior to him/her rendering her services. 2.4 Conflict in sick role

Due to illness an individual may see himself/herself as not being productive enough to his/her family due to being sick and forces him/herself to perform duties as o provide for the family even though he/she aggravates the condition if not hospitalised. A sick role that the individual is caught up in cause a conflict within him/her and the patient becomes confused whether to tolerate the treatment or quit to responsibilities involved. A nurse may be involved by making the patient accept the sick role even though hard for the nurse but has to be persuasive for the sake of the individual’s health as well as their well-being. (MELLISH) Role conflict may be caused by disability or injury of the patient which makes individuals to be dependant on the nursing staff during hospitalization and the person cannot resume his/her hobbies, work and frustrated whether the condition might be permanent and which will be more disturbing. Illness is a crisis in the life of everyone due to the fact that one cannot fulfil one’s normal role and duties may cause worries and delay response to treatment and recovery. (MELLISH .JM)

3. CONCLUSION
The nurse should understand the difference between the expressive and instrumental role even though at times or most of the practical times they combine automatically because the nurse has to take care of the patient holistically which is mind, body and soul of the patient as to have a happy healthy/well patient at the end of the journey.

4. REFERENCES

1. Goldsmith, J & Johnson, E. Health effects of community American Journal of Public health, vol 63, No 9 1973

2. Ethics of Nursing Practice
Pera & Van Tonder
Juta & Co, Cape Town
1996

3. Professional Practice
Charlotte Searle
South African Nursing Perspective
Butterworth, Durban
1957

4. Nursing Sociology
DA du Toit. SJ van Staden
Third Edition
Van Schaik Publishers

5. Nursing Theories
The Base for Professional Nursing Practice
Second Edition