NCMA110 Nursing Terminologies & Concepts PDF

NCMA110 Coverage: Terminologies: Professionalism 1. Introduction to nursing (Profession) - Refers to professional character, spirit, 2. Term...

NCMA110 Coverage: Terminologies: Professionalism 1. Introduction to nursing (Profession) - Refers to professional character, spirit, 2. Terminologies or methods. It is a set of attributes, a 3. Evolution of nursing way of life that implies responsibility 4. Metaparadigm and commitment. Professionalization - Is the process of becoming professional, NURSING that is, of acquiring characteristics considered to be professional. As an Art - As a professional nurse you will earn to Level of Proficiency Nurses deliver care artfully with compassion, (By Patricia Benner) caring, and respect for each patient's 1. Novice dignity and personhood. - Nursing student As an Science - Entering new field 2. Advanced beginner - Nursing practice is based on a body of - Have few experience knowledge that is continually changing 3. Competent with new discoveries and innovations. - 2-3 years’ experience - Evidenced based practices nursing 4. Proficient concept, theories, science subjects - 3-5 years’ experience - Can assist novice nurses - Can readily transfer knowledge gain Profession from multiple previous experiences. 5. Expert - An occupation that requires extensive education or a calling that requires - A lot of experience special knowledge, skill, and - Supervisor, head nurse preparation. - A profession is generally distinguished from other kinds of occupations by: Scope and Standards of Nursing Practices a) Its requirement of prolonged, specialized training to acquire a - Provide a specified service according body of knowledge pertinent to the to standards of practice and to follow a role to be performed. code of ethics (ANA, 2015) b) An orientation of the individual - Professional practice includes toward service, either to a knowledge from social and behavioral community or to an organization sciences, biological and physiological c) Ongoing research sciences, and nursing theories. d) A code of ethics - Nursing practice incorporates ethical e) autonomy and social values, professional f) Professional organization. autonomy, and a sense of commitment and community (ANA,2010b) 1|Page  NCMA110 a) Promote health and wellness 5. Nurse researcher b) Preventing illness 6. Nurse administrator c) Restoring health 7. Forensic nurse d) Caring for dying 8. Nurse entrepreneur 9. Military nurse 10. Flight nurse Professional Responsibilities and Roles: 1. Autonomy and accountability “Theory without practice is Empty; - This is an essential element of Practice without theory is blind.” professional nursing that involves the initiation of independent nursing intervention without medical orders. Common terminologies: 2. Caregiver - Maintain/ regain health of the patient. 1. Philosophy 3. Manager - Belieafs and values that define a way of 4. Advocate thinking and are generally known and - You protect your patient legal rights understood by a group or discipline. and provide assistant in certain rights 2. Nursing philosophy 5. Communicator - Declaration of a nurse’s beliefs, values - Good communicator and ethics regardunf their care and 6. Educator treatment of patients while they are in - Explain concept, procedures and facts nursing profession. about the health to patient Core values: Social justice Nursing education: Safe, compassionate and ethical care 1. Licensed practical/ vocational nursing Health and well-being program Respect - Assistant nurses Accountability 2. Registered nursing programs 3. Theory - Baccalaureate degree programs - A belief, policy or procedure proposed 3. Graduate nursing programs or followed as the basis of action - Master’s Degree Program 4. Nursing theory - Doctoral Programs (PhD) - Body of knowledge that describes or 4. Continuing education explain and is used to support nursing - Updating skills/ experience practice. Explains Describes Expanded Career Plans: Predicts 1. Nurse practitioner Prescribes 2. Nurse anesthetist 3. Nurse educator 4. Nurse midwife 2|Page  NCMA110 5. Concepts 9. Paradigm - Building blocks of theories - To a pattern of shared understanding - They are primarily the vehicles of and assumptions about reality and the thought that involve images world; worldview or widely accepted 6. Models value system. - Representations of the interactions - concepts among and between the concepts 10. Metaparadigm showing patterns. - The most general statement of 7. Conceptual framework discipline and functions as a - A group of related ideas, statements or framework in which the more restricted concepts structures of conceptual models - Set of interrelated concepts that develop. symbolically represents and conveys - Specific concepts mental image of a phenomenon Person Health Nursing Environment What can actually Nursing theory do for a nurse? 1. Improves nursing practice 2. Strengthens the nursing focus of a care 3. Provides consistency to nursing communication and activities 4. Improves the health and quality of life for; 8. Process a) Persons - Series of organized steps, changes or b) Families functions intended to bring about the c) Communities desired result. The Nursing Process: Diagnosis – what is the problem Components of nursing theory: Planning – make a plan to solve 1. Phenomenon – issues, events, previous the problem experience Implementation – putting the 2. Concepts - plan into action 3. Definition – giving definition/ Evaluation – did the plan work? explanation in concepts Assessment – data 4. Relational statements – cause and effect, relationships 5. Assumptions – testing 3|Page  NCMA110 Concepts: other grand theories that are generally Abstract concept not as specific as middle-range theories. - General – grand theory 4. Middle-range theories Concrete concepts - theories are that of Mercer, Reed, - Specific – middle range theory Mishel. Historical Sketch: 1. Curriculum era - Focuses on what must be studied and learned to become a nurse from hospital-based diploma program into college and nursing. 2. Research era - Nurses started to be introduced and Abstract concepts Concrete Concepts integrated in the nursing curriculum. 3. Graduate education era - From BSN to master Program ( nursing models and nursing theory course) Source of concepts: 4. Theory era Naturalistic concept - Contemporary phase where the - Seen in nature or in nursing practice. emphasis is on theory-based nursing Research-based concept practice and theory development. - The result of conceptual development that is grounded in research processes through qualitative, phenomenological EVOLUTION OF NURSING or grounded theory approaches - Previous topic of research Shiphrah and Puah - They rescue baby moses - They hid him in order to save his life Category of nursing theory: - Ditto nagsimula ang nursing. (Accdg. to Martha Raile Alligood 2017) 1. Nursing philosophy Ancient Civilization - Works of Nightingale, Watson, Ray, - Nursing was noted to be as old as time. and Benner are categorized under this - Started from: instinct, human nature group. nurturing, caring behavior 2. Nursing conceptual models - The term Nurse – originated from the - Conceptual models of Levine, Rogers, Latin word “Nutire” or Nurture in Roy, King, and Orem are under this English – meaning it’s to suckle or to group. feed the baby. - Wet nurses – the women who 3. Grand nursing theories - Are works derived from nursing breastfeed somebody else baby. philosophies, conceptual models, and - Man was Doctors; Women was Caregiver 4|Page  NCMA110 - Illness – considered to be a cursed from Hippocrates evil spirit; they use physical harm to – Known as a Greek physician. take away the evil spirit. – Invented Hippocratic Oath – you need to see the evidence that Egyptians Rites happening to patient before you - Health and healing beliefs of ancient conclude the condition of patient. civilization – Considered as the most - Superstition and magic\injuries from outstanding figures of history of wars and other tragic event. medicine. - Injuries from wars and other tragic – He encourage health care events. providers to look not just on the - Repairing and suturing wound physical part of the patient that has - Planning to decrease public health an ill. But also the environment problems. where the patient is. - They started out a calendar method and - Basket Healers – assistant of the priest. the writing. Palestinian Time - Under the leadership of Moses, Indian Period (Hindu) hydrous develop mosaic code which - 2000 ~ 1200 BC represented the one of the first - Vedas – books that contains spices and organized method of disease control herbs, magic and charms use for prevention. healing. - It contain public loss that did not - Prenatal and childhood illness. allowed to eat a slaughtered animals - Started performing cesarean deliveries. longer than 3 days. - Women at this time were primarily - Communicable disease – they are responsible for caring for the home and being isolated in the public and only the family. when the priest considered them healed is the only time that they can back home. Chinese Period - Home visit only - They practice stitching confuses. - The most important of tradition in china is the belief about health and Greek (Greece) illness being on the balance using the - 15 ~ 100 BC yin and yang technology/philosophy. - Greek mythology - Yin and yang – the imbalance of this - God Asclepius – god of medicine; will result as an illness. They should be pinatayuan sya ng temple na interconnected and interdepended in nagsisilbing hospital. the natural world. Athena Zeus Poseidon 5|Page  NCMA110 Roman Empires Sisters of Charity - During the military dictatorship - Established by St. Vincent de Paul in wherein they try to slave physicians, France. they ask them to cure the ill people. - Congregation for radical innovation Doctor Galen during the 17th century. – Greek physician - At first they dedicated their nursing – Expand his knowledge about skills to the poor in their homes. anatomy and physiology, - Hey eve recruited your women for pathology, and medical training in nursing and develop therapeutics. educational programs and cared for the – Discover the importance of abandoned children. anatomy and physiology. Order of the Deaconesses Middles Ages - Founded in Kaiserwerth, Germany. - Women used herbs; men used linta - Kaiserwerth – founded by Pastor - Most of the changes of health care were Theodor Fliedner and his wife based on Christian concepts and Friederike Munster 1836. charity. - Recognized the role of women in - Wife’s emperor were the nurse and taking care for the sick noble women in society. - Initiated the establishment of training - Women who are not trained as midwife school for nurses. – they are forbidden to witness childbirth. FLORENCE NIGHTINGALE - 1820 – 1910 (from Florence) Renaissance period - Mother of the modern nursing - AD 1350 ~ AD 1650 - An English lady from a wealthy family - Revirth of the sience of medicine during the Victorian era. (European country) - Crimean war - Dark ages of nursing - “Lady with the Lamp” - first anatomy book published - 1845 – she want to train to be nurse Michelangelo and Leonardo da Vinci - 1851 – her parents finally permitted her - Draws the human body. to pursue nursing training - Development of the printing - 1860 – started her training in press allows knowledge to be Kaiserweth (3 months – long) spread to others. Michael Servetus Prior to Florence Nightingale is the Dark - Describes the circulatory system Age for nursing because… in the lungs. Nursing considered as… Roger Bacon - A very low job in terms of social - Promotes chemical remedies to hierarchy treat disease - A job for the uneducated and poor - Average lifespan was 30-40 years. - A desperate occupation 6|Page  NCMA110 Florence Nightingale changed the image of Significance of Nursing Theory: Nursing… Discipline - 1860 – Nightingale laid the foundation - is refers to a branch of education, a of professional nursing when the first department of learning, or a domain of school of nursing was established. knowledge. - St. Thomas hospital Profession - This marked the birth of modern - Refers to a specialized field of practice nursing founded on the theoretical structure of - 1854 – She started training the nurses. the science or knowledge of that - During the Crimean war, she requested discipline and accompanying practice to help in the military hospital. abilities. - We need to follow the code of ethics Transformation of nursing into a profession Nightingale describe Nursing as… History and Philosophy of Science Science – nursing is a body of scientific Rationalism knowledge using empirics. - Emphasizes the importance of a priori Art – nursing has its own proper of reasoning as the appropriate method of doing things and applying knowledge. advancing knowledge. Priori Reasoning – use deductive Nursing as an Art logic by reason from the cause to effect - It is the art of caring sick and well or from a generalization to a particular individual. instance. - It refers to the dynamic skills and methods in assisting sick and well Paul Reynolds individual in their recovery. - 1971 Nursing as a Science - Labeled this approach theory then - It is the body of abstract knowledge research arrived through scientific research and Albert Einstein logical analysis. - Rationalist view very evident in his Nursing as a Profession work - A calling in which its members profess - Theoretical approach – that attempts to to have acquired special knowledge by understand the root cause of something training or experience or both so that and construct a predictive model that they may guide, advise or save others explicitly say when the event will in the special field. happen again. - According to American Association, Professional Nurses and compasses Francis Bacon upon a passion for increasing well- - Believed that scientific truth was being for patients, a desire to provide discovered through generalizing specialized skills and grow as a nurse. observed facts in the natural world. - Inductive reasoning – it aims to develop a theory based on evidences that you got 7|Page  NCMA110 Empiricism Harold Brown - Based on the central idea that scientific - Set forth a new epistemology knowledge can be derived only from challenging the empiricist view sensory experience. proposing that theories play a - Specific to general significant role in determining what the scientist observes and how it is Burrhus Frederic Skinner (B.F. Skinner) interpreted. - Asserted that advances in the science of - Each individual has its own phycology could be expected if interpretation of a certain scientist would focus on the collection issue/experience, based on their of empirical data. exposure education and knowledge. - Operant conditioning – ideas that behavior determined by consequences. - Reward and punishment. NURSING METAPARADIGM - The board conceptual boundaries of the Early 20th century views of science and discipline of nursing, human beings, theory environment and health. First half of 20th century - Philosophers focused on the analysis of theory structure. - Scientist – focused on empirical research - Positivism – term used by Auguste Comte emerged as the dominant view of modern science. - Believed that empirical research and logical analysis (deductive and inductive) were two approaches that would produce scientific knowledge. (deductive reasoning – proving) Person - Also referred to as client or human Late 20th century: beings Michael Foucault - The recipient of nursing care and may - Epistemology (knowledge) and include: Psychological tormented. Patients - He stated that empirical knowledge Groups was arranged in different patterns at a Families given time and in a given culture and Communities that humans were emerging as object of - Each person is treated and regarded as study. unique and autonomous. - His book “The Order of Things: an Archaeology of the Human Sciences” 8|Page  NCMA110 - The care structure considered the Nursing metaparadigm of Different Nurse person is spiritual, social and health Theorist: care needs. Florence Nightingale - The person is empowered to manage a) Person his/her health and well-being with - A multidimensional being, that dignity and self-preservation with includes biological, psychological, positive personal connection. social and spiritual components (Selanders, 2010) Health b) Health - Is defined as the degree of wellness or - Viewed as the combined result of well-being that the client experiences. environmental, psychological and - Characterized as one with multiple physical factors, not just the dimension in a constant state of motion. absence of disease (Parker, M. E., - Not mainly focus at physical aspect but 2005). the totality as a person. c) Environment - “What nursing has to do is to put Environment the patient in best condition for - Is defined as the internal and externals nature to act upon him.” surrounds that affect the client. d) Nursing - How a person continuously interacts - Nightingale’s writings reflect a with his/her surroundings is a very on community health model in which health and wellness. all that surrounds human beings is - Physical and Social Factors: considered in relation to their state of health. Economic conditions Geographic location Orem Culture a) Person Social connection - Humans are defined as “men, Technology women, and children cared for either singly or as social units.” Nursing And are the “material object” of - The attributes, characteristics and nurses and others who provide actions of the nurse providing care on direct care. behalf of or in conjunction with the b) Health - “Being structurally and functionally client. whole or sound.” - Main goal: to improve patient care c) Environment - Skills: medical knowledge, technical - The environment has physical, skills and nursing care. chemical, and biological features. It includes the family, culture, and community. 9|Page  NCMA110 d) Nursing - Includes: friendship, romantic - Nursing is an art through which the attachment family, social groups and practitioner of nursing gives religious groups specialized assistance to persons with disabilities which makes more than the Esteem ordinary assistance necessary to meet - People need to sense that they are needs for self-care. valued and by others. And feel that they are making contribution to the world. Maslow’s Hierarchy of Needs - Includes: self-esteem, personal worth, need for appreciation, respect Self-actualization - Involves the need to fulfill your total potential and to become the best that you can possibly be. How to prioritize the patient and prioritize the problem: - By using your Maslow’s Hierarchy of needs and ABC - ABC – A-Airway, B-Breathing and C- Circulation (gagamitin to pag parehas sila ng physiological needs at d mo alam kung sino uunahin mo) Psychological needs - Necessary for survival - Highest priority and must be met first - Includes: food, water, breathing, homeostasis, nutrition, air, temperature regulation, shelter clothing, sleep/rest, sex Lahat yan galing sa ppt, at kumuha din ako sa Safety notes ko at reviewer ni sarah sa evolution. - Contributes largely to the behavior at Kaya yun iba medyo mahaba HAHAHA tsaka this level. yun mga name ng tao dyan tama lang yun - Includes: financial security, freedom spelling nyan, sinearch ko pa yan isa isa kung from harm, psychological safety and tama bay un spelling nun name nila HAHA physical safety. Kaya natin to guys!! Study well  - Aki Love/Belonging - A need to form or maintain social connections. 10 | P a g e  NCMA110 COVERAGE: Caring Communion 1. Eriksson, Watson and Benner - Constitutes the context of the meaning of caring and 2. Rogers and Orem is the structure that determines caring reality. 3. Johnson, Roy and Neuman - Characterized by intensity and vitality, and by warmth, 4. Meleis, Leininger, Newman and Parse closeness, rest, respect, honesty and tolerance. 5. Hall, Travelbee and Orlando 6. King, Barker and Reed 7. Peplau, Mercer and Beck 8. Mishel and Pender 9. Swanson, Boykin & Schoenhofer Eriksson, Watson and Benner THEORY OF CARITATIVE CARING (Katie Eriksson) - means that we take “caritas” into use when caring for the human being in health and suffering. - a manifestation of the love that ‘just exist’, - Caring communion or true caring - occurs when the one caring in a spirit of caritas alleviates the suffering of the patient. - Caritas – an art of giving a nursing care that is unconditional love - How would you say that you are providing the caring - Main goal of the nurse in this theory: communion - if the type of environment you are - to alleviates the suffering and serve life and health. providing is warm, love and closeness. And providing - once you got involved in an alleviating the rest to the patient physically, mentally, emotionally. suffering of the patient you are already rendering Respecting the patient despite any regardless caritas condition of patient, and also honesty, tolerance. - and once you start rendering caritas, you are involving your patient in the caring communion. Caring elements Katie Eriksson - The act of caring contains: Faith, hope, love, - Finland-Swedish nurse tending, playing, and learning. - born in Nov 18, 1943 in Jacobstad, Finland. - Involves the categories of infinity and eternity and - 1965, graduate of the Heisinki Swedish School of invites to deep communion. Nursing. - The art of caring is the art of making something - 1967, she completed her public health nursing very special out of something less special. specialty education at the same institution. - She currently works as a professor of health science at Caring ethics Abo Akademi University in Vaasa, where she built a - Comprises the ethics of caring, the core of which master’s degree program in health science and four- is determined by the caritas motive. year postgraduate studies program leading to a - deals with the basic relation between the patient doctoral degree in health sciences. and the nurse – the way in which the nurse meets Major Concepts and Definitions the patient in an ethical sense. Caritas - Means love and charity - Eros and agape are united - Eros – passion; agape – unconditional love - By nature, unconditional love. 1|Page  NCMA110 Suffering related to Life Dignity - In the situation of being a patient, the entire life of - constitutes one of the basic concepts of caritative a human being may be experienced as suffering caring ethics. related to life. - Human dignity is partly absolute dignity, partly relative dignity. Suffering human being - A human being’s absolute dignity involves the - The concept that Eriksson uses to describe the right to be confirmed as a unique human being. patient. - Absolute dignity – it was provided to us upon in - The patient refers to the concept of “patiens” our creation, created by our parents, and you were (Latin) – means “suffering” born, you have your unique identity. - The patient is a suffering human being, or a - Relative dignity - we could acquire this through human being who suffers and patiently endures. our environment, the way people treat us, the way people give importance to us. They should Reconciliation recognize your existence. - Drama of suffering - A human being who suffers wants to be confirmed Invitation in his/her suffering and be given time and space to - Refers to the act that occurs when the career/nurse suffer and reach reconciliation. welcomes the patient to the caring communion. - Hindi mo pwedeng pilitin na madiliin un patient - Allowed to rest a place that breathes genuine na mag adjust agad. Hanggat maaccept nya yun hospitality, and where the patients appeal for condition nya at magadjust/move on. charity meets with a response. - “suffering is not holding you; You are holding - Once you embrace the patient, you introduce suffering” yourself, you start asking the patient about his condition and doing procedure for the patient Caring culture using the caritas – that’s already invitation. - the concept that Eriksson uses instead of environment. Suffering - It characterizes the total caring reality and is based - An ontological concept described as a human on cultural elements such as traditions, rituals and being’s struggle between good and evil in a state basic values. of becoming. - Respect for the human being, his or her dignity - Implies in some sense dying away from and holiness, forms the goal of communion and something, and through reconciliation, the participation in a caring culture. wholeness of body, soul and spirit is re-created, when the human being’s holiness and dignity Eriksson’s Metaparadigm in Nursing appear. Person/ The Human Being - Reconciliation – nahold mo na un suffering mo, - Based on the belief that the human being is an entity ikaw na nag cocontroll ng suffering mo. Nakapag of body, soul and spirit, emphasizes that the human recreate ka na ng bagong ikaw. being is fundamentally a religious being. Forms of Suffering: - Fundamentally holy, and this belief is related to the Suffering related to illness idea of human dignity, which means accepting the - Experiences in connection with illness and human obligation of serving with love and existing for treatment. the sake of others. Suffering related to Care - Seen as in constant becoming; he is constantly changing and therefore never in a state of full - When the patient is exposed to suffering caused completion. by care or absence of caring - Engaged in a continued struggle and living in a tension - Which is always a violation of the patient’s between being and non-being. dignity. - The human being is fundamentally dependent on communion. 2|Page  NCMA110 - Seeks a communion where he can give and receive love, experience faith and hope, and be aware that his Caritative caring existence here and now has meaning. - The innermost core of nursing Environment - She distinguishes between caring nursing and - Eriksson uses the concept of ethos nursing care. - The ethos of caring science as well as that of caring, - Nursing care is based on the nursing care process, consist of the idea of love and charity and respect and and it represents good care only when it is based honor of the holiness and dignity of the human being. on the innermost core of caring. - Ethos originally refers to home, or to the place where - Caring nursing represents a kind of caring a human being feels at home without prejudice that emphasizes the patient and - Alleviating a human being’s suffering implies being a his/her suffering and desires. co-actor in the drama and confirming his/her suffering. - love – we will alleviate the pain of the patient; - A human being who suffers wants to have the charity – we will provide the needs/desires of the suffering confirmed and be given time and space to patient. become reconciled to it. - The ultimate purpose of caring is to alleviate suffering In doing Health - The persons thoughts concerning health are - As soundness, freshness, and well-being. focused on healthy life habits and avoiding illness. - It implies being whole in body, soul and spirit. In being - As a pure concept wholeness and holiness - The person strives for balance and harmony. - To be able to consider whole (wholeness), balance - Balance of mind, body and spirit. between mind, body and spirit. (pwedeng sabihin na, In becoming okay ka sa physically pero mentally hindi, you are not - The human being becomes whole on a deeper considered as healthy); holiness – religion and faith. level of integration. - Both movement and integration. - Deeper level of wholeness and holiness. - Movement – implies a change; a human being is being formed or destroyed, but never completely. - Movement in time and space THEORY OF TRANSPERSONAL NUSRING - Movement – dependent on vital force and on vitality (JEAN WATSON) of body, soul, and spirit; the direction of this - Theory of human caring and nursing: human science movement is determined by the human being’s needs and human care. and desires; the will to find meaning, life, and love, - Caring is the essence of nursing. strives toward a realization of one’s potential - TLC – Tender Loving Care - Health is conceived as a becoming, a movement toward a deeper wholeness and holiness. Jean Watson - As a human being’s inner health potential is touched, - Born on June 10, 1940 in West Virgina a movement occurs that becomes visible in the - Received her BSN from the University of different dimensions of health as doing, being, and Colorado in 1964 becoming with a wholeness that is unique to human - 2013 – she was awarded the American Academy beings. of Nursing’s ‘Living Legend’ award, its highest Nursing honor. - Caritas as the basic motive of caring - The 2 basic forms of love – eros and agape are The Theory of Human caring and 10 Caritas Processes combined. The motive of caritas becomes visible - Which serve as a blueprint for professional in a special ethical attitude in caring, or what calls nursing practice. a caritative outlook. - You could be able to provide human caring to a - Caritas constitutes the inner force that is patient if the type of caring you provide involves connected with the mission to care. the 3 elements. - 10 carative factors, 3|Page  NCMA110 transpersonal caring relationship and caring - Goal is to protect, enhance and preserve the occasion/moment person’s dignity, humanity, wholeness, inner - Theory of caring focuses on the interpersonal and harmony and overall wellbeing. transpersonal relationship between nurse and - Can be nurtured by movements, gestures, facial other (self, patient, family, society, universe) and bodily expressions, the sharing of information, - “Human Caring is the moral idea of nursing” touch, sound, etc. TEN CARATIVE FACTORS 1. The formation of a Humanistic-altruistic system of values - Which begins at an early age with the values shared by parents. - The system of values is mediated by the nurse’s life experiences, learning gained, and exposure to the humanities. 2. The installation of Faith-hope - Which is essential to the carative and curative The core of the Theory of Caring processes. - Humans cannot be treated as objects and that - When modern science has nothing else to offer a humans cannot be separated from self, other, patient, a nurse can continue to use faith-hope to nature, and the larger workforce. provide a sense of well-being through a belief - Watson views the carative factors as a guide fop system meaningful to the individual. the core of nursing - Carative means caring with love 3. The Cultivation of sensitivity to one’s self and to others Transpersonal Caring Relationship - Which explores the need of nurses to feel an - Transpersonal – describes an intersubjective, emotion as it presents itself. human to human relationship that encompasses - The nurses promote health and higher-level two individuals, both the nurse and the patient in functioning only when they form person-to- a given moment. person relationships. - Describes how the nurse goes beyond the object assessment to show concern toward the person’s 4. The development of a helping-trust relationship subjective/deeper meaning of their health care - Which includes congruence, empathy, and situation. warmth. - Involves mutuality between the two individuals - The strongest tool a nurse has is his/her mode of involved. communication, which establishes a rapport with - Objective data – ito un naoobservahan mo lng; the patient, as well as caring by the nurse. Subjective assessment – communicating or by - Once na nagsabi na un pasyente about sa sensitive asking the patient about his/her condition information nya, ibigsabihin pinagkakatiwalaan - Occurs during the ‘caring event’, central to ka na nya. Watson’s view of nursing. - Calls the nurse to go beyond the objective, 5. The promotion and acceptance of the expression of physical assessment with concern for the person’s both positive and negative feelings deeper, subjective well-being. - Which need to be considered and allowed for in a - The nurse “seeks to connect with and embrace the caring relationship. spirits or soul of the other, through the process of - The awareness of the feelings helps the nurse and caring and healing and being in authentic relation, patient understand the behavior it causes. in the moment.” (Park, 2001) 4|Page  NCMA110 6. The systematic use of the scientific method for - “caritas” comes from the Greek word meaning to problem-solving and decision-making cherish, to appreciate, to give special attention; it - Which allows for control and prediction and connotes something very fine, that indeed is permits self-correction. precious. (Medscape Nurses, 2005) - Scientific method – it involves a process - Watson’s theory calls upon nurses to go beyond 7. The promotion of interpersonal teaching-learning procedures and task, but instead focuses on the - Since the nurse should focus on the learning nurse-patient relationship resulting in therapeutic process as much as the teaching process. outcome and transpersonal caring process - Understanding the person’s perception of the (Alligood et al., 2010) situation assists the nurse to prepare a cognitive plan. Caring Occasion/ Caring Moment 8. The provision for a supportive, protective and/or - The moment (focal point in space and time) when corrective mental, physical, socio-cultural and the nurse and another person come together in spiritual environment such a way that an occasion for human caring is - Watsons divides into interdependent internal and created. external variables, manipulated by the nurse in - Both persons, with their unique phenomenal fields order to provide support and protection for the have the possibility to come together in a human- patient’s mental and physical health. to-human transaction. 9. Assistance with satisfying human needs - based on a hierarchy of needs similar to Maslow's. Watson (1999) insists that the nurse, i.e., the caregiver, Each need is equally important for quality nursing also needs to be aware of her own consciousness and care and the promotion of the patient's health. authentic presence of being in a caring moment with - In addition, all needs deserve to be valued and her patient. attended to by the nurse and patient. Both the one care for and the one caring can be influenced by the caring moment through the choices and actions decided within the relationship, thereby, influencing and becoming part of their own life history. Watson’s Metaparadigm in Nursing Person - Watson defines the person as a being-in-the-world who holds three spheres of being—mind, body, and spirit—that are influenced by the concept of self and who is unique and free to make choices. Environment/ Healing space - can expand the person’s “awareness and consciousness” and promote mind-body-spirit wholeness and healing 10. The allowance for existential-phenomenological - importance of making the patient’s room a forces soothing, healing and sacred place. - which helps the nurse to reconcile and mediate the Health incongruity of viewing the patient holistically - Person’s health as a subjective experience. Health while at the same time attending to the also corresponds to the person’s harmony, or hierarchical ordering of needs. balance, within the mind body spirit, related to the degree of congruence between the self as Key components of Jean Watson’s Theory perceived - focuses on the ten caritas processes, these are - Health is a process of adapting, coping, and proceses Watson believes the nurse must consider growing throughout life and exemplify in order to be an effectively caring nurse (Alligood & Tomey, 2010) 5|Page  NCMA110 Caring 3. Competent - a transpersonal interactive process. The self and - Needs real world exposure. person as transpersonal “mind-body-spirit” 4. Proficient oneness. - Needs unhindered practice and "the big picture" 5. Expert Nursing care - Needs to expand knowledge and experience. - a “way of being” rather than doing. Benner's Stages of Clinical Competence Summary Novice - Watson’s present definition includes caring as a - The person has no professional background special way of being-in-relation with one’s self, experience of the situation he/she is involved with others, and the broader environment. - There is difficulty discerning between relevant - Such relationship requires both an intention and a and irrelevant aspects of the situation. commitment to care for the individual. – Caritas - Beginner to profession or nurse changing area of - In other words, the nurse has to be conscious and practice (Frisch, 2009) engaged to care in order to connect and establish - Generally, this level applies to nursing students a relationship with the cared-for to promote - Must function with a clinical instructor Advanced Beginner health/healing. - Can note recurrent meaningful situational components, but not prioritize between them THE PRIMACY CARING OF MODEL FROM - Develops when the person can demonstrate NOVICE TO EXPERT NURSING MODEL marginally acceptable performance having coped (Patricia Benner) with enough real situations to have pointed out by a mentor Patricia Benner - You need help of your nurse supervisor to help - “The nurse-patient relationship is not a uniform, you explain/define situations, to set priorities, and professionalized blueprint but rather kaleidoscope to integrate practical knowledge of intimacy and distance in some of the most - Nurses functioning at this level are guided by dramatic, poignant and mundane moments of life.” rules and oriented by task completion. - She was born on August 31, 1942 in Hampton, - Read books in order to explain situations Virginia Competent - BSN from Pasadena College in 1964 - Begins to understand actions in terms of long- - MSN in 1970 and PhD in 1982 at University of range goals California - After 2-3 years in the same area of nursing the - Retired professor of University of California nurse moves into the Competent stage - Is the most pivotal in clinical learning because the From Novice to Expert learner must begin to recognize patterns and - One of the most useful frameworks for assessing determine which elements of the situation warrant nurses' needs at different stages of professional attention and which can be ignored growth. - Devises new rules and reasoning procedures for a - Proposes that expert nurses develop skills and plan while applying learned rules for action understanding of patient care over time through a Proficient proper educational background as well as a - Perceives situations as wholes (total pictures), multitude of experiences. rather than in terms of aspects - "The nurse possesses deep understanding of The Dreyfus Model situations as they occur, less conscious planning - By Stuart Dreyfus and Hubert Dreyfus is necessary, critical thinking and decision- - They develop this model to explain the skill making skills have developed" (Frisch, 2009) acquisition but in line of sports (chess) - After 3-5 years the nurse moves into the 1. Novice Proficient Stage - Needs recipes, monitoring and first success. - Is a qualitative leap beyond the competent 2. Advanced Beginner - Demonstrate a new ability to see changing - Needs simple, controlled simulations. relevance in a situation including the recognition 6|Page  NCMA110 and the implementation of skilled responses to the - Providing comfort measures and preserving situation as it evolves personhood in the face of pain and extreme Expert breakdown - Has intuitive grasp of the situation and zeros in on - Presence (being w/ the patient) the accurate region of the problem - Maximizing the patient's participation and control - This stage occurs after 5 years or greater in the in his or her own recovery same area of nursing - Interpreting kinds of pain and selecting - The expert performer no longer relies on an appropriate strategies for pain management and analytic principle (rule, guideline, maxim) to control connect her or his understanding of the situation - Providing comfort and communication through to an appropriate action touch - Operates from a deep understanding of the total - Providing emotional and informational support to situation patient's families - Guiding a patient through emotional and Benner’s Metaparadigm in Nursing developmental change Client/Person 2. The teaching - coaching function - "The person is a self-interpreting being, that is the - Capturing the patient's readiness to learn (timing) person does not come into the world predefined - Assisting patients to integrate the implications of but gets defined in the course of living a life." -Dr. illness and recovery into their lifestyles Benner - Eliciting and understanding the patient's Health interpretation of his/her illness - Dr. Benner focuses on the lived experience of - Providing an interpretation of the patient's being healthy and being ill condition and giving a rationale for procedures - Health is defined as what can be assessed whereas - Making culturally avoided aspects of an illness well-being is the human experience of health or approachable and understandable wholeness 3. The diagnostic and patient-monitoring function - Well-being and being ill are understood as distinct - Detecting and documenting significant changes in ways of being the world. patient's condition Environment/Situation - Anticipating breakdown and deterioration prior to - Benner uses situation rather than environment explicit confirming diagnostic signs because situation conveys a social environment - Anticipating problems with social definition - Understanding particular demands and - "To be situated implies that one has a past, experiences of an illness present, and future and that all of these aspects… - Assessing the patient's potential for wellness and influence the current situation." -Dr. Benner for responding for various treatment strategies Nursing 4. Effective management of rapidly changing - Described as caring relationship situations - "Caring is primary because caring sets up the - Skilled performing in extreme life-threatening possibility of giving and receiving help." emergencies - Nursing is viewed as a caring practice whose - Rapid matching of demands and resources in science is guided by the moral art and ethics of emergency situations care and responsibility - Identifying and managing a patient crisis until a - Dr. Benner understands that nursing practice as physician assistance is available the care and study of the lived experience of 5. Administering and monitoring therapeutic health, illness, and disease and the relationships interventions and regimens among the three elements - Starting and maintaining intravenous therapy with - Dependent on the first 3 paradigms minimal risks and complications - Administering medications accurately and safety, Domains of Nursing Practice including monitoring untoward effects, reactions, 1. The helping role therapeutic responses, toxicity, and - Creating climate for and establishing a incompatibilities commitment to healing - Combating hazards of immobility, including preventing and intervening with skin breakdown, 7|Page  NCMA110 ambulating, exercising patients to maximize Rogers and Orem mobility and rehabilitation, and preventing UNITARY HUMAN BEINGS THOERY respiratory complications (Martha Rogers) - Creating a wound management strategy that - she describes this in 1961 which became controversial fosters healing, comfort, and appropriate drainage and a topic of numerous debates. 6. Monitoring and ensuring the quality of health care - During that time, it was rare that anyone in a medical practices profession viewed human beings as anything other - Providing a back-up system to ensure safe than the receiver of care from as nurses and doctors. medical and nursing care - Assessing what can safely be omitted from or - During that time, health care providers focus on a added to medical orders rendering treatment. - Getting appropriate and timely responses from - Rogers insisted that a person is a unitary energy physicians system in continuous mutual interaction with the 7. Organizational work-role universal energy system. - Coordinating, ordering, and meeting multiple - Her theory, dramatically influence nursing by patients’ needs and request - in other words, encouraging nursing to consider each person as a setting priorities whole being when planning and delivering care. - Building and maintaining a therapeutic team to provide optimal therapy Martha E. Rogers - Coping w/ staff shortage - May 12, 1914 – March 13, 1994 (80 years old) - American Nurse, Researcher, Theorist Key aspects of expert nurse's practice are as follows: - Her landmark book, “Introduction to the 1. Demonstrating a clinical grasp and resource- based practice Theoretical Basis of Nursing” 2. Possessing the embodied know-how - She began her college education to studying 3. Seeing the big picture science at the University of Tennessee 4. Seeing the unexpected - Receiving her nursing diploma from Knoxville General Hospital School of Nursing in 1936. Shaping our Future Nurse Leaders - She obtain her Bachelor’s degree from George New graduate nurses are the future employee pool Peabody College in Nashville, Tennessee, then Job satisfaction & retention are greatly influenced she pursued her various Master’s and Doctoral by the quality of orientation and support received degrees. by the new graduate nurse - She was appointed professor and Head of the A positive experience will encourage the now division of Nursing at New York University, right proficient nurse to mentor novice nurses after graduating from John Hopkins School of "The mediocre teacher tells. The good teacher explains. The superior teacher demonstrates. The Public Health were, she serves 21 years until the great teacher inspires." -William Arthur time that she retired in 1975. - Following her retirement, she continued to teach "The utility of the concept of skill acquisition lies in at New York University and was a frequent helping the teacher understand how to assist the learner presenter at scientific conferences throughout the in advancing to the next level" (McClure, 2005) world. - She was also actively involved in professional Summary nursing organizations and associations concerned - Each step builds on the previous one as abstract with an educations and scholarship. principle are refined and expanded by experience - 1979, she became professor Emerita and and the learner gains clinical expertise. continued to have active role in the development - This theory changed the profession's of a nursing and the science of Unitary Human understanding of what it means to be an expert, beings. placing this designation not on the nurse with the most highly paid or most prestigious position, but on the nurse, who provided the most exquisite nursing care. 8|Page  NCMA110 Human beings have the ability to adapt according to the new changes in the environment. Concepts: - abstract ideas that occur in the mind, in speech or thoughts; fundamental of building blocks of thoughts and beliefs; it contains 2 dimensions All the human being is viewed as an integral part of universe. (integral part - there is continuous mutual or simultaneous interaction between human and the environmental fields) Human beings and the environment have energy field, nursing action is directed towards patterning and maintaining these energy fields. - In 1970, Rogers conceptual model of nursing rested on 5 basic assumptions that describes the Energy fields life process in human beings. - It is the inevitable part of life. Human and - In her 1993 paradigm, Rogers postulated 4 environment both have energy field which is open building blocks for her model: Energy Fields, i.e. energy can freely flow between human and Universe of Openness, Pattern and environment. Pandimensionality. - It’s the fundamental unit of both the living and - Rogers consistently updated this conceptual non-living things. model through revision of the homeodynamics - It provides a way to view people and environment principle. It was that time, also that she decided to as irreducible wholes. change the wordings. - Continuously vary in intensity, density and extent. - Originally her theory called “Science of Unitary Man”, she removed the word Man and change it Openness to Human Beings because she wanted to remove - There is no boundary or barrier that can inhibit the the concept of gender. flow of energy between human and environment - She was the first to promote gender equality. which leads to the continuous movement or matter - She emphasizes that our care for clients should be of energy. Humanistic and Humanitarian in nature. Nursing - It refers to the fact that human and environmental should be directed towards the unitary human and fields are constantly exchanging their energies. its concerned with the nature and direction of the - In nursing, anything and everything can affect our human development. clients’ condition. Pattern Assumptions: - The distinguishing character of the energy fields. - beliefs and values that use to describe the - Single wave, it is an abstraction and gives identity foundation of nursing theory. to field. Human being is considered as whole which cannot be - The nature of the pattern changes continuously viewed as subparts. and innovatively, and these changes give identity The life process of human is irreparable and one way to energy field. Each human field pattern is unique. i.e. from birth to death. - There have pragmatic and imaginative patients. Health and illness are the continuous expression of the Pragmatic – realistic patients; Imaginative – they life process. think out of the box The energy flows freely between the individual and environment. Human being possesses the ability to think, imagine, sense, feel, and can use language for expression. 9|Page  NCMA110 - The human environment field is dynamic, its an Pandimensional open system in which change continuous due to - Undeviating field which is not constricted by the constant interchange between the human and space or time, it is and infinite domain without environment. boundary. - Spaceless and timeless reality. Rogers’ Metaparadigm in Nursing - Parameters that human used in language to Person describe events are arbitrary and the present are - A unitary human being is open system which relatives. There is no temporal ordering of lives. continuously interact with environment - A person cannot be viewed as parts, it should be Principle of Homeodynamics considered as a whole. - The balance between the dynamic life process and Environment environment. - It includes the entire energy field other than a person. - These principles help to view human as unitary - These energy fields are irreducible, not limited by human being space and time, identified by it pattern and - The three separate principles are integrality, organization. resonancy and heliecy. - It is interconnected with everything that happens to us. Health Principles of Integrality - It is determined by the interaction between energy - Energy fields are dynamic and constantly interact fields i.e. human and environment. with the human and environment, which affects - Bad interaction or misplacing of the energy leads to our environment and vice versa. illness. - Which meditation and humor works to produce a - As an expression of life process, it is the positive environment. characteristics and behaviors coming from the mutual - In this model, the role of the nurse is to serve simultaneous interaction of the human and people. environment. - Rogers also proposes noninvasive modalities for Nursing nursing. Such as Therapeutic touch. Being a nurse - Both science and art. doesn’t mean that we just need to carry out - It constantly maintains the energy fields which is doctors’ order, we have our own treatment conducive for patient. modalities and those are noninvasive. - Nursing actions directs the interaction of person and environment to maximize health potential. Principle of Resonancy - an ordered arrangement of rhythm characterizing Clinical Practice: both human field and environmental field. Nursing action is always focused on unitary human - Constant change in the way or pattern of the being and change the energy field between human and energy field from a lower to higher frequency. environment. - This movement of energy can be made by human Nursing interventions include all the noninvasive touch, guided imagery activities, drawing, actions such as guided imaginary, humor, therapeutic storytelling and other active use of imagination. touch, music etc. which are used to increase the potential of human being. Principle of Heliecy Nursing Education: - Any minute change in the environment which Emphasis should be given on the understanding of the leads to ripple effect i.e. results in a larger change patient and self, energy field and environment. in other field. Training should lay more focus on teaching non- - This change is constant, unpredictable and there invasive modalities such as therapeutic touch, are many factors which mutually interact and meditation, humor, regular in-service education cause the change. programmer etc. 10 | P a g e  NCMA110 Nursing process to according to SUBH: SELF-CARE DEFICIT THEORY 1. Pattern appraisal (Dorothea Orem) - It is an inclusive assessment of human and - Orem theory define nursing as the act of assisting environment energy fields, its organization of others in the provision and management of self-care to energy field, and identification of areas of maintain or improve human functioning at home level dissonance. of effectiveness. - Nurses validate the entire appraisal along with the client. Dorothea Elizabeth Orem 2. Mutual patterning - July 15, 1914 – June 22, 2007 (92 years old) - It is the proper patterning of the energy fields - From Baltimore, Maryland. between the human and environment. - She was considered as one of the American - It is the mutual interaction between the client and foremost nursing theorists who developed of the nurse. self-care deficit nursing theory. - Patterning can be done by suggesting the various - She began her nursing career at Providence alternatives, educating, empowering, encouraging Hospital School of Nursing in Washington, D.C. etc. depending on the client’s condition and needs. where she receives her diploma of nursing in the 3. Evaluation early 1930s. - Done by repeating the pattern appraisal after the - She receives her BS in Nursing Education from mutual patterning to determine the extents of the Catholic University of America in 1939. And dissonance and harmony. her Masters of science in nursing from the same university in 1946. Generality: - She earned several Honorary Doctorate degrees. - the uses on non-invasive modalities are very She was given Honorary Doctorates of Science useful and important to nursing even today. from both Georgetown University in 1976 and - SUBH is the foundation of many theories and it Incarnate Word College in 1980. She was given can be applied in a variety of setting and all sphere an Honorary Doctorate of Humane Letters from of life. Illinois Wesleyan University in 1988, and a Doctorate Honoris Causae from the University of Summary: Missouri in Columbia in 1998. - In this model, the role of the nurse is to serve people. Assumptions: - Rogers also proposes noninvasive modalities for People should be self-reliant, and responsible for their nursing, such as therapeutic touch, humor, music, care, as well as others in their family who need care. meditation and guided imagery, and even the use People are distinct individuals. of color. - The interventions of nurses are meant to Nursing is a form of action. It is an interaction coordinate the rhythm between the human and between two or more people. environmental fields, help the patient in the Successfully meeting universal and development self- process of change, and to help patients move care requisites is an important component of primary toward better health. care prevention and ill health. - The practice of nursing, according to Rogers, A person’s knowledge of potential health problems is should be focused on pain management, and needed for promoting self-care behaviors. supportive psychotherapy for rehabilitation. Self-care and dependent care are behaviors learned within a socio-cultural context. Central Theme: nursing and self-care activities 11 | P a g e  NCMA110 Nursing Orem’s Metaparadigm in Nursing - a service, an art and a technology. Person - The giving of direct assistance to persons who are - Humans with physical, psychological, unable to meet their own self-care needs, interpersonal and social components, meeting developed through nursing education and self-care needs through learned behavior. experiences. Man as an integrated Whole - As a community service: nursing is a service of - She further describes man as a logical organism deliberately selected and performed actions to with rational powers. assists individuals or groups to maintain self-care, - As a biological organism, man exists and responds including structural integrity, functioning and both as organism and object in an environment development. with physical and biological components. - As an interpersonal process: since it requires the social interaction of a nurse with a patient and involves transaction between them. Theory of Nursing system: Nursing system - the approaches nurses use to assist patient with deficits in self-care due to a condition of health. Wholly compensatory system - The patient has no active role in the performance of his care. The nurse acts for the patient. Partly compensatory system Environment - Both nurse and patient perform care measures - The modern society’s values and expectations. requiring manipulative tasks or ambulation. - Encompasses elements external to man. Supportive- educative system - She considered man and environment as an - The patient is able to perform, or can learn to integrated system. Environment conditions perform, required measures of therapeutic self- conductive to development include: care but cannot do so without assistance. 1. Opportunities to be helped by being with other persons or groups where care is Moving towards… offered. Quality 2. Available opportunities for solitude and Safe companionship. Nursing 3. Provision of help for personal and group Care concerns without limiting individual decisions and personal pursuits. 4. Shared respect, belief, and trust. 5. Recognition and fostering of developmental potential. Health - Wellness is the integrity of the individual, illness results in the person’s inability to maintain self- care. - A state of wholeness or integrity of the individual human being, his parts and his modes of functioning. - The responsibility of a total society and all its members. 12 | P a g e  NCMA110 Johnson, Roy and Neuman 7 Subsystems of the Behavior System Model: BEHAVIORAL SYSTEM MODEL 1. Attachment or affiliative subsystem (Dorothy Johnson) 2. Dependency subsystem Dorothy E. Johnson 3. Ingestive subsystem - was one of the greatest nursing theorists who 4. Eliminative subsystem developed the “Behavioral System Model.” 5. Sexual subsystem - Johnson has noted that her theory evolved from 6. Aggressive- protective subsystem philosophical ideas, theory and research, her 7. Achievement subsystem clinical background, and many years of thought, discussions, and writing. Johnson’s Metaparadigm in Nursing - Johnson’s Behavioral System Model (JBSM) was Person heavily influenced by Florence Nightingale’s - Defined as behavioral system that strives to make book, “Notes on Nursing” continual adjustments to achieve, maintain, or Education: regain balance to the steady state that is adaptation. 1942, graduated BSN from Vanderbilt University Environment School of Nursing, Nashville, Tennessee - is not directly defined, but it is implied to include all - Top student in her class elements of the surroundings of the human system - Received the Prestigious Vanderbilt Founder’s and includes interior stressors. Medal Health 1948, graduated master’s degree in public health - is seen as the opposite of illness, and Johnson from Harvard University in Boston defines it as “some degree of regularity and Career and Appointments: constancy in behavior, the behavioral system 1943-1944 reflects adjustments and adaptations that are - Staff nurse at the Chatham- Savannah Health successful in some way and to some degree… Council adaptation is functionally efficient and effective. - Instructor and an assistant professor in pediatric Nursing nursing at Vanderbilt University School of - is seen as “an external regulatory force which acts Nursing. to preserve the organization and integration of the 1949- 1978 patient’s behavior at an optimal level under those - Assistant professor of pediatric nursing, an conditions in which the behavior constitutes a threat associate professor of nursing, and a professor to physical or social health, or in which illness is of nursing at the University of California, Los found.” Angeles. Three functional requirements of Human: Behavioral System Model 1. To be protected from noxious influences with which - a model of nursing care that advocates the fostering the person cannot cope of efficient and effective behavioral functioning in 2. To be nurtured though the input of supplies from the the patient to prevent illness. environment - The patient is identified as a behavioral system 3. To be stimulated to enhance growth and prevent composed of seven behavioral subsystems: stagnation. affiliative, dependency, ingestive, eliminative, sexual, aggressive, and achievement. Concepts in Behavioral System Theory: The subsystem of Behavior 1. Behavioral system - parts of the behavioral system. - Man is a system that indicates the state of the - It carries out specialized task/function needed to system through behaviors maintain the integrity of the whole system 2. Boundaries - It has a set of behavioral responses that are - The point that differentiates the interior of the developed through motivation, experience and system from the exterior. learning 3. Function - Consequences or purposes of actions 13 | P a g e  NCMA110 4. Functional requirements Career: - Input that the system must receive to survive and Worked as a Pediatric nurse develop Associate professor and chairperson of the 5. Homeostasis Department of Nursing at Mount Saint Mary’s - Process of maintaining stabilit