TFN Notes PDF

**PHENOMENON** - - *In Nursing, phenomena can be observed in the following:* - - - - - **CONCEPT** - - *There are two types of concept:* 1. - 2. - - **CONCEPTUAL MODEL** - - - **THEORY** - ***Characteristics** **of a theory** are the...

**PHENOMENON** - - *In Nursing, phenomena can be observed in the following:* - - - - - **CONCEPT** - - *There are two types of concept:* 1. - 2. - - **CONCEPTUAL MODEL** - - - **THEORY** - ***Characteristics** **of a theory** are the following:* 1. 2. 3. 4. 5. 6. 7. *The **components** of a theory are as follows:* 1. 2. 3. 4. **NURSING THEORY** - **NURSING** - - - - - - - 1. 2. 3. - 1. 2. 3. 4. 5. **NURSING PARADIGM** - - - **METAPARADIGM** - - **NURSING METAPARADIGM** Embodies the knowledge base, theory, philosophy, research, practice and educational experiences and literature identified with the profession. **PHILOSOPHY OF NURSING** - **LESSON 2: Evolution of Nursing Theory** *Theoretical foundation in nursing* is a course that will allow students to appreciate that nursing started in the intuitive way of caring for the sick members of the family. Traditionally the roles of women are limited as wives, mothers, daughters, and sisters. This was the intuitive period of nursing. **NURSING SCIENCE AND THEORY IN THE EARLY 20TH CENTURY** 1\. During this period nurses endeavoured to support their actions based on scientific data as evidenced based practice. This was the product of investigative work to serve as the basis for nursing action. 2\. The period wherein discovery of the truth for the growth of science. Positivism, encompassed to make use of both logical reasoning and empiricism, became widespread during this time. 3\. To determine what is correct or not, Empirical and objective data co-exist as the center of interest of the study as one of each needs to be tried or tested. 4\. The result of the various viewpoints during this era had started the progress of the new scientific knowledge. This is shown with the advent of radical thinking, rationalism and empiricism. +-----------------------------------+-----------------------------------+ | **RATIONALISM** | **EMPIRICISM** | +===================================+===================================+ | 1\. The use of reason to | 1.Is used to collect and observe | | evidently prove something | data that are perceived through | | gained through expert study and | the senses; sight, smell, taste, | | established facts. | and touch. | +-----------------------------------+-----------------------------------+ | 2\. Deductive type of reasoning | 2\. Inductive type of reasoning | | starts from the general to | is used to formulate general | | specific knowledge. | knowledge. | +-----------------------------------+-----------------------------------+ | 3\. Emphasizes the use of | 3\. In nursing the use of | | rationale for any planned | empiricism is highly important | | nursing interventions before | in the assessment of patient | | putting the plan into action. | all throughout the entire | | | nursing process. | | (Example objective of nurse; | | | lower the temp from 40°C to 37°C | Ex. The nurse assesses the | | normal) | objective and subjective cues | | | before formulating the nursing | | | diagnosis. | +-----------------------------------+-----------------------------------+ | 4\. Emphasizes the use of | 4\. Emphasize the use of | | reasoning of any act either | objective and tangible data to | | good or bad done to a person. | observe and collect data. | +-----------------------------------+-----------------------------------+ **Nursing Leaders of the 20th Century** +-----------------------+-----------------------+-----------------------+ | **Nursing Leader** | **Year** | **Contribution to | | | | Nursing** | +=======================+=======================+=======================+ | Mary Grant Seacole | 1854 | Worked together with | | (England) | | Florence Nightingale | | | | during the Crimean | |  | | the wounded soldiers. | +-----------------------+-----------------------+-----------------------+ | Florence Nightingale | 1859 | Referred as the | | (England) | | \"Lady with the | | | | Lamp\" Contributed to | | | | the development of | | | | nursing education, | | | | practice and | | | | administration. | +-----------------------+-----------------------+-----------------------+ | \*\*\*Dorothea Lynde | 1861 | Appointed | | Dix (USA) | | superintendent of the | | | | Female Nurses of the | |  | | American Civil War Wr | +-----------------------+-----------------------+-----------------------+ | Louisa May Alcott | 1862-1863 | Wrote the book | | (USA) | | *"Hospital Sketches"* | | | | as she described the | | | | works of volunteer | | | | nurses during the | | | | Civil War. | +-----------------------+-----------------------+-----------------------+ | Harriet Tubman (USA) | 1861-1865 | *\"The Moses of Her | | | | People\"* | |  | | She served the slaves | | | | of the underground | | | | railroad during the | | | | Civil War. | +-----------------------+-----------------------+-----------------------+ | Walt Whitman (USA) | 1862-1865 | Worked together with | | | | Louisa Alcott during | | | | the Civil War. | +-----------------------+-----------------------+-----------------------+ | Sojouner Truth (USA) | 1862-1865 | Worked as a nurse | | | | during the Civil War | |  | | for the Freedman\'s | | | | Relief Association | | | | after. | +-----------------------+-----------------------+-----------------------+ | Jean Henri Dunant | 1862-1865 | Organized the | | (Switzerland) | | International | | | | Conference that | | | | founded the Red Cross | | | | during the Geneva | | | | Convention. | +-----------------------+-----------------------+-----------------------+ | Lucy Osborne | 1868 | Developed | | (Australia) | | Australia\'s first | | | | school for nurses | |  | | after training in St. | | | | Thomas Hospital under | | | | the supervision of | | | | Nightingale when she | | | | became the | | | | superintendent at | | | | Sydney Hospital. | +-----------------------+-----------------------+-----------------------+ | Linda Richards (USA) | 1873 | America\'s first | | | | trained nurse. | +-----------------------+-----------------------+-----------------------+ | Mary Mahoney (USA) | 1879 | America\'s first | | | | trained black nurse. | |  | | | +-----------------------+-----------------------+-----------------------+ | Clara Barton (USA) | 1812-1912 | Organized and | | | | established the | | | | American Red Cross. | +-----------------------+-----------------------+-----------------------+ | Mary Agnes Snively | 1884 | Developed the Toronto | | (Canada) | | General Hospital | | | | School of Nursing and | |  | | President of the | | | | Canadian Nurses | | | | Association. | +-----------------------+-----------------------+-----------------------+ | Lilian Wald (USA) | 1867-1940 | Founder of Public | | | | Health Nursing | | | | | | | | She also founded the | | | | Henry Street | | | | Settlement and | | | | Visiting Nurse | | | | Service which | | | | provided nursing | | | | services | | | | educationally, | | | | socially and | | | | culturally. | +-----------------------+-----------------------+-----------------------+ | Bedford Fenwick | 1899 | Established the | | (England) | | International Council | | | | of Nurses in Great | |  | | | +-----------------------+-----------------------+-----------------------+ | \*\*\*Clara Louise | 1876-1901 | Worked as a contract | | Mass (USA) | | nurse with the US | | | | Army during the | | | | Spanish-American War. | +-----------------------+-----------------------+-----------------------+ | Margaret Higgins | 1879-1966 | Founder of Planned | | Sanger (USA) | | Parenthood which | | | | initiated and | |  | | of birth control | | | | information. | +-----------------------+-----------------------+-----------------------+ | Lavinia L. Dock (USA) | 1858-1956 | During the 1920, she | | | | contributed in the | | | | 19th Amendment of the | | | | American | | | | Constitution, | | | | particularly in | | | | protect for the | | | | rights of women | | | | during her time. | +-----------------------+-----------------------+-----------------------+ | Mary Breckinridge | 1881-1965 | Established the | | (USA) | | Frontier Nursing | | | | Service (FNS) which | |  | | started at Leslie | | | | Country, Kentucky. | | | | She also opened one | | | | of the first | | | | midwifery training | | | | schools during her | | | | time. | +-----------------------+-----------------------+-----------------------+ +-----------------------+-----------------------+-----------------------+ | Dr. Lauranne Sama | 1971 | Served as the first | | (USA) | | President of the | | | | National Black Nurses | | | | Association. | +=======================+=======================+=======================+ | M. Lucille KinLein | 1972 | First independent | | (USA) | | nurse practitioner. | | | | | |  | | | +-----------------------+-----------------------+-----------------------+ | Dr. Iidaura Maurillo | 1974 | Served as the first | | Rohde | | president of National | | | | Hispanic Nurses | | (USA) | | Association. | +-----------------------+-----------------------+-----------------------+ | Eddie Bernice Johnson | 1992 | The first nurse to be | | (USA) | | elected to the United | | | | States House of | |  | | Representatives. | +-----------------------+-----------------------+-----------------------+ | Julia R. Plotnick | 1992 | Served as the Chief | | (USA) | | Nurse Officer, Rear | | | | Admiral and became an | | | | active leader in | | | | policy coordination | | | | for the US Surgeon | | | | General. | +-----------------------+-----------------------+-----------------------+ | Ada Sue Hinshaw | 1993 | Directed the National | | | | Center for Nursing | |  | | the International | | | | Institute for Nursing | | | | Research under the | | | | National Institutes | | | | for Health. | +-----------------------+-----------------------+-----------------------+ **NURSING SCIENCE AND THEORY IN THE LATE 20th CENTURY** 1\. The significant development of knowledge in the late 20th century was brought about by the different nurses who became leaders in their own right at the same time developed new nursing knowledge which eventually led to the different nursing theories that helped shape the contemporary practices in nursing. The role of nurses became more defined as nurses embarked on different fields in nursing. 2\. Nursing as it continually evolves brings into being the different theories that guide clinical practices. **THEORETICAL CONCEPTS OR KEY POINTS OF DIFFERENT CONTEMPORARY THEORIES** +-----------------------------------+-----------------------------------+ | **THEORISTS** | **THEORY/CONCEPT** | +===================================+===================================+ | \*\*\*Florence Nightingale | Environmental Theory | +-----------------------------------+-----------------------------------+ | Virgnia Henderson | Definition of Nursing | | | | |  | | +-----------------------------------+-----------------------------------+ | Martha Rogers | Unitary human being | +-----------------------------------+-----------------------------------+ | Sister Callista Roy | Adaptation Model | | | | |  | | +-----------------------------------+-----------------------------------+ | Dorothea Orem | Self Care theory | +-----------------------------------+-----------------------------------+ | Imogene King | Goal Attainment Theory | | | | |  | | +-----------------------------------+-----------------------------------+ | Betty Neuman | Healthcare System Model | +-----------------------------------+-----------------------------------+ | Dorothy Johnson | Behavioral System Model | | | | |  | | +-----------------------------------+-----------------------------------+ | Sigmund Freud | Psychoanalytic Theory | +-----------------------------------+-----------------------------------+ | Erick Erickson | Theory of Personality Development | | | | |  | | +-----------------------------------+-----------------------------------+ | Lawrence Kohlberg | Moral Development Theory | +-----------------------------------+-----------------------------------+ | Jean Piaget | Cognitive Development | | | | |  | | +-----------------------------------+-----------------------------------+ | \*\*\*Madeleine Leinninger | Theory of Personality Development | +-----------------------------------+-----------------------------------+ | \*\*\*Hildegard Peplau | Interpersonal Relations in | | | Nursing | |  | | +-----------------------------------+-----------------------------------+ | \*\*\*Ida Jean Orlando | Nursing Process Theory | +-----------------------------------+-----------------------------------+ | \*\*\*Jean Watson | Theory of Human Caring | | | | |  | | +-----------------------------------+-----------------------------------+ | \*\*\*Myra Estrin Levine | Conservation Model | +-----------------------------------+-----------------------------------+ | \*\*\*Lydia Hall | Core, Care, Cure Theory in | | | Nursing | |  | | +-----------------------------------+-----------------------------------+ | Faye Abdellah | Concept of Nursing Diagnosis | +-----------------------------------+-----------------------------------+ Nurses portray different roles in nursing as to the type of patients they care for. Below describe the professional and expanded role of nurses as they execute their respective roles in the delivery of nursing care. **PROFESSIONAL ROLES OF NURSES** **ROLE** **DESCRIPTION** ----------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Care Provider Nurses act as mother surrogate. The provision of care such as assisting the client perform the activities of daily living which will make the client comfortable and being cared for. The clients are provided with the feeling of being treated as a valued person with dignity. Communicator The core of nursing practice is communication. This is where the nurse establishes a nurse patient relationship with the use of therapeutic communication. This will establish trust and cooperation on the part of the patient. And as a team player with other health teams, good communication will yield good collaboration with other members of the health team. Teacher Nurses act as health educators. Assist clients understand their health state as well as the interventions that will be done to ease their conditions. With the health teachings the patients can see clearly the advantages and disadvantages of the actions that will be done to them. Teaching roles can also help in the development of the nursing profession especially in education. Counsellor Nurses are also counsellors, they assist patients cope with their health conditions. It also promotes client\'s holistic growth such as physical, emotional, psychological and even spiritual. Client Advocate As an advocate, the nurse stands on behalf of the clients. Protecting their rights, not to be harmed intentionally or unintentionally. Ensures that they are treated fairly and their needs are met. Change Agent Nurses\' role is to assess and determine alternatives to guide the client in the change of behaviour towards health. Leader As a positive (goal oriented) behaviour involving an exchange with other people. Leadership is an attempt to influence others. The process of influencing will aid clients in their decision making toward achieving their goal and that is to allay their conditions. Manager Manager works with people and through people to achieve organizational goals. Nurses act as managers when they perform their management functions such as planning, organizing, directing and controlling in the delivery of nursing care. Researcher Nursing is never static. Evidence-based practice is an offshoot of the investigative role of nurses which further improves the nursing practice. Research substantiates practices as they were tested and further studied upon. **EXPANDED ROLE OF NURSES** +-----------------------------------+-----------------------------------+ | **ROLE** | **DESCRIPTION** | +===================================+===================================+ | Nurse Generalist | Has mastery in certain practices | | | of nursing.. | | | | | | Ex. General nursing practice | | | | | | Medical-Surgical Nursing | +-----------------------------------+-----------------------------------+ | Nurse Clinician | Performs direct nursing actions | | | in specialty areas. They may or | | | may not have advanced educational | | | preparation as long as they are | | | certified by a governing body to | | | perform such duties. | +-----------------------------------+-----------------------------------+ | Nurse Practitioner | Has an advanced education in | | | nursing practice as certified by | | | a governing body. | +-----------------------------------+-----------------------------------+ | Nurse Specialist | A holder of a Master\'s degree in | | | nursing with a specialized field | | | in the practice of nursing. | +-----------------------------------+-----------------------------------+ **LESSON 3: EMERGENT VIEWS** This time let us focus on the importance of Nursing Theory to Education. Research and Clinical Practice and how they are interrelated to each other in the practice of nursing. Let us look into the four ways of knowing as it encompasses on how an ideal nurse is expected to possess as part of her personality in relating to her patients and to other persons as well. **NURSING THEORY IN EDUCATION, RESEARCH, AND CLINICAL PRACTICE** Nursing theory has been defined in Lesson 1 as \"a body of knowledge that describes or explains nursing and is used to support nursing practice\" (Quiambao-Udan, 2011). In this lesson, you will learn that nursing theory does not only explains and directs those who practice nursing, but it also helps in the development and expansion of knowledge through education and research. **IN EDUCATION, NURSING THEORIES:** are utilized to develop and guide nursing education in universities and other educational institutions. gave birth to unique terms such as clinical performance criteria, program or course objectives, etc. prepare students for practice. ensure adequate and quality nursing delivery and to clarify and improve the status of nursing as a profession. Nursing theories are more strongly established in the field of academics rather than in clinical practice. According to **Kozier (2008)**, the complete nursing curriculum was built around the nursing models or concepts. - - *Invasive* - doing something that allows you to penetrate the patient's body. *When you are in doubt, don\'t.* **Other importance of theories to clinical practice are:** Nursing theories strengthen professional independence by guiding the deepest and most important part of their practice. Nursing theories assist nurses to facilitate questions, reflections and critical thinking in every aspect of care. Nursing theories develop analytical skills and critical thinking ability for the purpose of safe and effective nursing practice! **LEVEL OF NURSING THEORY** There are 4 levels of theoretical thinking in nursing (Meta-theory, Grand theory, Middle range theory and Micro-range theory). The Middle Range Nursing Theory will be the focus of discussion as this is specific to nursing activities. **MIDDLE-RANGE NURSING THEORIES** It has been said that most of the middle-range nursing theories are formed on the efforts of the grand theories but they can be envisioned from research, nursing practice or theories of other disciplines. Middle range theories are more narrow in scope as compared to grand theories. In terms of the level of abstraction, the concepts and propositions are said to be at an inferior or lower level. Middle range theories direct a specific happening in nursing. Grand Theories are difficult to test thus nursing scholars suggested using this level of theory, the middle range theories. +-----------------------+-----------------------+-----------------------+ | **CATEGORY** | **DESCRIPTION** | **SCOPE** | +=======================+=======================+=======================+ | Middle-Range Nursing | Directs more narrowly | Concepts, limited in | | Theories | defined happening and | number Propositions: | | | can be used to | tangible and in | | Examples: | suggest an action. | detail | | | | | | Orlando\'s theory of | ([[www.delmarlearning | Middle range theories | | the deliberative |.com]](ht | are used for practice | | nursing process | tp://www.delmarlearni | activities such as | | | ng.com)) | assessment and | | Peplau\'s theory of | | intervention. | | interpersonal | | | | relations | | Obtained and tried by | | | | investigative work or | | Watson\'s theory of | | research. | | human caring | | | | | | ([[https://medical-di | | ([[www.scielo.org.co] | | ctionary.thefreedi]{. | | ](http:// | | underline}](https://m | | www.scielo.org.co)) | | edical-dictionary.the | | | | freedi)) | +-----------------------+-----------------------+-----------------------+ **THE FOUR WAYS OF KNOWING** The typology identifies four fundamental \"patterns of knowing\", these are the following: 1\. **Empirical** - the scientific discipline of nursing that is focused on evidence-based research for effective and accurate nursing practice. *Examples:* a. b. c. 2\. **Personal** - the learning and attitudes derived from personal understanding of self and empathy, including imagining one\'s self in the patient\'s position. It encompasses knowledge of the self in relation to others and to self. It involves the entirety of the nurse-patient relationship. *Examples*: a. b. 3\. **Ethical** - the attitude and knowledge derived from an ethical framework, including an awareness of moral questions and choices. It entails the judgment of right and wrong in relation to attributes, reasons, and intentions of individuals and situations. A - Airway B - Breathing C - Circulation *Examples*: a. b. c. 4\. **Aesthetic** - the awareness of the actual situation, including awareness of the patient and their circumstances as a unique individual, and of the combined wholeness of the situation. It is used in the process of giving appropriate nursing care through understanding the uniqueness of every patient, thus emphasizing use of creative and practical styles of care. *Examples*: a. b. c. **Interdependence of Theory and Research**  \"Practice without theory, like map without route, is blind; theory without practice, like route without map, is empty"