Maslow’s have the perception that their opinion

Maslow’s Hierarchy
of Needs is a non-nursing theory that many people are familiar with. Abraham
Maslow developed a theory in 1943 that motivates individuals to achieve certain
needs in order to eventually attain self-actualization or reaching one’s full
potential. Maslow’s theory is based on one level or tier of needs being met
before moving onto the next level. There are five ascending levels in this
theory: physiological, safety, belonginess, esteem, and self-actualization. The
physiological tier consists of the most basic needs of humans such as air, food,
water, sleep, and other factors that affect homeostasis. Once our basic needs
as humans are met, the individual will go to the next tier, safety. This includes
security of the environment, employment, heath, and having proper resources.
Belongingness is achieved by having friendships, love, and intimacy. Esteem is
the next tier which includes confidence, self-esteem, achievement, and respect.
The final tier in Maslow’s hierarchy is self-actualization which consists of
morality, creativity, and problem solving. The first four levels are considered
deficiency (“D-needs”). “Deficiency needs arise due to deprivation and are said
to motivate people when they are unmet” (McLeod, 2017). Not until the needs of the
person on the current level have been satisfied will the person be motivated to
attain needs on higher tiers of the hierarchy.

            Maslow’s theory is applied in the
nursing setting as a guide to prioritize patient care and needs. It contributes
to nursing knowledge by providing the framework which enhances nursing models
for patient assessment, care, and interventions. According to McEwen (2014), “Although
one might “borrow” theory and apply it to the realm of nursing actions, it is
transformed into nursing theory because it addressed phenomena within the arena
of nursing practice” (p. 40). In labor and delivery, all the tiers of Maslow’s
Hierarchy of Needs are applicable. The tier I focus on with the majority of my
patients is that of esteem. Validating my patient and her experiences through
the labor and birth process is essential. Often times in scenarios where woman
have experienced emotionally traumatic births, esteem through validation was
not demonstrated. Women who have the perception that their opinion mattered and
whose choices were validated had better psychological outcomes following delivery
(Green, Coupland, & Kitzinger, 1990). One important component is choice. By
giving the patient the choice, she is empowered and validated that her opinion
matters. An example of that is the position in which the patient pushes in for
delivery. Many times, lithotomy is the position preferred by doctors and
especially residents. I had a patient who was preparing to delivery her second
child. It was time to push and the resident had her positioned on her back in
the lithotomy position. We pushed for over an hour in that position and made no
progress in the decent of the fetal head. Understandably, in certain situations
the lack of decent of the fetus is a cause for concern suggesting maybe the
infant will not fit and a cesarean is the best option. This was not true for
this patient. The lack of fetal decent was simply due to the patient ineffectively
pushing. The patient said to me “I can’t do it. It’s not working!” I validated
her opinion and encouraged her by telling her and she could do it and was
indeed “doing it.” I suggested different positions for the patient to push in
and gave her the option to decide the position. This way she felt empowered in
her plan of care. We pushed for an additional 30 minutes in a hands and knees
position the patient had chosen in which she pushed effectively. That night she
delivered a healthy baby girl.

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            Maslow’s hierarchy of needs is applicable
in a variety of different nursing situations. Not always is the esteem tier the
one that is addressed in labor patients. For this particular patient, esteem and
validation were what she was motivated to achieve. Through esteem and
validation, I was able to help her in her labor and delivery which in turn enabled
her to have a more positive experience in the birth of her daughter.