Borrowed theories come from fields such as philosophy, psychology, and sociology.
They play a critical role in nursing research. These theories have concepts and propositions which provide strong foundations for the synthesis of nursing theories (Fawcett, 2005). Borrowed theories create a framework for multi-disciplinary and interdisciplinary relationships which improves comprehension and interpretation of human phenomena.
Shared theories belong to two or more disciplines. Shared theories are important in nursing research because they help researchers to use innovations from other disciplines (King, 2004). Shared theories provide researchers with a wide body of knowledge. They can be used to solve nursing problems and challenging situations (Fawcett, 2005). Solutions applied to related problems in other fields can be extended to nursing through shared theories.
Using theories non-nursing theories in nursing research is important because it enriches the practice. Additional knowledge, ideas and solutions from other fields help the field of nursing to address several unresolved problems and complex challenges. Using borrowed and shared theories improves the quality of nursing research (Fawcett, 2005). However, not all outside theories add quality to nursing research.
Sample Size, Validity and Generalizability
A sample is a group of objects included in a research study. Sample size determines the validity of any generalization. There are different ways of choosing a sample size. One of them is expedience. This entails using items that the researcher can access conveniently. Expedience allows researchers to use readily available items. The second method is target variance. This method derives a certain estimate from a sample.
Validity can be defined as the ability of a researcher or a study to answer relevant questions correctly. There are three types of validity. Construct validity is the ability of a construct to measure relevant variables (Kothari, 2004). Content validity is the ability of the contents of a research study to relate with the contents of a certain construct. Criterion validity is the ability of a test to correlate with criterion variables that represent a construct.
Generalizability refers to the ability to describe a larger population using findings derived from a small sample (Herzog, 1996). It refers to how research findings and conclusions from a smaller population can be used to define or characterize a larger population. A researcher can ensure an adequate and a diverse sample by using sampling methods that target a wide range of views and subjects. For example a researcher can identify all the ethnic groups living in a city and derive a sample from each.
Patient Care Issue and Qualitative Research
Effects of Family Presence during Paediatric Resuscitation on Family Members
The presence of family members during paediatric cardiopulmonary resuscitation is a controversial issue in emergency health operations. There are concerns that the presence of family members during paediatric cardiopulmonary resuscitation could traumatize them (Bauchner & Waring, 2002). There are several elements of this patient care issue that can be studied using qualitative inquiry. One of them is medical risk involved due to the presence of family members during the process. Others include the legal risk exposed to a health facility, estimated level of sympathy for the family members present during the process, and the level of concern by the health care providers (McGahey, 2002). There are several characteristics of this issue which are amenable to a qualitative study. The issue has descriptive characteristics which require qualitative data. Furthermore, the issue revolves around conflicting perceptions which require descriptive solutions.
References
Bauchner, H., & Waring, C. (2002). Parental presence during procedures in an emergency room: Paediatrics, 87(1), 544-547.
Fawcett, J. (2005). Contemporary nursing knowledge: analysis and evaluation of nursing models and theories. Philadelphia: F. A. Davis.
Herzog, T. (1996). Research methods and data analysis. New York: Harper Collins College Publishers.
King, M. (2004). Toward a theory for nursing: general concepts of human behavior. New York: Wiley.
Kothari, C.R. (2004). Research methodology. ND: New Age International Publishers.
McGahey, P.R. (2002). Family presence during paediatric resuscitation. Crit Care Nursing, 22(1), 29-36.
A distinguished nurse, social scientist, and chaired professor at Pasadena City College, Patricia Benner, dedicated her professional experience to the study of nursing behaviors and proficiency. The scholar developed a working theory of nursing competence together with her former students in four years (Benner, Sutphen, Leonard, & Day, 2009, p. 9). The theorist’s decision to develop the system of expertise levels for nurses was stipulated by the idea, according to which there appeared a significant distance between acute care and critical responsibility (Benner, Hooper-Kyriakidis, & Stannard, 2011).
From Novice to Expert: Critical Analysis
The work summarizes the key points of Patricia Benner’s article that discloses the peculiarities of contrastive proficiency levels (Benner, 2011). The study provides a consistent evaluation of nursing skills.
Primarily, the author points out that the art of nursing has been long ignored for two reasons. First, the medical workers were not inclined to adopt a nursing profession as a long-term career. Second, health-care activities were not fully developed since little attention was paid to the patients’ comfort. Therefore, Benner theorized a set of proficiency stages that demonstrate a worker’s occupational progress in the position of a nurse. These are novice, advanced beginner, competent, proficient, and expert (Table 1). The author describes each stage in detail and lists some recommendations on competence improvement.
The Significance of the Theory for Modern Nursing Education
The distinguished scholar strives to prove that proficiency levels can represent a ladder of success. Thus, it should be noted that every novice can become an expert, provided he/she receives appropriate instructions. Subsequently, the idea of nursing education, today, targets five levels of competence. For instance, the facets of personal digital assistants for novices are reviewed in the research studies (Krauskopf & Farrell, 2011). Consequently, Patricia Benner managed to prove that nursing proficiency may be acquired through elaborate educational preparation.
References
Benner, P. (2011). From novice to expert. The American Journal of Nursing, 82(3), 402-407.
Benner, P., Hooper-Kyriakidis, P., & Stannard, P. (2011). Clinical wisdom and interventions in acute and critical care. New York: Springer Publishing Company.
Benner, P., Sutphen, M., Leonard, V., & Day, L. (2009). Educating nurses: A call for radical transformation. New York: John Wiley & Sons.
Krauskopf, P., & Farrell, S. (2011). Accuracy and efficiency of novice nurse practitioners using personal digital assistants. Journal of Nursing Scholarship, 43(2), 117-124.
There is no use denying the fact that it is difficult to imagine modern medicine without a good theoretical base which makes the work of people more efficient and helps to save the life of patients. However, very often some theories can be too complicated and, additionally, they could even have the lack of practical background. That is why, it is difficult to accept some theories or suggestions because they are very vague. With this in mind, under modern conditions it seems vital to make some theories more understandable and clear for people, who study them, to be able to use them in practice. It will obviously help to increase the level of efficiency of the whole sphere.
Being a very important part of modern medicine, nursing as a science obviously has a great number of different theories which main aim is to increase the level of knowledge of people who work in this sphere and moreover, create some theoretical basis for it (What Nurses Do, n.d.). Its importance could not be overestimated because they help nurses in their work. The level of their efficiency depends on the level of understanding of the material (Statement of Purpose, n.d.). From these statements, it becomes obvious how vital it is for nurses to understand all main points of every theory. Under these conditions, the issue of operationalization and simplification obtains especial significance.
Nevertheless, it is obvious that these issues obtain importance because of a great complexity of some theories connected with nursing. The thing is that modern process of teaching suggests a great amount of information which a young specialist should process and understand. Sometimes, it is very complicated for him/her and, as a result, the gap in knowledge remains. At the same time, if some complicated theory can be simplified without any loss of its meaning, it can help professionals who work in this sphere to become more efficient and understand it. For example, according to the latest researches success rate among cancer patients depends heavily on the level of care which a nurse suggests them (Coban & Yurdagul, 2014). That is why, a special attention should be given to the process of preparation of these specialists. All theories connected with cancer should be explained for nurses with the usage of examples from practice for them to understand it better.
Additionally, it should be said that further operationalization and simplification of theories can be rather beneficial and have only positive influence on the whole sphere of nursing. Moreover, the practice should not also be forgotten. According to some researches, people accept information better if it is supported by some examples. That is why, it is possible to suggest further implementation of these practices can lead to the development of the whole sphere and help to make these very theories more applicable to clinic practices.
With this in mind, having analyzed the main ideas connected with the latest tendencies in nursing, it is possible to make a certain conclusion. It should be said that under modern conditions the issue of nursing theories and the level of their understanding obtains great significance. The thing is that very often people who work in this sphere feel the lack of knowledge connected with some issue. That is why, operationalization and simplification of nursing theories can help them.
References
Coban, G. & Yurdagul, G. (2014). The relationship between cancer patients’ perception of nursing care and nursing attitudes towards nursing profession. Asia-Pacific Journal of Oncology Nursing, 1(1), 16-21.
Statement of Purpose. (n.d.). American Nurses Association. Web.
What Nurses Do. (n.d.). American Nurses Association. Web.
Nursing has evolved over time into a profession with its own body of knowledge (Abdellah, 1972). Research has picked momentum and is currently generating a lot of new knowledge. Research in various areas of nursing has necessitated the establishment of learning and practice theories. Theories attempt to explain phenomena.
A theory is a set of closely linked ideas. A theory represents an attempt to explain phenomena that are associated with certain behaviors. Nursing theory is a set of concepts, assumptions and definitions obtained from nursing models (Abdellah, 1972). Nursing theories often link the concepts, assumptions, relationships and definitions together. This gives rise to an explanation, a system of doing things or a way of performing certain procedures. That is, it lends guidance to the nursing practice.
Theories enable both nursing students and qualified nurses to understand the principles underlying certain interventions and to predict the likely outcomes of the said interventions. However, theories do not provide guidance to all aspects of nursing. In addition, theories may be largely made of opinions and not facts. Nursing should always focus on both patient and nurse safety. Where theory is thought to be insufficient, the best practice principles should be followed. Theory may undergo some modifications over time owing to emergence of new evidence and better understanding of phenomena.
Theories in nursing research may be used to explain certain behavior. Understanding behavior is necessary in some studies because it may be the only logical explanation of some findings. In nursing, theories are often used to guide interventions, patient safety, and nurse safety. No theory can sufficiently explain a phenomenon. A theory may guide the development of new knowledge in the field. It directs the course of the profession. Without theories of nursing, the development of knowledge may become slow. Generally, nursing theories guide patient care, nursing education, and professional development.
The major problem facing hand hygiene is lack of compliance with hand hygiene standards (Caglar, Yildiz & Savaser, 2010; CDC, 2002). Several studies have shown that this phenomenon is not related to lack of knowledge and moral issues (De Wandel, Maes, Labeau, Vereecken, & Blot, 2010; Galway et al, 2003). Some researchers have reported that attitude and motivation are the most accurate predictors of hand hygiene behavior (Parmeggiani, Abbate, Marinelli & Angelillo, 2010).
A theory has been proposed to explain this behavior; attribution theory. The theory was developed in the twentieth century. Attribution theory was identified as the most appropriate theory to explain the proposed intervention in this study. To explain reasons why health workers find it hard to comply with hand hygiene guidelines, it is necessary to understand their behaviors.
Attribution refers to the process of explaining phenomena by linking them to others or things. In the case of hand hygiene, attribution theory may be used to explain the hand hygiene behaviors of the health workers. This implies that behavior is caused. There is a reason for every behavior. Hand hygiene behavior can be attributed to self or to others. Attribution theory exists in two forms; situational and dispositional. Situational refers to external factors while dispositional attribution refers to factors inherent in the individual.
References
Abdellah, F. (1972). Evolution of nursing as a profession: Perspective on manpower development. International Nursing Review, 19, 219-238.
Caglar, S., Yildiz, S., & Savaser, S. (2010). Observation results of handwashing by health-care workers in a neonatal intensive care unit. International Journal of Nursing Practice, 16(2), 132-137. Web.
De Wandel, D., Maes, L., Labeau, S., Vereecken, C., & Blot, S. (2010). Behavioral determinants of hand hygiene compliance in intensive care units. American Journal of Critical Care, 19(3), 230-239. Web.
Galway, R., Harrod, M., Crisp, J., Donnellan, R., Hardy, J., Harvey, A., & Senner, A. (2003). Central venous access and handwashing: variability in policies and practices. Paediatric Nursing, 15(10), 14-18.
Parmeggiani, C., Abbate, R., Marinelli, P., & Angelillo, I. (2010). Healthcare workers and health care-associated infections: knowledge, attitudes, and behavior in emergency departments in Italy. BMC Infectious Diseases,1035. Web.
Over the years, the world has been experiencing different changes in all sectors of the economy. Although some may argue that change is often not recommended, it is good for people to adapt to the dynamics they are experiencing. For instance, ever since the agrarian revolution, the agricultural sector witnessed the transformation and people started using sophisticated machines to produce enough cultivated products. This change is depicted in the industrial revolution era which forced many regions across the globe to invest in industries and create more jobs. However, the current digital era has created and caused the loss of many jobs, in equal measure, to people and industries.
Nonetheless, the firms which ignored the changes have either become extinct or are on the verge of closing the business. For example, some pharmaceuticals firms across the world have been experiencing constant change on the types of medicine they give to their patients. Most drugs have either been declared not suitable for consumption while others cannot currently perform their intended functions. Similarly, the healthcare sector has been experiencing transformation in service delivery. Recently, the inpatient nursing in med surgery or sub-acute unit experienced numerous changes in the number of patients, demographic population, human resources, usage of technology, and teamwork activities.
Recent Changes in the Inpatient Nursing
One of the changes in the inpatient nursing is the surge in the number of patients. Initially, few people needed the services of the medical surgery nurses due to the high expenses. However, currently, many sick people undergo surgery with more complexities than it was previously witnessed. As a result, the number of nurses rendering the services are overwhelmed with the number of sick individuals and the patients who prefer more personalized care. The nurses not only provide the services in the hospital setups as it has been initially done, but they also offer their care through telecommunication and homecare. Therefore, the nurses have to adapt to the increased activities in the facilities and also to ensure that the clients are satisfied with the services.
Another change witnessed in inpatient nursing is the demographic fluctuations. America’s population is aging and many citizens are above 65 years of age and the figure is expected to increase by more than half in the next 25 years (Kanasi et al., 2016). According to the research conducted by Kanasi et al. (2016), elderly individuals are more susceptible to chronic illnesses and almost over 50 percent of the old persons across the country are suffering from chronic diseases.
This, therefore, implies that more nurses will be required in the acute and medical surgery units, thus, making the nurses to adapt to the situation. Initially, people who were operated were placed in the acute units were the individuals of average age (Kanasi et al., 2016). However, the elderly who have undergone surgery need more care and are supposed to be handled with diligence. Besides, the facilitates advocate for a shorter stay in the hospital environment and this further makes it difficult for the nurses to offer their services. Therefore, registered nurses will have to adapt to the changes and ensure that clients are taken care of regardless of the place where the patients are based.
Health care facilities have also been trying to cut the expenditure by striving to use the services of the human resources effectively. As a result, the leaders in the health amenities have been forced to integrate the duties of both the Registered Nurses (RNs) and Licenced Practical Nurses (LPNs). The introduction of unregulated health care workers into the surgical units has changed the way RNs provide their services in the acute areas.
As a result, registered nurses working in the department are required to enhance the safety of the patients because some healthcare providers perform the activities they are not trained to do. Instead of blaming other people who work in the medical surgery unit, nurses are required to provide leadership and look at the main cause of the problem. In other words, the tasks of RNs have increased since they have to perform the role of caregiving in addition to guiding other non-registered nurses on what to do.
Because of the overlap in the tasks performed by RNs and LPNs, there is a difficulty in making decisions which can improve the health of the patients since each category of nurses has a varied opinion on how the patients should be treated Currently the nurses’ activities in the medical surgery units risk the health of patients. Therefore, there is transformation on the duties of the nurses.
Technology is also a change that has been witnessed in inpatient nursing. Over the past few years, healthcare facilities have adopted usage of technology ranging from keeping patient records to performing complex operations. Nurses in the medical surgery and acute units have also been involved in the widespread use of technology. Initially, nurses in the surgical departments were manually taking patients’ records and monitoring their progress. However, they currently use electronic health records (EHRs) database to record and keep the patients’ data. As a result, they are required to adapt to the current technological changes and be conversant with information technology.
Teamwork is also a change that is seen in inpatient nursing. Nurses are required to work in groups to ensure effective service delivery and also promote patient safety. Working individually has been found to promote patient negligence and also cause the deaths of many patients in the US (Kaiser & Westers, 2018). A study conducted by Rodziewicz et al. (2020) concluded that many patients have died in the US due to complications that would have been prevented if the nurses worked in a group. As a result, nurses are required to currently work in teams to ensure there is an effective flow of information and delivery of services. Although some nurses who were previously enjoying working solely, opposed this action, they are currently required to form teams, especially in the medical surgery departments.
The Changes Presented and Received
Some changes such as the surge in the number of patients and demographic changes were naturally presented. The healthcare facilities had no control over the number of patients they received although they could regulate those that they admit into their facilities. Aging is also normal and the type of diseases that the elderly experience cannot be determined by both the hospitals and the caregivers. Therefore, the nurses in the medical surgery department had to adapt to the new changes. They had to learn how to handle the old patients and also dealing with the increased population. Although some healthcare facilities opted to hire new nurses trained in dealing with patients at the acute departments, the number of healthcare providers could still not march the increased number of patients. Therefore, the changes forced the nurses to get out of their comfort zones and adopt new ways.
Integration of all human resources in inpatient nursing and the use of technology to keep the records of the patient was positively received by some nurses while others were reluctant to adopt the changes. Incorporating all the human resources, for instance, did not go well with the nurses who had primary training on dealing with patients in the acute and medical surgery unit and were registered. These nurses felt that their positions were being taken by people who were not qualified to offer the services.
Equally, the untrained personnel also felt that they were being tasked with additional responsibility that they did had little knowledge. As a result, untrained human resources were reluctant to take their new duties and perform them with zeal. However, there was a group of nurses that fully embraced the changes and adopted the new ways. They guided their new team members and were also willing to consider what the new members had to offer. In the end, they ensured that the patients’ safety was enhanced.
In regards to teamwork, the nurses in the department were not all willing to participate. There were those who instantly took the challenge and started working in teams. Quality service delivery to the patient was their main goal and they had to do everything it takes to ensure that patients are served. Nonetheless, some were hesitant to engage in teams the same way it is presented in Business Recovery (2017). They were comfortable with working individually thus, they initially avoided any form of teamwork. They gave all the reasons that could make them be omitted from the groups and not to be answerable to the team leaders.
Change Theory
Force Field Model and the Unfreezing-Change-Refreezing Model is the best theory that can accurately describe the changes that recently occurred in inpatient nursing. The theory was pioneered by Kurt Lewin and it helps to explain the dynamics witnessed in the development of an organization (Rosenbaum et al., 2018). It is a three-stage model and it examines the forces that influence a situation. It makes the organizational leaders to ignore the previous knowledge while replacing them with the new information. Based on the theory, change occurs when the driving forces overcome the restraining situations.
In the case of inpatient nursing, the powerful forces are the increase in the population of patients and the aging group. These categories of individuals come with new diseases that require close care, while the restraining forces are the unwillingness of the nurses to work in groups, embrace information technology among others. The change, however, occurs in the thoughts, feelings, and behaviors of the nurses and all the human resources tasked with providing care for the patients in the medical surgery units.
In conclusion, change is inevitable and people should embrace change as soon as possible. Inpatient nursing is one of the areas that has received several changes in terms of offering services to patients. The changes range from the number of patients who require the services of the nurses in medical surgery sections to the care given. Nurses in this sector are constantly overwhelmed and, as a result, they are required to adapt to the new changes to offload some of the tasks while ensuring quality service delivery. Therefore, change is important and every nurse should not hesitate to take the changes they experience in life positively.
References
Business Recovery (2017). Who moved my cheese. YouTube. Web.
Kaiser, J. A., & Westers, J. B. (2018). Nursing teamwork in a health system: A multisite study. Journal of nursing management, 26(5), 555-562. Web.
Kanasi, E., Ayilavarapu, S., & Jones, J. (2016). The aging population: Demographics and the biology of aging. Periodontology 2000, 72(1), 13-18. Web.
Rodziewicz, T. L., Houseman, B. & Hipskind, J. E. (2020). Medical error prevention. In StatPearls [Internet]. StatPearls Publishing. Web.
Rosenbaum, D., More, E., & Steane, P. (2018). Planned organizational change management. Journal of Organizational Change Management, 31(2),286-303. Web.
Describing a clinical practice situation which requires the applicant to use problem-solving skills successfully and how the applicant will take a leadership role as an FNP.
Virginia Henderson, a nurse theorist, describes a nurse as one who has the unique function of assisting the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that they would otherwise perform unaided if he had the necessary strength, will or knowledge and to do this in such a way as to help them to gain independence as rapidly as possible. The nurse must in a sense, get inside the skin of each of her patients in order to know what they need. This means, that the nurse finds herself with a new challenge to handle since each patient is an individual with their own unique needs. Abdellah, F. (1987), in his theory, Topology of 21 Nursing Problems, states problem solving as one of the eleven fundamental skills of a nurse. He further describes people as having physical, emotional and sociological needs hence; a patient is described as the only justification for the existence of nursing.
In my profession as a Family Nurse Practitioner, FNP, I have encountered a myriad of challenges that required me to apply my problem solving skills. It was a few weeks ago when my patient whom I choose to refer to as Mr. X for confidentiality purposes came into the clinic with very low blood sugars that he almost went into a hypoglycaemic coma. He was shaking, sweating profusely and was confused. Hypoglycaemia is a condition in which blood sugar levels are unusually low and it could be fatal if not attended to promptly since the brain may be deprived of glucose leading to its damage.
I had known Mr. X as my patient for one year. He is a fifty three year old man from Iraq who works as a bus driver. He is a father of three and is married to one wife. He was newly diagnosed with type 2 diabetes which is a condition characterized by tissue resistance to the action of insulin combined with a relative deficiency in insulin secretion. Although insulin is produced by the B cells in these patients, it is inadequate to overcome the resistance, resulting in raised blood sugars. He was initially put on oral ant diabetic agents but the sugars were still not controlled hence, he was put on insulin. I had taught Mr. X and his wife the technique of injecting the insulin subcutaneously, the dosage, the time to have it because he was on the 70:30 mixtard preparations and how to properly plan for his meals. He had followed my instructions to the letter and the times he came for revisits, I emphasised on the instructions. In fact, he had been faithful with his exercises and was determined to lose weight and maintain a healthy lifestyle. He had also tried to reduce the number of cigarettes he smoked from twenty to ten in a day. Generally, Mr. X was doing well and his blood glucose was under control until this day that he came in with hypoglycaemia.
Mr. X was put on 25 millilitres of 50% glucose intravenously over three minutes to reverse his hypoglycaemic condition. The blood sugar levels were controlled and a glycosylated Hemoglobin, HbA IC of 5.9% was achieved. The normal level is below 6%. Once he was stable, I decided to discuss his condition with him and to get a more detailed history of what exactly had happened.
Mr. X insisted that he was not sure of what had happened because he had followed his drug regimen faithfully and my instructions too. As we discussed about the aetiology of hypoglycaemia and its complications, the wife interjected saying that perhaps Mr. X suffered from hypoglycaemia due to injecting himself with insulin yet he had not eaten since it was the Muslim Ramadan month. She explained that Ramadan is a month of obligatory daily fasting. It is the ninth month in the Islamic lunar calendar. Daily fasts begin at dawn and end with sunset. Special nightly prayers called, Taraweeh are held and the entire Quran is recited in Mosques all around the world. She explained that they both took part in this fast because they believed that they will draw nearer to Allah who would heal Mr. X of his condition.
This information unravelled the mystery. Mr. X confirmed that he had not eaten the whole day but he had had his insulin shot. As a nurse, I knew this was a critical issue; it touched on religion. I am not Islam but ethically, I had to respect my patient’s beliefs and not impose my views on him. Certainly, this was a situation that needed to be handled carefully because the patient’s health was at stake yet his firm believe had to be respected.
A sombre mood had engulfed the room; I could feel it. Mr. X was not pleased. His wife had spilled the beans and in their culture, women are not to be heard, they are only to be seen. I had to quickly take control and discussed more about starving as a major aetiology of hypoglycaemia and I explained how lack of eating and taking insulin affected the body. I made it clear to Mr. X that it was not a bad thing to fast and that he was justified to do so by his faith. However, I explained to him that there were exceptions to the rule if the fast would be detrimental to his health. As I spoke to him, he seemed adamant and disagreed with what I was saying. At some point, he harshly yelled at me that I spoke like an atheist who knew nothing about Allah.
Noticing the situation was going to get out of hand, I thought of my colleague who was a doctor and was also a Muslim. With the consent of Mr. X, my colleague came in and explained to him. He even called one of the Islamic religious leaders to affirm that there are people exempted from the fast such as Mr. X and that it was not a sin. Mr. X was convinced and he really appreciated us for enlightening him and saving his life. They both left my office a happy couple who would enjoy the rest of the holy month without any health issues.
This was a situation that not only put a demand on my problem solving ability but also on my leadership skills. As an FNP, I had to take control of the situation. First, I had to contain my emotions and not react to Mr. X’s insults. True leaders do not react to situations, they respond instead. I had to respect my patient’s religious beliefs and not judge them or try to impose mine on them. This means as a nurse, one should handle each patient as an individual and holistically. As a leader, critical and quick thinking is a vital skill. One must prioritize their actions like in this situation; I had to ensure that Mr. X was in a stable health condition before making further enquiries on what had happened. This shows that you care about the patient’s welfare. Leadership as an FNP also means that one has to embrace teamwork. In the health profession, teamwork is indispensable and we should work in concerted efforts to provide quality care for the patient, George Julia B. (1990).
Nursing is indeed a profession that presents the nurse with different situations to deal with. Thus, proper problem solving and leadership skills are valuable tools of trade that one must have.
References
Abdellah, F.G. (1987) Citing websites. In Topology of 21 Nursing Problems, Web.
George Julia B. (1990) Citing website: Nursing theories. In Nursing Research and Theories, Web.
The conceptual models contain values that underlie nursing, views on health, roles, functions, tasks, and ways to determine patients’ needs. An effective nursing model should be focused not only on illness but also on a person (Lim-Saco, 2019). It must pay attention to maintaining human health, improving the quality of life, and solving problems related to the health of a person, family, groups of people, and the whole society.
The Theory of Integral Nursing is a holistic worldview that includes all aspects of human existence: spiritual, intellectual, emotional, physiological, and social. Using a personalized approach that takes into account the patient’s unique internal and external factors, this theory offers the most appropriate methodology (Smith & Parker, 2015). This model can benefit society since it aims at restoring and supporting health and wellness throughout a person’s life. It considers all factors that affect health, including body, mind, spirit, and community. The advantage is given to effective, more natural, and less invasive therapies. Along with the treatment concept, the concepts of health promotion and disease prevention are of great importance (Smith & Parker, 2015). With an increased integral awareness and a holistic worldview, nurses who practice this theory have new opportunities and ways to strengthen their abilities.
The Theory of Modeling and Role Modeling in nursing focuses on the client’s needs and respects the uniqueness of every person. The patient is viewed as an individual with a certain set of behavioral subsystems. This theory helps to restore the balance in the disturbed subsystem of behavior by influencing the internal and external factors, and the environment surrounding the patient (Alligood, 2017). Using this model, a nurse aims at achieving a change in the person’s behavior to lead him or her to recovery and social adaptation. This approach is the key to responding to the patient’s unique conditions and circumstances.
These theories in the integrative-interactive paradigm focus on the person as an active participant, as well as on his or her self-esteem, the ability to communicate, and perform certain roles. Nursing assistance plays an important role when the self-perception of a person associated with the state of his or her health cannot be easily adapted. The goal of these conceptual models in nursing is to achieve a state of health through a holistic approach and therapeutic interaction between a nurse and a patient.
References
Alligood, M. R. (2017). Nursing theorists and their work (9th ed.). St Louis, Missouri: Elsevier.
A theoretical framework helps the researchers structure the study and move the investigation forward, using principles and terms grounded in the existing body of scientific literature. In nursing, theories allow one to imagine a problem under examination from a certain viewpoint and focus on its specific details (Gray et al., 2017; McEwen &Wills, 2019). For example, in the study “Analysis of the UCSF Symptom Management Theory: Implications for Pediatric Oncology Nursing,” Linder (2010) uses the Symptom Management Theory (SMT) in the field of pediatric oncology. To ensure that this theory is suitable for research, a theory evaluation is necessary.
As stated above, Linder (2010) chose the Symptom Management Theory to investigate issues in pediatric oncology nursing. SMT was developed published in 1994, although it has been re-released with revisions later (Landers, 2014). According to the basic ideas of SMT, the process of symptom management can be systematized to ensure the best patient outcomes. The theory comprises three elements – symptom experience, symptom management strategies, and symptom status outcomes (Landers, 2014). These concepts are interconnected, and they influence one another; for example, a person’s response to a symptom can influence their perception of that symptom (Landers, 2014).
Linder (2010) selected this theory for oncology as symptom management is a large part of dealing with cancer. The author suggests that the multidimensional description of symptoms makes SMT a suitable approach to assessing pediatric oncology nursing research. Linder (2010) appraises the theory using Walker and Avant’s method and determines that SMT is a good fit for their investigation sphere. In particular, SMT origins are related to conditions such as diabetes, cardiac disease, chronic pain, and cancer. Thus, as SMT was initially developed with cancer patients in mind, its suitability for cancer-related research is significantly increased.
The assumptions in SMT address a wide variety of scenarios of symptom management. For instance, the gold standard is the perception and self-reporting of patients’ symptoms (Landers, 2014). SMT considers cases where people are nonverbal or cannot describe their symptoms, and the interpretation given by the guardian or caregiver is treated as valid (Landers, 2014; Linder, 2010). Here, the theory’s authors demonstrate how it can be used in a pediatric setting.
Linder (2010) states that the meaning of SMT and its main concepts are limited to the middle range theory, which grounds it in practice. The three components of SMT raise some questions when using it in pediatric nursing. For example, parents can be less perceptive of the children’s symptoms, thus lowering the quality of perception-based evidence for treatment; technology and observation can mitigate this risk. Linder (2010) argues that symptom outcomes are underdeveloped in SMT, as the relationships between different dimensions of the outcomes are not specified.
Nevertheless, Linder (2010) finds SMT to produce consistent results in other studies. Cwiekala-Lewis et al. (2017) and Linder (2010) show that both adult and pediatric studies can benefit from using SMT as the framework. The several logical fallacies that Linder (2010) documents deal with applying the theory in pediatric settings. The author believes that parental reports may be insufficient for initiating treatment (Linder, 2010). SMT has limitations in describing the plurality of symptoms in cancer and similar conditions (Linder, 2010). Therefore, it may be necessary to test SMT with such symptom clusters in mind further.
Overall, SMT is an empirical middle-range nursing theory used for various conditions; it has shown positive results in its applicability. Its basic concepts are grounded and clear, although some statements raise questions when applied in pediatric nursing. SMT has limitations in this area and its inability to capture changing and multiplying symptoms characteristic of cancer. SMT has the potential for being helpful in pediatric oncological nursing if it addresses these problems.
References
Cwiekala-Lewis, K., Parkyn, B. H., & Modliszewska, K. (2017). Analysis of University of California in San Francisco (UCSF) symptom management theory and theory implication for persons with neurological disorders/diseases. The Journal of Neurological and Neurosurgical Nursing, 6(2), 55-65. Web.
Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). Saunders Elsevier.
Landers, M. G. (2014). Symptom management theory. In J. Fitzpatrick & G. McCarthy (Eds.), Theories guiding nursing research and Practice: Making nursing knowledge development explicit (pp. 35-50). Springer Publishing Company.
Linder, L. (2010). Analysis of the UCSF symptom management theory: Implications for pediatric oncology nursing. Journal of Pediatric Oncology Nursing, 27(6), 316-324. Web.
McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.) Wolters Kluwer Health.
The initiative on improving patient outcomes requires the use of theoretical approaches to the problem. They are frequently provided by other fields when applicable to nursing and used by scholars for researching the ways to modify the patterns of healthcare services provision (Ryan, 2009). The lack of thereof might result in the impossibility to use their findings in practice due to their ambiguity, and this fact defines the need to adopt various frameworks. Therefore, it is vital to examine the application of social and behavioral theories to the operations of healthcare facilities in practice by considering the case of the 65-year-old woman admitted for a mastectomy.
In the situation under consideration, the principal factors, which should be examined for selecting applicable theories, are the effects of the condition on the patient. According to the information, the woman expressed fear and depression as the main obstacles to providing medical services (McEwin & Wills, 2019). Hence, the most suitable concepts include symbols as per symbolic interactionism, a social position as per the role theory, age appropriateness as per the developmental theory, and cognitive restructuring as per the cognitive theory.
The planning of care should start with assessing shared meanings stemming from the patient’s belonging to her population group defined by gender and age. In other words, the reported feelings should be viewed through the lens of their connection to symbols reflecting their basic perceptions (McEwin & Wills, 2019). They will be complemented by analyzing her social position with corresponding beliefs contributing to the negative attitude towards the proposed interventions (Conrad & Barker, 2010). In turn, the inclusion of age appropriateness and cognitive restructuring will allow assessing her behavior concerning her development stage and reveal possible bias in the perspective.
In practice, it is possible to incorporate the concepts stemming from the corresponding theories described above in the plan of care for the woman. They will be useful in acquiring sufficient information regarding the obstacles to her well-being and finding methods to overcome them as per symbolic interactionism. First, the symbols typical for female patients over 65 years include the increasing concerns about health typical for this population group alongside their worries about negative consequences of interventions (Conrad & Barker, 2010). Even though the creation of such shared meanings is critical in terms of survival in society, it can become exaggerated with age, as follows from the developmental theory (McEwin & Wills, 2019). It means that a nurse should start communicating with the patient by debunking the myths of lower quality of life, which is the main woman’s fear.
Subsequently, the attention to the person’s social position and cognitive restricting will help avoid misinterpretation of the information provided by healthcare employees. The former will be useful in revealing the impact of the woman’s family and friends on her attitude towards the proposed intervention in accordance with the critical social theory and the role theory (Carnegie & Kiger, 2009). In turn, the latter will be advantageous for ensuring that the woman understands the actual meaning of mastectomy for her and does not rely on distorted facts (McEwin & Wills, 2009). The information regarding these two aspects should be included in the initial conversations with the patient so that they are not overlooked in the process of treatment.
If the woman were 25 years old or 45 years old, the provision of care to her would have changed dramatically due to the difference in circumstances. First, she would have shared different convictions deriving from belonging to another population group. They will be less likely to view the situation as critical in terms of complications, and their more positive perceptions will facilitate the work of nurses (McEwis & Wills, 2019). Second, the patient would have been considered from the perspective of her characteristics, such as younger age, varying beliefs, and other personal factors. Their combination allows for addressing other concerns deriving from different views. In this way, the nursing approach should have been readjusted following these conditions.
Social psychology theories are helpful in this case because they have been widely used for promoting breast cancer awareness. Their effects can be clearly seen from the adoption of social constructivism as an instrument to inform people and predict their reactions based on one’s culture (Conrad & Barker, 2010). Hence, the woman expressed negative feelings because she was already aware of the significance of this intervention for her future well-being from the shared meaning of this event while realizing its inevitability. In this way, applying theoretical approaches allowed revealing the source of the patient’s concerns while acknowledging the information available to her.
These theories have also been suitable for my clinical practice area. Thus, examining sociological and behavioral factors as per the commitment to health theory and the critical race theory helped understand the patients better (Kelly, 2008; Ford & Airhihenbuwa, 2010). In other words, their evaluation helped me determine the probability of behavior change for active participation as well as the impact of race, among other characteristics, on the outcome.
To summarize, the case under consideration can be successfully addressed when using various theories. They can demonstrate the significance of personal and external factors for care provision and adjust the plan of interventions accordingly. In this way, it can be concluded that sociological and behavioral factors have a tremendous impact on one’s health and affect the overall process of rendering medical services in a clinical setting.
Nursing is a complex profession that involves a wide variety of hard and soft skills that are needed to achieve its goals. The primary objective of nursing is closely linked with the concept of care and patient well-being. The profession of nursing highly involves interpersonal skills, which may significantly influence the relationship between the clinician and the patient, resulting in better physiological and physical wellness as well as better outcomes. Therefore, it may be possible to assume that such interpersonal skills play a key role in the provision of care. However, even though soft skills are essential, there are also numerous hard skills that may improve the quality of nursing. It is vital not only to have sufficient theoretical knowledge regarding prescriptions, medical conditions, possible contradictions, and disorders but also to learn about the theoretical frameworks of nursing in general. As the profession frequently involves high-risk decision-making, it may be vital to utilize existing experience in order to introduce the most appropriate solution to controversial issues.
Nursing theory is a multifunctional tool that allows nurses to implement the best existing frameworks into practice. Some sources state that nursing theory is an inseparable part of nursing development as a science and as a profession (Yu & Song, 2021). Moreover, it may be used as a guide to developing better decisions for diverse problems that occur. For example, a patient was refusing to take prescribed medication as he did not trust the healthcare system for personal reasons. Theoretical knowledge about the principles of holistic care encouraged the nurse to consider other dimensions, including social, economic, and spiritual wellness of the patient. Such an approach allowed the nurse to establish trusting relationships and identify that the patient refused to take medications as they were too expensive. As a consequence, a more affordable treatment plan was developed.