Ernestine- Wiedenbach-report PDF

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REPORT KO MISMO ERNESTINE WIEDENBACH (1900-1998) 

Born on August 18, 1900 in Hamburg, Germany



R.N. from Johns Hopkins School of Nursing in 1925



Certificate in nurse-midwifery from the Maternity Center Association School for Nurse-Midwives in New York in 1946.



a progressive nursing leader and best known in theory development and maternal infant nursing



First published “Family-Centered Maternity nursing” in 1958 -

she recommended in this book that babies should be in hospital rooms with their mothers rather than in central nursery.

-

so basically, this book is designed primarily to answer the question of what the nurse needs to know and do inclined with the experience of childbearing.



Patricia James, James Dickoff and Ida Orlando Pelletier are the influencers of Wiedenbach but Ida Orlando influenced her theory the most.

THE HELPING ART OF CLINICAL NURSING Nursing - the practice of identifying a patient’s need for help through the observation of presenting behavior and symptoms, exploration of the meaning of those symptoms, determination of the cause of discomfort, the determination of the patient’s ability to resolve the patient’s discomfort, or determining if the patient has a need for help from the nurse or another health care professional. Patient - any person receiving help of some kind from the health care system. Help can include care, teaching, and advice. -

a patient does not need to be ill or injured since health education qualifies someone as a patient.

Need-for-help - measure desired by the patient that can potentially restore or extend the patient’s ability to cope with situations that affect health. -

it is crucial that a patient’s need for help come from the individual patient’s perception of his or her own situation.

Nurse - a functioning human being who not only acts, but thinks and feels. A nurse uses his or her knowledge in his or her role. Knowledge encompasses all that has been perceived and grasped by the human mind. It may be factual, speculative, or practical. Clinical Judgement - represents the nurse’s likeliness to make sound decisions, which are based on differentiating fact from assumption, and relating them to cause and effect. Sound Judgement - the result of disciplined functioning of mind and emotions, and improves with expanded knowledge, as well as increased clarity of professional purpose.

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nursing skills are carried out in order to achieve a specific patient-centered purpose rather than the completion of the skill itself being the end goal.

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Skills are made up of a variety of actions, and are characterized by harmony of movement, precision, and the effective use of self.

Sensitivity – alerts the nurse to an awareness of inconsistencies in a situation that might signify a problem. -

key factor in assisting the nurse to identify the patient’s need for help.

Person - each person, whether a nurse or patient, has a unique potential to develop self-sustaining

resources. -

People tend to be independent and fulfill their own responsibilities.

-

self-awareness and self-acceptance are essential to personal integrity and self-worth; whatever an individual does at any given moment is representative of the best judgment available for that person in that moment.

4 Main Elements of Clinical Nursing 

Philosophy - his or her attitude and belief about life and how that attitude affected his or her reality. 3 Essential Components:

1. reverence for life 2. respect for the dignity, worth, autonomy, and individuality of each human being 3. resolution to act on personally and professionally held beliefs. 

Purpose - which the nurse wants to accomplish through what he or she does. -



It is all the activities directed toward the overall good of the patient.

Practice - the observable actions that are affected by the nurse’s beliefs and feelings about meeting the patient’s need for help.



Art - understanding a patient’s needs and concerns, developing goals and actions intended to

enhance

a

patient’s

ability,

and

directing

the

activities

related to the medical plan to improve the patient’s condition. -

The

nurse

also

focuses

on prevention of complications that can come up due to re-occurrence, or the development of new concerns. WIEDENBACH’S PRESCRIPTIVE THEORY -

it is a situation-producing theory that may be described as one that conceptualized both a desired situation and the prescription by which it is to be brought about.

3

-

directs action toward an explicit goal

-

type of theory that stipulates what the healthcare professional must do to attain a prescribed goal.

Factors:

1. Central Purpose -

defines the quality of health the nurse desires to effect on her patient.

-

it is a concept what the nurse puts into words, believes in, and accepts as a standard against the value of her actions.

-

Central purpose reflects the nurse’s philosophy of care

-

Purpose and Philosophy are, respectively, the goal and guide of clinical nursing

Purpose -

which the nurse wants to accomplish through what she does.

-

etong purpose na to kailangan constant dahil ito yung goal and reason nya for being and doing. Philosophy

-

an attitude toward life and reality that evolves from each nurse’s beliefs and code of conduct, motivates the nurse to act, guides her thinking about what she is to do and influences her decisions

-

stem from her culture and subculture

-

etong philosophy daw ay unique to each nurse, it is personal in character, kung paano mag express ng way of nursing ang isang nurse ay ganun yung philosophy nya.

Philosophy underlies purpose and purpose reflects philosophy. 3 Essential Components for a Nursing Philosophy: 1. A reverence for the gift of life 2. A respect for the dignity, worth, autonomy and individuality of each human being 3. A resolution to act dynamically in relation to one’s beliefs

2. Prescription -

appropriate nursing actions selected to create and implement a care plan in accordance with the central purpose.

-

once the nurse has formulated a central purpose and has accepted it as a personal commitment, she not only has established the prescription for her nursing but also is ready to implement it.

-

these actions may be voluntary (intended response) or involuntary (unintended response) response.

-

A prescription is a directive to at least 3 kinds of voluntary action: 1. Mutually understood and agreed upon action

-

understood and agreed upon by the practitioner (nurse) and the recipient (patient). The recipient understands the implications of the actions and is receptive to it. 2. Recipient-directed action

-

which the recipient directs the way the action is carried out 3. Practitioner-directed action

-

which the practitioner carries out the action

3. Realities -

consist of physical, physiological, psychological, emotional and spiritual factors that are at play in a situation in which nursing actions occur at any given moment.

-

After the nurse has determined her central purpose and has developed the prescription, she must then consider the realities of the situation in which she is to provide nursing care.

5 Realities 1. The Agent -

practicing nurse or her delegate

-

the nurse is the propelling force that moves her practice toward its goal.

4 Basic Responsibilities: 1. To reconcile her assumptions about the realities with her central purpose 2. To specify the objectives of her practice in terms of behavioral outcomes that are realistically attainable 3. To practice nursing in accordance with her objectives 4. To engage in related activities which contribute to her self-realization and to the improvement of nursing practice 2. The Recipient -

patient

-

the one on whose behalf the action is taken

-

vulnerable, dependent on others for help, and risks losing individuality, dignity, worth and autonomy.

3. The Goal -

desired outcome the nurse wishes to achieve

-

eto yung end result ng nursing action

-

nakakatulong to para mamotivate ang nurse para gawin yung nursing action, ito yung rason ng kanyang actions.

4. The Means -

includes skills, techniques, procedures and devices that may be used to facilitate nursing practice

-

the nurse’s way of giving treatments, of expressing concern, ay determined by her central purpose and prescription. Ano nga ulit yung central purpose? diba it reflects nurse’s philosophy. Iba iba or unique to each nurse ang kanilang way of expressing their nursing actions.

5. The Framework -

consists of the human, environmental, professional and organizational facilities.

-

composed of all extraneous factors and facilities in the situation that affect the nurse’s ability to obtain the desired results.

-

“objects, existing or missing, such as policies, setting, atmosphere, time of day, humans and happenings that may be current, past or anticipated”

The realities offer uniqueness to every situation. The success of professional nursing practice is dependent on them. Unless the realities are recognized and dealt with, they may prevent the achievement of the goal. The concepts of central purpose, prescription and realities are interdependent in Wiedenbach’s theory of nursing. The nurse develops a prescription for care that is based on her central purpose, which is implemented in the realities of the situation. NURSING PRACTICE 

The practice of nursing comprises a wide variety of services, each directed towards the attainment of one of its 3 components: 1. Identification of the patient’s need for help -

first, the nurse observes the patient, looking for an inconsistency between the expected behavior of the patient and the apparent behavior. Second, she attempts to clarify what the inconsistency means. Third, she determines the cause of the inconsistency. Finally, she validates with the patient that her help is needed.

-

within this component, she presents 3 principles of helping: a) The principle of inconsistency/consistency

-

kinakailangan ma-assess and mga apparent actions na iba sa what is expected or ordinary then tsaka pa lang maccritically analyze kapag naobserbahan nang maayos. b) The principle of purposeful perseverance

-

dito papasok ang nursing as an art, dahil sinasabi dito na in spite of difficulties she encounters while seeking to use her resources and capabilities, magagawa pa rin niyang ma-identify and meet the patient’s need for help. c) The principle of self-extension

-

alam dapat ng nurse and kanyang limitations, kung hanggang saan lang ang kanyang capabilities and all. Kapag itong mga limitations ay nareach na, matuto dapat ang isang nurse magseek ng help sa others, dito naka-include din ang prayers.

2. Ministration of the help needed

-

ministration refers to attending to the needs of the patients. The nurse may give advice or information, make a referral, apply a comfort measure, or carry out a therapeutic procedure. Kapag ang patient ay uncomfortable sa nangyayari, the nurse will need to identify the cause then if kailangan, make an adjustment in the plan of action.

3. Validation that the action taken was helpful to the patient -

after attending to the needs of the patients, evidence must come from them that the purpose of the nursing actions has been fulfilled.

HANDOUTS Ernestine Wiedenbach (1900-1998)  Biography 

Born on August 18, 1900 in Hamburg, Germany



Education:

-

B.A. from Wellesley College in 1922

-

R.N. from Johns Hopkins School of Nursing in 1925

-

M.A. from Teachers College, Columbia University in 1934

-

Certificate in nurse-midwifery from the Maternity Center Association School for Nurse-Midwives in New York in 1946.



A progressive nursing leader and best known in theory development and maternal infant nursing



“Mother of Nursing Theory Development”



She first published “Family-centered Maternity Nursing” in 1958

-

she recommended in this book that babies should be in hospital rooms with their mothers rather than in central nursery.

-

this book is designed primarily to answer the question of what the nurse needs to know and do to provide a service geared to all the needs arising out of the tremendous experience of childbearing.

-

“Nursing is nurturing and caring for someone in a motherly fashion. That care is given in the immediate present and can be given by any caring person.”



Ida Orlando Pelletier is one of the great influencers of Wiedenbach in her nursing writing and development

 3 Principles of Helping 

The principle of inconsistency/consistency

-

refers to the assessment of the patient to determine some action, word or appearance that is different from expected or from ordinary.



The principle of purposeful perspective

-

based on the nurse’s sincere desire to help the patient.



The principle of self-extension

-

recognizes that each nurse has limitations that are both personal and situational.

 Conceptual Model: “The Helping Art of Clinical Nursing” or “Clinical Nursing: A Helping Art”

-

It defines nursing as the practice of identifying a patient’s need for help through the observation of presenting behavior and symptoms, exploration of the meaning of those symptoms, determination of the cause of discomfort, the patient’s ability to resolve the patient’s discomfort, or if the patient has a need for help from the nurse or another health care professional.

-

If the need for help requires intervention, the nurse facilitates the medical plan of care and also creates and implements a nursing plan of care based on needs and desires of the patient. In providing care, a nurse exercises sound judgment through deliberative, practiced, and educated recognition of symptoms. The patient's perception of the situation is an important consideration to the nurse when providing competent care.

 The Prescriptive Theory

-

it is a situation-producing theory that may be described as one that conceptualized both a desired situation and the prescription by which it is to be brought about.

-

Directs action toward an explicit goal.

3 Factors: 

Central Purpose

-

defines the quality of health she desires to effect or sustain in her patient.

-

“commitment”

-

it is based on the individual nurse’s philosophy and suggests the nurse’s reason for being, the mission she believes is hers to accomplish.

-

one she has to put into words. believes in and accepts as a standard against which to measure the value of her action to the patient.

-

it is based on her philosophy and suggests the nurse’s reason for being, the mission she believes is hers to accomplish. Purpose and Philosophy are, respectively, the goal and guide of clinical nursing.

Purpose -

which the nurse wants to accomplish through what she does.

-

the overall goal toward which she is striving, and so is constant.

-

her reason for being and doing

Philosophy -

an attitude toward life and reality that evolves from each nurse’s beliefs and code of conduct, motivates the nurse to act, guides her thinking about what she is to do and influences her decisions.

-

it stems from both her culture and subculture, and is an integral part of her.

-

it is personal in character, unique to each nurse, and expressed in her way of nursing.

-

Philosophy underlies purpose and purpose reflects philosophy.

3 Essential Components for a Nursing Philosophy: 1. A reverence for the gift of life 2. A respect for the dignity, worth, autonomy, and individuality of each human being 3. A resolution to act dynamically in relation to one’s beliefs 

Prescription

-

is a directive to activity

-

specifies both the nature of the action that will most likely lead to fulfillment of the nurse’s central purpose and the thinking process that determines it.

-

it may indicate the broad general action appropriate to implementation of the basic concepts as well as suggest the kind of behavior needed to carry out these actions in accordance with the central purpose.



Realities

-

consist of physical, physiological, psychological, emotional and spiritual factors that are at play in a situation in which nursing actions occur at any given moment. 5 Realities:

1. The Agent -

the practicing nurse or delegate

-

characterized most importantly by the commitment and competence in nursing

-

as the agent, the nurse is the propelling force that moves her practice toward its goal.

2. The Recipient -

the patient

-

characterized by personal attributes, problems, capacities, aspirations and most importantly, the ability to cope with the concerns or problems being experienced.

-

the patient is vulnerable, dependent on others for help, and risks losing individuality, dignity, worth and autonomy.

3. The Goal -

desired outcome the nurse wishes to achieve

-

it is the end result to be attained by nursing action

-

the stipulation of an activity’s goal gives focus to the nurse’s action and implies her reason for taking it.

4. The Means -

comprises the activities and devices through which the practitioner is enabled to attain her goal.

-

includes skills, techniques, procedures and devices that may be used to facilitate nursing practice.

-

the nurse’s way of giving treatments, of expressing concern, of using the means available is individual and is determined by her central purpose and the prescription.

5. The Framework -

consists of the human, environmental, professional and organizational facilities that not only make up the context but...