TFN Notes.pdf

TFN Lesson 1: History of Nursing What is Nursing - A healthcare profession that integrates the art and science of caring History of Nursing Words fair in Chicago (1893) - First national gathering of nurses American Journal of Nursing (AJN) - First national orga...

TFN Lesson 1: History of Nursing What is Nursing - A healthcare profession that integrates the art and science of caring History of Nursing Words fair in Chicago (1893) - First national gathering of nurses American Journal of Nursing (AJN) - First national organ of communication for nurses (Oct 1900) Four Historical Era Curriculum Era - Courses was made and had standardized curriculum for diploma programs Research Era - More nurse leaders embraced higher education and arrived at common understanding of the scientific age Graduate Education Era - Master’s degree programs in nursing emerged. Development of nursing knowledge was a major force during this period. Theory Era: Prolif Theory Era - Proliferation of Nursing Doctoral Programs from the 1970s. Introduction of new programs and theory development The Meaning of a Discipline and a Profession Discipline - specific to academe and refers to a branch of education, a department of learning or a domain of knowledge Profession - refers to a specialized field of practice, founded upon the theoretical structure of the science or knowledge of that discipline and accompanying practice abilities. TFN Lesson 2: Structure of Nursing Knowledge Rationalism - a view that regards reason as the chief source of knowledge - emphasize a priori reasoning A Priori Reasoning Latin: From the former - Deductive logic by reasoning from the cause to effect Rene Descartes (1596-1650) - First modern rationalist - Knowledge could be attained by reason alone - “Cogito Ergo Sum” or “I think, therefore I am” Empiricism - All knowledge are obtained through senses. - emphasize a posteriori reasoning A Posteriori Reasoning Latin: From the latter - Concepts that can be applied only on the basis of experience John Locke (1632-1704) - Made the most elaborate and influential presentation of empiricism Early 20th Century Views Positivism - dominant view of modern science Deductive Reasoning - Theories are tested through research - General to specific Deductive Approach - Observation - Theory is developed - Theory is tested Inductive Reasoning - Theories developed from data that explains phenomenon - Specific to general Inductive Approach - Observation - Data are examined - Explains the phenomenon Emergent Views Paul Michael Foucalt - Humans were emerging as objects of study - Discussed the notion of history, change, and historical method - “Human knowledge and existence are profoundly historical Alfred Schutz - Ways in which people grasp consciousness of others - Deal with the “lifeworld”; people create social reality under pre-exsiting social factors Edmund Husserl - Principal founder of phenomenology - Phenomenology is a science of consciousness rather than emotion Phenomenology Phenomenology - Direct investigation and description of phenomena Structure of Nursing Knowledge Structural Holarchy of Contemporary Nursing Knowledge - Heuristic device that places components of contemporary nursing into Holarchy Holarchy of Contemporary Nursing Nursing Knowledge - Guides day-to-day responsibilities - Distinguish nurses from other healthcare providers Nursing Paradigm Nursing Paradigm - Patterns or models usedto show relationship among existing theoretical works in nursing Metaparadigm - Most general statement of a discipline and functions Four Nursing Metaparadign Concepts Person - Recipient of the nursing care Environment - All internal, external, and social factors Health - Patient’s level of wellness Nursing - Actions, characteristics, and attributes Philosophies in Nursing Philosophy - Attitude toward life and reality that evolves from each beliefs Significance Achieve intellectual enlightenment Individual is offered an opportunity to understand and value Governs science through logics and ethics Conceptual Models - Set of concepts that integrates into meaningful configurations Newman Systems Model Orem Self-care Framework Roper-Logan-Tierney Model of Nursing Ray Adaptation Model Theory Theory - Creative and religious structuring of ideas - Abstract statement to predict, explain, or describe relationships How Nurses uses Theory Organize, understand, and analyze patient data Make decisions about nursing interventions Plan, predict, and evaluate patient care and outcomes Characteristics  Logical, simple, and generalizable Composed of concepts and preposition Provide bases fro testable hypotheses Consistent with other validated theories Contribute to body of knowledge Ethical and moral structure to guide nurse action Describe, explain, predict or be used to control a phenomenon Facilitates coordnatied and less fragment care Classifications of Theories Depending on: Function or Purpose Descriptive Factor-isolating Identify and describe major concepts Explanatory Factor-relating Examine how properties relate to discipline Predictive Situation-relating Calculae relationships between properties and how they occur Prescriptive Sitatuon-producing Used in testing new nursing intervention Range or Scope Metatheory Identifies the domain of nursing that address philosophical perspective Grand Theory Provides conceptual framework under key concepts Middle Range Theory More precise and analyze a situation with limited number of variables Practice Theory Explores situation and identifies explicit goals and details how these will be achieved Philosophical Underpinnings Needs Explains how needs for achievement, power, and affiliation affect actions of people Interaction Approach to questions about social cognition or how people understands others Outcome Conceptual basis for thinking and working with outcomes Humanistic Emphasizes empathy and stresses the good in human behavior Abraham Maslow and Carl Rogers TFN Lesson 3: Florence Nightingale Florence Nigtingale Born: May 12, 1820 (Florence, Italy) Death: August 13, 1910 (United Kingdom) Known as: Lady with the Lamp Accomplishments: Pioneer of professional nursing Theory: Environmental Adaptation Theory Describe nursing as divine calling to serve others Philosophy is about healing The first to propose nursing required specific education and training Notes on Nursing - Published by Florence in 1859 - Guide nurses Environmental Adaptation Theory Environmental Adaptation Theory - Believed that symptoms of disease are response to negative environment - Three are affected by environment: habitat tracking, genetic change, and extinction - Focuses on the care of the patient rather than the nursing process  Major Assumptions Person Reffered to as the patients Environment Could be altered in a matter for healing to occur Health Does not need to be disease-free to be healthy; maximize optimal potential to be in a healthy state Disease is a repitative process Nursing It is not the fault of the disease if the patient is suffering, rather, the fault of nursing Nightingale’s Model of Needs Consistent with Maslow’s Hierarchy of Needs Nightingale’s 13 Cannons Ventilation and Warmth Assess the body and room temperature, and room for fresh air and foul odors Keep the room airy and free of odor Light Assess the room for adequate light Sunlight si the best light source Cleanliness of Rooms Asses the room and keep the room free from and Walls dampness, darkness, and dust. Health and Houses Assess the surrounding environment for pure water, drainage, cleanliness, and light Remove garbage from the area Noise Assess the noise level in the room  Bed and Beddings Assess the bed for dampness, wrinkles, and soiling Personal Cleanliness Keep the client dry and clean Frequent assessment is needed Variety Stimulate variety through cards, flowers, pictures, and conversation Chattering Hopes and Avoid talking without reason or giving advice without Advices fact Taking food Assess the clients diet and note the amount of food and drink ingested What food Assess the type of food and drink the client likes or dislikes Petty Management Ensure continuity of care through documentation Observation of the sick Record all observations and it must be factual. Make alterations in the nursing plan if needed. TFN Lesson 4: Jean Watson Jean Watson - Founder of “Caring Theory” - Created “Watson Caring Science” in 2008 Caring Theory Caring Theory - humans cannot be treated as objects and that humans cannot be separated from self, other, nature, and the larger workforce. Development Overview - Inductive - Examines the relatedness of: - Research - human science and caring process - Deductive - experience - Revision - phenomena Evolution - First published in 1970 and reviewed in 1985 and 1988 10 Carative Factors 1st to 3rd - Form philosophical foundation for science of caring 4th to 10th - spring from 1st to 3rd 10 Caritas Process Caritas - Giving of help Carative Factors Caritas Process The formation of a humanistic altruistic Practice of loving-kindness and system of values equanimity within the context of caring consciousness The instillation of faith-hope Being authentically present and enabling and sustaining the deep belief system and subjective lifeworld of self and one being cared fo The cultivation of sensitivity to one’s Cultivation of one’s own spiritual self and to others practices and transpersonal selfgoing beyond the ego self Development of a helping-trust Developing and sustaining a helping relationship trusting authentic caring relationship The promotion and acceptance of the Being present to, and supportive of, the expression of positive and negative expression of positive and negative feelings feelings as a connection with deeper spirit and self and the one-being-cared for The systematic use of the scientific Creative use of self and all ways of problem solving method for decision knowing as part of the caring process; making to engage in the artistry of caring-healing practices The promotion of transpersonal Engaging in genuine teachinglearning teaching-learning experience that attends to unity of being and meaning, attempting to stay within others’ frame of reference The provision of supportive, protective, Creating healing environment at all and (or) corrective mental, physical, levels (physical as well as nonphysical, societal, and spiritual environment subtle environment of energy and  consciousness, whereby wholeness, beauty, comfort, dignity, and peace are potentiated) The assistance with gratification of Assisting with basic needs, with an human needs intentional caring consciousness, administering ‘human care essentials,’ which potentiate alignment of mind body spirit, wholeness, and unity of being in all aspects of care The allowance for Opening and attending to existentialphenomenological forces spiritualmysterious and existential dimensions of one’s own life-death; soul care for self and the one-beingcared for Four Major Concepts Human being - A complex, holistic being; an evolving soul - A human being has complex needs including physical, psychological, psychosocial Environment - An open system containing both internal (mental, spiritual, and cultural) and external (physical, environmental, and safety) variables that we as caregivers can manipulate Health - A high level of overall physical, mental and social functioning - The absence of illness (or the presence of efforts that leads its absence) Nursing - “Nursing is concerned with promoting health, preventing illness, caring for the sick and restoring health”. - She believes that holistic health care is central to the practice of caring in nursing Watson’s Hierarchy of Needs Lower-order biophysical Survival needs Fuid and Food Elimination of Waste Ventilation Lower-order psychophysical Functional needs Activity Inactivity Sexuality Higher order psychosocial Integrative needs Achievement Affilation Higher order Growth-seeking need intrapersonal-interpersonal Self-actualization TFN Lesson 5: Patricia Benner Patricia Benner - An Influential Nurse in the Development of the Profession of Nursing - was influenced by a Martin Heidegger Novice to Expert Model Novice to Expert Model - Also known as Benner’s Stages of Clinical Competence. - Adapted from the Dreyfus Model of Skill Acquisition. Novice - Has no background experience of the situation - Beginner to profession or nurse changing area of practice - Generally this level applies to nursing students, new graduates, etc Advanced Beginner - Can demonstrate performance having enough real situations to note - Guided by rules and oriented by task completion. Competent - After two to three years in the same area of nursing - Recognize patterns and determine which elements of the situation warrant attention and which can be ignored  - Devises new rules and reasoning procedures for a plan while applying learned rules for action Proficient - After three to five years in the same area of nursing - Deep understanding of situations as they occur, less conscious planning is necessary - Nurses at this level demonstrate a new ability to see changing relevance in a situation Expert - This stage occurs after five years or greater in the same area of nursing - The expert performer no longer relies on an analytic principle - The expert operates from a deep understanding of the total situation. Four Domains of Nursing Paradigm Client/Person - The person is a selfinterpreting being, that is the person does not come into the world predefined but gets defined in the course of living a life Health - What can be assessed, whereas well-being is the human experience of health or wholeness. Environment/Situation - Uses situation rather than environment because situation conveys a social environment with social definition - Implies that one has a past, present, and future and that all of these aspect influence the current situation. Nursing - As a caring relationship, an “enabling condition of connection and concern