Grand Theories Application in Nursing Discipline

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Introduction

A nursing theory is a set of assumptions, definitions, notions, and relationships derived from tending models (Cowden & Cummings, 2012). It can also be described as a structured and systematic enunciation of reports related to the queries encountered in the nursing discipline. The suppositions are beneficial to the practitioners in diverse ways. For example, they depict, predict, and clarify the nursing phenomenon. In addition, a good theory allows for improved patient care, as well as for professional engagement and communication between nurses.

The suppositions selected for the purposes of the current paper are grand nursing theories. Presumptions at this level provide a conceptual framework for identifying major principles and concepts related to the nursing discipline (Eun-Ok & Chang, 2012). However, they are not developed for empirical testing. As a result, grand theories can only be used to direct, clarify, and predict nursing under specific situations. Generally, they are complex and broad. As a result of this, the grand presumptions may incorporate a range of theories.

In this paper, the author will discuss how grand theories can be used by leaders and managers in the nursing discipline to improve patient satisfaction and care delivery. A number of problems and issues in nursing will be discussed. Under each problem, a strategy that can be used to resolve it will be provided. In addition, there will be an analysis of ethical concerns in the field. Other aspects to be discussed include appropriate leadership needed to enhance staff engagement and how the grand theory can be applied in community settings.

Analysis of Problems and Issues in Nursing and Strategies to Resolve them from the Perspectives of Grand Nursing Theories

Patient Satisfaction and Care Delivery

Patient satisfaction and care delivery is a major issue in the nursing field. Improving the experiences of patients and quality of care delivered is the primary goal of all nurse leaders (Cowden & Cummings, 2012). The provision of the desired services can be hindered by a variety of factors. They include poor management, staffing problems, lack of equipments, and bottlenecks in nursing.

One strategy to resolve this problem entails the application of the science of unitary human beings concept. The concept was developed by Martha Rogers. She considered nursing as a unique profession. According to her, it brought together art and science. Nursing managers can apply the theory to develop a symphonic relation between the environment and the patients (Cowden & Cummings, 2012). Through this, the coherence and integrity of people can be reinforced. In addition, nurses can offer their services to all people regardless of where they reside. When clients receive proper care, satisfaction is guaranteed.

Publicized Ethical and Legal Concerns in the Nursing Discipline

Overview

Ethics is another problem facing nursing practitioners in the world. The demands placed on the providers in today’s healthcare environment are immense (Burtson & Stichler, 2010). An ethical issue in the discipline can occur in instances where profound moral questions of right and wrong influence the process of professional decision making.

One recently publicized legal and ethical concern was the case where a nurse refused to carry out a CPR on a patient. The licensed healthcare provider failed to attend to an 87 year old lady who collapsed at Glenwood Gardens, a senior living facility in Bakersfield (Eun-Ok & Chang, 2012). A 911 dispatcher pleaded with the nurse to offer aid in order to save the life of the elderly lady. However, the healthcare provider claimed the residence policy did not allow employees to perform CPR on the senior tenants. Due to the lack of assistance, the 87 year old Lorraine Bayless died of breathing difficulties.

Analysis of the case from the perspective of need and interpersonal theories

According to the need theory, the primary function of a nurse is to help an individual. The person can be sick or healthy. To perform her duties, the healthcare provider should have developed a unique relationship with each of her patients (Cowden & Cummings, 2012). The interpersonal theory argues that the relationship between a nurse and a patient is affected by four factors. A personal relationship is developed when a felt need is present (Burtson & Stichler, 2010).

The actions of the practitioner in the publicized case above can be considered to be unethical. The reason is because she failed the old lady when she needed her help the most. In addition, the nurse can be accused of ignorance and having a strained relationship with the patient. That is why she failed to perform the CPR. As a licensed nurse, she knew she was required to offer help as required. However, it is important to note that the practitioner could have been advised against the CPR by the patient. Most elderly people are reported to sign Do Not Resuscitate (DNR) caveats. As a result, the nurse may have been respecting the wishes of the lady. It is also noted that performing CPR on the elderly often leads to breakage of ribs. The situation results in other complications, such as punctured lungs and spleen (Burtson & Stichler, 2010).

Administrative Concerns in Nursing

The issue

The healthcare profession is rapidly changing. It is also becoming complex. The developments raise a number of problems in the profession. Nursing administrators are required to be at the forefront of the leadership teams (Cameron, Harbison, Lambert & Dickson, 2012). The aim is to deal with issues that arise in the workplace. Such aspects include regulatory, community, safety, and financial problems.

One administrative issue entails the crises characterizing hospital staffing. The condition continues to be a major challenge due to the increase in healthcare costs. In addition, majority of hospital leaders are investing more in advanced medical technologies (Burtson & Stichler, 2010). As a result of this, they ignore the importance of maintaining an adequate threshold of members of staff. Such administrators no longer focus on safety in patient care. On the contrary, their main aim is making profits.

Resolving the problem of hospital staffing using trans-cultural and system model theories as a strategy

According to the trans-cultural theory, care is the primary goal of nursing. In addition, it is the distinctive and unifying feature of the profession (Eun-Ok & Chang, 2012). Healthcare providers should guarantee the safety and wellbeing of patients. Under the system model, nurses are required to provide the best care to patients by use of primary, secondary, and tertiary prevention means. An analysis on the administrative concern from the perspective of the theories reveals that most nursing managers fail to prioritize the wellbeing of their patients. Instead, they put their own needs ahead of those of the clients.

Nursing Leadership and Staff Engagement

Senior nurses engage in a range of leadership activities in the workplace. Some leaders are able to adopt effective administration styles. However, others find management to be a difficult task. Effective leadership is critical in the nursing discipline (Cameron et al., 2012). The reason is because it improves safety and quality of care. In addition, it ensures positive staff engagement.

Transformational leadership can be adopted as a strategy to address this problem. The reason is that the model puts emphasis on the building of relationships and motivation of staff through a collective vision and mission. Leaders who employ this style are charismatic and willing to share their ideas (Cameron et al., 2012). In addition, they act with confidence. As a result, they command respect and are able to motivate employees to perform tasks that may be difficult.

Use of Delivery Theory by Nurse Leaders to Deal with Staff Performance Issues

A health organization is an open system (Burtson & Stichler, 2010). It entails energy transformation, feedback, integration, and event cycles. The nursing services delivery theory emphasizes that input and output factors should interrelate dynamically. Consequently, it highlights a relational composition of streams of studies associated with nursing staff and work environments.

The performance of nurses is largely determined by the conduct of their leaders. Managers can employ delivery theory as an overarching framework to deal with issues that deter nurses from offering patient care services as required. One such factor is lack of respect in the workplace. In some situations, healthcare providers are disrespected by both administrators and patients. Findings by an ANA Health and Safety Survey support this assertion. According to the study, 11% of RNs were physically assaulted in 2011. In addition, 52% were threatened or verbally abused (Cameron et al., 2012). The study revealed that mistreatment is a common occurrence in the discipline. However, most nurses fail to report the cases. The reason is because they consider the problem to be part of their work.

Early Discharge before Sufficient Education on Ostomy Care

Ostomies affect patients in diverse ways. Most clients are distressed and find it hard to cope with the new experience. Nurses also face challenges when handling such patients. The difficulties result from lack of experience, low comfort levels, and inadequate formal training (Burtson & Stichler, 2010). Individuals who have undergone an ostomy surgery need patience and support. In addition, it is vital to educate them on how to care for themselves on discharge. In certain instances, the patients are discharged before they have been fully trained on how to manage the condition.

To help reduce cases of early discharge, nurses can apply Virginia Henderson’s need theory. The model focuses on the need to enhance the autonomy of the patient. It supports healing even after discharge. Consequently, healthcare providers should be committed to educate their clients on how to take care of themselves (Eun-Ok & Chang, 2012). In addition, nurses with little or no experience in ostomy should undergo training on patient care.

Application of Nursing Theory Concepts in Third World Countries

Nursing in third world countries is both exciting and dangerous. However, working in these nations is beneficial in various ways. The healthcare provider has an opportunity to learn from different cultures, grow personally and professionally, and promote their wellbeing (Burtson & Stichler, 2010).

The concepts of various nursing theories can be applied in different ways. Nurses understand the need to assist patients perform tasks that they are currently unable to handle due to illness (Cowden & Cummings, 2012). As a result, they promote quick recovery or facilitate peaceful death for patients in final stages of chronic illnesses. The concepts enable nurses to help patients be self-reliant and responsible for their own care. In addition, healthcare providers learn how to exercise patience when dealing with clients who require a lot of attention.

Applying the Theory of Constraints to Optimize Patient Flow in a Hospital Setting

Efficient and safe patient flow throughout the healthcare system is a major challenge to many hospitals (Burtson & Stichler, 2010). The problem is mainly caused by an increase in the number of clients. The admissions lead to overcrowding, poor handoffs, and delays. The theory of constraints states that there is always a holdup that affects the rate at which care services are provided. The model highlights five steps that can be used to ensure a smooth flow of clients (Eun-Ok & Chang, 2012). They include identifying, exploring, and supporting the system’s constraints. The other steps involve elevating the constraint and focusing on continuous improvement. Consequently, managers understand the causes of bottlenecks in the system. As a result, they can devise ways to reduce unnecessary waits, pool analogous work together, and share staff resources.

Conclusion

In the process of writing this paper, the author gained new knowledge on the nursing discipline and its theories. For example, the author realized that nursing entails the protection, promotion, and optimization of wellbeing and capabilities. In addition, it involves the prevention of injuries and illnesses through proper treatment and diagnosis. Nursing theories offer a wide range of benefits to the discipline. They include providing a strong foundation for the practice and generation of knowledge to map the future of the profession. In addition, the suppositions help to improve patient care and establish elements that form the basis of nursing practice.

References

Burtson, P., & Stichler, J. (2010). Nursing work environment and nurse caring: Relationship among motivational factors. Journal of Advanced Nursing, 66(8), 1819-1831.

Cameron, S., Harbison, J., Lambert, V., & Dickson, C. (2012). Exploring leadership in community nursing teams. Journal of Advanced Nursing, 78(7), 1469-1481.

Cowden, T., & Cummings, G. (2012). Nursing theory and concept development: A theoretical model of clinical nurses’ intentions to stay in their current positions. Journal of Advanced Nursing, 68(7), 1646-1657.

Eun-Ok, I., & Chang, S. (2012). Current trends in nursing theories. Journal of Nursing Scholarship, 44, 156-164.

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