Saturday, 3 September 2011

Basic Concept in Nursing

Nursing is Profession and Vocation

Criteria is a Profession
1. Code of Ethics
2. Research
3.Evidence base in Practice
4. Autonomy
5. Education
5. Service



      CONCEPTUAL AND THEORETICAL MODELS OF NURSING PRACTICE

Theorist
Description

FLORENCE NIGHTINGALE

·      Developed the first theory of nursing.
·      Focused on changing and manipulating the environment in order to put the patient in the best possible conditions for nature to act.

HILDEGARD PEPLAU

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

FAYE ABDELLAH

·      Defined nursing as having a problem-solving approach, with key nursing problems related to health needs of people; developed list 21 nursing problem areas
·             === To promote good hygiene and physical comfort ===
·             === To promote optimal activity, exercise, rest, and sleep ===
·             === To promote safety through prevention of accidents, injury, or other trauma and through the prevention of the spread of infection ===
·             === To maintain good body mechanics and prevent and correct deformities ===
·             === To facilitate the maintenance of a supply of oxygen to all body cells ===
·             === To facilitate the maintenance of nutrition of all body cells ===
·             === To facilitate the maintenance of elimination ===
·             === To facilitate the maintenance of fluid and electrolyte balance ===
·             === To recognize the physiologic responses of the body to disease conditions ===
·             === To facilitate the maintenance of regulatory mechanisms and functions ===
·             === To facilitate the maintenance of sensory function ===
·             === To identify and accept positive and negative expressions, feelings, and reactions ===
·             === To identify and accept the interrelatedness of emotions and organic illness ===
·             === To facilitate the maintenance of effective verbal and nonverbal communication ===
·             === To promote the development of productive interpersonal relationships ===
·             === To facilitate progress toward achievement of personal spiritual goals ===
·             === To create and maintain a therapeutic environment ===
·             === To facilitate awareness of self as an individual with varying physical, emotional, and developmental needs ===
·             === To accept the optimum possible goals in light of physical and emotional limitations ===
·             === To use community resources as an aid in resolving problems arising from illness ===
·             === To understand the role of social problems as influencing factors in the cause of illness ===

IDA JEAN ORLANDO

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

MYRA LEVINE

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

DOROTHY JOHNSON

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

MARTHA ROGERS

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

DOROTHEA OREM

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

IMOGENE KING

Nursing process is defined as dynamic interpersonal process between nurse, client and health care system.
Goal Attainment Theory Action is a sequence of behavior or activities that are towards the accomplishment of certain act. It is both physical and mental. Actions are aimed towards setting goals through communication between the nurses and the client then exploring and agreeing means to perform them thereby achieving the set goal

BETTY NEUMAN

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

SISTER CALLISTA ROY

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


LYDIA HALL

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

JEAN WATSON

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

ROSEMARIE RIZZO PARSE

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

MADELEINE LENINGER

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

Virginia Henderson




14 BASIC NEEDS

Henderson conceptualized the 14 Fundamental Needs of humas. These needs are:

    Breathe normally. Eat and drink adequately.
    Eliminate body wastes.
    Move and maintain desirable postures.
    Sleep and rest.
    Select suitable clothes-dress and undress.
    Maintain body temperature within normal range by adjusting clothing and modifying environment
    Keep the body clean and well groomed and protect the integument
    Avoid dangers in the environment and avoid injuring others.
    Communicate with others in expressing emotions, needs, fears, or opinions.
    Worship according to one’s faith.
    Work in such a way that there is a sense of accomplishment.
    Play or participate in various forms of recreation.
    Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities.

Ernestine Wiedenbach



Nursing Helping Art Theory The theory directs a nurse to identify her patient's need for assistance through observing the patient, striving to understand his behavior, identifying causes of his discomfort and determining whether the patient can solve the problem on his own or needs the nurse's help






  ROLES AND FUNCTION OF A NURSE


a.                    Communicator – communication is an integral to all nursing roles. Nurses communicate with the client, support persons, other health professionals, and people in the community. In the role of communicator, nurses identify client problems and then communicate these verbally or in writing to other members of the health team. The quality of a nurse’s communication is an important factor in nursing care.
-   Inform and Reports
 
B .        Collaborator -  Team / Interprets

 
C .                    Leader – a leader influences others to work together to accomplish a specific goal. The leader role can be employed at different levels; individual client, family, groups of clients, colleagues, or the community. Effective leadership is a learned process requiring an understanding of the needs and goals that motivate people, the knowledge to apply the leadership skills, and the interpersonal skills to influence others.
D.                    Manager – the nurse manages the nursing care of individuals, families, and communities. The nurse-manager also delegates nursing activities to ancillary workers and other nurses, and supervises and evaluates their performance.

 
E.                    Teacher/Educator – as a teacher, the nurse helps clients learn about their health and the health care procedures they need to perform to restore or maintain their health. The nurse assesses the client’s learning needs and readiness to learn, sets specific learning goals in conjunction with the client, enacts teaching strategies and measures learning. 
                                     - Primary role Prevent Illness and Promote Health
F.                   Counselor – counseling is a process of helping a client to recognize and cope with stressful psychologic or social problems, to developed improved interpersonal relationships, and to promote personal growth. It involves providing emotional, intellectual, and psychologic support.
G.                 Change agent – the nurse acts as a change agent when assisting others, that is, clients, to make modifications in their own behavior. Nurses also often act to make changes in a system such as clinical care, if it is not helping a client return to health.
H.                 Caregiver – the caregiver role has traditionally included those activities that assist the client physically and psychologically while preserving the client’s dignity.  Caregiving encompasses the physical, psychosocial, developmental, cultural and spiritual levels.
I.                   Client advocate – a client advocate acts to protect the client. In this role the nurse may represent the client’s needs and wishes to other health professionals, such as relaying the client’s wishes for information to the physician. They also assist clients in exercising their rights and help them speak up for themselves.

 J.                  Case manager – nurse case managers work with the multidisciplinary health care team to measure the effectiveness of the case management plan and to monitor outcomes

K.                  Research consumer – nurses often use research to improve client care. In a clinical area nurses need to:
·   Have some awareness of the process and language of research
·   Be sensitive to issues related to protecting the rights of human  subjects
·   Participate in identification of significant researchable problems
·   Be a discriminating consumer of research findings





 















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