Nursing Theory PDF

NURSING THEORY NURSING - STRIVES TO EXPLAIN THE SCIENCE & VARIED - encompasses a wide range of ART OF NURSING responsibilities, from providing basic care to managing complex medical conditions. Nursing as a Science - it is base...

NURSING THEORY NURSING - STRIVES TO EXPLAIN THE SCIENCE & VARIED - encompasses a wide range of ART OF NURSING responsibilities, from providing basic care to managing complex medical conditions. Nursing as a Science - it is based on a body of knowledge that has been developed DYNAMIC - constantly evolving and through research and evidence-based adapting to meet the changing needs of practice. patients and healthcare systems. Nursing as an Art - nursing is an art DIVERSE - practiced in a variety of settings, because it requires creativity, intuition, and including hospitals, clinics, schools, and empathy. homes. THEORY - a systematic and organized body AMERICAN NURSING ASSOCIATION of knowledge that describes, explains, (ANA) predicts, and prescribes phenomena. It is based on a set of concepts, propositions, founded in 1896 and assumptions. represents 4 million registered nurses in COMPONENTS OF THEORY united states Content advocates for nurses and patients, set standard nursing practices Context INTERNATIONAL COUNCIL OF NURSES Process (ICN) NURSING THEORY - articulated and founded in 1899 communicated conceptualization of invented or discovered reality represents more than 130 million nurses associations and over 28 million nurses Explains worldwide Describes - promotes the development of nursing and healthcare around the world Predict ASSOCIATION OF DEANS OF Prescribes PHILIPPINE COLLEGES OF NURSING (ADPCN) THE COMPLEXITY OF NURSING founded in 1954 NURSING PARADIGM - patterns or models used to show relationships represents dean of nursing school and among the existing theoretical works in college in PH nursing. promotes advancement of nursing DIFFERENT TYPES OF THEORIES education and research in the Philippines Classification of Nursing Theories according to function CHARACTERISTIC OF THEORIES CONCEPT - building blocks of theories. They are primarily the vehicles of thought Descriptive that involve images. Explanatory MODELS - representations of the interaction among and between the Predictive concepts showing patterns. Prescriptive present an overview of the theory’s thinking and may demonstrate how theory can be ; introduced into practice. Interralating Concept CONCEPTUAL FRAMEWORK - group of related ideas, statements, or concepts. It is Logical in Nature often used interchangeably with the conceptual model and with grand theories. Generalizable PROPOSITION - are statements that Basis for Hypothesis describe the relationship between the concepts. Guide and improve practice PHENOMENON - emperical data or Consistent with other laws experienc e that can be physically observed or tangible such as crying in pain CONCEPTUAL MODELS OR FRAMEWORK - representation of an idea DOMAIN - view or perspective of the or body of knowledge based on the own discpline understanding or perspection. PROCESS - are organized steps, changes, THEORETICAL MODELS OR or functions intended to bring about the FRAMEWORK - highly establish set of desired result. concepts that are testable PARADIGM - refers to a pattern of shared PHILOSOPHY - next knowledge levels of understanding and assumptions about metaparadigm and specifies the definition reality and the world, worldview, or widely of metaparadigm’s concept. accepted value system. SCIENCE - organized body of knowledge METAPARADIGM - is the most general gained through research statement of discipline and functions as a framework in which the more restricted (SCIENTIFIC METHODS) structures of conceptual models develop. Observation, Gathering Data, Forming person, environment, health, and nursing. Hypothesis, etc PURPOSES OF NURSING THEORIES IN KNOWLEDGE - information, skills and RELATION TO expertise acquired through formal/informal learning EDUCATION - to establish the profession’s place in the university sources are traditional, authoritative, scientific RESEARCH - identifies the philosophical 1850 traveled to alexandria, egypt, began assumptions or theoretical framework studying in nursing at the institute of saint vincent de paul PRACTICE - facilitation of reflection, questioning, and thinking about what nurses 1851, 31 y/o, went to germany to train to do become a nurse HISTORY OF NURSING THEORIES: 1853 became superintendent in hospital of gentlewoman of london Appeared in late 1800’s when strong emphasis was placed on Nursing Education 1854 the crimean war broke NURSING PROCESS 1907 - King Edward conferred on her the 'Order of Merit' 1. Are organized bodies of knowledge to define what nursing is, what nurses do, and ENVIRONMENTAL THEORY - restoration why they do it. of the usual health status of the nurse’s clients into the delivery of healthcare 2. It provides a way to define nursing as a unique discipline that is separate from other defined Nursing as: “the act of utilizing the disciplines (e.g., medicine). patient’s environment to assist him in his recovery.” 3. It is a framework of concepts and purposes intended to guide nursing practice external factors associated with the patient’s at a more concrete and specific level surroundings affect the life or biologic and physiologic processes and his development. FLORENCE NIGHTINGALE (May 12 1820- August 13 1910) involves the nurse’s initiative to configure environmental settings appropriate for died in 1910 August 13 in her sleep the gradual restoration of the patient’s health. known as the lady of lamp providing care through soldiers in Crimean war CRIMEAN WAR - nursing is an act of utilizing the environment of the patient to founder of educated and scientific assist him in the recovery nursing INTELLECTUALS - beliefs of changing first nursing theorist things as she viewed as unacceptable to society mathematician (a nurse statistician) RELIGIOUS BELIEF - for Nightingale, an philosopher action for the benefit of others is called “God’s Calling” DUM VIVIMUS, SERVIMUS september 1837 (traveled to france, italy and switzerland (attended concerts, THE CRIMEAN WAR operas, parties) 1854-1856 1839 (presented to queen victoria of england) England and France were helping Turkey in a war against Russia 1849 traveled to europe to study european hospital system Russia & France had religious sister to care World witnessed the change Nightingale for wounded made in the Crimean war and witnessed the power of Nursing. England only trained men A FACELIFT TO NURSING Nightingale receives appeal from the minister of war to go to Turkey to founded Nightingale School and Home for manage the nursing of British the Nurses using money donated in tribute to her service. she’s with 38 nurses, she called them “Handmaiden of the Lord” The school marked the beginning of professional education in nursing fields found the hospital conditions to be in a very poor state. Her books, “Notes on Hospitals” “Notes on Nursing” become the first definitive textbook Many of the wounded were unwashed and in field were sleeping in overcrowded, dirty rooms without blankets or decent food. - transformed the nursing profession forever through selfless devotion and sheer In these conditions diseases such as determination typhus, cholera and dysentery spread quickly. As a result, the death rate amongst -gave dignity and honor to nursing, wounded soldiers was very high. revolutionized hospital conditions (more organized and sanitary) Most soldiers died from infections and disease. (Only one in six died from their war CONFIGURE EXTERNAL FACTORS - wounds; the other five in six died from associated with the patient’s surroundings infections and disease.) that affect life or biological and psychological processes and his Through her tireless efforts the mortality development rate among the 5 Essential Components of A Healthy sick and the wounded was greatly reduced Environment: (from 42% to 2%) pure air 5- 6 nurses shared one room including eating and sleeping. pure water -they scrubbed and cleaned, improved efficient drainage drainage, procured soaps, towels and clothing, cleanliness -opened diet kitchens, made good food, light visited the sick and wrote letters for them What are the MAJOR CONCEPTS of the -set up laundries, reading rooms and post MODEL? offices for them. Nightingale’s Environmental Theory focuses THE LADY WITH THE LAMP - At night she on the patient and the environment carried a lamp while taking rounds from room to room to look after her patients. Nightingale’s philosophy are centered in 13 How do the COMPONENTS relate to canons and 7 assumptions NURSING METAPARADIGM? (Person, Health, Environment, Nursing) - believed that nursing was a calling card (holistic and in spiritual dimension) PERSON: Recipient of nursing care 13 CANONS HEALTH: “not only to be well, but to be able to use well every power we have to use” Ventilation and warning (Nightingale, 1969) Health of houses ENVIRONMENT: external and internal Petty management NURSING: alter or manage the environment to implement the natural laws of health Noise Variety Taking food What food? Bed and bedding Light Cleanliness of rooms and walls Personal Cleanliness Chattering hopes and advices Observation of the sick 7 ASSUMPTIONS 1. Natural laws 2. Mankind can achieve perfection 3. Nursing is a calling. 4. Nursing is an art and a science. 5. Nursing is achieved through environmental alteration. 6. Nursing requires a specific educational base. 7. Nursing is distinct and separate from medicine.  PATRICIA BENNER Her work provides the profession of nursing with what we now know as the Novice to - Birthdate: August 1942 Expert model, also known as Benner's - Known for its Novice to Expert Stages of Clinical Competence. Theory and Excellence and Power in Clinical Nursing Practice - work as applied to the nursing - Professor in the department of profession is adapted from the physiological nursing in the school of Dreyfus Model of Skill nursing at the university of Acquisition. california - Received her bachelor degree in Dreyfus Model of Skill Nursing from Pasadena College Acquisition. - Master’s degree in medical surgical nursing from University NOVICE - ADVANCED BEGINNER of California - COMPETENT - PROFICIENT - - Ph.D from University of California, EXPERT Berkeley, in stress and coping and health under the direction of Hubert Skill Acquisition - the utility of the concept Dreyfus and Richard Lazarus of skill acquisition lies in helping the teacher Is an internationally noted understand how to assist the learner in researcher and lecturer on health, advancing to the next level (McClure, 2005) stress and coping, skill acquisition and ethics. Benner’s model of novice- expert theory Recently elected an honorary fellow of the Royal College of NOVICE - ADVANCED BEGINNER - Nursing. COMPETENT - PROFICIENT - EXPERT Staff nurse in the areas of medical-surgical, emergency room, Novice - STAGE 1 The person has no coronary care, intensive care units background experience of the situation in and home care. which he or she is involved. Currently, her research includes the -there is difficulty discerning between study of nursing practice in intensive relevant and irrelevant aspects of the care units and nursing ethics. situation. BOOKS - Beginner to profession or nurse changing 1. from Novice to Expert area of practice (Frisch, 2009) 2. The Primacy of Caring - Generally this level applies to nursing 3. Interpretive Phenomenology: students. Embodiment, Caring and Ethics in Health and Illness These inexperienced nurses function at the 4. The Crisis of Care level of instruction from nursing school. 5. Expertise in Nursing Practice: They are unable to make the leap from Caring, Clinical Judgment, and the classroom lecture to individual Ethics patients. Often, they apply rules learned in 6. Caregiving nursing school to all patients and are unable 7. Clinical Wisdom and Interventions in to discern individual patient needs. These Critical Care: A Thinking-In-Action nurses are usually new graduates, or those Approach. nurses who return to the workplace after a long absence and are re- educated in - Proficient level is a qualitative leap refresher programs. beyond the competent. ADVANCED BEGINNER - STAGE 2 The - Nurses at this level demonstrate a new advanced beginner stage in the Dreyfus ability to see changing relevance in a model develops when the person can situation including the recognition and the demonstrate marginally acceptable implementation of skilled responses to the performance having coped with enough real situation as it evolves. situations to note, or to have pointed out by mentor, the recurring meaningful EXPERT - STAGE 5 This stage occurs components of the situation. after five years or greater in the same area of nursing (experienced nurses changing - Nurses functioning at this level are guided areas of nursing practice may progress by rules and oriented by task more quickly through the five stages) The completion. expert performer no longer relies on an analytic principle (rule, guideline, maxim) to - Still requires a mentor or experienced connect her or his understanding of the nurse to assist with defining situations, situation to an appropriate action. to set priorities, and to integrate practical knowledge (English, 1993) - The expert nurse, with an enormous background of experience, now has an COMPETENT - STAGE 3 After two to intuitive grasp of each situation and zeroes three years in the same area of nursing the in on the accurate region of the problem nurse moves into the Competent Stage of without wasteful consideration of a large skill acquisition. range of unfruitful, alternative diagnoses and solutions. - The competent stage is the most pivotal in clinical learning because the learner must - The expert operates from a deep begin to recognize patterns and determine understanding of the total situation. which elements of the situation warrant attention and which can be ignored. HOSPITAL SURVIVAL - Her theory of expert nurses is critical today as the - The competent nurse devises new rules profession begins to realize the aging of the and reasoning procedures for a plan members of its workforce and the increasing while applying learned rules for action on age of the population who will require more the basis of the relevant facts of that nursing services. situation. - Her theory is applicable today, as it was at PROFICIENT - STAGE 4 After three to five its publication, and provides us with a years in the same area of nursing the nurse foundation to use for assigning clinical moves into the Proficient Stage "The nurse competence, a tool to use to assess possesses a deep understanding of competence in the staff nurse. situations as they occur, less conscious planning is necessary, critical thinking and WHAT CAN NURSES DO? Nurse leaders decision-making skills have developed" can help address the issues of nursing (Frisch, 2009) shortage and staff retention by supporting new graduate nurses by: -perceives situations as wholes rather than in terms of chopped up parts or aspects. - Advocating for transition or residency programs to competency, confidence & satisfaction of new RNs. - Maintaining a healthy working environment > Not using novice RNs to cover for staffing shortage before the end of orientation period > Zero tolerance for lateral violence or bullying. -Supporting experienced RNs who are serving as preceptors and mentors for novice RNs SHAPING OUR FUTURE NURSE LEADERS 1. New graduate nurses are the future employee pool 2. Job satisfaction & retention are greatly influenced by the quality of orientation and support received by the new graduate nurse. 3. A positive experience will encourage the now proficient nurse to mentor novice nurses & give them the same positive experience he/she had during the transition period. The mediocre teacher tells. The good teacher explains. The superior teacher demonstrates. The great teacher inspires. (William Arthur)