Description
Directions:
Initial Post
Review nursing theories in the assigned reading. Select one nursing theory that you would like to integrate into your nursing practice. In your initial post address the following prompts and/or questions.
Describe the components of the nursing theory. Include specific examples.
Explain how you will incorporate this nursing theory into your nursing practice. Include rationales and examples.
Reply Post
In your reply post, write a reflection on one student’s initial post who discussed a different theory than you selected. In your response address the following prompts and questions:
Explain the similarities and differences between the two theories.
Initial post requirement must be 250 words minimum and done by Wednesday night at 11:59pm. The 2 peer responses must be 150 words minimum each and must be completed by Saturday night at 11:59pm.
Unformatted Attachment Preview
Chapter 1
The Development of a
Profession
Joseph T. Catalano
Copyright ©2019 F.A. Davis Company
Introduction
• Professionalizing nursing: began with Florence Nightingale
• Desire to have nurses seen as high-level healthcare providers
• Staff nurses, students, and some others may not see the importance of
having this professional image.
• So, where is nursing on the road to being a profession?
What Is a Profession?
Defining profession has met with
mixed success.
Current leaders: Flexner, Bixler, and
Pavalko
Common important
characteristics
High intellectual level
High level of individual
responsibility an accountability
Specialized body of knowledge
What Is a Profession?
Knowledge that can be learned in institutions of higher
education
Public service and altruistic activities
Public service valued over financial gain
Relatively high degree of autonomy and independence of
practice
Need for well-organized and strong organization
representing the members of the profession and
controlling the quality of practice
A code of ethics that guides the members of the
profession in their practice
What Is a Profession?
Strong professional identity and commitment to the
development of the profession
Demonstration of professional competency and
possession of a legally recognized license
Nursing as a Profession
• Evidence-Based Practice
Almost all current theories of nursing have evidencebased work as key.
Information technologies play a key role.
Step 1: ask what an intervention is supposed to
accomplish.
Nursing as a Profession
Nurses’ Code of Ethics
Competency and
Professional License
The A N A Code of Ethics is the most
widely used: current version is from
2015.
Licensure requires passing a national
exam.
Licensure occurs at the state level.
It is a professional standard for other
professions to compare.
When Nursing Falls
Short of the Criteria
• Autonomy and Independence of
Practice
Florence Nightingale began the
separation of education for nurses
from that for doctors.
There is a role of shifting social
norms.
Nurses still generally suffer from a
subservient image.
Some progress has been made in
some areas, such as nurse
practitioners.
Members of the
Health-Care Team
• Many different kinds of individuals
work to deliver health care.
• Different kinds of nurses require
different education and posteducation
training.
• Examples
Registered nurse
Nurse practitioner
Case manager
Members of the HealthCare Team
• Advanced Practice Nurses
Nurse Practitioner: direct primary care for clients
Certified Nurse Midwife: like a nurse practitioner
specializing in care before, during, after pregnancy and
of newborns
Members of the HealthCare Team
Clinical Nurse Specialist: deals with acute cases or
aggravated chronic illness
Usually practice in secondary- or tertiary-care
setting and focus on care of individuals who are
experiencing an acute illness or an exacerbation
of a chronic condition
Attempts have been made to combine the roles of
the C N S and N P so that the best qualities of
both roles are preserved.
•
Case Managers
May need skills of nurse practitioner and clinical
nurse specialist
Empowerment in Nursing
Political Activity
Nurses are constantly affected by
politics and political action.
Nurses can either participate in
politics or have decisions made for
them by non-nurses.
Accountability and
Professionalism
Demonstrating competence and
improving care quality: peer review
and evaluation
Accepting responsibility for the care
and setting standards: power to
govern nursing accrues to nurses.
Conclusion
• Changes in the health-care system,
such as the Affordable Care Act, are
having a major impact on the who,
how, and where of nursing practice.
• Nursing has matured and evolved into
a field of study with an identifiable
body of knowledge.
Questions and problems remain.
Chapter 2
Historical Perspectives
Joseph T. Catalano
Copyright ©2019 F.A. Davis Company
Understanding Our History
Threads
throughout
the history
of nursing
• Society’s beliefs about the causes
of illness
• The value placed on individual life
• The role of women in society
Modern
wars’
impact on
nursing
• Influencing technology
• Guiding the direction of health
care
Origins of Nursing
• Nursing is the
Protection, promotion, and optimization of clients’ health
and abilities
Prevention of disease and illness
Alleviation of suffering through the diagnosis and
treatment of human response to disease and injury
Origins of Nursing
• Before Nursing
Survival and propagation
Prehistoric times
Women as primary care providers
Intertwining with primitive
religion
Origins of Nursing
• Early Historical Development
Some connections with driving out demons
Some concept of preventive health care and the
importance of good hygiene
Physicians often refused to come in contact with blood
and infectious body secretions.
Hebrews: good knowledge of anatomy and physiology,
some operations, emphasis on purification
Origins of Nursing
• Health Care in the Roman Empire
Ancient Rome: superstitions and polytheism
An advanced system of medicine and a pharmacology
Creations include
Surgeries
Physical therapy
Medical textbooks
Unlimited supply of clean water
Developed early hospitals for soldiers
Origins of Nursing
Early Military
Hospitals
For military sick and injured
far from home
Military nursing orders: men
in armor wearing a Red Cross
Development of the Modern Nurse
involved acceptance of science and
technology.
Origins of Nursing
• A Nursing Hierarchy
In Protestant nations, health care soon degenerated.
Secular nursing orders took over many duties.
Hierarchy: sisters assisted by helpers and watchers
Social changes in the Industrial Revolution (1760–1840)
led to
Spread of disease
Creation of some community
health nursing
New orders
Nursing in the United States
European-style health care
High infant mortality
One of the first schools of nursing: 1640, Sisters of Saint
Ursula, Quebec
Most care provided at home by family
Nursing in the United
States
The Civil War: more death and injury
than any war in U. .S. history
• Origin of Army Nurse Corps nurses, Navy
Nurses, and the American Red Cross
After 1914, nurses’ roles rapidly
expanded due to demand.
• Red Cross began a training program for nurse’s
aides.
• Nurse’s aides: cheap labor, lower quality of care
Nursing in the United
States
• Between the World Wars
The Great Depression caused decline.
Joint Committee on Nursing recommended shorter
workday.
Hospitals: primary source of health care
Nursing in the United
States
• Establishing Standards
Bolton Act shortened hospital-based diploma programs
from 36 to 30 months.
Cadet Nurse Corps: minimum educational standards,
forbade discrimination
Women fully commissioned
African American and male nurses
Nursing in the United
States
• A Growing Need
Technical nursing programs to fix the nursing shortage
Baby Boom
Mid-1960’s, associate degree nurses (A D N’s) take the
same licensing exam as R N graduates
The Evolution of Symbols
in Nursing
• The Cap
Rare today
Connects to early Christian history and veils for women
Capping ceremonies
Nursing Leaders
• Florence Nightingale (1820–1910)
Founder of modern nursing
3-month training in Kaiserswerth, Germany
When the Crimean War broke out in 1854, she obtained
permission to take a group of 37 volunteer nurses into a
battlefield area.
In 6 months, nursing, cooking, and cleaning, reduced
mortality from 42% to 2%.
Nursing Leaders
• Lillian Wald (1867–1940)
Henry Street Settlement in New York City
Columbia University courses to prepare
nurses for careers in public health
American Red Cross’s Town and Country
Nursing Service
First president of the National
Organization of Public Health
Nursing Leaders
• Lavinia Lloyd Dock (1858–1956)
Professionalization of nursing
and the equity of women
First medication textbook for
nurses
Lobbied legislators at all levels
about women’s right to vote
Nursing Leaders
• Annie W. Goodrich (1866–1954)
In 1919, she was appointed as state inspector of nursing
schools.
Nursing training program at Vassar College
Dean of the Yale School of Nursing
Nursing Leaders
• Loretta C. Ford (1920–)
Founded Nurse Practitioner (N P) practice
Became the founding dean of the University of
Rochester School of Nursing and director of the Nursing
Service at the University Hospital in 1972
In 2003, was awarded the Blackwell Award from Hobart
and William Smith Colleges
Nursing Leaders
• Travel Nursing as a Career
Requires a B S N or higher degree
Usually committed to working for a facility for
predetermined length of time (usually about 3 months)
Provides more continuity of care and fill in for long-term
needs
Salaries tend to be higher
Nurse has autonomy and control
Conclusion
• Nursing and the modern health-care system are in transition.
• Florence Nightingale had the greatest impact.
• Nurses today still typically have a high level of responsibility but a low
level of power.
• Those in the nursing profession must learn from the past and use those
lessons to create the premier profession of the future.
Chapter 3
Theories and Models of
Nursing
Joseph T. Catalano
Copyright ©2019 F.A. Davis Company
Caring for Real People
• Most nurses work on real-world problems, not theories.
• Therefore, nurses need to understand the value of
theories and models for improving nursing.
Differences Between
Theories and Models
• Theory
Speculation about
something not proved,
though it may be well
accepted
Begin with hypotheses
Nursing theories have
become more complex.
Role in evidence-based
practice
Differences Between Theories
and Models (continued)
• Model
Hypothetical representation of something that exists in
reality
More concrete than a theory
Conceptual models
Example: classification using N I C, W C A
Key Concepts Common to
Nursing Models
• 4 Key Concepts:
Client/patient (individual/collective)
Complex entities
Not just about disease
Health
Difficult to define/varies
individually
Cultural perceptions enter into any
definition.
Key Concepts Common to
Nursing Models
Environment
Physical environment
Social aspects of environment
Nursing
The concept has expanded in
recent decades beyond providing
comfort and helping to cure
disease.
Nursing Theories and
Models
• All nursing models should address or define four
concepts.
Person
Environment
Health (illness)
Nursing
The Orem SelfCare Model
• Dorothea E. Orem’s: health care is
each individual’s own responsibility.
• The nurse helps clients direct and
carry out activities to help maintain or
improve health.
• Client: biological, psychological, social
being with capacity for self-care
The Orem Self-Care Model
• Health
The person’s ability to live fully within a particular
physical, biological, and social environment, achieving a
higher level of functioning that distinguishes the person
from lower life forms
Quality of life is an extremely important element.
The Orem Self-Care Model
• Self-Care: a two-part concept
Universal self-care
Elements commonly found in everyday life that support
and encourage normal human growth, development, and
functioning
The Orem Self-Care Model
• Healthy persons carry out six activities.
Breathing air; ingesting water and food
Excreting waste
Participating in activity and resting
Being alone and participating in social interactions
Avoiding hazards to life and well-being
Being normal mentally under universal self-care
The Orem Self-Care Model
Health deviation self-care occurs with
fewer than six activities.
Care can be wholly or partially
compensated or supportive
developmentally.
The Orem Self-Care Model
• Three steps to the nursing process
1. Determine whether nursing care is necessary.
2. Determine the appropriate nursing care system
category and plan care.
3. Provide nursing care.
The Johnson Behavioral
System Model
• This model integrates systems theory
with behavioral theory.
• It considers client behavior to be the
key to preventing illness and to
restoring health when illness occurs.
• Human behavior is really a type of
system in itself.
The Johnson Behavioral
System Model
• Human behavior is influenced by input factors from the
environment and has output that in turn affects the
environment.
The Johnson Behavioral
System Model
• Client
The person, or client, is viewed as a
behavioral system that is an organized and
integrated whole.
The whole is greater than the sum of its
parts because of the integration and
functioning of its subsystems.
The client as a behavioral system is
composed of seven distinct behavioral
subsystems.
The Johnson Behavioral
System Model
• Behavioral subsystems
Security
Dependency
Taking in
Elimination behavior
Sexual behavior
Self-protection
Achievement
Betty Neumann
The
Neumann
HealthCare
Systems
Model
Focuses on the individual and
his or her environment
Applicable to a variety of
health-care disciplines apart
from nursing
Lines of defense and
resistance
The Neumann HealthCare Systems Model
• Client
The client is viewed as an open
system that interacts constantly
with internal and external
environments through the system’s
boundaries.
Represented graphically as a series
of concentric circles that surround
the basic core of the individual
The goal of these boundaries is to
keep the basic core system stable by
controlling system input and
output.
The Neumann HealthCare Systems Model
• Health
Health is the relatively stable
internal functioning of the client,
optimal when the client is
maintained in a high state of
wellness or stability.
Health is a continuum that reflects
the client’s internal stability while
moving from wellness to illness and
back.
• Illness
Environmental factors, whether
internal or external, are called
stressors.
Purchase answer to see full
attachment
