Theoretical Foundations in Nursing Reviewer PDF

THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P. Prehistoric Medical Practice DEFINITION OF THEORY D...

THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P. Prehistoric Medical Practice DEFINITION OF THEORY Different Prehistoric Medical  A set of propositions Practices: (statements/opinions), suppositions (assumptions/hypothesis) or constructs Use of mercury (ideas) that purpose to explain, describe, Blood Letting with the use of leeches and predict a reality. Lobotomies Heroin for headaches THE EVOLUTION OF NURSING Electroconvulsive Therapy (ECT) Trephining Cannibalistic Medical Practice A. Intuitive Period Radium Water B. Apprentice Period Ecraseur C. Educational Period Plombage D. Contemporary Period Peg Legs Morphine for teething Intuitive Period Starvation for Aneurysms (Primitive Era - 6th Century) Hydroelectric Baths for Migraines Rise of the Early Civilization and  What is Intuition? Ancient Cities and their Contribution  Nursing was “untaught” and to Medicine instinctive. It was performed of compassion for others, out of the  Mesopotamia wish to help others.  No distinction between rational  Nurse’s role was instinctive and science and magic. directed toward comforting, practicing midwifery and being wet nurse to a  Diagnostic Handbook - child. introduced the methods of therapy and cause. The text  Intuitive Period contains a list of medical  Nursing was a function that belonged to symptoms and often detailed women. empirical observations along with  No caregiving training is evident. logical rules used in combining  Primitive men believed that illness was observed symptoms on the body caused by the invasion of the victim’s of a patient with its diagnosis and body of evil spirits. prognosis.  Believed that medicine man was called  Asipu – Medical Authority/ shaman or witch doctor having the power Exorcist- Healer to heal using white magic.  Prophylaxis  Trephining  Mental Illness is associated with Deities EARLY THEORIES  Music or singing was often used to chase away spirits.  In some cases trephening was used: 1 Cutting a hole in the head of the afflicted to let out the evil spint.  THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P. CHINA EGYPT  Huangdi neijing  Egyptians are considered “The  The foundational text of Chinese Healthiest of all men” medicine written 5 th century to 3rd century BC- Basis of  Public Health System traditional Chinese medicines, acupuncture and moxibustion.  Medical information in the Edwin Smith Papyrus may date to a time as early as 3000 BC. It details cures ailment GREECE AND ROMAN EMPIRE and anatomical observation  Wound treatment.  Edwin Smith Papyrus is an  The Romans attempted to ancient textbook on surgery maintain vigorous health, almost completely devoid of because illness was a sign of magical thinking and describes in weakness. exquisite detail the examination,  Care of the ill was left to the diagnosis, treatment, slaves or Greek physicians. Both and prognosis of numerous groups were looked upon as ailments. inferior by Roman society.  The Kahun Gynaecological Papyrus treats women's The Apprentice Period complaints, including problems (6th Century- 18th Century) with conception.  What is an Apprentice?  The earliest known physician is  Period of “on the job” training. also credited to ancient Egypt  From the founding of the Religious ("Chief of Dentists and Physicians" orders in the 11th century up to for King Djoser in the 27th 1836 with the establishment of century BCE) the Kaiserwerth Institute for training of Deaconesses.  Peseshet – Earliest known woman physician.  Early Nurses - Deaconesses INDIA  Nursing performed without any formal education and by  The Atharvaveda – Ancient text dealing people who were directed by with Medicine more experienced nurses.  Ayurveda – “Complete knowledge for long life” Medical system of India with 8  Founding of religious order. branches of medicine  Charaka and Sushruta – 2 most famous medical texbooks that describes physical examinations, diagnosis, treatment and prognosis and several surgical procedures.  Suśrutasamhitā - Describes several surgical procedures 2  THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P. THE BEGINNING OF RELIGIOUS WAR SECULAR ORDERS FOUNDED DURING THE PERIOD OF CRUSADES  A religious war or holy war - is a war primarily caused or justified by  Order of St. Francis of Assisi (1200- differences in religion. Present)  The Crusades -- They were Holy  The Beguines - composed of lay Wars waged in an attempt to recapture nurses who devoted their lives to the Holy Land from the Turks who denied service of suffering humanity. Christ’s pilgrims permission to visit Holy  The Oblates (12 th Century) Sepulcher.  Benedictines  Ursulines MILITARY RELIGIOUS ORDERS AND THEIR WORK IMPORTANT NURSING PERSONAGES  Knights of St. John of Jerusalem (Italian) - Also known as “Knight  St. Clare - founder of the second order Hospitalers” They founded Hospitals of St. Francis of Assisi.  Teutonic Knights (German)-  St. Elizabeth of Hungary – known as Established tent hospitals for the the “Patroness of Nurses” , she was WoundeD. the daughter of the Hungarian King.  Knights of St. Lazarus- Founded She lived her life frugally despite her primarily for nursing care of lepers in wealth. Jerusalem.  St. Catherine of Siena – The first lady  The Alexian Brothers were members with the lamp. She was a hospital of a monastic order founded 1348. nurse, prophetess, researcher and a They established the Alexian Brothers reformer of society and the church. Hospital School of Nursing the largest School of Nursing under religious order. It operated exclusively for men in THE RISE OF PROTESTANTISM United States. (1520-1562)  From 1520 onwards, Martin Luther’s THE RISE OF SECULAR ORDER ideas and works could be found in France – they even influenced the court of Francis I. The king’s sister,  There was the rise of Religious Nursing Marguerite of Angoulême asked the Orders for women. Although Bishop of Meaux to reform his diocese Christianity promoted equality to all so he asked James Lefèvre d’Etaples men, women were still concentrated in to come and join him. their roles as wives and mothers.  He was the author of a French version of the New Testament which had been  Religious taboos and social restrictions considered heretical by the Sorbonne influenced nursing at the time of the and was the founder of the Circle of religious Nursing Orders. Reformers in Meaux which had been forbidden by the Church. Luther’s works were translated into French, mostly printed in Switzerland and passed from one person to another in secret. 3  THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P.  The Protestants, who were called  Theodore Fliedner – Reconstituted ‘Lutherans’ at the time, belonged to the the deaconesses and later higher, literate class of society and established the school of nursing in were condemned as heretics by the Kaiserwerth, Germany where Church. Persecution began in 1521: Florence Nightingale had her first they had to pay fines, were sent to formal training for 3 months as a prison and even burnt at the stake. nurse. THE START OF DARK PERIOD OF NURSING 1st TRAINING SCHOOL OF NURSING  The world of nursing, despite wars and plagues made considerable progress Bellevue Hospital School of Nursing under the influence of Christianity. It  Founded in 1873 in New York. It was maybe said that nursing owes its the first school of nursing in the foundation to the work of benevolent United States to be founded on the men and women, the crusades and the principles of nursing established guilds. by Florence Nightingale.  But this progress in nursing was brought to a halt by industrial and political revolution and the Reformation in the 16th century. Iloilo Mission Hospital School of Nursing  Established in 1906 it is the first DARK PERIOD PERIOD OF NURSING hospital in the Philippines which 17TH TO 19TH CENTURY trained Filipino nurse.  Also known as the period of reformation and American civil war. NIGHTINGALE ERA  Hospitals were closed.  Nursing was the works of least Florence Nightingale desirable people.  Born on May 12, 1820  Nurses were uneducated, filthy and  Born to a wealthy English parents overworked.  Known as  Mass exodus of nurses. “The Lady with the  The religious upheaval led by Martin Lamp” and “Professional Nurse Luther destroyed the unity of the Pioneer Christian faith. The wrath of  Most famous for her work during the Protestantism swept away from Crimean War (1854-1856) everything connected with Roman Catholicism in schools, orphanages and  Under Florence’s leadership, the hospitals. Properties of hospitals and nurses brought cleanliness, schools were confiscated. sanitation, nutritious food and comfort to the patients. 4  THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P.  Nightingale was known for providing  Nightingale implemented the kind of personal care, like writing handwashing and other hygiene letters home for soldiers, that practices in the war hospital in which comforted them and improved their she worked. psychological health.  More soldiers die because from  Her group of nurses transformed the infection than from bullets. hospital into a healthy environment within six months, and as a result, the  She advocated sanitary living death rate of patients fell from 40 to 2 conditions as of great importance. percent (5). In 1857, Florence returned home a heroine. It was the soldiers in Crimea that initially named Education Period her the “Lady with the Lamp” (18th – 20th Century) because of the reassuring sight of her carrying around a lamp to check on the sick and wounded during the  Florence Nightingale was one of night, and the title remained with her. the pioneers in establishing the idea of nursing schools from her  Published in 1859 Notes on Nursing base at St Thomas' Hospital, provides a simple but practical London in 1860 when she opened discussion of good patient care, along the 'Nightingale Training School with helpful hints. According to for Nurses’, now part of King's Florence Nightingale, hygiene, College London. sanitation, fresh air, proper lighting, a good diet, warmth, NIGHTINGALE SCHOOL OF quietness and attentiveness were NURSING necessary conditions for hospitals and were to be ensured by trained nurses..  Environmental Theory and  During the war a public Statistical - Nightingale implemented subscription fund was set up for handwashing and other hygiene Florence Nightingale to continue practices in the war hospital in which her education of nurses in she worked. More soldiers die England, and the Nightingale because from infection than from Training School at St. Thomas’ bullets she advocated sanitary living Hospital opened in 1860. conditions as of great importance.  The education of recruits involved a year of practical instruction in the wards, supplemented with courses of lecturing, and followed by two years of work experience in the hospital. After graduation, many of the students staffed British hospitals, and others spread the Nightingale education system to other 5  THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P. CONCEPT IN THE NIGHTINGALE 13. A major component of training was SYSTEM OF EDUCATION moral: ethical standards for patient care. 14. Technical training had to be Updated. 1. Government funds should be allotted to nursing education. 15. A Probationers’ Home should be  First nurse political activist. provided, with a private room for each, comfortable (common) living. 2. Training schools of Nursing should be in close affiliation. 16. Responsibility for probationers’ health and safety, including rules to prevent 3. Professional nurses should train nurses. septicemia and ongoing monitoring of probationers’ health. 4. Nursing students should be provided with residence near their training hospitals. 17. Certificates and letters of reference  Written orders of doctors were had to be dated and were relevant only insisted. for a short time.  Nurses should go with doctors during their rounds. 18. A matron should have a housekeeper under her so that she could concentrate 5. All nurses must be trained, in a regular on the nursing and the nurse training. civil hospital. 19. The superintendent herself must have 6. Training was fundamentally on the the highest knowledge of nursing, be apprenticeship model: handson, in the herself resident in the hospital, make the wards, under the wardSister. training in nursing her first object, and be herself a trained nurse of the highest 7. Classes, given by medical doctors, order. augmented training in the wards. 8. The “home sister” or “mistress of Contemporary Period probationers” organized the Training. (21st Century) 9. District nurses had to be hospital trained (or they would not see enough serious What is Contemporary? cases).  Contemporary means something that is happening now or belongs to 10. Midwifery nurses had to be hospital the present time. It reflects current trained. ideas, styles, or practices in various aspects of life, like art, culture, or 11. Training was required for administrative technology. positions. How will you describe nurses and nursing today?  Nurses today are highly trained 12. Probationers kept diaries and case professionals who provide comprehensive notes of their work, examined by the care to patients. They work closely with matron and home sister, and often by other healthcare professionals, use Nightingale. advanced technology, and focus on treating the whole person, not just the illness. Modern nursing is about compassion, expertise, and adapting to new challenges in healthcare. 6  THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P.  Nurses earned the respect of those NURSING AFTER WORLD WAR I they served with, and they were decision-makers. That was very different for them, not just as  World War I - World War I (often nurses but as women. abbreviated as WWI or WW1), also known as the First World War or the  New Opportunities for Women: Great War, was a global war originating Wartime and the American in Europe that lasted from 28 July 1914 Workforce to 11 November 1918.  Nurses on the Front Lines  Conflict between the great powers of Europe were divided into two coalitions:  The Scars of War: PTSD in WWII the Triple Entente—consisting of France, Nurses (Post Traumatic Stress Russia and Britain—and the Triple Disorder) Alliance of Germany, Austria-Hungary and Italy. RISE OF THE BSN CURRICULUM  The silver lining of the great war. The Degree of Bachelor of  Volume of patients drastically change Science in Nursing: the role of nurses.  A nursing curriculum which was based on the thesis presented by  The nurses performed triage as Julita V. Sotejo, graduate of the patients came in on ambulance trains, Philippine General Hospital directed corpsmen who had little School of Nursing, tackles on the medical training, managed entire wards development of a nursing of patients and performed a variety of education within a University procedures, including irrigating wounds based College of Nursing. and managing infection.  When the Japanese occupied the  Dependent to Independent nursing Philippines in 1942, training and practice. practice at the hospital schools of nursing in Manila was “violently  Good Infection control and wound care disrupted.” even with the absence of antibiotics and electricity.  However, U.S. colonial patterns in Philippine nursing education soon  American nurses worked on base returned after the U.S. reclaimed hospitals, hospital trains, hospital the country in 1945 and even after ships, field hospitals, camp hospitals the Philippines gained and even evacuation hospitals and independence from the U.S. July mobile units. 4, 1946.  Mobilizing women and women empowerment. 7  THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P. The First Colleges of Nursing in Roles and Functions of the Nurse the Philippines Today;  University of Santo Tomas College 1. Caregiver of Nursing (1946) - In 1947, the 2. Communicator Bureau of Private Schools permitted 3. Teacher UST to grant the title Graduate Nurse 4. Client Advocate to the 21 students who were of 5. Counselor advanced standing from 1948 up to the 6. Change Agent present. 7. Leader 8. Manager  Manila Central UniversityCollege of 9. Case Manager Nursing (1947) - The MCU Hospital 10. Expanded Career Roles first offered BSN and Doctor of Medicine degrees in 1947 and served as the clinical field for practice. Expanded Career Roles for Nurses:  University of the Philippines  Nurse Practitioner ManilaCollege of Nursing (1948) -  Clinical Nurse Specialist The idea of opening the college began  Nurse Anesthetist in a conference between Miss Julita  Nurse Midwife Sotejo and UP President. In April 1948,  Nurse Research the University Council approved the  Nurse Administrator curriculum, and the Board of Regents  Nurse Educator recognized the profession as having an  Nurse Entrepreneur equal standing as Medicine, Engineering etc. Miss Julita Sotejo was its first dean. NURSING IN TODAY’S SOCIETY  Change is the only constant thing in the world.  “Nursing is caring” (Womb to Tomb)  “Nursing is an Art”  Recipient of Nursing - Patients, community, family, clients and co- workers.  Scope of Nursing: 1. Promoting Health and Wellness 2. Preventing Illness 3. Restoring Health 4. Care for the Dying 8  THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P. Introduction to Nursing Theory: Its History VIRGINIA HENDERSON and Significance NURSING THEORIST OF HISTORICAL SIGNIFICANCE Hildegard Peplau  The Mother of Psychiatric Nursing “The nurse is temporarily the  Hildegard Peplau’s Interpersonal consciousness of the unconscious, the Relations Theory emphasized the nurse- love of life of the suicidal, the leg of the client relationship as the foundation of amputee, the eyes of the newly blind, a nursing practice. It gave emphasis on means of locomotion for the newborn, the give-and-take of nurse-client knowledge and confidence for the young relationships that was seen by many as mother, a voice for those too weak to revolutionary. Peplau went on to form an speak, and so on.” interpersonalmodel emphasizing the — Virginia Henderson need for a partnership between nurse and client as opposed to the client  Henderson was born on November 30, passively receiving treatment and the 1897 in Kansas City, Missouri, USA. nurse passively acting out doctor’s Henderson is famous for a definition orders. of nursing: "The unique function of the nurse is to assist the individual, sick or Roles of a Nurse well, in the performance of those  S activities contributing to health or its  R recovery (or to peaceful death) that he  C and T would perform unaided if he had the  Su necessary strength, will or knowledge"  L  Henderson's early education was at home  TE in Virginia with her aunts and her uncle at his all-boys school. In 1921, Henderson graduated from the US Army School of PHASES IN THE NURSE-PATIENT Nursing in Washington, D.C.. She RELATIONSHIP received a BS in 1931 or 1932 and a Master's degree in 1934 from Teachers College, Columbia University.  Orientation Phase  Henderson's career in public health  Identification Phase nursing began in 1921 at the Henry Street  Exploitation Phase Settlement in Manhattan, New York. She  Resolution Phase worked for the Visiting Nurse Association of Washington, D.C. from 1921 to 1923 9  THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P.  She was the first full-time nursing Henderson identified three levels of instructor in Virginia where she worked nurse-patient relationships in which the at the Norfolk Presbyterian Hospital from nurse acts as: 1924 to 1929. Henderson taught at Teachers College, Columbia University 1. A substitute for the patient from 1934 to 1948 2. A helper to the patient 3. A partner with the patient  Henderson has received numerous honors. The International Council of Nurses presented her with the  Through the interpersonal process, inaugural Christiane Reimann Prize in the nurse must get “inside the skin” 1985 considered the most prestigious of each of her patients in order to award in nursing. know what help is needed.  She was an honorary fellow of the United THE NURSING NEED THEORY Kingdom's Royal College of Nursing (FRCN). She was selected to the American Nurses Association Hall of Fame  In 1966, Virginia Henderson’s definition and has received honorary degrees from of the unique function of nursing was a thirteen universities. major stepping stone in the emergence of nursing as a discipline separate from  She died in 1996 at the Connecticut medicine. Hospice in Branford, Connecticut, aged 98,and was interred in her family's plot of  Henderson conceptualized the nurse’s the churchyard of St. Stephen's Church, role as assisting sick or healthy Forest, Bedford County, Virginia. She is individuals to gain independence in survived by her great-niece, Catherine meeting 14 fundamental needs. Mark Burdge, a nurse practitioner in Fairfield, Connecticut and a graduate of the Yale School of Nursing. Henderson’s Definition of Nursing  Virginia Henderson viewed the patient as an individual who requires help toward achieving independence and completeness or wholeness of mind and body.  Her work is based on (1) Thorndike, an American psychologist, (2) her experiences with the Henry House Visiting Nurse Agency, (3) experience in rehabilitation nursing, and (4) Orlando’s 1. Breathe normally. conceptualization of deliberate nursing 2. Eat and drink adequately. action 3. Eliminate body wastes. 4. Move and maintain desirable postures.  Henderson emphasized the art of nursing 5. Sleep and rest. and proposed 14 basic human needs on 6. Select suitable clothes; dress and which nursing care is based. Her undress. contributions include defining nursing, delineating autonomous nursing 7. Maintain body temperature within a functions, stressing goals of normal range by adjusting clothing and interdependence for the patient, and modifying the environment. creating self-help concepts.  10  THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P. 8. Keep the body clean and well groomed Environment and protect the integument.  The environment is made up of settings 9. Avoid dangers in the environment and in which an individual learns unique avoid injuring others. patterns for living. All external conditions 10. Communicate with others in expressing and influences that affect life and emotions, needs, fears, or opinions. development. 11. Worship according to one’s faith.  The environment also includes 12. Work in such a way that there is a individuals in relation to families. sense of accomplishment. 13. Play or participate in various forms of  Basic nursing care involves providing recreation. conditions in which the patient can 14. Learn, discover, or satisfy the curiosity independently perform the fourteen that leads to normal development and components explained in the model. health, and use the available health facilities. Nursing  Henderson's definition of nursing states: "I say that the nurse does for others what they would do for themselves if they had THE METARAPARADIGM OF NURSING the strength, the will, and the knowledge. NEED THEORY But I go on to say that the nurse makes the patient independent of him or her as Person soon as possible."  Individuals have basic needs that are components of health. They may require  The nurse is expected to carry out a assistance to achieve health and physician's therapeutic plan, but independence, or assistance to achieve a individualized care is result of the nurse's peaceful death. creativity in planning for care.  This theory presents the patient as a sum  The nurse should be an independent of parts with biophysical needs rather than practitioner able to make independent as a type of client or consumer. judgments as long as he or she is not diagnosing, prescribing treatment, or Health making a prognosis, since those activities  The theory's definition of health is based are the function of the physician. on an individual's ability to function independently as outlined in the fourteen The Metaparadigm of Nursing Need components. Theory  Nurses need to stress the promotion of  Henderson explains in Nature of Nursing health and prevention, as well as the that the role of a nurse is "to get inside curing of diseases. According to the patient's skin and supplement his Henderson's model, good health is a strength will or knowledge according challenge because it is affected by so to his needs." many different factors, such as age, cultural background, emotional balance,  The nurse has the responsibility to and others. assess the needs of the patient, help him or her meet health needs, and provide an environment in which the patient can perform activity unaided. 11  THEORETICAL FOUNDATIONS IN NURSING BSN-1- Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P. THE NURSING NEED THEORY  Faye Glenn Abdellah is recognized as a leader in the development of nursing research and nursing as a profession within the Public Health Service (PHS) and as an international expert on health problems.  She was named a “living legend” by the American Academy of Nursing in 1994 and was inducted into the National Women’s Hall of Fame in 2000 for a lifetime spent establishing and leading essential health care programs for the United States.  Abdellah views nursing as an art and a science that mold the attitude, intellectual competencies, and technical skills of the individual nurse into the desire and ability to help individuals cope with their health needs, whether they are ill or well.  She formulated 21 nursing problems based on a review of nursing research studies. She used Henderson’s 14 basic human needs and nursing research to establish the classification of nursing problems. ABDELLAH’S TYPOLOGY OF 21 NURSING PROBLEMS 1. To maintain good hygiene and physical comfort 2. To promote optimal activity: exercise, rest, FAYE ABDELLAH sleep 3. To promote safety through prevention of  Abdellah earned her Bachelor’s degree accident, injury, or other trauma and through in nursing, master’s degree and prevention of the spread of infection doctorate from Columbia University, and 4. To maintain good body mechanics and she completed additional graduate prevent and correct deformity studies in science at Rutgers University. She served as the Chief Nurse officer 5. To facilitate the maintenance of a supply of and Deputy U.S Surgeon General, U.S. oxygen to all body cells Public Health Service before retiring in 1993 with the rank of rear admiral. 6. To facilitate the maintenance of nutrition for all body cells 12  THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P. 7. To facilitate the maintenance of elimination. 10 STEPS TO IDENTIFY THE CLIENTS PROBLEMS 8. To facilitate the maintenance of fluid and electrolyte balance. 1. Learn to know the patient. 9. To recognize the physiologic responses of 2. Sort out relevant and significant data. the body to disease conditions—pathologic, 3. Make generalizations about available physiologic,and compensatory. data in relation to similar nursing problems presented by other patients. 10. To facilitate the maintenance of regulatory 4. Identify the therapeutic plan. mechanisms and functions. 5. Test generalizations with the patient and make additional generalizations. 11. To facilitate the maintenance of sensory 6. Validate the patient’s conclusions about function. his nursing problems. 7. Continue to observe and evaluate the 12. To identify and accept positive and patient over a period of time to identify negative expressions, feelings, and reactions. any attitudes and clues affecting his behavior. 13. To identify and accept interrelatedness of 8. Explore the patient’s and family’s emotions and organic illness. reaction to the therapeutic plan and involve them in the plan. 14. To facilitate the maintenance of effective 9. Identify how the nurses feels about the verbal and nonverbal communication. patient’s nursing problems. 10. Discuss and develop a comprehensive 15. To promote the development of productive nursing care plan. interpersonal relationships. 11 NURSING SKILLS 16. To facilitate progress toward achievement and personal spiritual goals. 1. Observation of health status 17. To create or maintain a therapeutic 2. Skills of communication environment. 3. Application of knowledge 4. Teaching of patients and families 18. To facilitate awareness of self as an 5. Planning and organization of work individual with varying physical, emotional, and 6. Use of resource materials developmental needs. 7. Use of personnel resources 8. Problem solving 19. To accept the optimum possible goals in 9. The direction of work of others the light of limitations, physical and emotional. 10. Therapeutic use of the self 11. Nursing procedure 20. To use community resources as an aid in resolving problems that arise from illness. METARAPARADIGM OF 21 NURSING PROBLEMS 21. To understand the role of social problems as influencing factors in the cause of illness. Person  Abdellah describes people as having physical, emotional, and sociological needs.  Patients and families are recipients of nursing care. 13  THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P. Health NURSING PROCESS THEORY  In Patient–Centered Approaches to Nursing, Abdellah describes health as a state mutually exclusive of illness.  The Deliberative Nursing Process has five stages: assessment, diagnosis, planning,  Abdellah does not give a definition of health, implementation, and evaluation. Nurses she speaks to “total health needs” and “a use the standard nursing process in healthy state of mind and body” Orlando’s Nursing Process Discipline Theory to produce positive outcomes or Environment patient improvement. Orlando’s key focus  Society is included in “planning for optimum was the definition of the function of health on local, state, national, and nursing. international levels”. However, as she further delineated her ideas, the focus of nursing  The goal of this model is for a nurse to act service is clearly the individual. deliberately rather than automatically. The nurse will have a meaning behind the Nursing action. This nursing process is use to  Nursing care is doing something to or for the different patients with different problems, person or providing information to the person and can be stopped at any time, with the goals of meeting needs, increasing depending on the patient’s progress or or restoring self-help ability, or alleviating health. This makes Orlando’s theory impairment. universal for the nursing field.  Nursing is broadly grouped into the 21 problem areas to guide care and promote use of nursing judgment. IDA JEAN ORLANDO  Orlando’s nursing theory stresses the reciprocal relationship between patient and nurse.  What the nurse and the patient say and do affects them both. Orlando’s theory focuses on how to produce improvement in the LYDIA HALL patient’s behavior. Evidence of relieving the patient’s distress is seen as positive changes in the patient’s observable behavior. Orlando  Core, Care, and Cure Model/Theory may have facilitated the development of nurses as logical thinkers. 14  THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P.  Hall used three interlocking circles to PHILOSOPHY represent aspects of the patient and nursing functions.  The second component of the  The Core- represents the inner feelings STRUCTURAL HIERARCHY OF and management of the person. CONTEMPORARY NURSING  The Care- represents the patient’s KNOWLEDGE is the PHILOSOPHY. body.  The Cure-represents the disease that  A statement encompassing ontological affects the patient’s physical system. claims about the phenomena of central interest to a discipline, epistemic claims about how those phenomena come to be known, and ethical claims about what the members of a discipline value. FUNCTION OF A PHILOSOPHY  The function of a philosophy is to communicate what the members of a discipline believe to be true in relation to the phenomena of interest to that discipline, what they believe about the development of knowledge about those phenomena, and what they value with regard to their actions and practices.  In other words, the function of each philosophy is to inform the members of disciplines and the general public about the beliefs and values of a particular discipline. Core, Care, and Cure Model/Theory CONCEPTUAL MODELS  The three circles change in size and overlap in relation to the patient’s phase in the disease process. A nurse  The third component of the functions in all three circles but to STRUCTURAL HIERARCHY OF different degrees. CONTEMPORARY NURSING  For example, in the care phase, the KNOWLEDGE is the CONCEPTUAL nurse gives hands on bodily care to the MODEL. patient in relation to activities of daily living such as toileting and bathing.  A set of relatively abstract and general  In the cure phase, the nurse applies concepts that address the phenomena of medical knowledge to treatment of the central interest to a discipline, the propositions that broadly describe those person, and in the core phase, the concepts, and the propositions that state nurse addresses the social and relatively abstract and general relations emotional needs of the patient for between two or more of the concepts. effective communication and a comfortable environment 15  THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P. 4. Provides a structure and a rationale for the scholarly and practical activities of its adherents, who comprise a subculture or community of scholars within a discipline. 5. Conceptual model gives direction to the search for relevant questions about the phenomena of central interest to a discipline and suggests solutions to practical problems. 6. Provides general criteria for knowing when a problem has been solved. CONCEPTUAL MODELS IN NURSING  What is your perception of the word “Model”?  We all use models to guide our actions, be it the way we conduct our personal lives or the way we nurse. These are based on the beliefs and values of family, friends, peers, and those we respect or those who have influenced us greatly.  Conceptual models of nursing, then, are the explicit and formal presentations of some nurses’ implicit, private images of nursing.  The term conceptual model is synonymous with the terms: conceptual framework, conceptual system, paradigm, and disciplinary matrix. FUNCTIONS OF A CONCEPTUAL MODELS 1. Provides distinctive frame of reference. 2. Tells how to observe and interpret the phenomena of interest to the discipline. 3. Simplification of reality that includes only those concepts that the model author considers relevant and as aids to understanding. 16  THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P. THEORY  The fourth component of the STRUCTURAL HIERARCHY OF CONTEMPORARY NURSING KNOWLEDGE is the THEORY.  One or more relatively concrete and specific concepts that are derived from a conceptual model, the propositions that narrowly describe those concepts, and the propositions that state relatively concrete and specific relations between two or more of the concepts. GRAND THEORY  Grand theories are broad in scope. They are made up of concepts and propositions that are less abstract and general than the concepts and propositions of a conceptual MIDDLE RANGE THEORY model but are not as concrete and specific as the concepts and propositions of a middle-range theory.  Middle-range theories are narrower in scope than grand theories. They are made up of a limited number of concepts and propositions that are written at a relatively concrete and specific level.  Each middle-range theory addresses a more or less relatively concrete and specific phenomenon by describing what the phenomenon is, explaining why it occurs, or predicting how it occurs. 17  THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P. FUNCTION OF A EMPIRICAL INDICATORS  The function of empirical indicators is to provide the means by which middle- range theories are generated or tested. Empirical indicators that are instruments yield data that can be sorted into qualitative categories or calculated as quantitative scores. METHODS OF THEORY DEVELOPMENT 1. Theory-Practice-Theory – Directs that theory development in nursing is based on and parallel to other theories used in other discipline. Example: Nurse Rodney wants to develop a new theory that is inspired from Abraham Maslow’s Hierarchy of need. 2. Practice Theory – Directs that the theory development is based on the life/work experience and professional practice of the theorist. FUNCTION OF A THEORY Example: Nurse Harry is assigned in the ICU for 20 years, he developed a theory  One function of a theory is to narrow and about nurse’s coping mechanism in caring for more fully specify the phenomena contained terminally ill patients called the “ Theory of in a conceptual model. attachment”.  Another function is to provide a relatively 3. Research Theory - Directs that the concrete and specific structure for the theory development is based on the interpretation of initially puzzling behaviors, extensive research done by the theorist situations, and events. Example: Prof. Rem did research on the reasons why nurses stay in the hospital to EMPIRICAL INDICATORS work and their reason for leaving she called it “Theory of Tenure”.  The fifth and final component of the THEORY DEVELOPMENT PROCESS STRUCTURAL HIERARCHY OF CONTEMPORARY NURSING KNOWLEDGE is the EMPIRICAL  Development of theory requires INDICATOR. understanding of selected scholarly terms, definitions, and assumptions so Nursing Empirical Indicators that scholarly review and analysis may  Nurses have developed a plethora of occur. Attention is given to terms and empirical indicators in the form of research defined meanings to understand the instruments and distinct clinical tools. theory development process that was used. 18  THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P.  Three categories of theory components are 2. Relational Statements – Propose presented as a basis for understanding the relationships between and among two or function of each element in the theory- more concepts. Concepts are the building building process. blocks of theory, and theoretical statements are the chains that link the blocks to build THEORY COMPONENTS theory. Concepts must be connected with one another in a series of theoretical statements 1. Concepts and Definition to devise a nursing theory. Concept - Concepts, the building blocks of theories, classify the phenomena of interest. Example: Definition- Conveys general meaning and reduce vagueness in understanding a set of concept.  Concepts may be abstract or concrete. Abstract - concepts are mentally constructed Legend: Wellness Motivation (WM) independent of a specific time or place Adherence to Regimen Concrete - directly experienced and relate to a particular time or place 3. Linkages and Ordering - Development of theoretical linkages provides an explanation Abstract Concepts of why the variables are connected in a certain manner; that is, the theoretical reason  Transport for particular relationships.  Cardiovascular Diseases  Nurse Competency  Operational linkages contribute testability to the theory by specifying how Concrete Concepts measurement variables are connected.  Stretcher, Wheelchair, hospital bed  A theory may be considered fairly  Stroke, Myocardial Infarction complete if it presents the concepts,  Vital Signs Taking, Insertion of Nasogastric definitions, relational statements, and Tube, IV Catheter insertion linkages. Complete development of a theory, however, requires organizing the concepts, definitions, relational statements, and linkages into premises and hypotheses. 19  THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P. CHARACTERISTICS OF A THEORY  It is the most abstract component of the structural hierarchy. 1. A theory must be “falsifiable.” 2. A theory must be simple in terms of the  The concepts and propositions of a general principles involved. metaparadigm are admittedly extremely 3. It must be workable. global and provide no definitive direction 4. It must be elegant or beautiful (Symmetry, for such activities s research and clinical Simplicity, Accuracy). practice. 5. The theory should be as general as possible. 6. It should have few or no anomalies.  “Meta” means with and “Paradigm” 7. If possible, the theory ought not to be purely means pattern of shared statistical. understanding and assumption. 8. The theory should bring out analogies and use models.  The METAPARADIGM OF NURSING is made up of four concepts, four non relational propositions, and four relational propositions. PURPOSE OF NURSING THEORY 4 Concepts of Metaparadigm of  Education Nursing  Research  Person  Clinical Practice  Environment  Health  Nursing STRUCTURE OF NURSING KNOWLEDGE 5 COMPONENTS 1. Metaparadigm 2. Philosophies 3. Conceptual Models 4. Theories 5. Empirical Indicators  The components of the structural hierarchy are made up of concepts and propositions. Concept- is a word or phrase that summarizes the essential characteristics or properties of a phenomenon. Proposition- is a statement about a concept or a statement of the relation between two or more or different concepts. METAPARADIGM  The first component of the structural hierarchy of knowledge. 20  THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P. METAPARADIGM OF NURSING FLORENCE NIGHTINGALE 4 NON-RELATIONAL PROPOSITIONS THE ENVIRONMENTAL THEORY 1. The metaparadigm concept person refers to the  Florence Nightingale often considered the individuals, families, communities, and other first nurse theorist. groups who are participants in nursing.  Defined nursing more than 100 years ago 2. The metaparadigm concept environment refers to the person’s significant others and physical as the “Act of utilizing the environment of surroundings, as well as to the setting in which the patient to assist him in his recovery”. nursing occurs, which ranges from the person’s home to clinical agencies to society as a whole.  Linked health in 5 environmental factors (pure/fresh air, pure water, efficient 3. The metaparadigm concept health refers to the drainage, cleanliness, light) person’s state of well-being at the time that nursing occurs, which can range from high-level  Stress the importance of keeping the client wellness to terminal illness. warm, maintaining a noise-free environment, and attending to the client’s 4. The metaparadigm concept nursing refers to the definition of nursing, the actions taken by nurses diet in terms of assessing intake, timelines on behalf of or in conjunction with the person, of the food, and its effect on the person. and the goals or outcomes of nursing actions. 10 Aspects of The Environmental Theory 4 RELATIONAL PROPOSITIONS 1. Patients should have clean air and a 1. The discipline of nursing is concerned with the temperature-controlled environment. principles and laws that govern the life-process, wellbeing, and optimal functioning of human beings, 2. Patients should have access to direct sick or well sunlight and not be subjected to unnecessary noise, especially when sleeping. 2. The discipline of nursing is concerned with the patterning of human behavior in interaction with the environment in normal life events and critical life 3. Rooms should be kept clean. situations. 4. Hospital facilities should be well- 3. The discipline of nursing is concerned with the constructed. nursing actions or processes by which positive changes in health status are effected. 5. Bedding should be changed and aired frequently. 4. The discipline of nursing is concerned with the wholeness or health of human beings, or health of 6. Patients should be offered a variety of the human being that they are in continuous scenery, such as new books or flowers, to interaction with their environments. prevent boredom. 7. Nurses should be positive but not offer false hope to patients or make light of their illness. 8. Patients should be kept clean and nurses should wash hands frequently. 21  THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P. 9.Offer a variety of small meals instead of large Spirituality ones, and do not do patient care while patient  intertwined with Nightingale’s own is eating as it is distracting. spiritual beliefs; that the person is valued. 9. Consider not only the individual patient but  Nightingale theory of the Person is based the context of where he or she lives. on holism. Holism is the concern of integrating the biological, social, psychological and spiritual with its environment HEALTH  Health is viewed as the combined result of environmental, psychological and physical factors, not just the absence of What are you 2 cents? disease.  The images depict crowded hospital  Nightingale states that “health is not only settings where multiple patients share to be well, but to be able to use well beds, and the overall environment seems every power we have.” quite congested. This does not align well  This is consistent with our perception of with Florence Nightingale's theory, which health today, where one does not have to emphasizes the importance of sanitation, be disease free to be healthy but to proper ventilation, and adequate space in maximize their potential to be in a healthy promoting healing. Nightingale believed state. that overcrowded and unsanitary  Disease is portrayed as dys-ease, or conditions hinder recovery, and advocated the absent of comfort. for environments that allow for cleanliness, air circulation, and patient comfort. The  Nightingale isolated 5 factors essential in overcrowded state seen in the images securing an individual’s health; these could lead to poor health outcomes, as it include pure air, pure water, efficient compromises both hygiene and patient drainage, cleanliness and light well-being. Nightingale’s 6 D’s of “Dys-ease” The 4 Metaparadigms of Environmental Theory PERSON  In Florence Nightingale’s theory, the Person, one of the elements in the four metaparadigms, is the individual receiving care.  Nightingale’s perception of the Person is that the person is a multidimensional being, that includes biological, psychological, social and spiritual components. ENVIRONMENT Biological  There exist five environmental  Addressed by the use of medicine and components which are all essential to an nursing to address various diseases. individual’s health. These are known collectively as the “health of houses”, and Psychological and social components outline factors of the physical  Consists of self-concept, feelings, thought- environment which must receive processes and social interactions. attention. 22  THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P.  The underlying principle of maintaining MARILYN ANNE RAY health of houses is to put the patient in a condition which is best for nature to act upon him or her. An environment that promotes health allows the patient to retain their energy, or “vital powers” for use towards self healing. NURSING  Nightingale’s view on nursing is one that is largely intertwined by factors pertaining to the environment.  Nightingale believed that many of the Marilyn Anne Ray is a nursing theorist symptoms and sufferings of patients were known for developing the Theory of not directly related to their disease or Bureaucratic Caring, which integrates ailment, but rather consequences of poor human caring with the complexities of environmental conditions. organizational structures in healthcare. Her  The duties of nursing include providing theory emphasizes that caring in nursing essentials such as fresh air, warmth, light, goes beyond the personal interaction cleanliness, quiet and a proper diet. By between nurse and patient; it also involves helping to control environmental understanding the influence of factors like influences, nurses can aid in the economics, technology, law, politics, and the maintenance of health of their patients. organizational environment on care delivery. Ray's work highlights the need for balancing Case Study compassionate, holistic care with the realities  You are caring for an 82 year old woman who has of modern healthcare systems, ensuring both been hospitalized for several weeks for burns that human connection and effective care she sustained on her lower legs during a cooking accident. Before the time of her admission, she lived management in bureaucratic settings. alone in a small apartment. The patient reported on admission that she has no surviving family. Her support system appears to be other elders who live THEORY OF BUREAUCRATIC CARING in her neighborhood. Because of transportation difficulties, most of them are unable to visit  Inspiration frequently. One of her neighbors has reported that  Origin she is caring for the patient’s dog. As you care for this woman, she says that none of the other nurses  What is it? have listened to her about such visit. As she asks you about this, she begins to cry and tells you that  Thesis they have been separated. You recall that the staff discussed their concern about this woman’s well- being during report that morning. They said she has been eating very little and seems to be depressed.  Anti-Thesis  As her nurse, it's important to acknowledge her feelings and show compassion. I would sit with her, listen carefully, and reassure her that her Major Concepts and Definition concerns about her dog and feeling isolated  Caring are valid. It's clear that being separated from her dog is affecting her emotionally, possibly  Spiritual-Ethical Caring contributing to her depression and lack of  Educational appetite. I would talk to the care team about  Physical finding ways to help her reconnect with her  Social Cultural dog, perhaps arranging for a visit or even  Legal showing pictures or updates from her neighbor.  Technological Helping her feel less isolated and more  Economic connected to her normal life could improve her  Political mood and overall recovery. 23  THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P. JEAN WATSON Metaparadigm  Nursing  Person  Health "We are the light in institutional darkness, and  Environment in this model we get to return to the light of our humanity." -Dr. Jean Watson (June 10, 1940 – present) Watson was born Margaret Jean Harmon and grew up in the small town of Welch, West Virginia, in the Appalachian Mountains. She was the youngest of eight children and was surrounded by an extended family–community environment. Watson attended high school in West Virginia and then the Lewis Gale School of Nursing in Roanoke, Virginia, where she graduated in 1961.  Educated: BSN, University of Colorado, 1964, MS, University of Colorado, 1966, PhD, University of Colorado, 1973.  Distinguished Professor of Nursing and Chair in Caring Science at the University of Colorado Health Sciences Center.  Fellow of the American Academy of Nursing.  Dean of Nursing at the University Health Sciences Center and President of the National League for Nursing.  Undergraduate and graduate degrees in nursing and psychiatric-mental health nursing and PhD in educational psychology and counseling.  Six (6) Honorary Doctoral Degrees.  Research has been in the area of human caring and loss. 24  THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P.  In 1988, her theory was published in THE TEN CARITAS PROCESSES “nursing: human science and human care”. The Theory of Transpersonal Caring 1. Cultivating the practice of loving- kindness and equanimity toward self and  Watson bases her theory for nursing other as foundation to caritas practice on the following 10 carative consciousness. factors. Each has a dynamic 2. Being Authentically Present- Enabling, phenomenological component that is sustaining, and honoring faith, hope, and relative to the individuals involved in the deep belief system and the inner relationship as encompassed by nursing. subjective world of self/other. 3. Cultivation of one’s own spiritual practices and transpersonal self, going beyond ego-self. 4. Development and sustaining a helping trust caring relationship. 5. Being present to, and supportive of, the expression of positive and negative feelings. 6. Creative use of self and all ways knowing as part of the caring process; engage in the artistry of caritas nursing. 7. Engage in genuine teaching-learning experience that attends to unity and being and subjective meaning- Attempting to stay within other’s frame of reference 8. Creating a healing environment at all levels. 9. Administering sacred nursing acts of caring healing by tending to basic human needs. 10. Opening and attending to spiritual/mysterious and existential unknowns of life-death. THE SEVEN ASSUMPTIONS 1. Caring can be effectively demonstrated and practiced only interpersonally. 2. Caring consists of carative factors that result in the satisfaction of certain human needs. 3. Effective caring promotes health and individual or family growth. 4. Caring responses accept person not only as he or she is now but as what he or she may become. 5. A caring environment is one that offers the development of potential while allowing the person to choose the best action for himself or herself at a given point in time. 25  THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P. 6. Caring is more “healthogenic” than is curing. NURSING A science of caring is complementary to the  “Nursing is concerned with promoting science of curing. health, preventing illness, caring for the 7. The practice of caring is central to nursing. sick and restoring health” Transpersonal Caring Theory  According to Watson, the word nurse is Metaparadigm both a noun and a verb. To her, nursing consists of “Knowledge, thought, values, PERSON philosophy, commitment and action with  Watson uses interchangeably the terms some degree of passion” human being, person, life, personhood, and self. She views the person as “a unity of mind/body/spirit/nature”  Watson states, “I make the point to use mind, body, soul or unity within an evolving emergent world view-connectedness of all, sometimes referred to as Unitary Transformative Paradigm-Holographic thinking. HEALTH  She defined health as “unity and harmony Case Study: A 62 year old inmate is admitted to this hospital from within the mind, body, and soul”; prison with a complaint of chest pain. The patient is associated with the “degree of congruence being worked up for possible myocardial infarction and between the self as perceived and the self admitted to the cardiac unit. Because the patient is an as experienced” inmate, while he is in the hospital a prison guard will be poste outside of the patient’s room and the patient will be handcuffed to the bed rail. During the initial  Watson’s definition of health has evolved. assessment, the admission nurse finds the patient to be The positive state of physical, mental and withdrawn. The nurse discovers the patient has a past social well being with the inclusion of 3 medical history significant for abuse of multiple elements; substances. The patient describes behaviors led to his incarceration and estrangement from his family. The  A high level of overall physical, mental and patient expresses to the nurse interest in meeting with a social functioning. chaplain while in the hospital.  A general adaptive maintenance level of functioning.  Absence of illness.  I understand that this patient’s situation is challenging, but using Jean Watson’s Theory ENVIRONMENT of Human Caring, I would focus on building a  Watson speaks to the nurse’s role in the caring relationship and offering emotional environment as “attending to supportive, support. Watson’s theory emphasizes the protective, and or corrective mental, importance of compassion, empathy, and treating the person as a whole, not just their physical, societal, and spiritual illness or situation. I would show him respect environments” and listen without judgment, acknowledging his desire to meet with a chaplain. This  She emphasizes the person and the demonstrates caring for his spiritual and environment has a connection, nurses are emotional needs, which is a key part of part of the patient’s environment and once Watson’s holistic approach. By showing a nurse enters the patient’s room an kindness and understanding, I can help him expectation is already present. feel valued as a person, which might contribute to his healing, both physically and emotionally. 4o 26  THEORETICAL FOUNDATIONS IN NURSING BSN-1-Y1-23 | PROF. Edquibal, Shiella May | Sem 1 | JSB 205 | Batuigas, Camille P. PURPOSE OF NURSING THEORY  Exemption to informed consent emergencies when there is no time to  Education disclose the information, waivers to  Research patients who do not want to know their  Clinical Practice prognosis or risk of treatment.  Who will give consent for minors? ETHICAL PRINCIPLES Emancipated minor? Unconcsious? Mentally challenged patients? Tubal 1. Respect for Individuals ligation on women? 2. Autonomy 3. Nonmaleficence Key Elements for Informed Consent 4. Beneficence 5. Justice  Mentally competent adult that voluntarily 6. Confidenciality give consent and not coerced 7. Fidelity  Client understands exactly what they are 8. Veracity consenting to. In case of foreign language and deafness and interpreter RESPECT FOR INDIVIDUALS should explain the consent.  The essential prerequisite of beneficence,  Decision Support - Supporting clinical non maleficence and justice. annosis and treatment plan processes;  Recognition of the autonomy of individuals conion singie go best practices, and treated as autonomous agents. population based management.  Ex. A pregnant patient who chooses not to undergo chemotherapy to continue her BENEFICIENCE pregnancy.  The goal of the health care providers should be that which would benefit the AUTONOMY client.  Free Action  To take positive steps to prevent and  Authentic remove harm from them  Effective Deliberation  To do good  Moral Reflection  Always remember to review and be  Literally means self governing familiar with hospital protocols on  Autonomy will not thrive in climate that does resuscitation, restraints and side tails not allow independent planning and Case: If upon computation you realized that choosing options for goals. the remaining medication in a multi drug vial is less than the dose on what is written in the Application of Autonomy doctor's order.  Informed Consent - relates to the process by which the patients are informed of the NON MALEFICENCE possible outcomes, alternatives, and the  The principle of Nonmaleficence is based risks of treatments, and are required to give on a person's rigorous obligation to avoid their consent freely. injuring another individual. What is the responsibility of the nurse when it  Obligation of health care provider to DO comes to consent? NOT HARM and to protect from harm to  The nurse's responsibility when it comes to consent those who cannot protect themselves. is to make sure the patient understands what they are agreeing to before any treatment or procedure. This includes making sure the patient knows the risks, benefits, and alternatives in simple terms and feels no pressure to decide. The nurse should also ensure the patient is menta