Evolution of Nursing PDF

EVOLUTION OF NURSING Theory Era (1980-1990’s) Florence Nightingale (1800’s) - Emphasis on theory development and testing. - Considered the founder of modern nursing....

EVOLUTION OF NURSING Theory Era (1980-1990’s) Florence Nightingale (1800’s) - Emphasis on theory development and testing. - Considered the founder of modern nursing. - Transition from the pre-paradigm to paradigm period in nursing. - Tended injured soldiers in the ‘Crimean - Emphasis shifted from learning about war’. the theorist to use the theoretical works. - Founded the school of nursing at St. Thomas Hospital. Theory Utilization Era (21st century) - Based on principles and traditions that were handed down. - Emphasis shifted to theory application in nursing practice, research, education, Curriculum Era (1900-1940’s) and administration. - Restored balance between research and - Addressed the question of “what practice for knowledge development in concept student nurses should study to the discipline of nursing. learn how to be a nurse”. - Emphasis to produce evidence for - The emphasis here was on what quality professional practice. courses nursing students should take, to - Shifts from theory development to theory create a standard curriculum that application and utilization recognizes of ensures every nursing student gets the a framework for critical thinking and same training. decision- making in professional nursing - Standardized curricula for diploma practice. programs. Research Era (1950-1970’s) - Role of nurses and what to research. NURSING THEORY - Research courses were included in - A group of interrelated concepts that are nursing curricula. developed from various studies of discipline - Focused on the research process and and related experiences. the long-range goal of acquiring -Nursing is varied as the people who practice it substantive knowledge to guide nursing and is dynamic and diverse as a kaleidoscope practice. of ethnic, cultural, and religious manifestations - Sought degrees in higher education of the people who receive nursing care. began to emerge. - Theory is an organized system of accepted Graduate Education Era (1950-1970’s) knowledge composed of concepts, propositions, definitions, and assumptions - Developed in tandem with the research intended to explain a set of facts, events, or era. phenomena. - Master’s degree program in nursing - Nursing Theory strives to explain the Science emerged to meet the need nurses with and Art of Nursing. specialized education in nursing. - Transition from vocation to profession - The emerging goal is to focus graduate education on knowledge development.  theoretical works provide such perspectives of the patient. How Other Authors Define THEORY CONCEPTS An idea formulated by the mind or an experience perceived and observed, such as justice, love, war, and disease. PROPOSITIONS Explains the relationships of different concepts DEFINITION Composed of various descriptions which convey a general meaning and reduce the vagueness in understanding a set of concepts. HOW TO DETERMINE THEORETICAL ADEQUACY? ASSUMPTION A statement that specifies the relationship or connection of factual concepts 1. CLARITY - How clear is this theory? or phenomena -Speaks to the meaning of terms used, definition consistency, and structure forms in the theory. SIGNIFICANCE OF NURSING THEORY 2. SIMPLICITY - How simple is this theory? - A theory should be sufficiently DISCIPLINE comprehensive, presented at a level of -Specific to academia and refers to a branch of abstraction to provide guidance, and have as education, a department of learning, or a few concepts as possible. domain of knowledge. 3. GENERALITY - How general is this theory? - The development of nursing knowledge is the -Speaks to the scope of application and the basis for nursing practice. purpose within the theory - Both nursing degrees and master's programs -The broader the scope, the greater the were developed. significance of the theory - The need for accreditation to nursing 4. ACCESSIBILITY - How accessible is this programs for the standard curriculum was theory? realized. -Linked to the empirical indication for testability - Nursing was in conflict if it was a basic or and ultimate use of a theory to describe applied science. aspects of practice. PROFESSION 5. IMPORTANCE - How important is this - Refers to a specialized field of practice, theory? founded upon the theoretical structure of the -Nursing theory guides research and practice, science or knowledge of that discipline and generates new ideas, and differentiates the accompanying practice abilities. focus of Nursing from that of other professions. - Professional practice requires a systematic -The usefulness of a theory to nursing practice. approach focused on the patient, and the PHILOSOPHY AND SCIENCE IN PHILOSOPHICAL VIEWS AND NURSING EPISTEMOLOGY Nursing Philosophy Philosophical views - A statement of foundational and - Knowing universal assumptions, beliefs, and - What is science, knowledge, and truth principles about the nature of knowledge and thought (epistemology) and about Epistemology the nature of the entities represented in - Study of the theory of knowledge the meta paradigm. Ex; - The belief system or worldview of the - What is the extent of our knowledge? profession provides perspective for - What do we know? practice, scholarship, and research. - How do we decide whether we know? Nursing is a multi-paradigm discipline. - What are the criteria of knowledge? Nursing Science Way of Knowing - Substantial, discipline; specific 1. Empirics - the scientific form of knowing knowledge that focuses on the human- 2. Personal Knowledge - a prior knowledge universe-health process articulated in 3. Intuitive Knowledge - feelings and the nursing framework and theories. hunches (Parse,2016) 4. Somatic Knowledge - knowledge of the - It gives direction to the future generation body in relation to movement. It also of substantive nursing knowledge, and includes the experiential use of muscles its nursing science that provides the and balance to perform a physical task knowledge for all aspects of nursing. 5. Metaphysical (Spiritual) Knowledge - (idea; Holmzer,2007 seeking the presence of higher power modified; Parze,2006) 6. Esthetics/Aesthetics - Knowledge - Its goal is to represent the nature of related to beauty, harmony, and nursing expression o Understand 7. Moral/Ethical Knowledge - knowledge of o Explain what is right and wrong o Use for the benefit of human kind THEORY DEVELOPMENT PROCESS Philosophy of Science in Nursing - Helps to establish the meaning of - To improve the quality of care rendered science through an understanding and by nurses to their clients examination of nursing concepts, - It is important in the different nursing theories, laws and aims as they relate to fields of education, research, and nursing practice. practice. - It seeks to understand the truth; to describe nursing; to examine prediction Uses of Nursing Theories and casualty; to critically relate theories, medals, and scientific systems, and to a) In EDUCATION: heart of NT explore determinism and free will. - Primarily used to develop and guide nursing (Nytanga,2005; Polifroni.2015) education and institutions - Theories are more commonly used in education than in clinical practice  - In 1970s-1980s Nursing models/theories were “STUDYING NURSING THEORY DEVELOPS made into a conceptual framework as a basis ANALYTICAL SKILLS AND CRITICAL to complete curriculum THINKING …” - Theoretical concepts primarily to prepare student nurses INTERDEPENDENCE OF - To ensure adequate and quality nursing THEORY AND RESEARCH development - To clarify and improve the status of nursing as -Practice without theory is like a map without a profession route, it is blind; theory without practice is like route without a map, it is empty. b) In RESEARCH -The relationship between nursing theory and I.Grand Theories nursing research helps in building nursing - Broad in scope and complex in Nature knowledge. - Assists nursing research in an occasional manner > Anchored through theoretical and conceptual framework > Broad/General II. Middle-Range Theories - Focus on the discovery of concepts such as pain, self-esteem, and learning. - Theoretical concepts are based on social sciences as one of the foundations of qualitative nursing research. THEORETICAL KNOWLEDGE > More specific. Based on perception, attitude Stimulates thinking and broadens understanding of the science and practice III. Critical Theories of the nursing discipline - Helps to elaborate on how structures such PRACTICAL KNOWLEDGE as race, gender, sexual orientation, and economic class affect the experiences and Referred to as Art of Nursing health outcomes of the patients (Kozier, 2008) Link of Research and Theory - Clarifies how social structures influence a > THEORY-GENERATING RESEARCH wide variety of human experiences. Discovers and describes relationships and phenomena w/o imposing predetermined c) In CLINICAL PRACTICE notions on the nature of the phenomena - With the guide of NT, a nurse’s abilities can >THEORY-TESTING RESEARCH be enriched by: Determines how accurately a theory … I. Guides a nurse in critical thinking and decision-making situations II. Strengthens professional independence III. Assisting nurses to facilitate questions, reflections, and critical thinking in every aspect of care. TYPES OF THEORETICAL Emphasizes the appearance of things as opposed to the things themselves WORKS Understanding is the goal of science Its objective is to connect one’s experience, values, and perspectives Based on human experience and personal interpretations NURSING EPISTEMOLOGY Defined as the origins of nursing knowledge, its structure and methods, the patterns of knowing of its members, and the criteria for validating its knowledge claims NURSING SCIENCE AS A PHILOSOPHICAL KNOWLEDGE FOUR FUNDAMENTAL 1. Rationalism PATTERNS OF NURSING (Carper’s, Cause and effect 1978) Rationalist epistemology (scope of 1. Empirical Knowledge knowledge) Science of nursing Emphasizes the importance of priori Quantifiable reasoning It draws on verified observation and proved Priori reasoning uses deductive logic (by by hypothesis testing reasoning the cause and effect) 2. Esthetic Knowledge Generalization to particular Art of nursing Theory-then-research strategy Relies on perception 2. Empiricism Creative and incorporates empathy and The belief that what is experienced is what understanding exists, 3. Personal Knowledge Therefore, these experiences must be Therapeutic use of self verified by scientific methods (Danhke and Personal views/ experiences of nurses Drehner) Promotes wholeness and integrity in Reflected from the work of B.F. Skinner personal encounters Collection of empirical data 4. Ethics Knowledge Inductive method (Bacon) Moral code of nursing Research-then-theory strategy Based on obligations to service and respect 3. Positivism life Similar to empiricism, it follows the reductionist principles that in order to OTHER VIEWS OF PATTERN OF understand the complex, it is best to understand the basic components KNOWLEDGE IN NURSING Logic Positivism- States that science is (Schultz & Meleis, 1988) value-free, independent of the scientist, and 1. Clinical Knowledge obtained using methods. Individuals nurses personal knowledge 4. Phenomenology Manifested in the acts of practicing nurses Study of phenomena, philosophy of experience  Results from combining personal knowledge and empirical knowledge 2. Conceptual Knowledge Abstracted and generalized beyond experience Incorporates curiosity, imagination, persistence, and commitment RESEARCH METHODOLOGY AND NURSING SCIENCE Nursing as a Human Science According to Wilhelm Dilthey, human science requires concepts, methods, and theories fundamentally different from those NURSING THEORETICAL of the natural sciences. WORKS Quantitative vs. Qualitative Methodology 1. Nightingale’s Environment Theory Debate 2. Watson’s Theory of Human Caring 3. Benner’s Stages of Nursing Expertise Quantitative follows empiricism, while 4. Erikson’s Caritative Caring Theory qualitative follows the phenomenology method. 1. Florence Nightingale’s Environment QUANTITATIVE METHODS Theory (1820-1910) It has been justified by its success in Founder of the Modern Nursing measuring, analyzing, replicating, and The lady of the lamp applying the knowledge gained Born on May 12, 1820 QUALITATIVE METHODS Florence, Italy (named after her) Study on human phenomena and is Well-educated, affluent, with an aristocratic grounded in the social sciences Victorian Family Died at August 13, 1910 - 90 years old CONCEPTUAL MODEL AND 1837 - She decided that God called her to be in THEORETICAL MODELS His service as a nurse Theoretical models or frameworks are 1851 - started her training in Kaiserwerth, highly established set of concepts that Germany are testable. The following is a - A community with a hospital facility theoretical framework as proposed by 1853 - She completed her training after 2 years Lydia Hall, a nurse theorist. and went back to England Hospital for Invalid Gentlewomen - became a superintendent November 1854 - Crimean War, took care of wounded soldiers with 34 newly recruited nurses The Lady of the Lamp - because she made 3. CLEANLINESS ward rounds during the night, providing - Cleanliness is one of the critical components emotional support and comfort to the soldiers of Nightingale's environmental theory. - She noted that a dirty environment was a WORKS OF NIGHTINGALE source of infection through organic matter it 1. Army Sanitation Reform prevented contained. 2. The Functions of Army Hospitals - She addresses the patient, the nurse, and the 3. Sanitation in India physical environment 4. Sanitation and Health Care for the Poor 4. EFFECTIVE DRAINAGE - Appropriate handling and disposal of body WRITINGS secretions and sewages were required to 1. Notes on Matters Affecting the Health prevent contamination of the environment. 2. Hospital Administration of the British Army 5. PURE WATER Found Chiefly on the experience of the later - She advocated bathing the patient on a war (1858a) frequent, even daily basis at a time when this 3. Notes on Hospitals (1858b) was not practiced. 4. Report on Measures Adopted for Sanitary - She also required nurses to bathe daily Improvements in India (June 1869 - June 1870) Nightingale emphasized that Nurses were THEORETICAL SOURCES FOR THEORY in control of the environment both physically AND DEVELOPMENT -Her works focused on and administratively. the Physical Environment (surroundings) USE OF EMPIRICAL EVIDENCE - Her works during the Crimean War in England 5 ESSENTIAL COMPONENTS OF - Identify her as an outstanding scientist and ENVIRONMENTAL HEALTH empirical researcher. 1. PURE AIR- Proper Ventilation - The efficacy of her hospital nursing system - The nurse should keep the air in the patient’s and organization during the Crimean War is breathes as pure as the external air. perhaps her best-known work. - Nightingale recognized that surroundings as a source of disease and recovery MAJOR ASSUMPTIONS - Palpation of extremities to check for heat loss NURSING- every woman who at some and in measuring the patient’s body point became a nurse who can take care of temperature (1969) the sick in their home 2. LIGHT PERSON- patient - Nightingale identified direct sunlight as a HEALTH- being well and using every power particular need of patients. to the fullest extent in living and maintaining - "Light has quite as real and tangible effects life upon the human body" ENVIRONMENT- surroundings - She believes in the purifying effect of light. - To achieve the beneficial effects of sunlight, nurses were instructed to move and position patients to expose them to sunlight. THEORETICAL ASSERTIONS - She also believed that the art of nursing could (Nursing Educ) not be measured by licensure examinations, - She was totally committed to nursing but rather, she used testing methods like case education. She emphasized in her “Notes on studies. Nursing" the distinction between the role of - Good practice could result from a good household servants and those trained nurses education to provide care for the sick person. 3. RESEARCH - She emphasized also the importance of - Her ability to gather and analyze data and to Observation, Common Sense, Perseverance, represent data graphically was first identified in and Ingenuity as an ongoing activity for trained the polar diagrams, the graphical illustration nurses. style that she invented. - Contagion and Contamination (fr, germ - Her work is often discussed as a theory, and it theory) through organic materials from the is clear that Nightingale's premise provides a patient and environment. foundation for the development of both nursing - She did not discuss the caring behaviors of practice and current theories. nurses (personal relationship) as this will affect - Her works were described as " the trunk of the reparative process (healing). the living tree of nursing theories" (Tourville - It was also the basis of works of Watson's and Ingalls, 2003) transpersonal meanings and models for caring. CLARITY 1. Environment to patient LOGICAL FORM 2. Nurse to Environment - She used inductive reasoning to extract laws 3. Nurse to patient of health, disease, and nursing from her observations and experiences. Environment is the main factor that - Her experiences during the war and her creates illness in a patient and regarded childhood education may have contributed to disease as the "Reaction of kindly her logical thinking and inductive reasoning nature against the conditions in which abilities. we have placed ourselves" (Nightingale, 1969) ACCEPTANCE BY COMMUNITY 1. PRACTICE SIMPLICITY - Her nursing principles remain the foundation - verified her work by collecting data and of nursing practice today. verifying improvements. - The environmental aspects of her theory - Its environmental focus along with its remain integral components of nursing. epidemiological components have predictive - Her idea on ventilation has protected the potential. public from 2nd-hand cigarette smoke, toxic gases, auto emissions, and other GENERALITY environmental hazards. - Nightingale's theories have been used as > Proper disposal of bodily fluids: Not towards general guidelines for all nurses since she sewage introduced them more than 150 years ago. 2. EDUCATION - Observation and measurement of outcomes - Her principles of nurse training (Instruction in as an essential component of nursing practice. Scientific Principles and Practical Experience for the Mastery of Skills) provided a universal template for early nurse training schools. EMPIRICAL PRECISION Emphasis on the interpersonal and - She advised nurses that their practice should transpersonal qualities of congruence, be based on their observations and empathy, and warmth. experiences. Nurses are not here to manipulate and - Thus, making her concepts both qualitative control (clinicalization) but rather to and quantitative understand. Transpersonal Caring Relationship 2. Margaret Jean Watson’s Theory of Foundation to her relationship Special kind of human care relationship Human Caring More of nursing phenomena. PHILOSOPHY AND THEORY OF TRANSPERSONAL CARING Carative Factors- aims at the caring process, focusing on holistic healing “We are the light in institutional darkness, and Caritas Consciousness- awareness and in this model, we get to return to the light of our intentionality in caring humanity.”- Watson, 2012 Veritas- truth and authenticate in the caregiver- patient relationship 1964 - BS in Nursing Caritas Process- actions that promote healing 1966 - Masters in Science in Psychiatric- and caring relationship Mental Health in Nursing CARITAS - A Latin word that means to 1979 - Nursing: The Philosophy and Sciences cherish, to appreciate, or to give special of Caring attention or a loving attention to your - 1st Book patient. - Defines and distinguishes the science of nursing from as distinct from medical science 1980 - Established Watson’s Caring Science CARATIVE FACTORS Institutes (WCSI) with her colleagues 1. The formation of humanistic-altruistic - Center for Human Caring system of values. - Was discovered by NYC 2. The instillation of faith-hope. 3. The cultivation of sensitivity to one’s self to WORKS AND WRITINGS OF MARGARET other. JEAN WATSON: 4. “Development of a helping-trust 1. Nursing: The Philosophy and Science of relationship” became “Development of a Caring (1979) helping-trust, human caring relationship” 2. Nursing: Human Science and Human Care- 5. The promotion and acceptance of the Theory of Nursing (1988 and 1999) expression of positive and negative 3. Post Modern Nursing and Beyond (1999) feelings. 4. Caring Science as Sacred Science 6. The systematic use of the creative problem- solving process. THEORY OF TRANSPERSONAL 7. The promotion of transpersonal teaching- CARING by MJW learning. - A special kind of human care relationship 8. The provision of supportive, protective, and - Has a high regard for the whole person and (or) corrective mental, physical, societal, their being-in-the-world and spiritual environment. - Focus of Nursing is on CARATIVE factors that 9. The assistance with gratification of human are combined with scientific knowledge based needs. 10. The allowance for existential- ACCEPTANCE IN THE NURSING phenomenological-spiritual forces. COMMUNITY 1. NURSING PRACTICE CARITAS PROCESS - Her philosophy invites to explore one’s 1. The practice of loving-kindness and curiosities about the origins of his/her call to equanimity within the context of caring care. consciousness. What calls me to care? Equanimity - Equal treatment to patient What is the root of my caring response? 2. Being authentically present and enabling How will I respond? and sustaining the deep belief system and Why do I fail to respond? subjective life-world of self and one being When is it hard to care? cared for. How will I sustain and nurture my caring consciousness? 3. Cultivation of one’s own spiritual practices Who will care for me? and transpersonal self-going beyond to the ego-self. 2. NURSING EDUCATION 4. Developing and sustaining a helping-trust - Her study emphasizes deep inner reflection and authentic-caring relationship. and personal growth, communication skills, use of self-transpersonal growth, and attention to 5. Being present to, and supportive of, the both nurse and patient. expression of positive and negative feelings as a connection with deeper spirit and self and the 3. NURSING RESEARCH one-being-cared for. - Patient outcome in caring transactions. - Focus is on subjective and objective patient 6. Creative use of self and always knowing as outcomes to determine whether or not caring is part of the caring process and to engage in the needed the truest essence of nursing. artistry of caring-healing practices 7. Engaging in genuine teaching-learning experience that attends to the unity of being ANALYSIS ON WATSON’S and meaning, attempting to stay within other’s THEORY frame of reference 8. Creating a healing environment at all levels Simplicity (physical as well as nonphysical, subtle Reading between the lines environment of energy and consciousness, whereby wholeness, beauty, comfort, dignity, Generality and peace are potentiated). Provides moral and philosophical basis for 9. Assisting with basic needs, with an nursing intentional caring consciousness, administering Encompasses all aspects of the health- ‘human are essentials’, which potentiate illness continuum. alignment of mind body spirit, wholeness, and EMPIRICAL PRECISION unity of being in all aspects of care. 10. Opening and attending to spiritual- - Her work draws heavily on widely accepted mysterious and existential dimensions of one’s work from other discipline. own life-death, soul care for self and the one- - The methodologies that are important in being cared of. studying transpersonal caring. 3. Patricia Benner’s Novice to Expert 2. Advance Beginner - A nurse demonstrates marginally acceptable Theory/Model performance. “The nurse-patient relationship is not a uniform, - Has enough experience to grasp aspects of professionalized blueprint but rather the situation. kaleidoscope of intimacy and distance in some - Newly graduated nurse. of the most dramatic, poignant, and mundane - A nurse still relies on the help of those who moments of life.” have more experience. 3. COMPETENT 1964- B.S. in Nursing - Increase level of efficiency is evident 1970- Masters degree in Nursing Major in - Consistency, predictability, and time Medical-Surgical nursing management are important skills She describes nursing as enabling - The focus is on time management and condition of connection and concern. organization of patient’s needs. She views nursing practice as “lived - The most pivotal stage because learner or experiences of health, illness, and disease nurse must begin to recognize patterns and and the relationships among these three determine which situation is a priority and elements. which to ignore. 4. PROFICIENT Experiences: - The nurse acquires an “intuitive grasp” of the - Acute medical-surgical situation based on background understanding. - Critical Care Nursing - The nurse perceives the situation as a whole - Home Health Care Nursing rather in terms of aspects. - Researcher - The nurse involvement includes the patient’s family. BOOK: - Performance of the nurse is guided by - From Novice to Expert (1984a) maxims - Acknowledges that her works had been 5. EXPERT influenced greatly by Virginia Henderson - The nurse no longer relies on analytical - Scope of work had a potential to materially principles but rather connect an understanding affect practice and at the same time, the of the situation to an appropriate action. nurses’ preparation. - Her work/theory is mainly used in the KEY ASPECT OF EXPERT PRACTICE Nursing Practice. a. Demonstrate a clinical grasp and - She used Dreyfus Model to interpret skill resource-based practice acquisition in Nursing. b. Possessing embodied knowledge c. Seeing the big picture d. Seeing the unexpected 7 DOMAINS OF NURSING SKILL ACQUISITION IN PRACTICE NURSING 1. Helping Role 1. Novice Nurse 2. Teaching or Coaching Function - No background experience of a situation. 3. Diagnostic Client-Monitoring Function - Nursing students belong 4. Effective Management of rapidly changing - A nurse can be placed in this level in an situations unfamiliar situation. 5. Administering and monitoring therapeutic Caring communion, true caring, occurs interventions and regimens when the one caring in a spirit of Caritas 6. Monitoring and ensuring quality of health alleviates the suffering of the patient. care practices 7. Organizational and work-role competencies CARITATIVE CARING THEORY ACCEPTANCE BY THE NURSING - The Patient Care Process- an approach to COMMUNITY curriculum construction within nursing 1. NURSING PRACTICE education. - The model has been used to aid in the Doctoral dissertation in pedagogy development of clinical ladder of promotions - Human Science cannot exist without values - Used for new graduate orientation programs - The substance of caring, but also to - Used for clinical knowledge program develop caring science as an independent discipline. 2. NURSING EDUCATION - Caring Science as Humanistic Science to - The 7 domains of nursing practice have the "the theory for science for caring science" - greatest influence and impact on nursing 1988, 2001 education - Nursing Educators realized that learning needs at the early stages of clinical knowledge development is different from those required at MAJOR CONCEPTS AND later research DEFINITIONS 3. NURSING RESEARCH 1. CARITAS - The 7 domains have been used in studying - Means love and charity the impact of nursing - Unconditional love - Several researches tested these models and - Fundamental motive of caring science validated them - Motive for all caring 2. CARING COMMUNION - Constitutes the context of the meaning of 4. Katie Eriksson’s Theory of Caritative caring. - Intimate connection that characterizes caring. Caring - Requires meeting in time and space, an - Pioneer of caring science in the Nordic absolute, lasting presence Countries. 3. THE ACT OF CARING - Contains the caring elements 1965 - Graduate of the Helsinki Swedish - Involves the category of infinity and eternity School of Nursing. - Invites to deep communion. 1986 - Served as the Director at Helsinki 4. CARITATIVE CARING ETHICS University Central Hospital - Basic relationship between the nurse and the 1987 - She founded the Department of Caring patient Science at Abo Akademi University - Way of approach of the nurse to the patient 5. DIGNITY Caritative caring means that we take Human Dignity- Absolute dignity "Caritas" into use when caring for the Relative Dignity- influenced and formed human being in health and suffering... through culture and external factors Caritative caring is a manifestation of the 6. INVITATION love that just "exists" - The act that occurs when the carer welcomes the patient to the caring communion. 7. SUFFERING MAJOR ASSUMPTIONS - Human being's struggle between good and AXIOMS evil in a state of becoming. fundamental truths in relation to the - A unique isolated total experience and is not conception of the world. synonymous with pain. 8. SUFFERING RELATED TO; Axioms are as follows: a. Related to ILLNESS - experienced in 1. Human being is fundamentally an entity of connection with illness and treatment body, soul, and spirit b. Related to CARE - experience of patient 2. The human being is fundamentally a either presence or absence of care. religious being. c. Related to LIFE - experience through 3. The human being is fundamentally holy. being a patient. Human dignity means accepting the 9. SUFFERING HUMAN BEING human obligation of serving with - The concept of Eriksson uses to describe the love, of existing for the sake of patient others. - Being a patient is a suffering. 4. Communion is the basis of all humanity. 10. RECONCILIATION 5. Caring is something human by nature, a call - Drama of suffering. to serve in love. - Implies a change through which a new 6. Suffering is an inseparable part of life. wholeness is formed of the life the human 7. Health is more than the absence of illness. being has lost in suffering. 8. The human being lives in a reality that is 11. CARING CULTURE characterized by mystery, infinity, and eternity. - Environment - Total caring reality that is based on cultural THESES elements 12. HERMENEUTICS Ethos(ethics) confers ultimate meaning on the - Interpretive caring context. - Meaningful human phenomena in a careful The basic motive of caring is the caritas and detailed manner as free as possible from motive. prior theoretical assumptions- no judgement. The basic category of caring is suffering 13. FORMATION Caring communion forms the context of - Address the development of senses, meaning of caring an derives its origin from esthetics, perceptual acuities, relational skills, ethos of love, knowledge, and dispositions that take place as responsibility, and sacrifice, namely, caritative SN from professional. ethics Health means a movement in becoming, being, and doing while striving for wholeness and holiness. Caring implies alleviation of suffering in charity, love, faith, and hope The Human Being- Constant change Environment- Human being innermost space Nursing- Act of caring Health- Whole body, soul, and spirit NURSING CONCEPTUAL MODEL Comprises of: A. Four Major Concepts 1. Martha E. Rogers (1914-1994) B. Five Assumptions C. Three Major Principles - 1936 - BSN degree - MA Public Health in Nursing 4 MAJOR CONCEPTS - Early practice is in the Rural Public Health Nursing 1. ENERGY FIELD - 21 years as a professor and head division - Fundamental unit of both living and non-living of Nursing in NYU - Infinite and pandimensional - 2 ENERGY FIELDS Main focus was on Nursing Education a. Human Field - "Professor Emerita" – 1979 - irreducible, indivisible, pandimensional - "Society of Rogerian Scholars" formed 1988 energy field identified by pattern and - American Nurses Association' Hall of Famer manifesting characteristics that are specific - 1996 to the whole and cannot be predicted from PUBLICATIONS knowledge of the parts - Educational Revolution in Nursing (1961) b. Environmental Field - Reveille in Nursing (1964) - specific to its given human field - An Introduction to the Theoretical Basis of - although not necessarily quantifiable, an Nursing (1970) energy field has an inherent ability to create change ROGERS SCIENCE OF UNITARY In this case, both human and environmental HUMAN BEINGS fields change continuously, creatively, and “The study of the moving intuitive experience of integrally. (Rogers, 1994) nurses in mutual process with those they 2. UNIVERSE OF OPEN SYSTEM serve” - Neuman,1997 - OPENNESS The Environment and the Human Being - Holds that energy fields are infinite, open, and - An introduction to the Theoretical Basis of integral with one another Nursing, 1970 - The human being and environmental fields - The foundation for the scope of modern are in continuous process and are open nursing system. -The relationship of the human being 3. PATTERN and the environment. - Identifies energy field - Human beings are dynamic energy fields - Its nature of pattern changes continuously, that are integral to the environmental fields. innovatively, and relative - Human and environmental fields are - It gives identity to the energy field identified by patterns and characterized by - It is abstraction that reveals itself through a universe of open systems. (Martha manifestations Rogers, 1983) - Pattern may manifest through illness or well- being “Irreducible, indivisible, pandimensional energy field identified by pattern and manifesting 4. PANDIMENSIONAL characteristics - Nonlinear domains without spatial or temporal that are specific to the whole.” - Rogers, 1992 attributes - It is an infinite domain without limit. - It best expresses the idea of a unitary whole - Essentially a spaceless and timeless reality 4 MAJOR ASSUMPTIONS 1. RESONACY 1. NURSING - Continuous change from lower-to-higher - Rogerian Nursing focuses on concern with frequency wave patterns in the human people and the world they live in (environment) and environmental fields. - Promotion of health and well-being for all 2. HELICY persons. - Continuous innovative, unpredictable, - Art of Nursing increasing diversity of human and environmental field patterns. 2. PERSON 3. RECIPROCACY - Open system in a continuous process. - Continuous mutual interaction between - Unitary human being the human and environmental fields. - Person and environment are integral with one 4. SYNCHRONY another. - Continuous mutual human field, and 3. HEALTH environmental field process. Passive health - Symbolizes wellness and absence of ACCEPTANCE BY THE COMMUNITY disease and major illness PRACTICE - Stresses the totality of and experience 4. ENVIRONMENT - Continuum of care - Irreducible, pandimensional energy field. - Nursing is based on theoretical knowledge - Infinite and change is continuously innovative. that guides nursing practice 3 PATTERNS (3 MAJOR PRINCIPLES) 5 THEORETICAL ASSUMPTIONS 1.Pattern Appraisal 1. Man is a unified whole possessing his own - meant to avoid integrity and manifesting characteristics more 2.Mutual Patterning than and different from the sum of his parts - implies knowing participation but does not (energy field) lead to the nurse’s prescribing change of 2. Man and environment are continuously predicting outcomes exchanging matter and energy with one 3.Evaluation another (openness) - centers on the perceptions emerging during 3. The life process evolves irreversibly and mutual patterning unidirectionally along the space-time continuum (helicy) EDUCATION 4. Pattern and organization identify man and - Articulates values and beliefs about human reflect his innovative wholeness (pattern and beings, health, nursing, and the education organization) process. 5. Man is characterized by the capacity for - Her model has been used to guide curriculum abstraction and imagery, language and development of all levels of nursing education. thought, sensation, and emotion (sentient, thinking being) RESEARCH - Identify the purpose and scope of nursing and provide frameworks for objective records of the PRINCIPLES OF HOMEODYNAMICS effects of nursing. - Postulates the nature and direction of human - The conceptual model of Roger's had made beings’ attention other theories emerge. - Intercoined all the definitions of etymologically consistent and logical