Middle Range Nursing Theory Analysis

Nursing is defined as the promotion, protection and the prevention of illness and Injury, the treatment of a patient’s disease or diseases, the patient’s response to a disease, as well as one big thing that nurses are known for, and that is being a patient’s advocate nursing has been one of the fastest growing fields since the 1990’s (Mueller et al.,2012). Advocacy is defined as an action in which a person speaks out, argues a cause, supports and defends on the behalf of others. I believe that the role of being a patient advocate is one of the most important things a nurse can do because there are many patients that cannot speak on their behalf, I believe that it is up to the nurses to be those patients as well as all patient’s voices (Mueller et al., 2012).

Nursing theories have been a fundamental tool used to explain, guide and improve the practice of nursing. Theorists have contributed enormously to the growth of nursing as a profession. The four grand theorists I chose are Virginia Henderson, Peplau, Myra Levine and Jean Watson. These theorists have contributed tremendously in the field of nursing through their theories, and research. One thing the theorists have in common is that they are patient centered. They are all concerned on ways we can improve our responsibility to the patients, their families and the environment. They have different ideas but they are all aiming towards achieving the same goal, which is patient satisfaction and safety. Their differences are in their areas of

When reflecting on current trends of clinical practice, I feel that middle-range theories are more applicable. Middle-range theories are broad enough to incorporate in everyday clinical practice for the average floor nurse without being too narrow in scope as the situation-specific theories. Additionally, middle-range theories are less abstract than grand theories and are easier to relate to and put into practice (Liehr & Smith, 1999, p. 85).

Betty Neuman is a renowned nursing theorist who developed the Neuman System Model. This model emphasizes stress and the impact it can have on patients and nursing care. Key concepts of this theory include preventions, stressors, and lines of defense. Neuman also addresses the metaparadigms of nursing, health, human being, and environment in relation to her model. The Neuman System Model is recognized by nurses across the globe, and a Neuman System Practice Center has been established to help develop her theory (Gigliotti, 2012, p. 298). This theory can be utilized in any nursing care and is inspiration for other nursing theorists.

In Nursing, there will always be instances where the patient's nurse needs to advocate for their patient. There are numerous reasons why a nurse would advocate for their patient ranging from getting the doctor to change the patient’s orders, helping the patient’s treatment team understand what it is the patient is requiring for the day, to expressing the patient’s last wishes before death. In every situation, the nurse should do what is in the patient’s best interest. Tomajan (2012), “Advocacy skills are the ability to successfully support a cause or interest on one’s own behalf or that of another. Advocacy requires a set of skills that include problem solving, communication, influence, and collaboration”(p. 2). With those skills, the

The Synergy Model was created by nurses who wanted to assess the tie between nursing and patient outcomes. These nurses listed eight common patient characteristics along with eight common nursing competencies. This model has previously tested patients, resiliency, vulnerability, stability,

The AACN Synergy Model for Patient Care falls in the middle range nursing theories classification. According to McEwen (2014a) middle range nursing theories can be found in between abstract theories and concrete theories because they are specific. Middle range nursing theories have the ability to be operationally defined with a view into

Middle range nursing theories are abstract, testable theories that contain a limited number of variables. According to Chinn and Kramer (2011), middle range nursing theories can lead to new practice approaches as well as examine factors that influence the desired outcomes in nursing practice. One beneficial and widely used middle range nursing theory is the theory of unpleasant symptoms, developed collaboratively by Lenz, Pugh, Milligan, Gift, and Suppe in 1995.

With the health care system changing so rapidly, it is important that nurses are autonomous. It is necessary, as patient advocates, that we understand the cause and effect of all entities involving our patients. Critical thinking and making the correct judgment call clinically is vital. A patient situation which comes to mind is an 86 year old female, weighing 50kg, Vital Signs: Blood Pressure: 80/50, Heart Rate: 102 (Sinus Tachycardia), Respirations:

Throughout nursing, there are many theories that nurses may come across and use. Calista Roy’s and Betty Neuman are two theorists that use two different types of models to encompasses the health, person, and the environment. Callista Roy uses a theory that promotes adaptation to the stimuli a person may encounter. Betty Neuman uses a theory that promotes equilibrium in a time where a person will encounter stress. These theories allow the nurse to bring a knowledge to learn more about the person and the factors that influence their health. Although with any theory there are different approaches in how the nursing plan is done, but with the patient in mind, it makes the difference in care that is given and allows for better outcomes for the patient.

Huber (2006, p154) states that clinical decision making in nursing relates to the quality of care the patient receives and how competent the nurse is.

The Synergy Model defines eight patient characteristics that nurses must understand in order to facilitate optimal clinical outcomes. All eight patient characteristics will be discussed as they relate to this particular case study.

To this end, I believe middle-range theories are best suited to advance nursing knowledge and practice in the 21st century. “Middle-range theories are at those levels of conceptualization that could inform nursing practice and research, and thus continue the cycle of advancing foundational knowledge and enhancing quality care”, (Meleis, 2012). Middle-range theories were created to help the nursing profession realize its overall mission and goal, now and in the future; to alleviate pain, suffering and distress, as well as promote health-seeking behaviors which will lead to improved health outcomes and attainable goals. Because middle-range theories lie in the middle of grand theories and situation specific theories, they are directed more toward specific interventions that can be implemented at the ‘bedside’. As such, they are designed to provide frameworks to manage patients’ experiences with symptoms, as well as the ability to understand responses to health and illness phenomenon.

The development of the nurse’s ability to clinically reason and take appropriate and timely action can, in time, become an instinctive and automatic process. Reflective practice by the nursing professional will highlight the areas in which further improvement is needed. Essentially, it is the responsibility of the individual nurse to identify the need to develop this ability, and the skill to effectively communicate the patient’s condition to the other members of the healthcare team to produce positive patient outcomes.

Nursing is a unique profession which is built upon theories that guide everyday nursing practice. According to Taylor, Lillis, & Lynn (2015), “Nursing theory differentiates nursing from other disciplines and activities in that it serves the purposes of describing, explaining, predicting, and controlling desired outcomes of nursing care practices” (p. 27). Many nurses may unknowingly apply a theory or a combination thereof, along with critical thinking to get the best outcome for a patient. Theories are used in practice today because they have been supported by research and help the profession uphold its boundaries. Most nursing theories consist of four concepts which are the patient, the environment, health, and nursing. Each patient is at the center of focus and they have the right to determine what care will be given to them using informed