Nursing Theories and Florence Nightingale
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Questions and Answers

What is a primary focus of Florence Nightingale's philosophy regarding nursing?

  • The relationship between patients and their surroundings (correct)
  • The integration of multiple disciplines into nursing education
  • The advancement of medical technology in nursing practice
  • The elimination of all waste products in healthcare settings

    • Which of the following components is NOT one of Nightingale's five components of the environment?

  • Warmth
  • Ventilation
  • Effluvia
  • Technology (correct)

    • What major shift in healthcare delivery did Florence Nightingale advocate for?

  • Incorporating alternative medicine into nursing
  • Focusing solely on mental health interventions
  • Transitioning care from private home nursing to hospitals (correct)
  • Moving care from hospitals to mobile clinics

    • In her work 'Notes on Nursing', what did Nightingale stress the importance of recording?

    <p>Observations of the patient and relevant information</p> Signup and view all the answers

    Which theoretical model reflects the issues influencing the context of nursing during its formation?

    <p>Practice-based theories</p> Signup and view all the answers

    What does the term 'client' indicate in the context of nursing care?

    <p>An individual with a range of health states</p> Signup and view all the answers

    Which model views the individual as having self-recuperative powers?

    <p>Nightingale model</p> Signup and view all the answers

    In the Neuman model, which of the following variables is NOT included?

    <p>Educational</p> Signup and view all the answers

    How does the Parse model conceptualize individuals within the health context?

    <p>Engaged in interaction with the environment</p> Signup and view all the answers

    According to Henderson's model, what is emphasized regarding individual needs?

    <p>14 unique basic needs</p> Signup and view all the answers

    What is a significant criticism of grand theories in nursing as mentioned in the content?

    <p>They are outdated and irrelevant at times.</p> Signup and view all the answers

    In what way does colonization impact nursing education?

    <p>Acts as a barrier to intellectual growth</p> Signup and view all the answers

    Which nursing model incorporates coping behaviors to fulfill basic needs?

    <p>Campbell model</p> Signup and view all the answers

    Which of the following best describes concepts in nursing?

    <p>Abstract ideas that can include constructs like health and powerlessness.</p> Signup and view all the answers

    What is a key characteristic of conceptual frameworks in nursing?

    <p>They include various theories related to human behavior.</p> Signup and view all the answers

    What are the major components of the metaparadigm in nursing?

    <p>Person, environment, health, and nursing.</p> Signup and view all the answers

    How does clinical judgment function in the nursing process?

    <p>It employs systematic strategies for clinical decision-making.</p> Signup and view all the answers

    Why is it important to understand the conceptual body of knowledge in nursing?

    <p>It helps in conceptualizing nursing interests and identifying researchable problems.</p> Signup and view all the answers

    What role do abstract concepts like stress play in nursing?

    <p>They can inform interventions and improve patient outcomes.</p> Signup and view all the answers

    Which of the following factors is NOT a consideration within the nursing metaparadigm?

    <p>Response to treatment</p> Signup and view all the answers

    In what way does the conceptual framework address nursing interests?

    <p>It offers a flexible approach to understanding nursing dynamics.</p> Signup and view all the answers

    What characterizes the wholly compensatory nursing system?

    <p>Patient is completely dependent on nursing actions.</p> Signup and view all the answers

    Which of the following roles is NOT associated with the nurse in Peplau's interpersonal relationship theory?

    <p>Psychiatrist</p> Signup and view all the answers

    According to Sister Callista Roy's Adaptation Model, how is the individual viewed?

    <p>As a biopsychosocial adaptive system.</p> Signup and view all the answers

    What is the primary focus of Johnson's Behavioural System Model?

    <p>Human behaviour across various contexts.</p> Signup and view all the answers

    What is the goal of nursing interventions in the Neuman System Model?

    <p>To maintain balance and harmony amid stressors.</p> Signup and view all the answers

    In Peplau's four phases, which phase follows 'identification'?

    <p>Exploitation</p> Signup and view all the answers

    Which subsystem is included in Johnson's Behavioural System Model?

    <p>Ingestive behavior.</p> Signup and view all the answers

    How does Sister Callista Roy suggest the environment can be manipulated?

    <p>To enhance adaptation and coping.</p> Signup and view all the answers

    What is the central theme of simultaneity theories in nursing?

    <p>Interdependence between individual and environment.</p> Signup and view all the answers

    What aspect do partially compensatory models focus on?

    <p>Patient's partial ability with some nursing assistance.</p> Signup and view all the answers

    What are theories in nursing primarily used for?

    <p>To provide a systematic view of phenomena</p> Signup and view all the answers

    Which of the following best describes a challenge in theorizing nursing practice?

    <p>Integrating personal philosophies with scientific evidence</p> Signup and view all the answers

    What does the historical development of nursing theories illustrate?

    <p>An ongoing evolution of clinical reasoning</p> Signup and view all the answers

    Which type of nursing theory focuses on specific aspects of practice or outcomes?

    <p>Middle-range theories</p> Signup and view all the answers

    What is the consequence of having a unique body of knowledge in nursing?

    <p>It differentiates nursing as a profession</p> Signup and view all the answers

    How do nursing theories typically vary?

    <p>By the level of abstract concepts presented</p> Signup and view all the answers

    What key questions shaped the education of nursing in the 50s and 60s?

    <p>What is the focus and scope of nursing?</p> Signup and view all the answers

    What aspect of nursing practice can theories help to organize and synthesize?

    <p>Nursing knowledge</p> Signup and view all the answers

    What is the primary environmental factor that Nightingale believed to influence health?

    <p>Physical conditions</p> Signup and view all the answers

    According to Henderson, what is a unique function of the nurse?

    <p>Assisting individuals in health-related activities</p> Signup and view all the answers

    What does Orem's theory of self-care emphasize?

    <p>Patient's responsibilities and abilities in self-care</p> Signup and view all the answers

    Which of the following is NOT one of Henderson's 14 basic needs?

    <p>Avoiding electrical hazards</p> Signup and view all the answers

    How does Nightingale believe health is maintained?

    <p>Through control of the environment</p> Signup and view all the answers

    Which aspect of nursing did Nightingale prioritize to aid a person's reparative process?

    <p>Fresh air and cleanliness</p> Signup and view all the answers

    What is one characteristic of Virginia Henderson's perspective on nursing?

    <p>Nurses serve as substitutes for patients' activities</p> Signup and view all the answers

    What does the need for 'sleeping and resting' signify in Henderson's model?

    <p>A critical need for recovery and wellness</p> Signup and view all the answers

    Which of Orem's self-care requirements focuses on environmental safety?

    <p>Preventing hazards to life and functioning</p> Signup and view all the answers

    What role does the environment play in the health care philosophies discussed?

    <p>It plays a critical role in support and recovery</p> Signup and view all the answers

    Study Notes

    Group Project

    • Components of a group project include: structure, deliverables, timelines, and a rubric.

    Theoretical Underpinnings

    • Course: BNUR 1001
    • Date: October 29, 2024
    • Instructor: Peter Kennedy RN, BScN, MBA

    Learning Objectives

    • Describe selected nursing theories and differentiate between them.
    • Describe challenges of theorizing about nursing practice.
    • Recognize conceptual frameworks associated with nursing practice.
    • Appreciate the historical development of thought related to nursing practice.
    • Describe relationships between theorizing and other forms of nursing knowledge.

    Theories

    • Nursing theory: The story of an enlightened attempt to articulate excellent clinical reasoning in nursing care.
    • Nursing practice: How does nursing organize and make sense of all available knowledge to tackle the challenges of patient care?
    • Theory in Nursing: A purposeful set of assumptions or propositions about concepts showing relationships between concepts; guides the systematic view for explaining, predicting, or prescribing phenomena.
    • Theoretical Variations: Nursing theories differ in their level of abstraction, conceptualization of the client, health, and illness, and the ability to describe, explain, or predict.
    • Application of Theory: Theories vary by definition of personal philosophy, scientific orientation, experience in nursing, and how the experience affected the theoriest's view of nursing.
    • Theories as frameworks: A way to organize and synthesize knowledge about nursing and the client, often described as a conceptual framework.
    • Theoretical classifications: Grand theory, middle-range theory, descriptive theory, and prescriptive theory.
    • Importance of Nursing theories: Theories are crucial for solving patient health problems, providing precise methods of care, demonstrating how nursing differentiates from medicine, and offering a systematic view for explaining, predicting, and describing phenomena.

    Do We Need Them?

    • A profession needs a unique, specialized body of knowledge.
    • 50s/60s nursing education focused on three questions: (1) What is the focus and scope of nursing? (2) How is nursing distinct from other health professions? and (3) What is the appropriate disciplinary knowledge for professional nursing practice?
    • Theories are not simply a compilation of other discipline's knowledge. Nursing must have its own character and nature as distinct as any other profession.

    Early Theorists

    • Nursing theory's early development includes Florence Nightingale and early theoretical and conceptual models.
    • Early theorists created conceptual frameworks, a structured framework that connects concepts to a specific purpose.
    • Linking concepts and phenomena is critical when making nursing decisions.
    • Early theorists sought to organize nursing knowledge though were limited by the concepts and issues shaping the role of nursing practice at that time.

    Ida Jean Orlando

    • Developed a problem-solving approach in nursing using various nursing process method: APIE & ADPIE.
    • Clinical judgement & critical thinking are essential parts of the nursing process, and involve using intuition and conscious thought when making clinical decisions.

    Concept of Hope

    • Hope is a contextual concept differing in settings such as oncology.
    • Studies suggest hope can be a direct or secondary mediator of outcome related to factors like personality or environmental factors.
    • This notion can be affected by physiological factors.
    • Research suggests that increasing hope could potentially alter outcomes in patients with cancer and thus improve their quality of life.

    Concepts

    • Concepts are abstract ideas or mental images of phenomena (e.g. using words to represent mental pictures); the properties and meanings associated with objects and events.
    • Types of concepts include readily observable, indirectly observable and non-observable concepts.
    • In nursing, concepts include health, helping relationships, communications.

    Conceptual Frameworks

    • Clinical judgement involves using nursing process systematically to develop intuitive conscious thinking to create clinical decision making.
    • Conceptual frameworks help professionals understand both the patient and the nurse's related role.
    • The process of inquiry, concepts, definitions, and model theories—are derived through logical thoughts & inductive reasoning.
    • Key concepts in nursing are, person, environment, health, and nursing.
    • Frameworks are useful tools for understanding human behaviour and theories, alongside other systems or interactions, used in nursing practice.
    • Framework structure is used to understand nursing interests and identify areas for research.

    Metaparadigm Concepts

    • The key concepts in nursing practice are person, health, environment and nursing. These concepts are interrelated within and across the concepts.

    Activity

    • Understanding the relationship of patient, environment, health and nursing is important.
    • Discuss how this conceptual body of knowledge is vital to nursing practice.

    Metaparadigm

    • Person: Individual, family, group or community
    • Environment: Social environment (significant people), physical/internal or external environment
    • Health: State of well-being, illness, absence of disease, or range of health state including ideal or optimal state
    • Nursing: Actions taken by nurses on behalf of the client that relates to their practice

    Model – Key Concepts

    • Categorizing models with a particular focus on "An Example: Person" with theoretical models: Florence Nightingale, Parse, Neuman, and Campbell.

    Post Truth and Reconciliation Commission Considerations

    • Colonization and neo-colonization create resistance to intellectual development within nursing.
    • Some argue grand theories and metaparadigms are irrelevant today.
    • Nursing's adoption of nursing, person, environment, and health is currently putting stress on the social mandate of nursing.
    • Oppression and inequality, such as racism, are now a focus and not just individual struggles.

    Paradigm Debates Within Nursing

    • Debates include: Nursing as art & science, Practical and applied, Totality paradigm frameworks, Simultaneity paradigm frameworks. (All these perspectives are debates within the field of nursing.)

    Major Theoretical Models

    • Classifying nursing theories into categories, including practice-based theories, needs theories, interactionist theories, systems theories, and simultaneity theories.

    Practice-Based Theories

    • Theories that reflect issues shaping the role and context of nursing, created during the time they were created, including Florence Nightingale and the McGill Model.

    Nightingale's Philosophy

    • Key concepts: Original notes published in 1859
    • Defined roles and scope of nursing (ex. importance of observing patients, and recording information; and principles of cleanliness and sanitation)

    Florence Nightingale

    • Philosophy of health, illness, and the role of the nurse.
    • Importance of patient relationships to their surroundings, patient observation, recording information, cleanliness, and how health is tied to the environment
    • Role changes from private, home-based nursing to hospital-based.

    Notes on Nursing

    • No amount of medical knowledge can lessen nurses' role/ responsibility.
    • To manage patient environments to facilitate positive life processes.

    Nightingale – 5 Components of Environment

    • Factors considered critical for patient wellbeing: Ventilation, light, warmth, effluvia (gases/vapors), noise.

    Nightingale Key Concepts

    • Person: Patients, who are impacted by nurses and their environment, possessing self-recuperating abilities.
    • Environment: Foundation of theory, all physical, psychological, social areas.
    • Health: Maintaining well-being, powers sustained by maintaining correct environmental control.
    • Nursing: Supplying fresh air, warmth, good diet, cleanliness, and quiet to facilitate reparations.

    Needs Theories

    • Theories of nursing that focus on patient needs with key figures include: Virginia Henderson, Dorothea Orem, and Maslow
    • Conceptualized patients responding to a collection of needs.

    Henderson

    • The Unique function of the Nurse: Identifying patient needs related to physical or mental health and guiding patient's recovery efforts during sickness, illness, or death.
    • Patient needs that nurses meet: Examples include breathing normally, eating & drinking adequately, and eliminating body waste.
    • Other aspects include moving/maintaining position, sleeping/rest, clothing selection, maintaining body temperature, avoiding dangers, using correct communication, and worshipping (spiritual needs).
    • Helping the patient regain their ability to do these activities.

    Henderson's 14 Basic Needs

    • 14 basic needs based on observation of patient behaviours: Breathing normally, eating, eliminating waste, moving, sleeping, clothing, maintaining temp, avoiding hazards, expressing opinions, worshipping, working, playing and learning.

    Orem Theory of Self-care

    • Maintains sufficient intake of air, water, and food.
    • Balances activity, rest, and interaction.
    • Addresses elimination processes and hazards.
    • Promotes growth and functioning in social groups.
    • Aims to maximize a patient’s ability to care for themselves, which would be a patient’s self-care capacities.
    • Nurse creates systems by identifying gaps in meeting the patients needs.

    Orem Theory of Self-care

    • Focus in on the patient's self-care capacities (identifying patients strengths, limitations, deficits)
    • Determining if patients are independent, dependent or if some degree of assistance is required
    • Types of compensatory systems for patients: wholly compensatory, partially compensatory, and supportive-educative.

    Interactions Theories

    • Theories that focus on the relationship between nurses and patients.
    • Focus on communication, behaviour, and the ways practitioners meet client needs with theorists like Hildegard Peplau, Joyce Travelbee, and Evelyn Adam.

    Peplau

    • Focused on interpersonal relationships between nurses and their patients, including phases like orientation, identification, exploitation, and resolution.
    • The nurse interacts with the patient, helping to alter behaviour and preventing illnesses or maintaining health.
    • Nurses have different roles in this relationship (strangers, resource, teacher, counselor, leader, expert).

    System Theories

    • Account for the whole as well as the parts of a patient and complex interactions between the two. Key theorists include Dorothy Johnson, The University of British Columbia model, Betty Neuman, and Sister Calista Roy.

    Sister Callista Roy

    • Introduced the Adaptation Model, viewing individuals as biopsychosocial adaptive systems.
    • Nurses are in part responsible for supporting a patient in their adaptive and coping abilities.
    • Identifying the patient's need to adapt and manipulate their environment by way of modifying and intervening.
    • Her model looks beyond behaviours and includes a broad view of adaptation.

    Roy's 4 Modes of Adaptation

    • Categorizing ways patients adapt, which include the needs of the patients in physiological needs, self-concept, role function, and interdependence.

    Johnson's Behavioural System Model

    • Focuses on human behaviour within a system of patient behaviours
    • Identifies a system of subsystems with behaviours in achievement, aggressive/protective, and dependant/ingestive.

    The Neuman System Model

    • Nursing interventions focus on strengthening the lines of defense.
    • Nursing interventions are used to maintain adaptation and flexibility and to strengthen resistance to stressors.
    • Identifying, classifying, and understanding stressors so that future occurrences can be avoided. (Including stressors as known or unknown).

    Neuman System Model

    • Views patients as systems, with internal and external stressors and risk factors.
    • The aim is to maintain a balance and harmony by adjusting to stress and defending against tension.
    • Wellness involves a state of equilibrium.

    Simultaneity Theories

    • Viewing individuals as irreducible wholes, inherently connected to a universal environment.
    • Key theorists include Martha Rogers, Rosemarie Parse, and Jean Watson.

    Jean Watson

    • Developed theories emphasizing caring and values.
    • Differentiating nursing from medicine by focusing on harmony and balance between mind, body, and soul within the patient.
    • Emphasizing a caring environment, recognizing the patient's needs, and providing care using the transpersonal method caring for the patient.

    Jean Watson's Philosophy

    • Caring and caregiving factors.
    • Formation of human-altruistic relationships and trust.
    • Assisting with human needs for recognition, support, acceptance, and sharing of feelings for confidence.
    • Nursing's role is to promote caring and assistance for the betterment of the patient’s spiritual wellness.

    Watson's Views with the 4 Concepts

    • Person: Human beings valued and cared for with assisting needs.
    • Environment: A setting impacted by social-interrelated matters.
    • Health: Complete well-being with respect to mental, physical, and social state.
    • Nursing: Intentional consciousness concerned with promoting and restoring health or preventing illness or disease.

    Ways of Knowing

    • Carper's patterns of knowledge are crucial aspects of nursing (Empirical, Ethical, Personal, Aesthetic)
    • Include Critical thinking, emancipatory knowing, and socio-political knowledge.

    Theorizing about Nursing

    • Philosophical struggle associated with making sense of nurses' highly skilled thinking.

    What have you learned about theories?

    • Discuss the identified categories of theories in nursing and their key concepts.
    • Understand the importance and use of theories and models by nurses.
    • Identifying the types of challenges that theories have.

    More Questions ...

    • Why is questioning one's understanding/knowing important for nurses?
    • What should be the discipline-specific knowledge for nursing?
    • How often do nurses refer to frameworks to guide their practice?
    • Use of theories in real-life scenarios and advantages of thinking in this way.

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    Description

    This quiz explores the key components of Florence Nightingale's nursing philosophy and various nursing models that have evolved over time. Test your understanding of Nightingale's influence on healthcare delivery and her importance in nursing education. Challenge your knowledge on different theoretical models and their implications in nursing practice.

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