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PRELIMS: Reviewer in Theoretical Foundations of NursingChapter 1: The Evolution of NursingNursing Key Pointso Nursing continues to flourish o Demand for nurses o Filipino caringNurse – state licensed health care professional engaged in practice of providing nursing careResponsibilities of Nurseso As...

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PRELIMS: Reviewer in Foundations of Nursing

Theoretical

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Chapter 1: The Evolution of Nursing Nursing Key Points o o o

Nursing continues to flourish Demand for nurses Filipino caring

Hildegard Peplau  

Nurse – state licensed health care professional engaged in practice of providing nursing care Responsibilities of Nurses o o o

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Assess patient’s needs and problems Health maintenance of healthy individuals Treatment, safety, and recovery of acutely or chronically ill or injured people Research and non-clinical functions Teaching and mentoring other nurses

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Promote health, prevent disease Advocate and educate patients Work with physicians Administer medications Assist clients in convalescence and rehabilitation Formulate, implement, and evaluate nursing care plans Teach patients and families about self-care Help individuals and groups take steps to improve health

Nursing – from Latin words nutricia, nutriz, nutrire, meaning nurse, nourish, cherish Nursing as an Art – use of imagination and creativity in caring Florence Nightingale

Mother of psychiatric nursing Nursing as an art has 3 major components: medium – art or intellectual creativity to bring about change, process – interaction initiated by nurse, product – result or outcome of nursing care Has 4 main goals: (1) understand the patient, condition, situation, or need; (2) enhance the patient’s capability; (3) improve the patient’s condition or situation; (4) prevent recurrence of problem or new problem

Nursing as a Science – expansion of body knowledge; health profession that establishes itself as separate form practice of medicine Definitions of Nursing o

Definitions of Nursing o o

Scope of Work of RNs o o o o o

matriarch of modern nursing “The act of utilizing the environment of the patient to assist him in his recovery.”

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Virginia Henderson – “Assisting the individual, sick or well, in the performance of those activities, contributing to health, its recovery, promoting quality of life or to a peaceful death that the client would perform unaided if he or she had necessary strength, will, or knowledge. International Council of Nurses (ICN) – “Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Other key nursing roles include advocacy, promotion of safe environment, research, participation in shaping health policies and in patient and health systems management and education.”

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Associations of Deans of Philippine Colleges of Nursing (ADPCN) – “A dynamic dicipline. It is an art and science of caring for individuals, families, groups and communities geared toward promotion and restoration of health, prevention of illness, alleviation of suffering, and assisting clients to face death with dignity and peace. It is focused on assisting the client as he or she responds to health-illness situations, utilizing the nursing processes and guided by ethico-legal and moral principles.” American Nursing Association (ANA) – “Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through diagnosis and treatment of human response. Nursing is giving direct care and advocacy in the care off individuals, families, communities, and populations.” Royal College of Nursing (RCN) – “Nursing is the use of clinical judgment in the provision of care with health problems; and nursing helps to achieve the best possible quality of life of individuals whatever their disease or disability, until death.”

Nursing as a Practice – requires a synergy of (1) theoretical knowledge, (2) clinical experience, and (3) technical skill. Recipients of Nursing o

Patient

its origin refers to an individual suffering any form of discomfort or pain  those who seek care  person who is waiting for or undergoing medical treatment and care Consumer  individual or group of people or community that uses a service or commodity  those who use healthcare products or services  Ex: person who undergoes liposuction Client  Individuals, families, groups and communities who need or require health services regardless of health care needs  Approach in professional manner  Ex: new mother asking for advice how to breastfeed 

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Historical Foundations of Professional Nursing o

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Nursing Periods  Intuitive Period – instinctive; given to women; “maskipaps/ maski-papaano”  Apprenticeship Period – on-the-job training or internship  Educated Period – Kaisersworth and Nightingale led the way; developed caring systems for sick and wounded; emphasis on clean environment and good sanitation Nursing Themes  Superstitions and Witchcraft  Earliest Organized Nursing  Dark Ages of Nursing  Golden Age of Nursing

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 Military Nursing  Professional Nursing Historical Eras in Nursing Education  Curriculum Era  Research Era  Graduate Education Era  Theory Era

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Chapter 3: The Emergence of Theory What is a theory? 

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A set of concepts, definitions, relationships, and assumptions that project a systematic view of a phenomena It may consist of one or more relatively specific and concrete concepts and propositions that purport to account for, or organize some phenomenon (Barnum, 1988) A group of related concepts that propose actions that guide practice. Systematic way of looking at the world in order to describe, explain, predict and control it.

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Theory  

“Theoria” - vision Established paradigm that explains all or much of data available and offers valid predictions that can be tested

Components of a Theory   

A set of well-defined constructs or concepts. A set of propositions that specify the relationships among the constructs. Hypotheses, conjectures that test the relationship between the constructs and propositions.

Elements of a Theory

Definitions – meaning of the word/ phrase/ term  Theoretical definitions – general or abstract meaning of the word/ concepts in a manner that fits the theory  Operational definitions – concrete meaning of the word necessary to measure a concept, construct, or variable used in the study Propositions – theorems or statements derived from axioms: statements/ assertions from which statements of theory can be logically derived Phenomenon – aspect of reality that can be consciously sensed or experienced; exists in real world Concepts – ideas or complex formulation of object, property or events; idea, mental image, or generalization  Abstract concepts – complex ideas completely independent of time or place; ex: temperature  Concrete concepts – simple or measurable and specific to time and place; ex: body temperature

Classification of Concepts o o o

Empirical – can be readily observed; ex: chair, desk Inferential – indirectly observable; ex: pain, blood pressure Abstract – not observable; ex: stress, wellness

Types of Theories o o

Descriptive - to know the properties and workings of a discipline Explanatory – to examine how properties relate and thus affect the discipline

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Predictive – to calculate the relationships between properties and how they occur Prescriptive – to identify under which conditions relationships occur

Metaparadigm – It specifies the main concepts that encompass the subject and the scope of a discipline 4 Concepts of Metaparadigm o o

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Person – the recipient of care Environment – the internal and external surroundings that affect the client Health – the degree of wellness or well-being that the client experiences Nursing – the attributes, characteristics and actions of the nurse providing care on behalf of in conjunction with the client

Paradigm – model that explains linkages of science, philosophy, and theory accepted and applied by the discipline (Alligood and Marriner – Tomey, 2002); represents global issues about individuals, groups, situations, and events of interest to the profession Domain - the view or perspective of the discipline; it contains the subject, central concepts, values and beliefs, phenomena of interest, and the central problems of the discipline How does domain relate to nursing theory? o Nursing has identified its domain in a paradigm that includes four linkages: 1. person/client 2. health 3. environment 4. nursing Conceptual paradigm – diagram that mentally and visually presents and interprets underlying theory

Model – provides outline for which theory depicts function of a phenomenon Conceptual model – represents a structure; description of how something works or is put together Theoretical model – suggests function or explains the sequence of events from which the phenomenon occurred Nursing theory – presents some aspect of reality communicated for the purpose of describing nursing phenomena and a group of related concepts that derived from the nursing models Construct - is a concept that has been invented to suit a special purpose and measurable and can be observed in relation to another construct Phenomena - observable facts that can be perceived through the senses and explained; extraordinary remarkable events or person Proposition - are theoretical statements that specify the proposed relationship of concepts of a theory Principle - the ultimate source of origin or cause of something; a law of nature as formulated and accepted by the mind

Chapter Theory

4:

The

Nature

of

o o o o

Theoretical framework – theory derivable theories relevant to the study

Three areas where nursing theory can have an impact 1) In clinical practice - assists nurses to describe, explain, and predict daily experiences 2) In education – integrates an eclectic body of knowledge 3) In research – framework for generating knowledge and new ideas Chapter 21: The Environment Theory Florence Nightingale   

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Six Types of Nursing Theory Definitions Structure – form and style uses shapes and arrows

Practice goals – intends to accomplish/ achieve Tentativeness – never absolute Research Creativity in practice theory and research Progression from conceptual framework to theory

Nursing theory should have context – environment in which nursing action takes place, content – subject matter of theory, and process – method the nurse uses in applying the theory.

Nursing

Conceptual framework – background or historical basis of concepts or variables

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05/12/1820 – 08/13/1910 Matriarch of modern nursing Her Environmental Theory was first explained in her books – Notes on Hospital (1859) and Notes in Nursing: What It Is and What It Is Not (1859) Coxcomb or cocks’ comb model – circular histogram which convinced queen victoria that the soldiers were not dying from war wounds but from preventable diseases Edward and Frances Nightingale She was named after her birthplace – Florence Italy She was called “The Lady with a Lamp”, during Crimean War, because she made rounds during the night

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She defines and describes in detail the concepts of ventilation, warmth, light, diet, cleanliness and noise which are components of the environment. Her concern about her healthy surroundings included not only the hospital setting but also extended to private homes of patients and to the physical living condition of the poor.

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o Nightingale’s Environment Elements 1) 2) 3) 4) 5)

Pure or fresh air Light (esp. direct sunlight) Pure water, food, and nutrition Cleanliness Efficient drainage

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Philosophy – an attitude toward life and reality that evolves from each nurse beliefs and code of conduct, motivates the nurse to act, guides her thinking about what she is to do and influences her decision Practice – overt action directed by disciplined thoughts and feelings toward meeting the patient’s need for help, constitutes the practice of clinical nursing Purpose – which the nurse wants to accomplish through what she does is the overall goal toward which she is striving Art – the application of knowledge and skill to bring about desired results

Nursing - is having the responsibility for someone else’s health

Nursing - the reason the nurse came into being is that there is a patient who needs for help

Person - referred to the person as the patient. Nurses performed tasks to and for the patient and controlled the patient’s environment to enhance recovery

Person - an individual should want to be healthy, comfortable, and capable and when unimpeded, he strives by his own efforts to achieve such status

Health - is being well and using every power that the person has to the fullest extent. Envisioned the maintenance of health through the prevention of disease via environment control Environment - those elements external to and which affect the health of the sick and healthy person Chapter 25: The Helping Art of Clinical Nursing Ernestine Weidenbach  

08/18/1900 – 03/08/1998 The Helping Art of Nursing (1964)

Nursing 4 Components

Clinical

Health - is neither defined nor discussed in Weidenbach Model Environment - it is implied that the environment may produce obstacles resulting in the person experiencing a need for help Three Main Theory

Points

in

Weidenbach’s

Nursing is a: 1) Concept and Philosophy 2) Mothering Profession 3) Helping Service Key Elements to Clinical Nursing o o

Philosophy Purpose

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Practice Art

Prescriptive Theory 1) Central purpose 2) Prescription 3) Realities Chapter 22: The Definition of Nursing Virginia Henderson   

11/30/1897 – 03/19/1996 Mother of modern nursing Defined nursing which was then adapted by International Council of Nursing (ICN)

Nursing - the unique function of a nurse is to assist the individual, sick or well in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will knowledge and to do this in such a way to help him gain independence as rapidly as possible; viewed health in terms of the patient’s ability to perform the 14 components of nursing care unaided Person - viewed the patient as an individual who requires assistance to achieve health and independence or peaceful death Health - patient’s ability to perform the 14 components of nursing care unaided. The quality of health rather than life itself, is the margin of mental/physical vigor that allows a person to work effectively and to reach highest potential level of satisfaction in life Environment - Henderson did not give her own definition of environment. Instead she used the Webster’s New Collegiate Dictionary, 1961 which defined environment as “the aggregate of all the external conditions and influences affecting the life and development of an organism”

14 Fundamental Needs 1) 2) 3) 4)

Breathing normally Eating and drinking adequately Eliminating body wastes Moving and maintain desirable position 5) Sleeping and resting 6) Selecting suitable clothes 7) Maintaining body temperature within normal range 8) Keeping the body clean and wellgroomed 9) Avoiding dangers in the environment 10) Communicating with others 11) Worshipping according to one’s faith 12) Working in such a way that one feels a sense of accomplishment 13) Playing/ participating in various forms of recreation 14) Learning, discovering, or satisfying the curiosity that leads to normal development and health and using available health facilities Chapter 28: Philosophy and Science of Caring Margaret Jean Watson  

06/10/1940 – Caring is the essence of nursing practice

Caring Theory “Caring is the essence of nursing practice.” 3 Major Elements of her Theory 1) Carative factors 2) Transpersonal caring relationship 3) Caring occasion or caring moment Caritas - to cherish and to give special loving attention Ten Primary Carative Factors

1) Embrace humanistic-altruistic system of values 2) Instill faith, hope, and honor with others 3) Cultivate sensitivity in one’s self and in others by nurturing beliefs and practices 4) Establish a helping-trusting-caring relationship 5) Promote and accept positive and negative feelings as one actively listen to other’s story 6) Use creative and systematic scientific problem-solving method for caring decision-making 7) Promote and share interpersonal teaching-learning that addresses the individual’s needs and comprehension styles 8) Create a healing environment for the physical and spiritual self which respects dignity 9) Assist with basic physical, emotional, and spiritual human needs 10)Allow for existentialphenomenological forces and be open to mystery and for miracles to enter Nursing - is a human science of people and human health illness experiences that are mediated by professional, personal, scientific, aesthetic, and ethical human care transactions Person - is a valued person in and of him to be cared for, respected, nurtured, understood, and assisted Health - refers to unity and harmony within the mind, body, and soul Environment - provides the values that determines how one should behave and what goals one should strive toward Chapter Nursing

24:

The

Patient-Centered

Faye Glenn Abdellah  

03/13/1919 – 02/24/2017 First woman and nurse to be Deputy Surgeon General

“Revolutionary” Procedures in Nursing Care o o o o o

Progressive Patient Care Coronary Care Unit Patient Assessment of Care Evaluation (PACE) Diagnostic Related Groups (DRG) Gerontological Nursing Care

3 Categories Problems

of

the

21

Nursing

1) Basic Care Needs 2) Sustenal Care Needs 3) Remedial and Restorative Needs

Care

Covert Nursing Problem – is a concealed or hidden condition faced by the patient or family which the nurse can assist him to meet through the performance of her professional functions Overt Nursing Problem – is an apparent condition faced by the patient or family which the nurse can assist or them to meet through the performance of her professional functions Nursing - is a helping profession; nursing care is doing something to or for the person or providing information to the person with the goal of meeting needs, increasing or restoring their self-help ability alleviating an impairment Person - describes people as having physical, emotional, and sociological needs. These needs may be overt, largely consisting of physical needs or covert consisting of emotional and social needs; people are helped by the identification and

alleviation of experiencing

the

problems

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of methods for helping and understanding patient roles in self-care

Health - the state when the individual has no unmet needs and no anticipated or actual impairments Environment - least discussed concept in Abdellah’s Model; the home and the community that the patient comes from is also the environment

Nursing System - series and sequences of deliberate practical actions of nurses performed at times in coordination with acti...