Nursing Theory Grid

Theory development stems from personal experiences, intuition, and knowledge of the theorist (Burns et al., 2013). When a scholar develops a theory, it has to be tested through research. The findings of the study are then presented to experts in the area of academics and the field of practice (Burns et al., 2013). The presentation of the findings allows experts to provide constructive criticism, highlight the pros and cons of the theory, and acknowledge whether or not the theory can be accepted as a guide to practice. This theory evaluation paper will give the reader a theory description, theory analysis, and an assessment of Dorothea Orem’s self-care deficit theory of nursing (Alligood et al., 2010).

In this assignment, the author has chose to critically analyse a situation where a second year nursing student Catherine, who is on a 7 week clinical placement is having an issue when communicating with patients at times.

| For nursing practice our goal is to help to promote health for the whole patient. We must remember that our goal is to get them back to a level where they are functional in the environment. Not all patient will get to the point that they are free from disease but we must help them get back to the level in which they can care for themselves and be as sound as possible for them. Our practice would involve teaching in this aspect in order to help the patient maximize the health that they either have or to help them reach the level that they want to achieve.

In her theory of deliberative nursing process, she describes the interaction between nurse and patient. Communication between nurse and patient is described in three concepts: the ‘Patient Behavior’, the ‘Nurse’s Reaction,’ and the ‘Nurse’s Activity’ (Sheldon & Ellington, 2008). The patient sends a cue in the form of behavior (Patient Behavior) and the nurse responds to the behavior (Nurse’s Reaction). ‘Nurse’s Activity’ is categorized into two stages: non-observable and observable. The nurse’s thoughts, perceptions, or feelings related to behavior are non-observable and the final action or response to the ‘Patient Behavior’ is observable (Sheldon & Ellington, 2008). Orlando labels ‘Nurse Activity’ as automatic or deliberative, allowing the nurse to identify the patient’s needs and then help the patient (Sheldon & Ellington, 2008). In patient care, this theory asks nurses to identify their perceptions, feelings, and thoughts as a basis for nursing actions. Orlando then takes it a step further by advocating that the nurse explore their assumptions with the patient to identify

Orlando’s Nursing Process Discipline Theory explains that the role of the nurse is to find out and meet the patient’s immediate needs for help. The patients’ presenting behavior might be a cry for help. However, the help the patient needs may not be what it appears to be. Because of this, nurses have to use their own perception, thoughts about perception, or the feeling engendered from their thoughts to explore the meaning of the patients’ behavior. This process helps nurses find out the nature of the patients’ distress and provide the help he or she needs. The concepts of the theory are: function of professional nursing, presenting behavior, immediate reaction, nursing process discipline, and improvement.

The Hospital environment can offer some practical challenges that could be barriers in communications. Many patients have individual needs and this can impede on a nurses time and emotions. Nurses put in long hours and have a high patient/nurse ratio or shortage of healthcare workers. Nurses/personnel have to deal with emergencies in an already challenging and busy hospital setting. Dealing with patients takes mental acuity and emotional support and sensitivity. Hospital guidelines might not have sufficient communication practices among personnel in place.

The nurse will use the deliberate nursing process to evaluate the patient. The time spent between the nurse, and the patient will bring out known problems. Orlando’s (1961)

In essence, the role played by the nurse is to increase and facilitate the self-care abilities and level of the individual patient (Smith & Parker, 2015). As such, self-care is neither reflexive nor instinctive. Instead, it is either performed rationally or intentionally in response to an already known need. Based on this Orem's theory, rational response is learned through communication and interpersonal relations. Orem asserts that self-care agency can also be defined as the power to take action (Caruso, Cisar & Pipe, 2008). It is a complex capability developed to enable maturing adolescents and adults to recognize, identify, and understand various factors to be managed or controlled so as to decide about, develop, and perform realistic care measures. The capability discussed above is strongly dependent on culture-related values and lifelong experiences.

Nursing theory is defined as “a creative and rigorous structuring of ideas that project a tentative, purposeful, and

Today health care systems are expected to meet set standards and core measures to earn everything from accreditation and recognition to payment. Reports need to filled to accomplish this, as well as what is being done to improve areas that may not be meeting standards. One way this is done is by utilizing dashboards. The purpose of this paper is to analyze the data from a dashboard and develop a nursing plan for improvement of a low scoring area.

PART 1 What is nursing theory? How does nursing theory differ from theories of other disciplines? How does nursing theory relate to nursing practice?

Effective communication is of tantamount importance in the scope of a successful nursing practice. It depends heavily upon both verbal and non-verbal methods (AJN). It is inclusive of both behavioral and speech components. Being efficient in both delivering and receiving messages between the nurse and the patient helps initiate and maintain a healthy relationship. Employing both verbal and non-verbal communication between the nurse and the patient will help ensure that the relationship they share remains satisfying to both parties.

It is critical that it is used in a multisensory manner for it to be fully effective (Pellico 2009). For example, a sense of hearing and touch may need to be used during observation of a wound healing, whilst simultaneously interacting with the patient. The nurse must then decide, with the help of the patient, what was identified from the healing wound, and use critical thinking to make effective and safe clinical decisions (Kisiel and Perkins 2006). Critical thinking not only involves thinking systematically, and questioning judgements and reasons related to decision making (Farell 2011), but it also requires all the skills identified above, throughout the whole of nursing practice.

This section presents an analysis of Orlando’s theory. The central thesis of the Theory of the Deliberative Nursing Process is finding out and meeting the patient’s immediate need for help. The concepts and propositions of the theory are written at a concrete level of discussion (Fawcett, & Desanto-Madeya, 2013). The theory is classified as a middle-range predicative theory. The theory identifies the effects of a specific interpersonal nursing process on identification of the patient’s immediate need for help.

For example, the nurse sees a patient grimace, thinks he is in pain, and feels concern. The nurse then shares