Among numerous nursing specialists, the legacies of Virginia Henderson and Dorothea Orem seem to be especially vital for the development of current medical practice. In the first place, these two figures focused on the input of the patient care theory, which allowed them to constitute theories of nursing process and self-care deficit, respectively. Huitzi-Egilegor et al. state that Henderson’s model is often applied in empirical research (777), while, according to Alligood, Orem’s theory gained worldwide recognition (206). As a result, their research opened new possibilities for nursing, which last to the present day. The approaches have not only shaped the face of nursing education and practice but also established a base for further studies.
Henderson and Application of Her Works
First, one should state that Virginia Henderson was a “nurse, teacher, author and researcher” (Masters 36), who worked throughout her life in developing the guidelines for the nursing process. She is mainly remembered for the construction of the scheme which is based on the human needs, mentioned in Maslow’s hierarchy. In her works, Henderson insisted that nursing healthcare was to be provided when a person was is not capable of reaching all the natural needs of humans. Hence, she offered nursing workers theoretical instructions about the patients’ functions, which were are to be maintained and normalized during medical care.
The importance of Henderson’s framework includes the following aspects which stem from her theory. Firstly, her model of assessing and satisfying patients’ needs, despite the gradual trend of replacement, is still deployed in the evidence-based research of the medical sphere (Huitzi-Egilegor et al. 777). Secondly, as Masters mentions, Henderson is responsible for “one of the most accurate definitions of nursing”, and the set of terminology accompanying it (36). Thus, one cannot underestimate her input in the theoretical base of nursing activities, which is reflected in the education in medical institutions and during the field practice.
Orem’s Theory and Its Use
As a proficient nurse and researcher, Orem similarly focused on the creation of theories that depend on human needs. According to Alligood, her studies were significantly based on her life-long experience in nursing (199). In the end, the self-care deficit theory emerged as the most notable feature of her research. As per Orem’s ideas, the self-care deficit describes the relationship between the patient and healthcare provider. It exists as a result of a person being unable to maintain independent self-care with their efforts. In such a relationship, nursing staff should develop methods and strategies for aiding the patients in eliminating the deficit or keeping them stable.
The system of nursing care shaped by Orem stands in high regard in medical institutions across the globe. Scientists widely reference Orem’s works, and the nursing advancements in Germany or the USA use Orem’s schemes to improve healthcare quality or the curriculum (Alligood 206). Moreover, Orem’s theory remains applicable in studying specific diseases such as dysmenorrhea, which also allows producing a proper course of treatment (Wong et al. 225).
Conclusion
Due to their proficiency in nursing activity, Henderson and Orem succeeded in developing detailed insight into the theoretical grounds of healthcare. Henderson is renowned for constituting a theory on the nursing process according to basic human needs. Hence, her terminology is applied in theoretical and practical education, as well as in evidence-based studies. Orem, in turn, received her fame for creating the theory of self-care deficit, which accurately describes the relationship in need of care help and the medical personnel which provides it. This theory is not only widely deployed in scientific studies but also for reforming the healthcare curriculum and reforming nursing quality in various countries.
Works Cited
Alligood, Martha Raile. Nursing Theorists and Their Work. Elsevier Health Sciences, 2017.
Huitzi-Egilegor, Joseba Xabier et al. “Implementation of the Nursing Process in a Health Area: Models and Assessment Structures Used.” Revista Latino-Americana de Enfermagem, vol. 22, no. 5, 2014, pp. 772-777.
Masters, Kathleen. Nursing Theories: A Framework for Professional Practice. Jones & Bartlett Publishers, 2014.
Wong, Cho Lee et al. “Examining Self-Care Behaviors and Their Associated Factors Among Adolescent Girls With Dysmenorrhea: An Application of Orem’s Self-Care Deficit Nursing Theory.” Journal of Nursing Scholarship, vol. 47, no. 3, 2015, pp. 219-227.
In all schools of thought, people have developed different systems to help approach questions that humanity faces. Theories are abstract models that are aimed at explaining real-world phenomena. This way of looking at the world provides people with a set of tools and frameworks for analysis. Although this method is useful, it has a set of limitations. All theories by their nature simplify reality and only focus on specific aspects of a phenomenon. Thus, different models have different accuracy, and it is important to have a method for evaluation that shows how well a particular theory serves its purpose. The goal of this paper is to discuss the criteria of theory evaluation and use them to analyze a grand nursing theory.
The set of criteria that scientists use to test a theory consists of the following items: empirical and pragmatic adequacy, utility, logical consistency, testability, and scope. In addition to that, it is also essential to assess in how much detail the model covers the phenomenon, and to what extent it stimulates new research (Smith and Parker 31). This framework can be used to critique and analyze theories in nursing.
Grand nursing theories are very broad, and they deal with questions at a high level of abstraction. They provide a conceptual framework that focuses on large domains of nursing and is large in scope (Reed and Nelma 8). The self-care deficit approach that was developed in the second part of the twentieth century is a good example of such a theory. The philosophy of this model is based on the fact that people adapt to their environment and have a natural strive to be able to care for themselves (Smith and Parker 108). The theory emphasizes that patients can recover faster if they perform self-care as well as they can and only rely on outside help and treatments when it is necessary.
The self-care deficit theory can be analyzed with the help of the mentioned criteria. The model covers a broad scope of nursing practices and can be applied in most branches of medicine. The approach is proved to be especially useful in primary care and rehabilitation, where patients’ contribution to the success of the treatment is especially big. Multiple controlled trials proved the utility and empirical adequacy of this model, showing that such an approach leads to improved quality of care (Smith and Parker 110).
The high level of testability of the model allows evaluating it with measurable and reliable results (Smith and Parker 110). The theory is also pragmatic because the vision it provides is highly applicable and can be used to deal with real situations in medicine. In addition to that, the theoretical framework of this model provides a perspective and a set of tools that can be used by future researchers, including both theorists and practitioners. Thus, having evaluated the self-care deficit theory, it is justified to say that this model is accurate, testable, and can be applied to improve the quality of care in medical institutions.
Grand nursing theories provide abstract models and frameworks that are aimed at helping develop practical approaches to real-life medical situations and solve problems that appear in the hospital environment. Evaluating these theories is necessary to determine their practical applicability, accuracy, and utility. The self-care deficit nursing theory is a good example of a model that meets the criteria for a well-developed scientific model, which allows successfully using it in practice.
Works Cited
Smith, Marlaine C., and Marilyn E. Parker. Nursing Theories and Nursing Practice. FA Davis, 2015.
Reed, Pamela G., and Nelma B. Crawford Shearer. Nursing Knowledge and Theory Innovation: Advancing the Science of Practice. Springer Publishing Company, 2017.
To contribute to a patient’s early convalescence, a nurse should adhere to a specific strategy while caring for a sick person. Although today the necessity of aligning a nurse’s actions with an effective pattern of treatment seems obvious, the situation was different until the 19th century when Florence Nightingale implemented hospital reforms. This paper will consider the role of Nightingale in the formation of the nursing profession, discuss a study based on her theory, and analyze the relationship among theory, research, and practice.
Florence Nightingale’s Role in the Nursing Profession
Florence Nightingale was a nurse caring for soldiers during the Crimean war in 1854-56. However, she was not an ordinary nurse since she aimed to change the established system of healthcare in Britain. The fact is that at the beginning of the 1800s, British hospitals were in a deplorable state. Patients were treated in barracks that were often overcrowded and infested with rats. Besides, nurses received no professional education, and most of them were distinguished by drunkenness and promiscuous sexual behavior. Nightingale decided to struggle with these conditions because she assumed that the environment in which patients were cured had much influence on their recovery process.
Nightingale was also engaged in collecting and analyzing statistics in healthcare. She found out that a considerable part of soldiers died from contagion and diseases rather than wounds because of inadequate sanitary conditions. The collected statistics of death rates among military men helped her to convince the authorities to accept her healthcare reforms. Another Nightingale’s significant contribution was establishing the first nursing school. Thus, Nightingale has played a substantial role in the nursing profession since she proved the necessity of proper sanitary conditions in hospitals, laid the foundation for the education of nurses, and initiated the application of statistics for analyzing medical data.
Research Using Nightingale’s Theory
Nightingale’s theory of environment importance for patient care is applied even nowadays, which confirms its soundness. For example, it was used in the research of Awalkhan who decided to test the theory on a female patient submitted to colostomy (97). After the operation, the patient was kept in a clean ventilated room, was given the prescribed medications, and had her colostomy bag changed. The nurse also took care of the patient’s psychological environment and provided her with a balanced diet.
The application of Nightingale’s theory led to an improvement in the patient’s health. The researcher concluded that this theory is efficient for caring for patients after colostomy (Awalkhan 100). However, two contradictions were found in the model. First, Nightingale suggested that patients should not be disturbed while sleeping, but the researcher argues that nurses have to wake them up for essential night procedures (Awalkhan 100).
Second, Nightingale considered personal qualities of a nurse more significant than education, but Awalkhan states that the nursing profession requires having a proper qualification (100). However, for the most part, this theory is applicable, which is why the researcher chose it for the patient. Awalkhan argues that “Nightingale caring model is functional” because it “fits to the basics of nursing” (100). Thus, this research proves that the environment, especially appropriate sanitary conditions, is indeed essential for patient care.
The Relationship Among Theory, Research, and Practice
Nightingale demonstrated that nursing could not rely only on practice. Awalkhan supports this idea: “Practice without integrating nursing theory is blind” (97). In the nursing profession, research, theory, and practical application are interrelated. Research implies observing implementations of specific procedures and finding a way of improving them. It gives rise to a theory, which then is to be tested in practice. Thus, these three notions interact with each other leading to advancements in the nursing field.
Conclusion
In conclusion, it is crucial that nurses should have a theory to guide them through their work. Nightingale’s model is one of the best solutions in this case since it shows concern for patients and the environment around them and has proved its effectiveness over time. Naturally, a nurse may adjust this theory to a specific patient using common sense, as the author of the described research remarked.
Work Cited
Awalkhan, Afsha. “Application of Nightingale Nursing Theory to the Care of Patient with Colostomy.” European Journal of Clinical and Biomedical Sciences, vol. 2, no. 6, 2016, pp. 97-101.
The first outcome describes nurses’ skills in using theoretical knowledge to improve the healthcare industry. First of all, I applied science-based theories to analyze the significance of health care delivery. Through personal reflection, I investigated the studies describing the transmission of gamete and eukaryotic formation to see how their analysis can impact our knowledge of sexual reproduction.
When examining case studies, I reflected on a variety of nursing theories to determine their role in the formation of nursing research. Middle-range nursing approaches, such as Peplau’s theory of interpersonal relations, for example, define nursing in a way that creates a connection between grand nursing concepts and practice. According to Hagerty, Samuels, Norcini-Pala, and Gigliotti (2017), these frameworks can help one to address specific problems in healthcare delivery and assist nursing researchers in finding a focus for academic studies.
By defining the Ten Strategic Points for outlining nursing theories, I was able to synthesize all available knowledge about various practices and concepts. I understood that all approaches, while viewing patients, nursing, and health, from different angles, had some similarities in their underlying principles, including empathy and patient-nurse relationships. This particular assignment was based on data gathering as I had to analyze major nursing theories to define their role in practice and determine which of their elements were the most important.
Apart from that, I also contributed 600 min of practice hours to case reports where I was able to apply science-based theories and see how they change the course of one’s thinking about the presented problem. I used my previously acquired knowledge from genetic studies to practice genetic testing for another 600 minutes. Here, the synthesis of scientific data provided me with enough information about the subject to apply it in practice successfully.
Another example of my applying theories in practice was the examination of clinical research concerned with the field of capnography during resuscitation. The implementation of studies laid a foundation for the project for evaluating the tools’ effectiveness and their role in emergencies. As a result, this and previously discussed information contributed to by theory-based beginnings of the DPI project. I have learned that a theoretical basis for a study or program allows one to see and appraise all information that was discovered by the other scholars. Nursing theories offer many tools and frameworks which can be employed to pinpoint the exact area of concern for patients and other stakeholders. Alternatively, these science-based data show which areas remain unexplored, thus calling other scholars to narrow or expand their focus.
My use of studies during practice hours has demonstrated the extent to which case report application and scientific data can inform one’s understanding and help find solutions that will overcome previously unseen pitfalls. For my DPI project, I will utilize both the knowledge that I acquired during my research as well as the understanding of how valuable theoretical pillars can be for practice. I will employ a theoretical framework to guide my research and use the information derived from earlier studies to support my findings or compare them to see the differences.
Outcome 2
Leadership is another role that a doctorally prepared advanced practice nurse has to assume. To achieve this outcome, I first employed principles for business and economic theories to see how they may assist me in creating initiatives for improving the quality of care. In my reflections, I evaluated the present state of bureaucratic structures in healthcare and determined their incompatibility with the consistently changing needs of the patient population (Klemsdal, 2013). Instead, organizations have to strive towards learning-based structures that are flexible and dynamic enough to address the problems that arise among patients and other stakeholders (Klemsdal, 2013).
I also presented case reports which contrasted different systems of payment, devising a structure that would be both fiscally beneficial and inviting interdisciplinary collaboration. According to Kingsley (2014), economic problems in the United States health care industry lie beyond people’s misunderstanding of payment systems and are connected to the country’s historical values of individualism and personal achievement. Thus, leaders encouraging change should also address these concerns and propose a structure overcomes people’s opposition.
My literature review for the outcome included studies concerned with the improvement of healthcare quality and patient outcomes. This activity presented me with data pertinent to my future projects and created a foundation for appraising other authors’ ideas about quality change. During my practice hours, I reviewed various issues that arose in the geriatric population in relation to their aging processes. Apart from that, I analyzed various trends in informatics for my practice to see how they can be implemented in my setting to raise the speed of documenting and improve the safety and quality of patient data.
Another assignment that gave me an opportunity to improve and practice my leadership skills was participation in a People Management Leadership Seminar. For this event, I examined the role of nursing leadership in healthcare and its implementation into interprofessional collaboration to improve patient-centered care. The idea that leadership among nurses is equal to management or collaboration is erroneous – these concepts differ in their primary areas of focus. For instance, management is concerned with operations and their completion, while neglecting such areas as workers’ empowerment or professional growth (Murray, 2009).
In contrast, leadership does not always apply to managers only, being a quality that defines professionals who encourage improvement in others and using themselves as an example as well (Russell, 2001; Smith, 2011). A leader can influence other members of the team to collaborate successfully, especially in the model of leadership targets the other individuals’ desire to grow and open to each other (Delmatoff & Lazarus, 2014).
The participation in the seminar allowed me to demonstrate my capabilities of a nursing leader and show my ideas for political activism. I will apply this knowledge to the initiative and purpose behind the project as well as its final steps detailing a proposal for quality change. Leadership skills allow one to see what problems need to be solved and communication with others with feedback about common issues is crucial for observing a project from all sides. The results of a project have to be informed by leadership principles to deliver actual change.
Outcome 3
This outcome’s primary goal is to teach nurses technical and analytical skills in using data and informatics for the improvement of healthcare delivery. To develop these skills and understand their current state in the US, I analyzed the federal and state laws regulating and setting standards for technology application in practice. After that, I used databases and searches to collect information about childhood obesity, particularly about the role of parental involvement. The resulting case report evaluated the statistical practices of these studies as well as their adherence to ethical guidelines of research.
For a literature review, I investigated inferential statistics and their implementation in research reports. The application of statistical analyses is one of the basic calculations in scholarly studies, as their results constitute the majority of theories and hypotheses for individual and population health. According to Bradley and Brand (2016), inferential statistics should be used with caution, but their results may demonstrate a variety of issues, changes, and differences among samples.
The exploration of this segment of analysis helped me understand how statistics are approached in healthcare research. For practice hours and the DPI project, I developed a competency matrix that outlined the main goals and objectives of the works completed. This step of the assignment is also related to technical skills as it involves data synthesis and organization into a system for future usage.
Moreover, I evaluated the current literacy practices developed by organizations for patients to increase health promotion and disease prevention. Patient education is now closely tied to healthcare technologies, and the interactivity of many materials makes necessary information more accessible to individuals than before. During my practice hours, I was able to use this knowledge as I was working with telehealth services and public health application.
Finally, I achieved the outcome by using scoring mechanisms in one of my case reports about childhood obesity and parental involvement. I also examined database structures, such as ANOVA and SPSS, as well as the completion of measurements and t-tests. In practice, I returned to my theoretical knowledge of previous topics – I tested capnography during resuscitation, utilized inferential statistics, and applied the qualitative method of inquiry.
These opportunities provided me with a well-rounded understanding of various tools, programs, analyses, and devices that are currently accepted in healthcare. Databases are helpful for many initiatives, and skills for using them are essential in healthcare research, which relies on previous findings and best practice guidelines. Telehealth and similar technology are one of the potential branches of the industry.
For my DPI project, I will mostly use the information about statistical analyses, including their importance, relevance, and application. The skills related to qualitative data gathering and statistical measurements are essential in conducting research and creating plans for the improvement of health care delivery. Data mining and implementation are crucial for all parts of a project – the literature review, formulation of a hypothesis, information gathering from participants, the evaluation of results, and potential spheres of further analysis. Thus, this outcome’s completion helps me in improving the quality of my DPI project significantly.
Outcome 4
Another role of an advanced practice nurse is that of a patient advocate. To achieve one of the objective’s smaller goals – the analysis of data related to population health – I reflected on the principles of epidemiological properties related to health disparities. Furthermore, I evaluated the bio-statistical data used in various methods to assess individual and population health. I also assessed social factors that have an impact on the population and individual health, including one’s personal and professional characteristics. Then, I collected some information about global health disparities to identify natural resource strains that lead to these major problems.
The connection between these concerns allows one to map out the plan for patient advocacy projects focused on global and local solutions – food insecurity and hunger, for instance, are among the factors that affect population health in the US (Gundersen & Ziliak, 2015). Thus, an advocacy initiative that targets food-related resource strains can be developed to improve people’s wellbeing.
For my Ten Strategic Points, I evaluated the community-based care to see how it can change the delivery of hospital readmissions. In my practice, I appraised practice guidelines to determine their effectiveness for the treatment of colon cancer – the evaluation of this data is related to establishing future standards for population care. I disseminated the information about barriers that do not allow health care providers to improve their outcome and gathered data about challenges that organizations face when addressing population-affecting diseases. Using the CPOE and CDSS systems, I was able to collect data in practice and see the potential and problems of my practice setting.
The question of healthcare accessibility is one of the central concerns in the US. My reflection about the ethical issues of making care more accessible and affordable, while improving its quality allowed me to see the scope of the problem and its connection to economic and political concepts (). The access to information and its analysis are not the only steps, however. I investigated the crucial role of knowledge dissemination and translation for patient advocacy. Without making the data understandable to populations and other specialists, one may risk failing to attract attention to the problem, which renders all advocacy actions useless.
Advocacy for social justice and equity often rely on a nurse’s preparedness to be a leader and a role model for other professionals. According to Totten (2010), the inclusion of nurses into healthcare boards is a necessary step for giving them an ability to present their opinions about individual and public health. The quality of care depends not only on available funds and workers’ professional knowledge but also their ability to listen to patients and other stakeholders and enact change when issues are identified. Thus, the process of creating advocacy projects has to rely on nurses’ soft skills, leadership style, and commitment to the profession.
The correctness of data collected as a result of scientific studies does not always result in an effective campaign if this information is not appropriately distributed (Camargo & Grant, 2015). I will base my project’s final discussion and conclusions on this idea, making sure that my proposals are based on findings and are easy to translate into practice.
Outcome 5
The evaluation of practice outcomes is a vital part of healthcare research and planning. To achieve the goals of this outcome, I reflected on strategies for change and evaluated possible bias mitigation procedures that would increase the quality of research. As a result, this assignment allowed me to see that evidence-based research has to go through a rigorous process of bias elimination in order to produce data that will be used in practice effectively. Next, I gathered and assessed studies discussing nurse migration to evaluate their quality and create strategies for improving patient outcomes using this process.
I analyzed various evidence-based strategies for health promotion and disease prevention – this step improved by skills of evaluating existing methodologies for influencing patient-centered care. The literature about innovative approaches to health promotion contains some information about accountable care – this strategy of organizing interventions is more beneficial in comparison to traditional change because it incorporates feedback and includes patients in the discussion (Institute of Medicine, 2012). I gathered the data related to this topic to gain a deeper understanding of this model.
By participating in a nursing intervention, I achieved the objective in practice. This program included the introduction of bedside rounding and the analysis of HCAHPS scores for the facility. The application of HCAHPS scores was a crucial part of the assignment, and it was an example of my using national benchmarks to evaluate practice outcomes in a clinical setting. Thus, the practical implementation of initiatives based on previous research contributed to better patient outcomes. I was a part of a Comprehensive Unit-Based Safety Program, which provided me with another opportunity to use theoretical knowledge in promoting health and translating research into practice.
Furthermore, I attended a Safety Together Training Workshop to enhance my skills as a safety leader in health promotion. This scholarly activity increased my knowledge about the continuum of care and its potential benefits for patient safety. The continuum of care is a concept that was created to improve the care delivery for all patients, especially those who have to transfer between different facilities and caregivers. These individuals’ mental and physical health may suffer from loss of information, inadequate nurse-patient and interprofessional communication, and other problems (Mills, Marks, Reynolds, & Cieza, 2017). Thus, by developing a framework that acknowledges these issues and introduces ways of mitigating their effects, nurses can contribute to the improvement of healthcare.
This outcome’s completion contributed to my understanding of quality improvement methods and their evaluation. It is clear that the use of national benchmarks is beneficial for medical facilities because it creates a standard of care and promotes change. Therefore, the ability of nurses to collect and praise information using the existing systems and tools is necessary for successful interventions. I will utilize this knowledge in my DPI project and ensure that the documentation, sources, and methodologies that I employ are of high quality and are supported by other resources and evidence. The project’s primary purpose will be to propose safe, equitable, and timely care.
Self-Reflection
The analysis of all competed assignments and my explanation of their connection to the course outcomes leads me to believe that I am prepared to undertake the DPI project. The finished course tested my skills as an advanced practice nurse and challenged me to apply my theoretical knowledge and communicational and leadership skills in practice. It also provided me with an opportunity to use all newly acquired information in practice.
The exploration of various scientific, ethical, political, and economic concepts broadened my view of nursing as a profession. The participation in seminars and quality improvement initiatives prepared me as a speaker and a member of an interprofessional team with the qualities of a nursing advocate and leader. Thus, I think that the scope of my current experience has prepared me for this project.
The information that I accessed during this course has greatly informed my strategies in preparing for the completion of the DPI project. First of all, I was able to reevaluate the role and purpose of nursing in healthcare. This part of the education granted me an in-depth understanding of what exactly makes nursing research valuable for patients and organizations. The connection between nurses and patients is unique, and empathy as a basis of nursing theories influences the lens through which every improvement project is viewed. Second, the theoretical knowledge derived from various sources and databases allowed me to see the extent to which some of the topics have been explored to this day. Thus, their contents informed by the perception of the topic’s choices and the availability of data for calculations and comparison.
Third, the exploration of various quantitative methods, including tools and tests for handling gathered data improved my skills as a researcher. The investigation into inferential statistics was particularly helpful as major nursing research projects often employ this type in studies to arrive at possible conclusions. Finally, the participation in advocacy-driven events provided me with an opportunity to see how research results are implemented into practice, showing me how I should handle the outcomes of my future projects.
To successfully implement my project, I need to update my 10 Strategic points and draft to reflect the experience that I acquired during the course. For instance, I may need to review my data collection and analysis methods and ensure that they are consistent with the topic and outcomes that I wish to achieve. Moreover, I have to update my sample and location choices to maintain an unbiased presentation of results. Otherwise, both documents seem to align with the information that I accessed as a result of learning. My progress in working on the project is tied to my continuously evolving understanding of the topic and the sphere in which it exists.
While I have collected the necessary information and appraised its quality, I am still in the process of analyzing data and arriving at conclusions that completely represent the amount and quality of information. To finish the project, I need to complete data analysis and develop the discussion and conclusion that include a review of previous studies and propose limitations and strengths for further consideration and implementation.
References
Bradley, M. T., & Brand, A. (2016). Accuracy when inferential statistics are used as measurement tools. BMC Research Notes, 9(1), 241.
Camargo, K., Jr., & Grant, R. (2015). Public health, science, and policy debate: Being right is not enough. American Journal of Public Health, 105(2), 232-235.
Delmatoff, J., & Lazarus, I. R. (2014). The most effective leadership style for the new landscape of healthcare. Journal of Healthcare Management, 59(4), 245-249.
Gundersen, C., & Ziliak, J. P. (2015). Food insecurity and health outcomes. Health Affairs, 34(11), 1830-1839.
Hagerty, T. A., Samuels, W., Norcini-Pala, A., & Gigliotti, E. (2017). Peplau’s theory of interpersonal relations: An alternate factor structure for patient experience data? Nursing Science Quarterly, 30(2), 160-167.
Institute of Medicine. (2012). Best care at lower cost: The path to continuously learning health care in America. Web.
Kingsley, T. (2014). Diagnosing the current problems of the united states health care system requires examining the history of health reform. Kennedy School Review, 14, 63-69.
Klemsdal, L. (2013). From bureaucracy to learning organization: Critical minimum specification design as space for Sensemaking. Systemic Practice and Action Research, 26(1), 39-52.
Mills, J. A., Marks, E., Reynolds, T., & Cieza, A. (2017). Rehabilitation: Essential along the continuum of care. In D. T. Jamison, H. Gelband, S. Horton, P. Jha, R. Laxminarayan, C.N. Mock, & R. Nugent (Eds.) Disease control priorities: Improving health and reducing poverty (3rd ed.). Washington, DC: The International Bank for Reconstruction and Development/The World Bank.
Murray, A. (2009). What is the difference between leadership and management?The Wall Street Journal. Web.
Russell, R. F. (2001). The role of values in servant leadership. Leadership & Organization Development Journal, 22(2), 76-84.
Smith, M. A. (2011). Are you a transformational leader? Nursing Management, 42(9), 44-50.
Totten, M. K. (2010). Nurses on healthcare boards: A smart and logical move to make. Healthcare Executive, 25(3), 84-86.
Theories are indissolubly connected with a nursing career, practice, and research. In general, a theory can be explained as a statement that describes or defines a phenomenon, and that needs to be proved. Theories are formed as a result of the desire to resolve a scientific or practical problem. Then a hypothesis, a question that is later checked to find the right solution, is built. However, verification and proof of any theory require a lot of time and effort. I believe a theory in the nursing field aims to improve understanding of the process of medical care to provide the best service for patients ultimately. In nursing theory, “competence, confidence, compassion, comportment, conscience, and commitment” are characteristics of caring which describe the behavior of nurses (Tappen, 2016, p. 22). Without theory, it would be challenging to make real progress, develop nursing practice, and improve the quality of care.
Reference
Tappen, R. M. (2016). Advanced nursing research: From theory to practice. Burlington, Massachusetts: Jones & Bartlett Publishers.
The nursing profession requires strong moral values and personal beliefs. The development of a worldview has had a significant impact on a nurse’s moral ways of seeing, believing, and acting. The more pluralistic the world has become, the more value systems there have been available to nurses and the more complex their ideas about what constitutes the moral life and how best to achieve it.
There is increasing recognition that our moral standards are not absolute, but are “ever-changing social creations” (Sullivan & Decker 2005, p. 4). Such skills include the ability: to read the world, which means not the only question but to call into question things as they are; to anticipate moral problems and take the necessary action to prevent them from occurring in the first place, otherwise known as preventive ethics.
The task of a nurse is to develop and follow moral philosophy that is concerned with establishing a standard of correctness by the prescription of certain rules and principles. Ethics inquiry is not so much concerned with how the world is, but with how it ought to be. In other words, it is not concerned with merely describing the world (although, of course, a description of the world is necessary as a starting point for an evaluative inquiry.
Worldview
The worldview is explained as the way a person or group understands the world about them and their perspective about life and the world (Tomey & Alligood, 2002). The worldview helps every person (and nurse) to think critically and reflectively about emergent and emerging moral issues; to discern a range of possible solutions to moral problems identified; to communicate effectively with others; to respect, listen to, understand, and be compassionate toward others; to be tolerant, flexible, creative and imaginative when dealing with and attempting to resolve moral problems; to act as a moral negotiator and mediator when confronted by competing moral viewpoints (Daniels, 2004).
My worldview is based on ideas of morality, ethics, and humaneness. The agreed end of the profession and practice of nursing is the promotion of health, healing, and wellbeing, together with the alleviation of suffering, in individuals, groups, and communities for whom nurses care.
This end is moral, and one that carries with it a strong moral action-guiding force for nurses insofar as it requires nurses to engage in the behaviors necessary to promote health, healing, and wellbeing in people, and, when manifest, to alleviate their suffering (Potter & Perry, 2005). The agreed ethical standards of nursing require nurses to promote the genuine welfare and wellbeing of people in need of help through nursing care and to do so in a manner that is safe, competent, therapeutically effective, culturally relevant, and just. My philosophy is to take care of the patient, to the best of my ability. Take care of the person as a whole. For me, it means taking patients and their environment as a single whole (Daniels, 2004).
Metaparadigm
Another important concept which helps to define my values is the metaparadigm. It can be explained as a phenomenon of central interest to the discipline (Fawcett 2000, p. 4). Metaparadigm concepts of Nursing involve health, person, environment, nursing, and caring. I suppose that moral diversity supports these issues and helps to ensure that no one moral point of view dominates; in short, it helps to prevent what might otherwise be termed “moral fascism” (Potter & Perry 2005, p. 76).
Meanwhile, its emphasis on understanding difference rather than striving for uniformity will help to ensure the moral system nurses end up in (Potter & Perry, 2005). Metaparadigm is the sub-domain of a worldview that is concerned with the nature, logical form, and language of the world structure and functions. Today, adopting a transcultural approach to nursing can be beneficial in a range of ways. Among other things, at a global level, it can enable cross-cultural interactions that ‘build bridges of understanding between persons and cultures that make cooperation possible and conquest unnecessary’ (Potter & Perry 2005, p. 6).
It can also help to avoid the perils of ‘moral suprematism’ such as those which have been amply exemplified during wartime. The goal of a nurse is ‘to reach a common set of moral ideals which everyone can follow’ or, rather, to ”seek principles of conduct which everyone can live by “ (Leininger & McFarland 2002, p. 34). Moral principles are needed to regulate our moral decisions and to help settle competing alternatives. Moral principles remind us of our overriding duties to others and the merits of morally principled action. Principles of morality also lend people ‘tools’ which can be used to deal appropriately and effectively with moral crises and dilemmas in both everyday and special (e.g. professional) worlds) (Leininger & McFarland, 2002).
Metaparadigm Concepts of Nursing
Health
I perceive health as a dying process at the slowest possible rate. The task of a nurse is to help the patient find ways and methods to prologue his well-being. Other important practical issues concern the moral imperatives of the professional, client relationship (including mutuality, therapeutic alliance, safety, security, trust, compassion, and empathy); the moral dimensions and unacceptable consequences of stigma and discrimination; and the moral imperatives of transcultural mental health nursing, to name some (Potter & Perry, 2005).
Health involves a holistic concept of wellbeing; this is in contrast with traditional medicocentric notions of health being merely the absence of disease or as something that can only be measured physiologically. Health care, in turn, can be provided by a range of people, not just members of the medical profession. Many people do not seek professional medical care; often they seek and receive help for their health problems from other people (Potter & Perry, 2005).
Person
The concept of ‘person’ means the one receiving care. In terms of meta paradigm, it could be one or a million. The nursing profession is fundamentally concerned with the promotion and protection of people’s genuine wellbeing and welfare, and in achieving these ends, responding justly to the genuine needs and significant interests of different people (Daniels, 2004). The nursing profession is, therefore, fundamentally concerned with ‘moral problems’ as well as other kinds of problems (for example, technical, clinical, legal, and so forth).
Mataparadigm involves multifaceted and complex human beings who have very real feelings and moral interests, and who are more often than not faced with very real and significant threats to these moral interests and, ultimately, their wellbeing. Dealing effectively with moral problems in nursing care domains is thus not an easy task and, among other things, requires a deep and informed understanding of the complexities and ‘messiness’ of human life. Nurses are not immune from the many and complex moral problems that plague health care domains (Potter & Perry, 2005). As in the case of other professional (client relationships, no nurse) patient relationship occurs in a moral vacuum or is free of moral risk.
Nurses have the capacity (whether by act or omission) to harm as well as benefit their patients. Nurses, therefore, need to be especially vigilant regarding both their capacity to harm the significant moral interests and wellbeing of patients, and to take appropriate action to prevent such harms from occurring, even those which might be deemed ‘inadvertent’ and ‘accidental’. To be effective in preventing harm occurring in nursing care domains, nurses must have an informed knowledge and understanding of the nature of problems and the various forms in which they can manifest (Sullivan & Decker, 2005).
Environment
The concept of environment evolves the patients’ surroundings: external and internal. It is quite probable that a nurse’s responsibilities do not just begin and end with an individual patient (Sullivan & Decker, 2005). If the whole notion of moral obligation is taken seriously from a professional point of view, then there is considerable room to suggest that the moral responsibilities of nurses extend far beyond their immediate one-to-one professional, client relationships to include other things such as professional and political activism aimed at improving the plight of those who suffer from mental health problems (Fawcett, 2002).
The activism of this kind could be aimed at securing such things as the demystification and destigmatization of mental health disorders, mental illness and other mental health problems, better mental health care services (to be distinguished here from psychiatric services) for the community, and other general mechanisms which will assist those with mental health problems to be spared the devastating consequences of stigma and discrimination which many continue to suffer (Daniels, 2004; Sullivan & Decker, 2005).
Nursing
Nursing means caring and medical help, support, and psychological help. When dealing with moral problems nurses need to remember, meanwhile, that sometimes it may be difficult to take the ‘morally correct’ action because of various institutional and legal constraints (Sullivan & Decker, 2005). As has already been discussed and demonstrated in this text, nurses can suffer enormously if they take a firm moral position about a clinical nursing or controversial medical matter. Life can be made torture for nurses if they do not conform to the status quo, and in many instances, they have no choice but to ‘voluntarily’ resign (Fawcett, 2002).
Nursing knowledge does not exist independently of medical knowledge; similarly, neither should overlap in medical and nursing care be taken as implying that nursing ethics is at best only vicarious to or a subcategory of medical ethics. Nursing ethics can be defined broadly as the examination of all kinds of ethical and bioethical issues from the perspective of nursing theory and practice which, in turn, rest on the agreed core concepts of nursing, namely: person, culture, care, health, healing, environment, and nursing itself all of which have been comprehensively articulated in the nursing literature (Fawcett, 2002).
Caring
Caring could be explained as an internal feeling or described as a feeling. My definition of caring is taking pride in meeting the patient’s needs, and aiding the patient and his/her body on the road to healing (Fawcett, 2002). Following Daniels (2004), my worldview is based on the idea of virtuous caring which is integral to ‘good’ (moral) nursing practice (and, by implication, nursing ethics) in at least two important ways.
First, virtuous caring or right attitudes (which include the behavioral orientations of compassion, empathy, concern, genuineness, warmth, trust, kindness, gentleness, nurturance, enablement, respect, mutuality, giving presence (being there), attentive responsiveness, providing comfort, providing a sense of safety and security, and others) have all been thoroughly implicated as effective nursing healing behaviors in the alleviation of human suffering (Sullivan & Decker, 2005).
Caring for patients and caring for people is not just a task; it is itself a virtuous moral ideal of nursing. If nurses are to uphold this ideal and uphold it well they must include a sound and experientially based moral point of view in their clinical nursing practice. As well as this, they must be able to function as competent moral problem-solvers and decision-makers, and truly make a difference in terms of promoting and protecting the welfare and genuine moral interests of all those for whom they care (Leininger & McFarland, 2002).
Conclusion
Nurses, like other health professionals, encounter many moral problems in the course of their everyday professional practice. These problems range from the relatively ‘simple’ to the extraordinarily complex and can cause varying degrees of perplexity and distress in those who encounter them.
For instance, some moral problems are relatively easy to resolve and may cause little if any distress to those involved; other problems, however, may be extremely difficult or even impossible to resolve, and may cause a great deal of moral stress and distress for those encountering them. Nurses, like other health care professionals, have a fundamental and unavoidable moral responsibility to be able to identify and respond effectively to the moral problems they encounter, and, where able, to employ strategies to prevent them from occurring in the first place.
References
Daniels, R. (2004). Nursing Fundamentals: Caring and Clinical Decision Making, Thomas Learning, Oregon.
Fawcett, J. (2002). The Nurse Theorists: 21st-Century Updates—Madeleine M. Leininger. Nursing Science Quarterly, 15 (2): 131-136.
Leininger, M. M., & McFarland, M. (2002). Transcultural nursing: Concepts, theories, research, and practices. 3rd edn. McGraw-Hill.
Potter, P. & Perry, A. (2005). Fundamentals of Nursing. Elsevier PTE LTD, Singapore.
Sullivan, E.J., Decker, Ph. J. (2005). Effective leadership & Management in Nursing 6th ed. Pearson Hall.
Tomey, A. M., Alligood, M. R. (2005). Nursing Theorists and Their Work. Mosby;.
This paper provides an analysis of the theory on medical non-adherence by Jonathan. This paper looks at the theory in terms of its scope, the context within which it developed the content of the theory, the significance of the theory, internal consistency within the theory, the testability of the theory and the pragmatic test of the theory. In essence, this paper looks into the key tenets of the theory in terms of relevancy and general applicability.
Scope
The medical adherence theory was constructed to provide a description of patterns related to treatment adherence in patients. This theory is concerned with the obstacles to medication adherence as well as its scope in terms of the population groups mostly affected by the non-adherence behavior. Besides this, the theory also provides the available solutions to the health workers dealing with patients who fail to adhere to medication instructions. Lack of adherence to medication in patients can at times be intentional – a decision made by the patient not to adhere to medication, or unintentional – interruptions beyond the patient’s control. In summary, therefore, the medication adherence theory , “defines the problem of medication adherence, provides information on the available measuring instruments and predictors of medication adherence, reviews specialized problems with medication adherence in minorities, adolescents and the mentally ill, and provides practical solutions for the health workers dealing with this challenge” (Johnson, 2002).
Context
The development of the medication adherence theory was steered by the increasing number of non-adherence cases in patients especially those suffering from chronic illnesses such as HIV/AIDS and hypertension. Statistics indicate that half of the patients who have been put on medication have problems adhering to the prescriptions either intentionally or unintentionally. This amounts to millions of dollars being spent annually on complicated cases, which could have been avoided. Besides the financial loss, non-adherence to medication has also resulted to reduced lifespan and poor quality of life.
This is what compelled the health analysts to develop this theory, which is aimed at reducing the number of premature deaths caused by ignorance towards medication, and to improve on the quality of life of patients living with chronic diseases (Johnson, 2002). This theory established the main causes of this health threatening behavior, the main one being lack of money to purchase drugs over a long period. This however became controversial when it was discovered that this problem is also common with patients on health plans, which enable then to have access to medication at absolutely no cost.
Content
The three main concepts evaluated in this theory in relation to medical adherence behavior include purposeful achievement, patterned behavior and feedback. Purposeful achievement involves the process whereby patients’ adherence to medication depends on their self-propelled decisions to do so and this is brought about by the effectiveness of the medication, the perceived need and the safety. Patterned behavior follows which is mainly concerned with the patterns developed by the patient with regards to taking medication. This is made possible when the patient has an infinite access to the medication and when they develop the routine in their mind set concerning the process of adhering to medication (McEwen & Willis, 2011). Finally, feedback comes because of the medication response in the health of the patient. When the medication is responding positively, the patient will tend to develop the purposeful achievement and the patterned behavior hence developing a complete medication adherence behavior.
Theory Evaluation
Significance
This theory is of great significance to both the patients and healthcare providers since it endows them with the framework of dealing with non-adherence patterns. The main idea behind this model is to try to influence the decisions made by the patients to forfeit medication, which eventually lands them into more serious health problems than the previous situation. The first step taken in order to reduce the trend of non-adherence to medication among patients is making them believe that they are vulnerable to the diseases. This is aimed at eliminating the notion that they are well immune from all kinds of diseases hence believing that they do not need medication. The second step is to inform them that the disease can be a possible threat to their lives and the third step is to educate them on the benefits that they will accrue from seeking medical help and adhering to the medication prescribed. Finally, they should be informed that the process of obtaining disease intervention is not a complicated one and it can fit into any person’s schedule.
The other significance of this model is that it illustrates health conducts in association with the individual’s psychological depiction of the possible health threats. This element has four main fundamental mechanisms. The first mechanism is identity, which is simply identifying the general symptoms of a disease even when it is considered asymptomatic (Peterson, 2008). The second one is cause whereby people associate different symptoms of diseases with their respective causes and have a pre-determined period over which they expect the disease to last. The last one is consequence evaluation, which involves assessing the cost of the disease, and the benefits accrued from adhering to medication. These are important tools to health care providers in determining the type of medication that should be administered to a patient and the consequences of failing to follow the medication instructions which most of the times leads to the development of resistance towards medication.
Internal Consistency
The medication adherence form is an important tool when determining internal consistency in the medical adherence model. Through this, the continuous variables are converted into discrete numbers, which allow a scale correlation to be conducted. Scores of 0’s or 1’s are attached to the variables and the percentage score is determined. The results of this indicate that most patients fail to adhere to medication intentionally, with lack of access being the least possible reason. The rate of non adherence especially in patients suffering from HIV is high ranging between 29% and 45% and this owing to the fact that this a life time medication (Gustafson et al, 2001).
The internal consistency in this theory can be considered to be an excellent one owing to the congruence between the content and the context of the model. The model is aimed at ascertaining the medication trends in patients, especially those suffering from long term illnesses such as hypertension and HIV/AIDS. The content of the theory and the research conducted shows that medication adherence is a big problem among this population. To come with this conclusion, the sample population was drawn from a group of patients suffering from hypertension. The outcome revealed that most of these people are compelled to take medication by the appearance of symptoms despite the fact that they are aware of their ill health.
Parsimony
The content of this theory has been clearly explained and illustrated with experimental results. This is brought out by the way the facts are stated and explained in a simplified and concise manner that is understandable. The theory has been broken down into other theories that are related to the entire subject such as the “theory of reasoned action, the social learning theory and the self regulation model” (Johnson, 2002). It also explains the factors that contribute to the development of the medical non-adherence trend in patients, and these are the issues affecting people in their daily lives such as financial difficulties. Besides this, the medical non-adherence model suggests possible solutions to this problem.
Research conducted on patients with problems of adhering to medication indicates that most of them have a cost cutting behavior, which compels them to cut on medication costs. Most patients seek medication only when they come across symptoms of diseases and terminate it the moment the symptoms disappear. They consider it a waste of resources treating a disease that is not visible yet they forget that the future cost of dealing with the consequences of non-adherence to medication is far much higher than the former. This is because failing to adhere to the prescribed medicine may bring about other health complications that could have been avoided.
Testability
In testing this theory, the study design used includes quantitative and descriptive correlational methods. When using the descriptive correlational method, non-adherence to medication is described in its natural state of occurrence for the results to represent reliable conclusions from the available information. The research population for testing the viability of this model is sample of patients suffering from hypertension and HIV mainly because these are the most common chronic illness that require a lifetime of medication. Another important aspect to consider when testing this model is the fact that medical adherence is a continuous variable which should be created by obtaining average scores for each respondent in the sample (Peterson, 2008). This study is conducted across both genders in order to determine the gender that is most vulnerable to the unhealthy habit of non-adherence to medication and the reasons behind this distribution.
Empirical Adequacy
This describes the descriptive models that provide support to the assumptions made in relation to medication adherence decision making in patients. One of these assumptions state that most patients who have problems adhering to medication lack social support and adherence self control (Fawcett, 2005). The other one purports that the treatment procedure of most of the chronic illnesses is a complex one. Research conducted based on empirical adequacy suggests a strong relationship between medical adherence and the patient’s characteristics such as race, age and socio – economic factors alongside psychological factors such as depression, drug abuse trends and the satisfaction obtained from the services offered by the health providers.
Pragmatic Adequacy
This describes the prescriptive models, which facilitate successful decision making in normative models. The theoretical allegations made in the medication adherence model are consistent with the pragmatic evidence brought out by the research conducted. One example of this is whereby the model illustrates “the effect of social and environmental factors and personal attributes on medication adherence patterns” (Johnson, 2002). The research findings indicate that the living conditions of patients, which is a social factor affects their medical adherence patterns of the patient directly.
Reference List
Fawcett, J. (2005). Contemporary Nursing Knowledge: Analysis and Evaluation of Nursing Models and Theories. 2nd Ed. Philadelphia: F.A. Davis Company.
Gustafson, D. H., Johnson, P. R., Molfenter, T. D., Patton, T., Shaw, B. R., & Owens, B. H. (2001). Development and Test of a Model to Predict Adherence to a Medical Regimen. The Journal of Pharmacy Technology: Jpt: Official Publication of the Association of Pharmacy Technicians, 17, 198-208.
Johnson, M. J. (2002). Medication Adherence Model: A Guide for Assessing Medication Taking. Research and Theory for nursing Practice. An International Journal, 16.3, 179 – 192.
McEwen, M., & Wills, E. (2011). Theoretical basis for nursing. (3nd ed.). Philadelphia: Lippincott Williams & Wilkins
Peterson, S. J. (2008). Middle Range Theories and Essentials of Nursing Research. Lippincott Williams & Wilkins.
Nursing theories portray the views that scholars had of nursing at that time. These nursing theories have evolved over time. In this paper I will examine closely the nursing theories using the microscope approach. The microscope is an instrument that is used to assist an individual focus on a particular item and examine it fully.
The nursing theories focused on the issue at hand fully and sought to bring certain changes to the individual. In order to get to a solution, the theorists highlighted the problem and the causes of the problem in the patient.
The nursing theories aimed to bring far away less understood issues closer for examination and observations in order to get a clearer understanding. At the end of the day, the theorists sought to achieve certain outcomes when their theories were applied by the nurses.
Nursing theories they can be classified into different categories according to the school of thought that was prevailing at that time. Under the three main categories of nursing theory, I will highlight the main focus of the nursing theory and the detail elements in nursing.
Care and Needs Theories
In the first classification of the nursing theories, the theorists showed that nurses were there to address the needs of the patients. A patient was an individual with unmet needs. He is unable to meet the needs therefore the nurse comes in to assist and equip the patient with the resources to be able to meet his needs. There were several scholars who contributed to the theory of care or needs. Jean Watson is famous for the theory of Human Caring which she put forward that
caring is a common and usual social behaviour in the world. This theorist felt that one could not take care of others unless the individual learnt to take care of himself. It was perceived that the people being treated have a need for provision of self-care in order to recover. The patient is taught how to nurture and intimately take care of his body. The nurse therefore came in to assist the patient take care of himself well. Non-provision of self-care services produces a deficit. In looking at humanness, love and care in the world were the most important things. Another theorist, Patricia Benner viewed caring as a process that created lasting human bonds in the world.
Virginia Henderson put forward the Development theory in 1961 stating the individual required a lot of help towards attaining independence (Lucille & Kelly, 2003, p 206). Nursing in detail consists of several stages where it is substitutive, the nurse doing for the patient, then supplementary where the nurse works with the patient. In the next stage, the nurse compliments the patient. The patient works with the nurse to take care of himself. Finally, the patient becomes fully independent. After hospitalisation, the rate of recovery in the patient is fast since he is independent in taking care of himself.
In taking care of himself, the nurse would in detail tell the patient how to take care of his needs. The patient should eat and drink adequately and ensure wastes are eliminated. Have adequate sleep and rest, select suitable clothes, keep the body clean and well-groomed and avoid dangers in the environment that would harm him. The patient was also expected to participate in recreational activities and have healthy and nurturing relationships.
It was also important to work and worship faithfully. The patient was to maintain healthy postures and modify clothing and change environment in different weather seasons in order to maintain acceptable body temperatures.
Humanistic or Interactive School of Nursing
The second classification focuses on the scholars from the humanistic school of nursing or the interaction school of nursing. The role of the nurse was to interact with the client
and help him or her set health promotion and maintenance goals and the means to achieve them. The patient and the nurse would have an interactive session and discuss the patient’s perceptions on the illness. The patient is an individual who is able to feel, think, choose and set goals. This goal oriented approach to nursing was put forward by Imogene King. She proposed that the nurse and the patient met as strangers in an environment where they interacted and set goals for development. Once the goals were achieved, there would be immense satisfaction experienced by both parties. If there was any role conflict then a lot of stress would be experienced in the nurse-patient relationship.
Ida Jean Orlando put forward the theory of Deliberative Nursing process theory which supported the use of goal-oriented behaviour (Roussel & Swansburg, 2005, p 16). The theorist wanted individuals to distinguish automatic actions from deliberative actions. The actions that were deliberate towards improving the health of individuals were what finally yielded solutions and change.
However automatic actions were just actions, nothing else. They did not cause the individual to learn much and meditate on their perceptions, thoughts and feelings concerning the disease that was affecting him. The role of the nurse was to help the
patient to learn lessons from his illness. This would be achieved through a therapeutic mutual relationship between the nurse and the patient. The patient should learn to accept that he is a human being who is prone to illness. If the patient is able to recover from their illness they will be able to function in their role. The focus of this school of thought is on both the individual and the nurse.
It focuses on the interaction between the two and how the nurse assists the patient cope with his illness. The individual is a unique being who perceives illness in a specific way. The nurse assists the patient to perceive the illness in a positive light. There is growth in personality when the individual views the illness positively. There is actually self-actualisation of the individual. The individual ends up being creative, constructive
and able to function in the community well since he learns from his experiences.
Care should be observed to ensure that there are no hindrances to the nursing process. The patient should get support from the nurse and have his needs validated. The interaction time should be fruitful and not mechanical.
The nurse would therefore go into detail getting the patient’s status of growth and development and his perception on the health status. Once the patient has communicated all these details, the nurse would bring in his special skills and knowledge and set goals for health promotion.
The System Theories
Nursing was viewed in terms of adaptation and the systems theories. Sister Callister Roy put forward the adaptation theory where she believed that if the level of simulation in the environment was at a level that could not be handled by the individual then it gave rise to a negative reaction to stress.
The stress could be internal in that it relates to the patient’s emotions and feelings and the perception he has of himself. It could also come from the external environment, where the individual is stressed by financial problems, work-related problems or family problems. Betty Neuman contributed to the stress theory by putting forward that every individual had the mechanism on how they reacted to stress which is the usual line of defence. If what is stressing the individual got through the line of defence then the individual would put up a lot of resistance against the stressors. The outcome of nursing in this grand school is to reduce the stress factors and those adverse conditions that end up affecting the optimal operation and well-being of an individual. The nurse works to assist the individual or patient to identify the stress factors and to strengthen his line of defence. The nurse would therefore assess the patient’s capability of coping with his environment. The nurse would keep providing stimuli for the patient to beef up his defence till there is a positive response.
The nurse therefore helps in restoring and maintaining the stability of the individual. When an individual was not at par with his or her environment it led to loss of energy. The nursing process therefore was present to assist the individual conserve his energy and maintain his structural, personal and social integrity. The patient was encouraged to have a healthy relationship with his environment.
Nursing Theories Perception on Leadership
Nursing theories viewed leadership in terms of the relationship between the nurse and the patient. The nurse as the leader was to help the patient take care of his needs and take care of himself.
True leadership would only be achieved by the nurses when the patient attained independence and was able to take care of himself. The nurse had to interact with the client and get all his personal details on his illness and his perception on the illness. Adequate physiological information also had to be obtained from the client. The outcomes of nurse leadership would be wellness and the attainment of health promotion goals.
A nursing theory that has been adopted by nurses is the Orlando’s theory of nursing leadership. It has been used in nursing administration and leadership. The interaction and exchange between the nurse and the patient is important and vital for the success of the treatment (Swansburg, 2002, p 231). The theory is based on several concepts that assist a nurse to be a great leader. The first one is the concept of professional nursing. The theory states that the nurse’s role is to provide assistance to a patient and meet his needs.
It is to help the patient be empowered and stop feeling helpless about the situation he is in. The second concept is providing a solution to the problem. The nurse provides the appropriate solution to solve the patient’s problem. There has to be an internal response to the cues that the nurse gets from the patients. The nurse will have certain perceptions and thoughts about the behavior of the patient. The nurse should act on these. The nurse should carry out an investigation of her response or reaction to the patient’s cues to find out its validity. He should not just assume that his automatic reactions are correct. The effectiveness of the nursing process is evaluated by the
resolution of the patient’s problem. Since the nurse and the patient are unique human beings, the process has to be repeated every time the nurse is treating a different client. Each time the nurse goes through the process he learns a new thing.
Orlando’s theory of nursing is a good foundation for nursing leadership or administration. The nurse leader ensures that the nurses engage in clinical treatment and not automatic reactions. The nurse’s action should be motivated by the patient’s needs and not the nurse’s past experiences, organizational needs or the doctor’s prescriptions. Nursing is about focusing on the patient and the interaction between the patient and the nurse. When it comes to leadership in the nurse’s profession, leaders are those who motivate other nurses to do their work well. They assist others have a good positive attitude towards their work. They also treat other nurses and patients with respect and are able to work towards the fulfillment of their goals and vision. Nursing theories pave way for the dynamic leader-follower model of nursing leadership. They provide a common concept and framework for the nurses to use. Since it is an interactive model, it can be used in leadership and management. The main reason the theory’s model can be applied to leadership is that it encourages feedback in the whole interaction process (Marquis & Huston, 2008, p 7).
Conclusion
Examining the nursing through the microscope approach shows their development over time. It shows the expectations of the nursing process in detail. It helps one understand what the patient should take care of when it comes to body cleanliness and exercise. It shows the specific communication and interaction between nurses and patients and the relationship a patient has with the environment. Nursing leadership, administration or management should ensure that the patient is the main focus and professional nursing is being practiced at the hospital.
References
Lucille A. & Kelly, Y. (2003). Kelly’s Dimensions of Professional Nursing New York: McGraw-Hill Professional.
Marquis, B. & Huston, C. (2008). Leadership Roles and Management Functions in Nursing: Theory and Application United States: Lippincott Williams & Wilkins.
Roussel, L. & Swansburg, C. (2005). Management and Leadership for Nurse Administrators, Massachusetts: Jones & Bartlett Publishers.
Swansburg, C. (2002). Management and leadership for Nurse Managers Massachusetts: Jones & Bartlett Publishers.
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.
Being one of the major events at the University of West Georgia nursing calendar, the American Idol Nursing Theory Contest was held this year with a view to come up with the best theorist based on the criteria set by the institution judges. This year’s competition attracted three judges who will be describing and selecting the best nursing theorist. The judges include Dr. Carol Wilson, Dr. O’Brian N., and Dr. Williamson. The three theories that will be examined by the judges comprise of Madeleine Leininger’s culture care theory, Hildegard Peplau’s theory of interpersonal relations, and Dorothea Orem’s nursing theory of self-care deficit.
The theories will be judged based on the criteria of their simplicity, clari,ty and clinical practice. The judges will be providing a brief overview of the theories including their conceptual framework, how the theories relate to the nursing practice, their philosophical background, their usefulness, and relevant assumptions. Each of the criteria has an individual range of scores in which they will be rated and the overall scores will be used to award the winning theory. Finally, the judges will explain the rationale of the final winner.
The Judges
This year’s contest has three judges, Dr. Carol Wilson, Dr. O’Brian N., and Dr. Williamson. Dr. Carol Wilson is a nursing professor at the University of West Georgia and has been lecturing nursing theory for over ten years. Similarly, Dr. O’Brian has experience in teaching and practicing nursing for over 15 years. At the University of West Georgia, Dr. O’Brian has been teaching nursing practice for over ten years. Dr. Williamson also has 25 years of experience in teaching nursing theory and application at the university. In addition, Dr. Williamson has over the years been a judge in the American Idol Nursing Theory Contest.
Theories and Theorists
As indicated before, the contestant in this year’s competition are Madeleine Leininger, Hildegard Peplau and Dorothea Orem. Madeleine Leininger culture care theory or trans-cultural nursing care theory is a known theory that has been widely applied in clinical nursing. The theory developed by Hildegard Peplau is known as the interpersonal theory while that developed by Dorothea Orem is called the self-care nursing theory. These theories will be judged according to the criteria of their applicability and usefulness. The winner will then be announced.
Madeleine Leininger’s Trans-Cultural Nursing
The trans-cultural nursing also known as cultural care theory is applied in both general practice areas as well as the specialty category (Basavanthappa, 2007). The Madeleine Leininger’s theory is today being studied as one of the nursing disciplines. According to this theory, the nurses have the task of recognizing the role culture plays in the health of the patient. While cultural background determines the type of care given to the patient as well as the patient’s health, the treatments that the patient get are also being determined by the patient’s culture (Leininger & McFarland, 2006). Moreover, this also theory considers the cultural background of the nurses.
In practice, nurses are supposed to take into consideration both the patients cultural background and that of themselves while providing care to the patient. The theory suggests that nurses must perform culturalogical assessment that evaluates the patient’s health depending on cultural condition (Leininger & McFarland, 2006). This appraisal is then applied in generating the nursing-care plan. Like the culturalogical health evaluation, the nursing care plan also considers the cultural setup of the patient.
Having the cultural background knowledge helps nurses to understand how to relate the patient’s culture and illness or suffering and how best they can provide care for the patients. Moreover, the knowledge enhances the nurse’s commitment towards providing care to the patient. The cultural knowledge enables the nurses to look at the patient holistically instead of the patient being considered merely as a set of warning signs of illness (Finkelman, & Kenner, 2010). Finally, the cultural knowledge enables the nurses to be open minded about the care and treatment they offer to the patients. In particular, the unconventional treatments such as religious-based treatments like anointing and spiritual reflection or meditation.
Hildegard Peplau’s Interpersonal Relations Theory
Hildegard Peplau’s interpersonal relations model was inspired by the relationship that exists between the nurses and the patients (Finkelman, & Kenner, 2010). According to this model, the patient-nurse relationship is the most important thing when offering care. This theory focuses on how the nurse-patient relationship is built while identifying the roles of nurses when discharging their duties. The theory has four components, the person, environment, health, and other human processes that include productivity, creativity, interpersonal, constructive, and community living (Masters, 2009).
The goal of this theory is to help nurses understand their own behavior, use their professional skills to help others identify their difficulties, and use the human relations principles to solve the problems that are being experienced in their daily duties (Peterson & Bredow, 2008). According to Peplau, nursing is therapeutic because of its healing characteristics. Peplau views nursing as a healing art where sick patients or those in need of health care are assisted to recover from their difficulties (Masters, 2009). Furthermore, nursing is interpersonal practice in which the relations between two or more persons with a common objective subsist. In this model, the patient and the nurse work together so as to gain a common knowledge in the care process, and is geared towards achieving a common purpose. The theory emphasizes on the roles the nurses play while discharging their duties. Hildegard Peplau acknowledged six main functions of nurses that among other comprises of the stranger and the leader.
As a stranger the nurse has the responsibility of meeting the patient and building a rapport just like in any other life situations. Acting as a teacher, the nurse passes on the necessary knowledge in accordance with the patient’s requirements and concerns. In proving the needed knowledge to the patient, the nurse also acts as a resource person (Peterson & Bredow, 2008). Specifically, the nurse communicates the essential information that is obligatory in the comprehension of the patient’s situation.
As a psychotherapist, the nurse has to offer assistance and give confidence that is vital for the patient’s recovery. In the process of guidance and encouragement, the nurse makes the patient appreciate and comprehend the existing life conditions (Peterson & Bredow, 2008). The nurse must also play the surrogating role by determining and clarifying to the patient the realm of interdependency, independence, and dependency. Finally, acting as a leader, the nurse will ensure that the patient have fully accomplished the treatment goals.
Dorothea Orem Self-Care Nursing Theory
Self-Care Nursing Theory of Dorothea Orem is also known as the Orem Nursing Model. The model is broad and takes into consideration various aspects and concepts that are applicable in all nursing situations. The primary viewpoint behind this theory is that all the patients should be assisted to care for themselves as almost all the patients would want to do so (Orem, & Taylor, 2003). The self-care enhances the patient’s quick recovery in a more holistic manner. In other words, the self-care enables the patient quickly recover in a manner they deem fit and appropriate.
The self-care prerequisites are basically categorized in three main areas. The universal self-care requisites that comprises of the needs every one else have such as food, rest, activity as well as risk prevention (Orem, & Taylor, 2003). The second requisite is the developmental self-care. The developmental self-care requisite is further divided into two categories. The maturation requisite advances the patient to the next level of development. The situational requisite protects the patient from detrimental effects during his development. The third requisite category is the health deviation. These are the requirements that normally arise depending on the patient’s condition. In case these requisites are not met, the patient suffers a self-care deficit. In such circumstances, nurses are anticipated to make available supportive modalities which in most cases are either entire or incomplete reparation.
One of the major advantages of this theory is that it can be used in various nursing circumstances and with a variety of patients (Kim, & Kollak, 2006). It has general principle and concepts that make it simple and applicable in many nursing set ups. According to the theory, nurses and patients ensure that the main goals of providing care are attained while at the same time take care of themselves for quicker recovery.
The Judge’s Overview of the Contestant
Dr. Carol Wilson
Madeleine Leininger’s theory of trans-cultural nursing seems to be more practical and simple to understand as compared to interpersonal relations theory of Hildegard Peplau and the self-care nursing theory of Dorothea Orem. In the performance criteria, the Leininger’s theory would have been graded seven out of ten. The reason is that the theory have been tested, applied and have been incorporated as a nursing discipline. The self-care nursing theory of Dorothy Orem is also more applicable in the nursing practice as compared to the interpersonal relations theory of Hildegard Peplau. Even though the theory can be applied in broad circumstances and with a variety of patients, self-care nursing theory has not been widely applied in the nursing fraternity. In terms of performance, the theory can have six points out of ten.
According to the simplicity criteria, the trans-cultural nursing theory of Madeleine Leininger will have the highest score in comparison to the other theories. The reason is that the premise is easy and straight, comprehensible and practical. In this criterion, the theory will have scored three out of three. In fact, the self-care nursing theory of Dorothy Orem will follow with a score of two out of three. The most complex theory is the interpersonal relations theory of Hildegard Peplau that has so many variables to be considered. However, Dorothy Orem’s self-care nursing theory is more useful in many fronts. It gives the patient time to have self-care while at the same time allow the nurses more time to attend to other issues. In this criterion, self-care nursing theory will have scored three out of four.
Dr. O’Brian
In the overall performance, Madeleine Leininger’s theory of trans-cultural nursing will have the highest score as compared to the rest of the theories. This theory is simple, direct, clear and more applicable. In the criterion, the theory will be rated seven out of ten. However, the Hildegard Peplau’s theory is more complex and require some of the attributes that some of the nurses may not have. The complexity of the theory makes it even harder to apply in the real nursing practice. Therefore, the theory is attractive in theory rather than in practice. Though the self-care nursing theory of Dorothy Orem is simple and has higher scores in other criteria, it has not been widely applied.
Dr. Williamson
The self-care nursing theory of Dorothy Orem should generally be the best in terms of performance. The reason being, it can be widely used in various nursing situations. This theory can be applied in all the circumstances at little cost compared to the other theories. This theory has attained higher scores in almost all the criteria. The interpersonal theory of Hildegard Peplau considers the patient care development as well as the best nursing attributes that are useful in their roles. However, the Hildegard Peplau’s theory of interpersonal relations is a bit complex as compared to the other theories. In general performance rating, it will still have lower scores compared to the other theories.
The Winner
Based on the criteria set by the judges, the overall agreement is that Madeleine Leininger is the winner of the competition. The Madeleine Leininger’s theory of trans-cultural nursing scored highly in most of the criterion set by the judges. The theory was simple, clear and has been applied in all clinical nursing. The theory has also been practiced in all other areas of nursing. In general, the theory had the highest performance.
Summary and Conclusion
The main aim of this paper was to discuss this year’s American Idol Nursing Theory Contest that includes the competition process, the contestants as well as the justification for selecting the winner. Moreover, each of the contestant theory was reviewed and rated based on the set criteria in order to come up with the best performance. On reviewing the contestant’s performances, Madeleine Leininger’s theory of trans-cultural nursing was chosen the winner. This was because of its simplicity, clarity, and wider applications in clinical nursing.
References
Basavanthappa, B. (2007). Nursing theories. Daryaganj, New Delhi: Jaypee Brothers Publishers.
Finkelman, A. & Kenner, C. (2010). Professional nursing concepts: competencies for quality leadership. Sudbury, MA: Jones & Bartlett.
Kim, H. & Kollak, I. (2006). Nursing theories: conceptual and philosophical foundations. New York, NY: Springer Publishing.
Leininger, M. & McFarland, M. (2006). Culture care diversity and universality: a worldwide nursing theory. Sudbury, MA: Jones & Bartlett.
Masters, K. (2009). Role development in professional nursing practice. Sudbury, MA: Jones & Bartlett.
Orem, K. & Taylor, S. (2003). Self- care theory in nursing. New York, NY: Springer Publishing.
Peterson, S. & Bredow, T. (2008). Middle-range theories: application to nursing research. New York, NY: Lippincott Williams & Wilkins.