Theoretical Framework Of Nursing Practice

1. THEORETICAL FRAMEWORK of NURSING PRACTICE A. Nursing As by the INTERNATIONAL COUNCIL OF NURSES (ICN, 1973) as written by Virginia Henderson: The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health. It’s recovery, or to a peaceful death that the client would perform unaided if he had the necessary strength, will or knowledge. Help the client gain independence as rapidly as possible. 1. CONCEPTUAL AND THEORETICAL MODELS OF NURSING PRACTICE Theorist

Description

FLORENCE NIGHTINGALE

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Developed the first theory of nursing.

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Focused on changing and manipulating the environment in order to put the patient in the best possible conditions for nature to act.

HILDEGARD PEPLAU

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Introduced the Interpersonal Model.

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She defined nursing as a therapeutic, interpersonal process which strives to develop a nurse-patient relationship in which the nurse serves as a resource person, counselor and surrogate.

FAYE ABDELLAH

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Defined nursing as having a problem-solving approach, with key nursing problems related to health needs of people; developed list 21 nursing problem areas

IDA JEAN ORLANDO

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Developed the three elements – client behavior, nurse reaction and nurse action – compose the nursing situation. She observed that the nurse provide direct assistance to meet an immediate need for help in order to avoid or to alleviate distress or helplessness.

MYRA LEVINE

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Described the Four Conservation Principles. 1. conservation of energy 2. conservation of structured integrity 3. conservation of personal integrity 4. conservation of social integrity

DOROTHY JOHNSON

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MARTHA ROGERS

Conceptualized the Science of Unitary Human Beings. She asserted that human beings are more than different from the sum of their parts; the distinctive properties of the whole are significantly different from those of its parts.

DOROTHEA OREM

Emphasizes the client’s self care needs; nursing care becomes necessary when client is unable to fulfill biological, psychological, developmental or

Developed the Behavioral System Model. 1. Patient’s behavior as a system that is a whole with interacting parts 2. how the client adapts to illness 3. goal of nursing is to reduce so that the client can move more easily through recovery.

social needs. IMOGENE KING

Nursing process is defined as dynamic interpersonal process between nurse, client and health care system.

BETTY NEUMAN

Stress reduction is a goal of system model of nursing practice. Nursing actions are in primary, secondary or tertiary level of prevention

SISTER CALLISTA ROY

Presented the Adaptation Model. She viewed each person as a unified bio-psychosocial system in constant interaction with a changing environment. The goal of nursing is to help the person adapt to changes in physiological needs, self-concept, role function and interdependent relations during health and illness.

LYDIA HALL

Introduced the notion that nursing centers around three components: person(core), pathologic state and treatment(cure) and body(care).

JEAN WATSON

Conceptualized the Human Caring Model. She emphasized that nursing is the application of the art and human science through transpersonal caring transactions to help persons achieve mind-body-soul harmony, which generates self-knowledge, self-control, self-care and self-healing.

ROSEMARIE RIZZO PARSE

Introduced the Theory of Human Becoming. She emphasized free choice of personal meaning in relating to value priorities, co-creating of rhythmical patterns, in exchange with the environment and contranscending in many dimensions as possibilities unfold.

MADELEINE LENINGER

Developed the Transcultural Nursing Model. She advocated that nursing is a humanistic and scientific mode of helping a client through specific cultural caring processes (cultural values, beliefs and practices) to improve or maintain a health condition

2. ROLES AND FUNCTION OF A NURSE

a. Caregiver – the caregiver role has traditionally included those activities that

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assist the client physically and psychologically while preserving the client’s dignity. Caregiving encompasses the physical, psychosocial, developmental, cultural and spiritual levels. Communicator – communication is an integral to all nursing roles. Nurses communicate with the client, support persons, other health professionals, and people in the community. In the role of communicator, nurses identify client problems and then communicate these verbally or in writing to other members of the health team. The quality of a nurse’s communication is an important factor in nursing care. Teacher – as a teacher, the nurse helps clients learn about their health and the health care procedures they need to perform to restore or maintain their health. The nurse assesses the client’s learning needs and readiness to learn, sets specific learning goals in conjunction with the client, enacts teaching strategies and measures learning. Client advocate – a client advocate acts to protect the client. In this role the nurse may represent the client’s needs and wishes to other health professionals, such as relaying the client’s wishes for information to the

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physician. They also assist clients in exercising their rights and help them speak up for themselves. Counselor – counseling is a process of helping a client to recognize and cope with stressful psychologic or social problems, to developed improved interpersonal relationships, and to promote personal growth. It involves providing emotional, intellectual, and psychologic support. Change agent – the nurse acts as a change agent when assisting others, that is, clients, to make modifications in their own behavior. Nurses also often act to make changes in a system such as clinical care, if it is not helping a client return to health. Leader – a leader influences others to work together to accomplish a specific goal. The leader role can be employed at different levels; individual client, family, groups of clients, colleagues, or the community. Effective leadership is a learned process requiring an understanding of the needs and goals that motivate people, the knowledge to apply the leadership skills, and the interpersonal skills to influence others. Manager – the nurse manages the nursing care of individuals, families, and communities. The nurse-manager also delegates nursing activities to ancillary workers and other nurses, and supervises and evaluates their performance. Case manager – nurse case managers work with the multidisciplinary health care team to measure the effectiveness of the case management plan and to monitor outcomes. Research consumer – nurses often use research to improve client care. In a clinical area nurses need to: • Have some awareness of the process and language of research Be sensitive to issues related to protecting the rights of human subjects • Participate in identification of significant researchable problems • Be a discriminating consumer of research findings