Overview Of Each Nursing Theory

Question 1 A). Describe in your own words what you believe nursing is? -Nursing is responsible to look after sick and injured people . It is a duty of care to assess, planned ,help what their needs to keep them healthy ,comfortable and happy. A nurse must have ability to ensure their knowledge , skills ,and experience and confident to ensure their profession. B). Provide an overview of each Nursing Theory. -Self-Care Deficit Nursing Theory (Orem) Dorothy Orem’s self care deficit theory, general theory of nursing is one of the host widely used model in nursing today.

In 1914,Orem was born in Baltimore ,Maryland. She received her nursing diploma in the early 1930’s from Providence Hospital School of Nursing ,Washington D. C. In addition to earning a BSN Ed. (1939) and MSN Ed. (1945), She has received three honorary doctorates and an Alumni Achievement Award For Nursing Theory in 1980 from Catholic University of America. (Hartweg,1995). In 1978, Orem (citied in Faucett, 2005) connected that the task required in dentification of the domain and boundaries of nursing as a science and an art .

After reflecting upon her own nursing experience, Orem says then answer . come to her as a flash of in sight an understanding that the reason why individuals could benefit from anything was the existence of self care limitations. -Interpersonal relations Model (Peplau) In 1952 Hildegard Peplau made an attempt to analyse nursing action using an interpersonal Page1 Theoretical framework. Her theory focuses on the relationship formed by people as they progress through each development stage.

She viewed the goal of nursing as developing a relationship between the nurse and client whereby the nurse acts as resource person, counselor, teacher and surrogate. -Complementary-Supplementary model (Henderson) In 1964 Virginia Henderson described the goal of nursing as helping the client to gain independence as rapidly as possible and defined nursing as assisting the individual sick or well ,in the performance of those activities contributing to health, is recovery promoting quality of life or to a peaceful death that the client would perform unaided if he or she had the necessary strength, will or knowledge.

Henderson identified 14 basic needs that provide a framework for nursing care. These are breathe normally, eat and drink adequately, eliminate by all avenues of elimination, move and maintain a desirable position, sleep and rest, select suitable clothing, dress, and undress, maintain body temperature within normal range, keep the clean and well groomed, avoid dangers in the environment, communicate with others, workship according to faith, work at something that provides a sense of accomplishment, play or participate in various forms of recreation, learn, discover or satisfy the curiosity that leads to normal development and health. hrough each development stage. She viewed the goal of nursing as developing a relationship between

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Informative Essay on Nursing Theory

There is an obvious deficiency in the application of theory in nursing practice. This paper will include a discussion of how nursing practice is affected by the use of nursing theory. I will provide evidence in relation to how theory based practice relates to the core competencies of the Institute of Medicine (IOM) and Quality and Safety Education for Nurses (QSEN) project. I will discuss a journal article that reinforces the gap of practice, and interview colleagues regarding the incorporation of theory in their individual practice.

In conclusion I will express my own view point of why theory has been neglected. Nursing Practice Theory In the 1920’s the American Journal of Nursing published proof that nurses use research in their practice. The discovery of theory as a foundation of nursing practice began in the 1960’s. Research and theory exploded among the nursing profession through case studies (American Nurses Association, 2010). Nurses began documenting their research which allowed other nurses to validate the research and theory by putting the ideas into action.

Theories were developed for two main reasons: to increase education and to improve nursing care. Theory helps nursing provide exceptional care by using research and education while also explaining the phenomenon of nursing. Theory proved to society that nursing was a scholarly profession. However almost 100 years later there is an embarrassing deficit of theory based practice amongst nurses. (Sitzman & Wright Eichelberger, 2011) Further proof that nursing theory is imperative to practice is clear to many organizations.

The Institute of Medicine (IOM) and Quality and Safety Education for Nurses (QSEN) project identified core competencies to improve health care. These competencies are as follows, safety, patient centered care, informatics, teamwork and collaboration, quality improvement, and evidence based practice. In my opinion I believe all six areas are used on a daily basis in my practice as a nurse. I ensure my patients safety through the use of time out prior to all procedures, fall risk assessment, and frequent rounding.

Safety is also maintained by using technology such as bed alarms to prevent falls and dose mode on intravenous pumps to confirm titration calculations. I also confirm patient’s identification by using the “5 rights” prior to any treatment or medication administration to ensure patient safety. I incorporate patient centered care by planning care around my patients needs. Informatics is incorporated through electronic health records and through the hospital’s intranet. I practice teamwork and collaboration by participating in critical care rounds every night to discuss the plan of care for my patients.

We perform most patient care as a team; we try to never say “that’s not my patient”. We continuously collaborate with our colleagues about our patient’s plan of care and any issues that arise. Quality improvement is one core competency used daily. After any emergent situation we engage in a debriefing procedure. We review what occurred and how it could go better in the future. I research through electronic resources and online databases such as ebsco host and lexicomp to ensure the use of evidence based practice. Research eliminates trial and error and integrates innovative solutions to nurses across the world.

If theory could be applied to all nursing practice the quality of health care would reach a shocking new level. Many articles clearly state that there is a problem integrating nursing theory and practice. The integration of theory and practice was discussed in an article published in the journal of Nursing Philosophy. The article calls on the social responsibility of the nursing profession to link nursing practice with theory, philosophy, and disciplinary goals. “The integration of theory into nursing practice provides a guide to achieving nursing’s disciplinary goals of promoting health and preventing illness across the globe. (McCurry, Hunter Revell, & Roy, 2009, p. 42) The article discusses that it is the nurse’s professional and societal responsibility to utilize research based practice to improve the health of society at a global level. When a society is educated continuously there is a direct improvement on their health. This was proved through many theorists in this article such as Sister Callista Roy, John Stuart Mill, and Amitai Etzioni. I agree with this article in that social transformation must occur amongst nurses.

I also agree that middle range theory is the most practical way to utilize nursing theory as a framework for nursing practice because it is concept specific and not as vague as grand theories. Nurses would be more willing to apply a middle range theory because they can relate to it. Many nurses feel grand theories are too broad and generalized to connect their practice to the theory. By utilizing a middle range theory, it would provide consistency in care and effective guidelines. By combining theory and practice, nursing will be able to promote health and minimize sickness throughout a community or across the world. (McCurry et al. 2009) Speaking with any nurse one could discover there is a knowledge deficit regarding the concepts of nursing theory. I interviewed thirteen nurses that work in various departments in the hospital. Eleven of those nurses looked at me like a deer in headlights. I could not be judgmental against those nurses because I honestly must admit that I am one of them. I decided to write about the two nurses who smiled when I mentioned the forbidden word “theory”. The two I chose both have a bachelor’s degree and both began their nursing practice in the past five years. My first interviewee relates Virginia Henderson to her nursing practice.

She promotes her patients to increase their independence. By assisting them in their basic needs while they are critically ill and incorporating self determination and autonomy as the long term goal (C. Audus, personal communication, September 21, 2012). The second nurse I interviewed incorporates the theory of Hildegard Peplau. She integrates Peplau theory in her practice because she believes the foundation of nursing is the relationship between the nurse and patient. She establishes a relationship with her patients based on trust and respect which in turn fosters a comfortable judgment free environment.

With each new patient relationship she takes away what she learned and in turn makes her a better nurse (M. Glennon, personal communication, September 26, 2012). I believe there is a gap between the nurses who have an understanding of nursing theory and the nurses caring for patients at the bedside. “It is important for the profession of nursing to close this gap so that nursing theory is interwoven into nursing practice as intended, rather than continuing the pretense that currently exists”. (Sitzman & Wright Eichelberger, 2011, p. 18) There are many barriers to overcome before this integration can occur.

One main reason nurses do not incorporate theory is because it is very difficult to understand. Some nurses shut down as soon as they hear the word theory because of the complexity and become completely consumed by the tasks of nursing practice. Theorists have added to the barrier between nursing theory and nursing practice by using complicated vocabulary in their literature. If nurses are unable to understand what the theory is they will not be able to apply it to their practice. Nursing theories need to be less vague and should be simplified so the nurse can relate the theory to their practice.

So if professional organizations, media, and nurses all agree that theory would improve healthcare and that it is a necessary aspect of caring for patients, why is it an unsolved problem? In my opinion the reason why theory is not utilized enough in nursing practice is because it is complicated, boring, and unrealistic. If nurses could simplify theory and eliminate the complicated language nurses would not shut down and be so resistant to learning. Nurses need to see how they could apply theory to their practice. I also feel there are too many theorists so nurses just give up because they are overwhelmed.

I know many experienced nurses that have a wealth of knowledge regarding how to perform a skill while lacking the reasoning of why they perform the skill. If theory was simplified and conferences and seminars were easily accessible more nurses would incorporate theory in their practice. Some theories appear farfetched with unachievable outcomes. Some theorists do not consider that resources and time are limited to most clinical nurses. Most theories involve a very intimate relationship between the nurse and patient. Clinical nurses have been consumed with computerized charting so much that they are spending much less time with their patients.

This time constraint makes it difficult to integrate theory and practice. In reality the nursing profession is responsible to integrate theory into our practice. It is our duty to integrate research and theory into our practice. It will not be easy or quick but it must be achieved. I believe the most effective way to integrate theory in practice is to actually lead by example. I believe we need to spark our peers to raise their professional standards and to help prevent stagnation amongst our colleagues.

References

  1. American Nurses Association. (2010). Scope of nursing practice, Nursing research and evidence – based practice. In (Ed. ), Scope and standards of practice: nursing (2nd ed. , pp. 15-17).
  2. Silver Spring, MD: Nursing Books. Masters, K. (2012). Nursing theories: a framework for professional practice. Sudbury, MA: Jones & Bartlett Learning.
  3. McCurry, M. K. , Hunter Revell, S. M. , & Roy, Sister, C. (2009). Knowledge for the good of the individual and society: linking philosophy, disciplinary goals, theory, and practice.
  4. Nursing Philosophy, 11(), 42-52. Sitzman, K. L. , & Wright Eichelberger, L. (2011). Understanding the work of nurse theorists: a creative beginning (2nd Ed. ). Sudbury, MA: Jones and Bartlett.

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Capillary Refills

Capillary refill is used for patient’s assessment. This method has been performed since the early days of nursing. Some studies show that the method is not full proof or accurate of the patient status. While other research claims validity to this test. Capillary refill is performed on the patient nail that is free of polish. The finger nails and toe nails could be used for this assessment. The nail is lightly compressed and released, it blanches and it is measured when the color comes back to normal.

The measurement is done in seconds if it is less than 3 seconds the patient’s circulation is with in normal limits, if it exceeds three seconds than further assessment is necessary to diagnose the problem (Nursing). The patient could be suffering from dehydration, peripheral vascular disease, hypothermia and shock Capillary refill is primarily used in assessment of pediatrics patient. When combining the lack of capillary refill the dry mucous membrane it could lead to diagnose of dehydration.

It is in concurrence with skin assessment to the hand that appears cold to touch; the infant is diagnosed with dehydration. In conjunction with infant when an adult is tested and results are abnormal further inquires is mandated. Anorexics individuals who lack the ingestion of electrolyte feel cold to touch. They may have brittle nails, poor circulation and longer than normal capillary refills.

These individuals’ electrolyte counts need to be closely monitored because it could lead to poor circulation, dysrhythmias and many other medical problems ( Dufault). It is important when assessing the patient to include the capillary refills, and closely monitor patient who seem abnormal. References: http://nursing411. org/courses/md0531 . Extracted 10/31/12. Dufault M. , Davis, B. , Garman D. , Hehl R. , Henry J. , Lavin M. , Mullany J. , Stout P. (2008). Translating Best Practice in Assessing Capillary Refill. Worldviews on Evidence-Based Nursing.

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Reflection Essay on Nursing Theory

Table of contents

The patient in this case has a condition that puts him at risk for illness and injury. is a conceptualization of some aspects of nursing communicated for the purpose of describing, explaining, predicting and or prescribing nursing care (Jacqueline, 2001). Imogene king’s theory focuses more specifically on the events and the phenomena of the discipline and is specific enough to contribute on a sound basis for achieving an effective behavioral outcome in this case study.

Applications of these theories in practice depend on the awareness, understanding and research on their interrelationships (Patricia A Potter, 2005). The American Nurses Association (ANA) is a full-service professional organization representing the nation’s entire registered nurse population. The ANA represents the interests of the nation’s 2.7 million registered nurses through its 54 constituent state and territorial associations and over 150,000 members. It is dedicated to ensuring that an adequate supply of highly skilled and well-educated nurses is available in USA. ANA is also committed to meeting the needs of nurses as well as health care consumers (http://www.nursingworld.org).

Imogene King (Jacqueline, 2001) formulated a goal attainment theory which focuses on three dynamic interacting systems namely, personal, interpersonal and social systems.  According to this theory, a personal relationship occurs between the client and the nurse, and this nurse-client relationship is the vehicle for the delivery of nursing care, which is defined as a dynamic interpersonal process (Jacqueline, 2001).  This theory emphasizes on the fact that the nurse and the client are affected by each other’s behavior and it is duty of the nurse to maintain this interpersonal process.

King’s Goal Attainment Theory involves a process where the nurse and the patient mutually communicate information, establish goals, and take action to obtain the common goals. This theory is about the interpersonal process where two people, usually strangers come together in a health care organization to obtain their health goals.

This goal attainment theory is based on personal and interpersonal systems, which includes interaction, communication, transaction, role, stress, growth and development, time and space. Goal attainment in this model is achieved through a goal-oriented nursing record, which is composed of five major elements namely, a database, a problem list, a goal list, a plan and progress notes. Active participation of the client in the process of goal setting and goal achievement are the major strengths of this model. This model framework is useful for nurses in social interactions with clients.

This theory is based on the principle that each individual (client) brings to an interaction a different set of values, ideas, attitudes, perceptions to exchange and the other person (nurse) receives this information and processes it. Thus, these two individuals mutually identify goals and the means to achieve them. In this interaction process they reach an agreement about how to attain these goals and then set about to realize them (Jacqueline, 2001).

According to King’s theory, Patient participation with the elements of communication, expression, interaction with the nurse is the most important factor, which keeps alive the interpersonal process of personal relationship. This brings the nurse and the patient to a common goal and both of them strive to achieve this common goal. This is supported by the strategies, the nurse record of the outcomes and the statistical analysis of the data.

Conclusion

Thus today Nursing is a profession rather than a vocation. Nursing as a profession accounts for its conscientious, knowledgeable and responsible actions.  The profession has extended education avenues, a body of knowledge leading to defined skills, an ability to provide specific service, professional autonomy to make decisions governed by a code of ethics (Patricia A Potter, 2005).

The theoretical models have served as frameworks for nursing curriculum and practice by increasing the scientific basis of nursing practice and in USA, ANA has been continuing its efforts to expand the scientific and research base for nursing practice, for the collective bargaining rights and workplace advocacy for all nurses, to gain better compensation and better working conditions for nurses, and to implement new ways in which nursing services can be delivered to respond to current and future demands for cost-effective, quality health care ( http://www.nursingworld.org ).It Strives to shape the future of healthcare through excellence in nursing education using education, science and technology to improve health.

Reference

  1. Jacqueline, “The Nurse Theorists-21st century updates”, Nursing science quarterly, Volume 14, 4; 311, 2001.
  2. Patricia A Potter, Anne Griffin Perry, Fundamentals of Nursing, 6th edition, Mosby, 2005.
  3. Ruth L.E. Murray, Marjorie Baier, ‘King’s conceptual framework applied to a transitional living program’, Perspectives in Psychiatric Care, Vol. 32, 1996.
    http://www.nursingworld.org/about/mission.htm

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The Self-Care Deficit Nursing Theory

The Self-Care Deficit Nursing Theory (SCDNT) was conceived and developed during a time when Nursing lacked definition and identity within the medical community. This theory, not only, helped to move nursing from vocation to profession, it “is one of the most commonly used in practice” (Alligood, 2010, p 261). The SCDNT has “four structured cognitive […]

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Nursing Theory: Overview

Theory is an analysis of a set of facts in relation to one another. A belief policy or procedure proposed or followed as the basis of action. Theory can be described as a concept that can be tested and used to explain an occurrence. (www. wisegeek. com) Nursing Theory is the term given to the […]

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The Self-Care Deficit Nursing Theory

The Self-Care Deficit Nursing Theory (SCDNT) was conceived and developed during a time when Nursing lacked definition and identity within the medical community. This theory, not only, helped to move nursing from vocation to profession, it “is one of the most commonly used in practice” (Alligood, 2010, p 261). The SCDNT has “four structured cognitive […]

Read more
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