Theoretical Foundation of Nursing UNIT I - Historical Overview of Nursing PDF

THEORETICAL FOUNDATION OF NURSING UNIT I - HISTORICAL OVERVIEW OF NURSING PERIOD OF INTUITIVE NURSING ANCIENT GREECE ➔ Nursing was untaught a...

THEORETICAL FOUNDATION OF NURSING UNIT I - HISTORICAL OVERVIEW OF NURSING PERIOD OF INTUITIVE NURSING ANCIENT GREECE ➔ Nursing was untaught and instinctive. It was performed out of ➔ Nursing was the task of untrained slave. compassion for others. It was practiced since prehistoric times among ➔ Hippocrates who was born in Greece was give the title “Father of primitive tribes and lasted through the early Christian era. Scientific Medicine”. He made a major advance in medicine by ➔ Nursing was a function that belonged to women. rejecting the belief that the diseases had supernatural causes. He ➔ They believed that illness was caused by invasion of the victim’s also developed assessment standards for clients and recognized a body by evil spirits through the use of black magic or voodoo. need for nurses. ➔ They believed that the medicine man was “Shaman” or witch doctor ➔ CADUCEUS - the insignia of the medical profession today. who had the power to heal by using white magic. Among others, the Shaman used hypnosis, charms, dances, incantations, massage, fire, ROME water, and herbs as means of driving illness from the victim. ➔ The Romans attempted to maintain vigorous health, because illness ➔ The Shaman also practiced “trephining” or drilling a hole in the skull was a sign of weakness. with a rock or stone without the benefit of anesthesia as a last resort ➔ Care of the ill was left to the slaves or Greek physicians (both to drive evil spirits from the victim’s body. groups were looked upon as inferior by Roman society). ➔ Man’s mode of living changed from nomadic to agrarian to an urban ➔ Fabiola was converted to Christianity made her home as the first community life so he developed a means of communication and the hospital in the Christian World. beginnings of a scientific body of knowledge. ➔ Nursing remained the duty of slaves, wives, sisters or mothers. PERIOD OF APPRENTICE NURSING ➔ Care of the sick was closely related to religion, superstition and ➔ This period extends from the founding of religious nursing orders in magic. the Crusades, which began in the 11th century. ➔ Astrology and numerology were also used in medical practice. ➔ Pastor Fliedner and his wife established the Kaiserwerth Institute for the training of Deaconesses (a training school for CONTRIBUTIONS TO NURSING AND MEDICINE nurses) in Germany. BABYLONIA ➔ It is called the period of “on the job training”. Nursing care was ➔ Code of Hammurabi - provided laws that covered every facet of performed without any formal education and by people who were Babylonian life including medical practice. The medical regulations directed by more experienced nurses. established fees, discouraged experimentation, recommended specific ➔ Religious orders of the Christian Church were responsible for doctors for each disease and gave each patient the right to choose the development of this kind of nursing. between the use of charms, medications, or surgical procedures to ➔ During this Period there was also the rise of Religious Nursing cure the disease. Orders for women. Although Christianity promoted equality to ➔ There was no mention of nurses or nursing. all men, women were still concentrated in their roles as wives and mothers. EGYPT ➔ Only by entering a convent that she could follow a career, ➔ Introduce the art of embalming which enhanced their knowledge of obtain an education and perform acts of charity that her faith human anatomy. taught would help her gain grace in heaven. ➔ Developed the ability to make keen observations left a record of 250 ➔ Queens, princesses and other ladies of royalty founded many recognized diseases. religious orders. ➔ Slaves and patient’s families nursed the sick. ➔ Religious taboos and social restrictions influenced nursing at the time of the religious nursing orders. ISRAEL ➔ Hospitals were poorly ventilated and the beds were filthy. ➔ Moses the “Father of Sanitation” who wrote the five books of the There were overcrowding of patients, 3-4 patients regardless of Old Testament which; diagnosis or whether they are alive or dead may have shared 1 ➔ Emphasized the practiced of hospitality to strangers and acts of bed. charity. ➔ Practice of environmental sanitation and asepsis were non- ➔ Promulgated laws of control on the spread of communicable disease existent. Older nuns were played with and took good care of and the ritual of circumcision of the male child. the sick; while the younger nuns washed soiled linens, usually ➔ Referred to nurses as midwives, wet nurses or child’s nurses whose acts in the rivers. were compassionate and tender. ➔ People entered hospitals only under compulsion or as last resort. CHINA ➔ There was little employment and education was only for rich ➔ Strongly believed in spirits and demons. and the titled. ➔ Practiced ancestor worship which prohibited the dissection of dead human body. IMPORTANT NURSING PERSONAGES DURING THE ➔ They gave the knowledge of materia medica (pharmacology) which PERIOD OF APPRENTICE NURSING prescribed methods of treating wounds, infections and muscular St. Clare - founder of the Second Order of St. Francis of afflictions. Assisi. ➔ No mention of nursing in their records. St. Elizabeth of Hungary - a daughter of a Hungarian king. ➔ Care of the sick - done by female members of the household. Also known as the “Patroness of Nurses”. St. Catherine of Siena - the first “Lady with a Lamp”. INDIA St. Camillus of Lellis - Patron Saint of Hospitals & Nurses ➔ Built hospitals, practiced an intuitive form of asepsis and were proficient in the practice of medicine and surgery. THE DARK PERIOD OF NURSING ➔ For the first time in recorded history, there was reference to the nurse’s ➔ This extends from the 17th to the 19th century from the Period taking care of patients. These nurses were described as combination by of Reformation until the U.S. Civil War. physical therapist and cook. ➔ The religious upheaval led by Martin Luther destroyed the ➔ Sushurutu made a list of function and qualifications of nurses. unity of the Christian faith. The wrath of Protestantism swept away everything connected with Roman Catholicism in schools, orphanages and hospitals. ➔ Properties of hospitals and schools were confiscated. Nurses fled for PERIOD OF CONTEMPORARY NURSING their lives. ➔ This covers the Period after World War II to the present. ➔ There were no provisions for the sick, no one to care for them. ➔ United Nations established the WHO to assist in fighting disease by ➔ Nursing became the work of the least desirable of women - those who providing health informion and improving nutrition, living standards, bribes from patients, stole patient’s food and who used alcohol and and environmental conditions of all people. tranquilizers. ➔ Health is perceived as a fundamental human right. Laws were ➔ Nurses worked 7 days a week, slept in the cubbyholes (cranny) near legislated to provide such right. the hospital ward and ate scrap of food when they could find them. ➔ Nursing involvement in community health is greatly intensified. ➔ Technological advances, such as the development of disposable SOME REFORMS DURING THE 18TH CENTURY supplies and equipment have relieved the nurse from numerous ➔ Pastor Theodor Fliedner and his wife established the Institute for the tedious tasks. Training of Deaconesses at Kaiserwerth, Germany (1836) which was ➔ Development of the expanded role of the nurses. the first organized training school for nurses. Among the ➔ Nursing became a dynamic profession because the scope of nursing requirements upon entering this school were; practice is expanding in the light of the modern developments in the 1. Character reference form clergyman constantly changing world. 2. Health certificate from a doctor Curriculum Era (1900-1940s) 3. Permission from their nearest relative ➔ Courses including in nursing programs. ➔ The most notable figure who became one of the students of Research Era (1950-1970s) Deaconess School at Kaiserwerth is Florence Nightingale, the ➔ Roles of nurses and what to research. “Mother of Modern Nursing”. Graduate Education Era (1950-1970s) ➔ In U.S, The Nurse’s Society of Philadelphia organized a school of ➔ Carrying out advanced role and basis for nursing practice. nursing under the direction of Dr. Joseph Warringtong in 1839. Theory Era (1980-1990s) Nurses were trained on the job and attended some preparatory ➔ There are many ways to think about nursing. courses. Theory Utilization (21st Century) ➔ Women’s Hospital in Philadelphia established a six- month course in ➔ Nursing theory guides research, practice, education, and nursing to increase the nurse’s knowledge while they worked. administration. ➔ They were taught a minimum amount of medical and surgical nursing, materia medica and dietetics. ➔ The American Medical Association during the Civil War created the ➔ Committee on Training of Nurses. ➔ It was designated to study and make recommendations with regards to the training of nurses. ➔ Doctors realized the need for qualified nurses. PERIOD OF EDUCATED NURSING ➔ This period began on June 15, 1860 when the Florence Nightingale School of Nursing opened at St. Thomas Hospital in London. (St. Thomas Hospital School of Nursing). ➔ The development of nursing during this period was strongly influenced by trends resulting from wars, from arousal of social consciousness, from emancipation of women and from the increased educational opportunities offered to women. SCRUBS published the following nursing job description from 1887: In addition to caring for 50 patients, each bedside nurse will follow these regulations: 1. Daily sweep and mop the floors of your ward, dust the patient’s furniture and window sills. 2. Maintain an even temperature in your ward by bringing in a scuttle of coal for the day’s business. 3. Light is important to observe patient’s condition. Therefore, each day fill kerosene lamps, clean chimneys and trim wicks. 4. The nurse’s notes are important in aiding your physician’s work. Make your pens carefully. 5. Each nurse on day duty will report every day at 7 a.m. and leave at 8 p.m., except on the Sabbath, on which day she will be off from 12 noon to 2 pm. 6. Graduate nurses in good standing with the director of nurses will be given an evening off each week for courting purposes, or two evenings a week if you regularly to church. 7. Each nurse should lay aside from each payday a goodly sum of her earnings for her benefits during her declining years, so that she will not become a burden. For example, if you earn $30 a month , you should set aside $15. 8. Any nurse who smokes, eses liquor in any form, gets her hair done at a beauty stop of frequents dance halls will give the director of nurses good reason to suspect her worth, intentions and integrity. 9. The nurse who performs her labors [and] seves her patients and doctors faithfully and without fault for a period of five days will be given an increase by the hospital administration of five cents per day.  UNIT II - HISTORY AND PHILOSOPHY OF SCIENCE NURSING AS A SCIENCE, AS A PROFESSION, A CHARACTERISTICS OF NURSING AS A PROFESSION: DISCIPLINE AND A PHILOSOPHY ➔ Has a defined body of knowledge What is Science? Have identifiable knowledge that belongs to our profession ➔ A science is concerned with cause and effect alone (unique). ➔ A science is a way of explaining observed phenomena The knowledge of nursing profession is well organized ➔ A science has a system of gathering, verifying, and around theories (basis). systematizing information about reality Science is both a Knowledge is largely intellectual, requiring higher learning process and a product that can be taught (critical thinking). As a PROCESS - science follows systematic inquiry and Nursing Knowledge continues to build as more nursing observations of the natural world. research is conducted. As a PRODUCT - it is grounded and tested in experience ➔ Power and authority over training and education and is the result of investigative efforts. Requires formal, in depth, and specialized education from institutions of higher learning. CHARACTERISTICS OF SCIENCE ➔ Registration requirements for practice ➔ Must explain its investigations and arguments Need to pass licensure exam. ➔ Must be logically ordered Need to finish a BSN degree and comply with PRC ➔ Statements must be true or probably true requirements before taking the exam. ➔ Expressed in universal statements Need to maintain professional conduct in order to keep ➔ Definite fields of knowledge license. ➔ Coherence ➔ Altruistic service All of these criterion is present in nursing, therefore, Nursing is Nurses are committed to service and doing good. a Science (hence the degree, Bachelor of Science in Nursing) Nursing provides something vital, often to groups who are unable to meet their needs on other ways. Discipline - it is a field of inquiry characterized by a unique ➔ A code of ethics perspective and a distinct way of viewing phenomenon (Parse, 1999). ➔ Autonomy It is a branch of educational instruction or a department of learning. ➔ Relevance to society ➔ 2 Kinds of Discipline: Nursing exists to provide service to others Academic Discipline Nursing’s work is focused on the act of caring ➔ History Health promotion, disease prevention, and the care of ➔ aims to know (theoretical) and their theories are descriptive individuals with altered health states all provide valuable in nature. Their research is both basic and applied. service to society. Professional Discipline ➔ Law What is Philosophy? ➔ are practical (skill application) in nature, and their research ➔ tries to discover knowledge and truth and attempts to identify tend to be more prescriptive and descriptive. (Donaldson & what is valuable and important. Crowley, 1978) ➔ some Branches of Philosophy: ➔ Nursing as a distinct discipline can be identified by: Epistemology - study of knowledge Identifiable philosophy Logic - study of principles and methods and reasonings At least one conceptual framework (perspective) for Ethics - study of moral philosophy delineation of what can be defines as nursing. Political philosophy - study of citizen and state Acceptable methodologic approaches for the pursuit and development of knowledge. Empiricism In general, nursing’s knowledge base draws from many ➔ is founded on the belief that what is experienced is what disciplines exists. ➔ Therefore, it is not just a professional discipline but an academic ➔ strives to explain nature through testing of hypothesis and discipline as well. development of theories ➔ focuses on understanding the parts of the whole in an attempt What is the difference between a Profession and an Occupation? to understand the whole. Occupation ➔ The empiricists valued observation, perception by senses and ➔ is a job or career experience as sources of knowledge. Profession ➔ Once measurement is determined, it is possible to test theories ➔ is a learned vocation or occupation that has a status of through experimentation or observation which results in superiority and precedence within a division of work. verification or falsification. ➔ must also have an institutionalized goal or social mission as well ➔ Another philosophical school of thought which has relevance as a group of scholars, investigators, or researchers who work to in nursing is positivism, which suggests that a complex whole continually advance the knowledge of the profession with the can be best understood in terms of its basic components. goal of improving practice. ➔ Many Philosophers influenced nursing in general, philosophy ➔ All professions are occupations, but not all occupations are in the context of nursing profession refers to the beliefs professions. (Logan, 2004) system of the profession and provides perspective for ➔ Until recently, nursing was viewed as an occupation rather than practice, learning, and research. a profession. ➔ Great is the influence of philosophy in nursing. In fact, the ➔ Nursing has had difficulty being deemed a profession because sources of nursing knowledge is backed by philosophical the services provided by nurses have been perceived as an methodologies extension of those offered by wives and mothers. ➔ Epistemology - is the study of the theory of knowledge or ➔ Historically, nursing has been seen as subservient to medicine. ways of knowing. Carper (1978), describes four essential ➔ Autonomy in practice is incomplete because nursing is still patterns of knowing in nursing: dependent on medicine to direct much of its own practice Empirical - scientific knowledge ➔ It is only recently that nursing was able to identify and organize Ethics - moral knowledge professional knowledge. Aesthetics - knowledge related to beauty and expression  Personal Knowledge - knowledge gained from thought PROMINENT NURSING LEADERS IN THE PHILIPPINES alone Cesaria Tan ➔ Nursing theories were founded from philosophical thoughts ➔ First Filipino Nurse who had a Masters Degree in Nursing in ➔ The science of any discipline is tied to its philosophy the US. ➔ Both science and philosophy are geared towards increasing Socoro Sirilan knowledge. ➔ Reformed social Service for Indigenous patients at San Lazaro Hospital HISTORY AND PHILOSOPHY OF SCIENCE Annie Sand Rationalism (Deductive method) ➔ Founded the National League of Philippine Government ➔ is a form of reasoning from the general to the specific. Nurses ➔ Rationalist epistemology (scope of knowledge) emphasizes the Col. Elvegia Mendoza importance of a priori reasoning as the appropriate method for ➔ First Female Military Nurse to hold the Rank of Brigadier advancing knowledge. General ➔ Utilizes deductive reasoning (general to specific) to generate Loreto Tupaz view ➔ Known as the Dean of Philippine Nursing Education Florence Nightingale of Iloilo Empiricism (Inductive method) Socorro Diaz ➔ Knowledge is derived from sensory experience and is based on ➔ First Editor of ‘The Messenger” the first journal of the PNA the idea that the collection of facts precedes attempts to previously known as the FNA (Filipino Nursing Association) formulate generalizations. Dr. Julita Sotejo ➔ makes use of objective and tangible data to observe and collect ➔ First Editor of “ The Filipino Nurses” the second journal of data. the PNA. ➔ This approach, called the inductive method, is based on the idea ➔ Florence Nightingale of the Philippines. that the collection of facts precedes attempts to formulate ➔ Founder and the first Dean of the University of the generalizations Philippines College of Nursing (UPCN), who gave way to professional Nursing in the Philiipines. Professor Emeritus of Early 20th Century Views UPCN. ➔ During the first half of this century, philosophers focused on the ➔ The author of Code of Ethics for Nurses (PRC BON Res. analysis of theory structure, whereas scientists focused on #633, 1982). empirical research. ➔ Chairman, Committee on Legal Aspect of Nursing which ➔ Positivism emerged as the dominant view of modern science created the first Philippine Nursing Law also known as RA (Modern logical positivists believed that empirical research and No. 877S.1953. logical analysis (deductive and inductive) were two approaches Anastacia Giron Tupaz that would produce scientific knowledge. ➔ First Filipino Nurse with a title of Nursing Superintendent Chief Nurse at the PGH. Founder of Filipino Nurses Emergent views of science and theory in the late 20th century Association ➔ Emphasized that science was a process of continuously building Rosario Montemayor Delgado research rather than a product of findings. (Brown, 1977) ➔ First President of the FNA. She was a graduate of the Philippine General Hospital School of Nursing in 1912 NURSING LEADERS OF THE 20th CENTURY Mary Grant Seacole (England) (1854) NURSING SCIENCE AND THEORY IN THE LATE 20TH ➔ Worked together with Florence Nightingale during the Crimean CENTURY War to give aid for the wounded soldiers. ➔ In the latter years of the twentieth century, several authors Florence Nightingale (1859) presented analyses challenging the positivist position, thus offering ➔ The Lady with the Lamp. Contributed to the development of the basis for a new perspective of science. Nursing, as it nursing education, practice and administration. continually evolves, brings into being the different theories that Dorothea Lynde Dix (USA) (1861) guides clinical practice. ➔ Appointed superintendent of the Female Nurses of the Union Army during the American Civil War. EMERGENT VIEWS OF SCIENCE AND THEORY IN THE Louisa May Alcott (USA) (1862-1863) LATE 20TH CENTURY ➔ Wrote the book “Hospital Sketches” as she described the works ➔ Brown (1977) emphasized that science was a process of of volunteer nurses during the Civil War. continuously building research rather than a product of findings. Harriet Tubman (USA) (1861- 1865) Theories play a significant role in determining the scientist ➔ “The Moses of Her People”. She served the slave of the observation and interpretation about the phenomena through data underground railroad during the Civil War collection and analysis. Jean Henri Dunant (Switzerland) (1862-1865) ➔ Presupposed theories and observable data interact in the process of ➔ Organized the International Conference that Founded the Red scientific investigation. Cross during the Geneva Convention. ➔ Understanding of evidence-based science begin. Nurses uses it to Linda Richards (USA) (1873) support the interventions for patient care. ➔ America’s First Trained Nurse. ➔ Brown (1977) emphasized that science was a process of Mary Mahoney (USA) (1879) continuously building research rather than a product of findings. ➔ America’s First Trained Black Nurse. Theories play a significant role in determining the scientist Clara Barton (USA) (1812-1912) observation and interpretation about the phenomena through data ➔ Organized and Established the American Red Cross. collection and analysis. Lilian Wald (USA) (1867-1940) ➔ Presupposed theories and observable data interact in the process of ➔ Founder of Public Health Nursing. Founded the Henry Street scientific investigation. Settlement and Visiting Nurse Services, which Provided nursing ➔ Understanding of evidence-based science begin. Nurses uses it to services educationally, socially, and culturally. support the interventions for patient care. Bedford Fenwick (England) (1899) ➔ Established the International Council of Nurses in Great Britain.  PROFESSIONAL ROLES OF NURSES Faye Glenn Abdellah Care Provider ➔ Provide care and comfort for persons together with preserving the dignity of human being. Considered as the mothering role of nurses Communicator ➔ Communication facilitates understanding and collaboration of nursing actions with their client and other members of the HC team. It develops rapport with clients to established their cooperation. Teacher ➔ Help the client learn the state of their well-being and therapies that will be done to them. Provide them imagery of the advantages and disadvantages of the actions that will be done to them. It can help in the development of the nursing profession. Counselor ➔ Help client to cope with stress brought about by their health conditions. Facilitates the clients growth in all aspect. Client Advocate ➔ Defends the client’s rights to be treated equally without any harm intentionally or unintentionally. Ensures that the client’s need are met. Advocacy, involves promoting what is the best for the client, ensuring that his needs are met and protecting his rights. Change Agent ➔ Identifies the problem Assessing the client’s motivations and capacities for change Determines alternatives Explores the possible outcomes of the alternatives Assesses resources Determines appropriate nursing role establishes and maintains a helping relationship Leader ➔ As a positive (goal oriented) behavior involving an exchange with other people. Leadership is an attempt to influence others Influencing helps the client in making decisions to establish and achieve their goals towards alleviating their conditions Manager ➔ Involves planning, giving direction, developing staff, monitoring operations, giving rewards fairly and representing both staff members and administration as needed. Researcher ➔ An investigative role of nurses which further improves the nursing practice. Research substantiates practices as they were tested and further studied upon. EXPANDED ROLES OF NURSES Nurse Generalist ➔ Has mastery in certain practice of nursing. Examples of special areas: med-surgical nursing, pediatric nursing geriatric nursing, psychiatric and mental health nursing, home health nursing. Nurse Clinician ➔ Performs direct nursing actions in specialty areas. They may or may have advances educational preparation as long as they are certified by a governing body to perform such duties. Nurse Practitioner ➔ Requires advance educational or nursing practice and must be certified by a governing body that they may practice. Nurse Specialist ➔ Requires to have a master’s degree in nursing and must have a specialization in a particular field of nursing. NURSING THEORISTS OF HISTORICAL SIGNIFICANCE (OVERVIEW) Hildegard E. Peplau Virginia Henderson  UNIT III : STRUCTURE OF NURSING KNOWLEDGE INTRODUCTION ➔ What is known in a particular field of discipline or study. ➔ Nursing profession is still under an evolution phase, a phase of ➔ Sources of Knowledge: receding and evolving new paradigms. TRADITIONAL KNOWLEDGE - is a nursing ➔ Nursing theories and models provide information about practice which is passed down from generation to definitions of nursing and nursing practice, principles that form generation. Its always been practiced that way. the basis for practice, goals and functions of nursing. AUTHORITATIVE KNOWLEDGE - an idea by a person of authority which is perceived as true because THEORY of his or her expertise. ➔ greek word “theoria” - speculate SCIENTIFIC KNOWLEDGE - it came from a ➔ a set of statements that tentatively describe, explain, or predict scientific method through research. They are tested relationships among concepts that have been systematically and measured systematically using objective criteria. selected and organized as an abstract representation of some phenomenon. (Mc. Ewan & Wills, 2019) PARADIGM ➔ an organized system of accepted knowledge composed of ➔ is a conceptual diagram. concepts, prepositions, definitions, and assumptions intended ➔ is a pattern. to explain a set of facts, events, or phenomena. STRUCTURE OF NURSING KNOWLEDGE CONCEPTS ➔ are often called the BUILDING BLOCKS OF THEORIES. ➔ enhances one’s capacity to understand phenomena as it helps define the meaning of a word. ➔ are vehicles of thoughts that involve images ➔ may be abstract or concrete. ➔ Examples: Noise, Cleanliness, Ventilation, Bed and Beddings, Warmth in Nightingale's Environmental Theory ➔ There are two types of concepts namely: Abstract concepts - are indirectly observed or intangible. NURSING METAPARADIGM It is independent in time and place. Examples are love, ➔ came from Greek words meta meaning with and care, and freedom. paradeigma meaning pattern. Concrete concepts - are directly observed or tangible. ➔ Collective term for concepts consisting four major Examples are nurse, mother and pain. concepts: person, environment, health, and nursing. Person - refers to all human beings; the recipients of DEFINITION nursing care. They include individuals, patients, ➔ Composed of various descriptions which convey a general groups, families, and communities. meaning and reduce the vagueness in understanding a set of Environment - factors that affect individuals concepts. internally and externally. Also includes setting where Conceptual definitions - are meaning of the word based nursing care is provided. on how a certain theory or relevant literature perceives it ➔ Ventilation to be. ➔ Warmth Operational definitions - are meaning of a word based ➔ Noise on the method of how it was measured or how the person ➔ Light come up with that perception. ➔ Cleanliness Health - the holistic level of wellness that the person PROPOSITION experiences. It addresses the person’s state of well ➔ Explains the relationship of different concepts. being. Goal of all nursing activity should promote client’s health. ASSUMPTION Nursing - is a science, an art and a practice discipline ➔ A statement that specifies the relationship or connection of which involves caring. Focuses on the factual concepts or phenomena. human-environment-health process and is articulated in nursing theories and generated through nursing PHENOMENON research. The interventions of the nurse rendering care ➔ set of empirical data or experiences that can be physically in support of, or in cooperation with the client. observed or tangible, such as crying, grimacing when in pain Nursing is a humanistic science dedicated to ➔ It is concerned by how the person reacts using human senses compassionate concern with maintaining and ➔ It could be clinical, disease process, clients behavior, promoting health and preventing illness and caring for interventions, practices and rehabilitating the sick and disabled. ➔ defines and describes relationships among major ideas and values. ➔ The highest level of knowledge. ➔ Are patterns or models used to show a clear relationship among the existing theoretical works in nursing. ➔ A diagram showing the relationships of concepts, propositions, NURSING PHILOSOPHY assumptions and definitions with theory and phenomena ➔ seeks to understand the core concepts of the profession through logical analysis and reasoning. Early nursing KNOWLEDGE thinkers, like Nightingale, laid the groundwork for ➔ Information, skills and expertise acquired by a person through subsequent nursing knowledge development. various life experiences, or through formal/informal learning ➔ Contemporary nursing theory incorporates modern such as formal education, self-study, vocational. scientific methods to expand upon these foundational ➔ The abstract or workable understanding of a subject or idea. principles. This evolution has transformed nursing from a  vocation to an academic discipline with its own distinct Practical Knowledge - referred to as the art of nursing. body of knowledge. NURSING PHILOSOPHIES NURSING CONCEPTUAL MODELS ENVIRONMENTAL THEORY – Florence Nightingale ➔ are frameworks developed by influential nursing theorists to ➔ Developed and described the first theory of nursing. Notes explain the core concepts of nursing. These models provide a on Nursing: WHAT IT IS , WHAT IT IS NOT and NOTES comprehensive understanding of the patient, environment, ON HOSPITALS. She focused on changing and health, and the nursing role. manipulating the environment in order to put the patient in ➔ Essentially, nursing conceptual models offer a structured way the best possible contributions for nature to act. to think about and approach patient care. ➔ She believed that in the nurturing environment, the body could repair itself. She linked with environmental factors: NURSING GRAND THEORIES 1. Fresh air, ➔ are broad ideas in nursing that come from conceptual models. 2. Light These big ideas can be tested through research. 3. Cleanliness ➔ When a grand theory is tested and proven, it strengthens the 4. Hygiene original conceptual model. However, if the test doesn't support 5. Proper nutrition the grand theory, it could weaken the original idea. STAGES OF NURSING EXPERTISE - Patricia Benner NURSING THEORY ➔ NOVICE ➔ comprises works derived from nursing philosophies, No background experience (e.g. nursing student that’s conceptual models, grand theories, abstract nursing theories, or why we are guided by our clinical instructors. works in other disciplines (e.g., caring, health, environment). ➔ ADVANCED BEGINNER This stage pertains to the newly graduated nurses. NURSING MIDDLE-RANGE THEORY ➔ COMPETENT ➔ has the most specific focus and is concrete in its level of Has 2-3 years of experience which he /she which abstraction that focuses on a particular area of nursing. (e.g., demonstrates planning and organizational abilities pain management, family care). ➔ PROFICIENT Has 3-5 years of experience which he/she perceives IMPORTANCE OF NURSING THEORIES situations as a whole. Has a holistic understanding of the ➔ Aim to describe, predict, and explain the phenomenon of client which improves decision making. nursing ➔ EXPERT ➔ Provide the foundations of nursing practice, help to generate Flexible and highly proficient performance which he/she further knowledge and indicate in which direction nursing no longer rely on rules, regulations, or maxims to should develop in the future connect his/her understanding of the situation to ➔ Help to distinguish what should form the basis of practice by appropriate action. explicitly describing nursing. ➔ Help to provide better patient care, enhanced professional THEORY OF HUMAN CARING - Jean Watson status for nurses, improved communication between nurses, ➔ Practice human kindness. and guidance for research and education. ➔ Instill faith and hope. ➔ Maintains professional boundaries in nursing ➔ Nurture individual spiritual beliefs and practices. ➔ Develop helping-trusting relationships. PURPOSES OF THEORIES ➔ Promote and accept the expression of positive and In Practice negative feelings. ➔ Assist nurses to describe, explain, and predict everyday ➔ Use creative and scientific problem solving methods for experiences decision making. ➔ Serve to guide assessment, intervention, and evaluation of ➔ Perform teaching and learning that address individual nursing care needs and learning styles. ➔ Provide rationale for collecting reliable and valid data about ➔ Create a healing environment for the physical and spiritual the health status of clients self which respects human dignity. ➔ Help to establish criteria to measure the quality of nursing care ➔ Assist with physical, emotional, and spiritual needs. ➔ Help build a common nursing terminology to use in ➔ Allow rooms to miracles to take place communicating with other health professionals. Ideas are developed and words defined. SELF-CARE DEFICIT THEORY - Dorotea Orem ➔ Enhance autonomy of nursing by defining its own independent ➔ SELF-CARE functions. Practice of activities that individual initiates and perform in their own behalf in maintaining life, health, and In Education well-being. ➔ Provide a general focus for curriculum design. ➔ SELF-CARE AGENCY ➔ Guide curricular decision making. Individual’s ability to perform self-care activities. ➔ SELF-CARE REQUISITES In Research Action directed towards provision of self care ➔ Offer a framework for generating knowledge and new ideas. ➔ THERAPEUTIC SELF- CARE DEMAND ➔ Assist in discovering knowledge gaps in specific field of study. “Totality of self-care actions to be performed for some ➔ Offer a systematic approach to identify questions for study. duration in order to meet self-care requisites by using valid methods and related sets of operations and actions” INTERDEPENDENCE OF THEORY AND RESEARCH ➔ The relationship between nursing theory and nursing research HEALTH CARE SYSTEM MODEL - Betty Neuman helps in building nursing knowledge, according to Meleis, 1997. ➔ Focuses on stress and stress reduction ➔ Nursing knowledge is composed of both: ➔ Primarily concerned with effects of stress on health Theoretical Knowledge - aims to stimulate thinking and ➔ Stressors are any forces that alters the system’s stability broaden understanding of the science and practice of the nursing discipline.  GOAL ATTAINMENT THEORY - Imogene King ➔ Describes the importance of the participation of all individual in decision making as well as choices, alternatives, and outcomes of nursing care. ➔ It pertains to the importance of interaction, perception, communication, transaction, self, role, stress, growth and development, time, and personal space. ➔ Reflects King’s belief that the practice of nursing is differentiated from other health care profession by what nurses do with and what they do for individuals. ➔ The nurse and the patient/client communicates, information in order to set goals mutually and then acts to attain those goals. NURSING THEORIES INTERPERSONAL RELATIONS THEORY - Hildegard Peplau ➔ 4 Phases of Nurse Patient Relationship: 1. Orientation 2. Identification 3. Exploitation 4. Resolution NURSING NEED THEORY - Virginia Henderson ➔ 14 Components: 1. Breathe normally. 2. Eat and drink adequately. 3. Eliminate body wastes. 4. Move and maintain desirable postures. 5. Sleep and rest. 6. Select suitable clothes-dress and undress. 7. Maintain body temperature within normal range by adjusting clothing and modifying environment. 8. Keep the body clean and well groomed and protect the integument. 9. Avoid dangers in the environment and avoid injuring others. 10. Communicate with others in expressing emotions, needs, fears, or opinions. 11. Worship according to one’s faith. 12. Work in such a way that there is a sense of accomplishment. 13. Play or participate in various forms of recreation. 14. Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities THE CORE, CARE, CURE - Lydia Hall ➔ Nursing Care can be delivered on three Interlocking levels: 1. Care - hands on bodily care 2. Core - using self in relationship to patient 3. Cure - seeing the patient and family through medical care. MIDDLE-RANGE THEORY MATERNAL ROLE ATTAINMENT THEORY - Ramona Mercer ➔ Anticipatory stage ➔ Formal Stage ➔ Informal Stage ➔ Personal Stage