Faye-Glenn-Abdellah-by-Dr.-Fely-T.-Lim.pdf

FAYE GLENN ABDULLAH (MARCH 13, 1919 – FEBRUARY 24, 2017 ) 21 NURSING PROBLEMS THEORY LEARNING OBJECTIVES At the end of this class the learner should be able to: Discuss the importance and purpose of Faye Glenn Abdellah’s theory of 21 Nursing Problems. Discuss the different me...

FAYE GLENN ABDULLAH (MARCH 13, 1919 – FEBRUARY 24, 2017 ) 21 NURSING PROBLEMS THEORY LEARNING OBJECTIVES At the end of this class the learner should be able to: Discuss the importance and purpose of Faye Glenn Abdellah’s theory of 21 Nursing Problems. Discuss the different metaparadigm of 21 Nursing Problems theory. Simplify the main ideas of the theory presented by relating it to everyday situations  FAYE GLENN ABDELLAH (MARCH 13, 1919 – PRESENT) Is a nursing research pioneer who developed the “Twenty-One Nursing Problems.” Her nursing model was progressive for the time in that it refers to a nursing diagnosis during a time in which nurses were taught that diagnoses were not part of their role in health care. She was the first nurse officer to rank a two-star rear admiral, the first nurse, and the first woman CREDENTIALS AND BACKGROUND FAYE GLENN ABDELLAH On March 13, 1919, Faye Abdellah was born in New York to a father of Algerian heritage and a Scottish mother. 1940’s nursing diploma from Fitkin Memorial Hospital’s School of Nursing, now known as Ann May School of Nursing. Three degrees from Columbia University: - a bachelor of science degree in nursing in 1945, - a master of arts degree in physiology in 1947, - doctor of education degree in 1955. CREDENTIALS AND BACKGROUND FAYE GLENN ABDELLAH May 6, 1937, the German hydrogen-fueled airship Hindenburg exploded over Lakehurst. Abdellah and her brother witnessed the explosion, destruction, and fire after the ignited hydrogen killed many people. That incident became the turning point in Abdellah’s life. It was that time when she realized that she would never again be powerless to assist when people were in such a dire need of assistance. It was at that moment she vowed that she would learn to nurse and become a professional CREDENTIALS AND BACKGROUND FAYE GLENN ABDELLAH CREDENTIALS AND BACKGROUND FAYE GLENN ABDELLAH Her first administrative position was on the faculty of Yale University from 1945-1949. She was required to teach a class called “120 Principles of Nursing Practice,”. The book included guidelines that had no scientific basis, which challenged Abdellah to explain everything she called the “brilliant” students. After a year, Abdellah became so frustrated that she gathered her colleagues in the Yale courtyard and burned the textbooks. It took a year for Abdellah to settle the debt, but she never regretted her actions because it started her on the long road to pursue the scientific basis of the nursing practice. CREDENTIALS AND BACKGROUND FAYE GLENN ABDELLAH 1949, she met Lucile Petry Leone, the first Nurse Officer, and decided to join the Public Health Service. They performed studies with numerous hospitals to improve nursing practice. 1957, Abdellah spearheaded a research team in Manchester, Connecticut, that established the groundwork for what became known as progressive patient care. During her 40-year career as a Commissioned Officer in the U.S. Public Health Service from 1949 to 1989, Abdellah was assigned to work with the Korean people during the Korean War. As a senior officer, she was alternatively assigned to Japan, China, Russia, Australia, and the Scandinavian countries to identify the Public Health Service’s role CREDENTIALS AND BACKGROUND FAYE GLENN ABDELLAH She served as Chief Nurse Officer from 1970 to 1987 The first nurse to achieve the rank of a two-star Flag Officer named by U.S. Surgeon General C. Everett Koop as the first woman and nurse Deputy Surgeon General from 1982 to 1989. After retirement, Abdellah founded and served as the first dean in the Graduate School of Nursing, GSN, Uniformed Services University of the Health Sciences (USUHS). She was crowned as a ”living legend” in (1994) ACCORDING TO FAYE GLENN ABDELLAH’S 21 NURSING PROBLEMS THEORY: “Nursing is based on an art and science that molds the attitudes, intellectual competencies, and technical skills of the individual nurse into the desire and ability to help people, sick or well, cope with their health needs.” ASSUMPTIONS 10 STEPS TO IDENTIFY THE PATIENT’S PROBLEM 1. Learn to know the patient. 2. Sort out relevant and significant data. 3. Make generalizations about available data concerning similar nursing problems presented by other patients. 4. Identify the therapeutic plan. 5. Test generalizations with the patient and make additional generalizations. 6. Validate the patient’s conclusions about his nursing problems. ASSUMPTIONS 10 STEPS TO IDENTIFY THE PATIENT’S PROBLEMS 6. Validate the patient’s conclusions about his nursing problems. 7. Continue to observe and evaluate the patient over a period of time to identify any attitudes and clues affecting this behavior. 8. Explore the patient’s and family’s reaction to the therapeutic plan and involve them in the plan. 9. Identify how the nurse feels about the patient’s nursing problems. 10. Discuss and develop a comprehensive nursing care plan. (NCP) MAJOR CONCEPTS AND DEFINITIONS OF 21 NURSING PROBLEMS THEORY FAYE GLENN ABDELLAH  MAJOR CONCEPT Individual She describes nursing recipients as individuals (and families), although she does not delineate her beliefs or assumptions about the nature of human beings.  MAJOR CONCEPT Health Health, or the achieving of it, is the purpose of nursing services. Although Abdellah does not define health, she speaks to “total health needs” and “a healthy state of mind and body.” Health may be defined as the dynamic pattern of functioning whereby there is a continued interaction with internal and external forces that results in the optimal use of necessary resources to  MAJOR CONCEPT Society Society is included in “planning for optimum health on local, state, and international levels.” However, as Abdellah further delineates her ideas, the focus of nursing service is clearly the individual.  MAJOR CONCEPT Nursing Problems The client’s health needs can be viewed as problems, overt as an apparent condition, or covert as a hidden or concealed one. Because covert problems can be emotional, sociological, and interpersonal in nature, they are often missed or misunderstood. Yet, in many instances, solving the covert problems may solve  MAJOR CONCEPT Problem Solving Quality professional nursing care requires that nurses be able to identify and solve overt and covert nursing problems.  TYPOLOGY OF 21 NURSING PROBLEMS FAYE GLENN ABDELLAH CATEGORIES OF PATIENT’S NEEDS 21 NURSING PROBLEMS THEORY FAYE GLENN ABDELLAH  21 NURSING PROBLEMS 3 CATEGORIES Physical, sociological, and emotional needs of patients Types of interpersonal relationships between the patient and nurse Common elements of patient care.  CATEGORIES OF PATIENT’S NEEDS ARE FURTHER DIVIDED INTO FOUR 21 NURSING PROBLEMS FAYE GLENN ABDELLAH FOUR CATEGORIES OF PATIENT’S NEEDS 1. Basic to all patients 2. Sustenance care needs 3. Remedial care needs 4. Restorative care needs. ABDELLAH’S 21 NURSING PROBLEMS ARE THE FOLLOWING: BASIC NEEDS 1. To maintain good hygiene and physical comfort 2. To promote optimal activity: exercise, rest, sleep 3. To promote safety by preventing accidents, injuries, or other trauma and preventing the spread of infection. 4. To maintain good body mechanics and prevent and correct the ABDELLAH’S 21 NURSING PROBLEMS ARE THE FOLLOWING: SUSTENAL CARE NEEDS 5. To facilitate the maintenance of a supply of oxygen to all body cells. 6. To facilitate the maintenance of nutrition for all body cells. 7. To facilitate the maintenance of elimination. 8. To facilitate the maintenance of fluid and electrolyte balance. ABDELLAH’S 21 NURSING PROBLEMS ARE THE FOLLOWING: SUSTENAL CARE NEEDS 9. To recognize the physiologic responses of the body to disease conditions—pathologic, physiologic, and compensatory. 10. To facilitate the maintenance of regulatory mechanisms and functions. 11. To facilitate the maintenance of sensory ABDELLAH’S 21 NURSING PROBLEMS ARE THE FOLLOWING: REMEDIAL CARE NEEDS 12. To identify and accept positive and negative expressions, feelings,and reactions. 13. To identify and accept interrelatedness of emotions and organic illness. 14. To facilitate the maintenance of effective ABDELLAH’S 21 NURSING PROBLEMS ARE THE FOLLOWING: REMEDIAL CARE NEEDS 15. To promote the development of productive interpersonal relationships. 16. To facilitate progress toward achievement and personal spiritual goals. 17. To create or maintain a therapeutic environment. 18. To facilitate awareness of self as an individual with ABDELLAH’S 21 NURSING PROBLEMS ARE THE FOLLOWING: RESTORATIVE CARE NEEDS 19. To accept the optimum possible goals in the light of limitations, physical and emotional. 20. To use community resources as an aid in resolving problems that arise from an illness. 21. To understand the role of social problems as THE 11 NURSING SKILLS ARE: 1. Observation of health status 7. Use of personnel resources 2. Skills of communication 8. Problem-solving 3. Application of knowledge 9. The direction of work of 4. The teaching of patients and others families 10. Therapeutic uses of the 5. Planning and organization self of 11. Nursing procedure work 6. Use of resource materials NURSING AS A COMPREHENSIVE SERVICE INCLUDES: 1. Recognizing the nursing problems of the patient 2. Deciding the appropriate course of action to take in terms of relevant nursing principles 3. Providing continuous care of the individual’s total needs NURSING AS A COMPREHENSIVE SERVICE INCLUDES: 5. Adjusting the total nursing care plan to meet the patient’s individual needs 6. Helping the individual to become more self-directing in attaining or maintaining a healthy state of body and mind 7. Instructing nursing personnel and family to help the individual do for himself that which he can within his limitations 8. Helping the individual to adjust to his limitations and emotional problems NURSING AS A COMPREHENSIVE SERVICE INCLUDES: 9. Working with allied health professions in planning for optimum health on local, state, national, and international levels 10. Carrying out continuous evaluation and research to improve nursing techniques and to develop new techniques to meet  PATIENT-CENTERED APPROACHES TO NURSING Faye Abdellah’s work is a set of problems formulated in terms of nursing-centered services used to determine the patient’s needs. The nursing-centered orientation to client care appears to be contradicting the client-centered approach that Abdellah professes to support. This can be observed by her desire to move away from a disease-centered orientation. In her attempt to bring the nursing practice to its proper relationship with restorative and preventive measures for meeting total client needs, she seems to swing the pendulum to the opposite pole, from the disease orientation to nursing orientation, while leaving the client somewhere in the middle.  21 NURSING PROBLEMS AND THE NURSING PROCESS In the assessment phase, the nursing problems implement a standard procedure for data collection. The overt or covert nature of problems necessitates a direct or indirect approach, respectively. The outcome of the collection of data in the first phase concludes the patient’s possible problems, which can be grouped under one or more of the broader nursing problems. This will further lead to the nursing diagnosis. After formulating the diagnosis, a nursing care plan is developed, and appropriate nursing interventions are determined. The nurse now sets those interventions in action, which complete the implementation phase of the nursing process. The evaluation takes place after the interventions have been carried out. The most convenient evaluation would be the nurse’s progress or lack of progress toward achieving the goals established in the planning phase. ANALYSIS With Faye Abdellah’s aim in formulating a clear categorization of patient’s problems as health needs, she rather conceptualized nurses’ actions in nursing care, which is contrary to her aim. The problem-solving approach introduced by Abdellah has the advantage of increasing the nurse’s critical and analytical thinking skills since the care to be provided would be based on sound assessment and validation of findings. One can identify that the framework is strongly applied to individuals as the focus of nursing care. CRITIQUE The following are the strengths of Faye Abdellah’s “21 Nursing Problems” theory. The problem-solving approach is readily generalizable to the client with specific health needs and specific nursing problems. With the model’s nature, healthcare providers and practitioners can use Abdellah’s problem-solving approach to guide various activities within the clinical setting. The language of Faye Abdellah’s framework is simple and easy to comprehend. The theoretical statement greatly focuses on problem-solving, an activity that is inherently logical in nature. CRITIQUE The following are the limitations of Faye Abdellah’s “21 Nursing Problems” theory. There is robust nurse-centered orientation. She rather conceptualized nurses’ actions in nursing care which is contrary to her aim. Lack of emphasis on what the client is to achieve was given in client care. Focus quite heavily on nursing practice and individuals. It is inconsistent with the concept of holism. The nature of the 21 nursing problems attests to this. As a result, the client may be diagnosed with numerous problems leading to fractionalized care efforts.  21 NURSING PROBLEMS FAYE GLENN ABDELLAH