Nursing Theory

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

I am currently employed in the Veteran’s Affairs Loma Linda HCS in the Emergency Department. Our target population are adults, mainly male, with multiple on-going health conditions. In our ED, we see a huge volume of veterans who have chronic illnesses and conditions. I noticed that many re-peat ED visits that could have been easily avoided and prevented. Some are legitimate emergencies and urgencies, but unfortunately the great majority are the result of non-compliance, lack of adequate knowledge in managing illness and failure to partner with their care provider to promote better overall health.

The universal portion of Orem’s theory consists of the self care that a patient needs to meet their physiologic and psychosocial need. The developmental portion of the theory covers the care when coping through developmental stages, and the health deviation, which cover the care a patient need when theory health has

Nursing theorist, Hildegard Peplau knew that in order to care for patients, the nurse must establish a strong relationship with the patient. This is an essential element in being able to provide adequate planning, diagnosing, and successfully treating patients. Personally, my desire to learn more about Peplau’s theory is because it is a very significant quality to have as a nurse. Nursing is a very interpersonal career, and by forming trusting relationships with patients early in one’s nursing practice, I can provide the best care possible to meet psychosocial needs as well as treat the present illness. The benefits that creating interpersonal relationships can have on the patients’ health condition and their planned outcomes, is also a very interesting area of focus. Many nursing students today did not understand the importance of Peplau’s theory. They choose a career in nursing because of the finical stability and wide range of options that the career offers. Overall, one cannot forget that nursing is patient centered care.

The metaparadigm of nursing consists of four parts comprised by Jacqueline Fawcett, in 1984, in her seminal work (Alligood, 2014). The metaparadigm she developed served to provide direction and guidance for the nursing framework already in use and became an organization tool for theories already in use (Alligood, 2014). The four parts being person, health, environment, and nursing. The four components of the metaparadigm concept of nursing is important to nursing theory because they are the key areas of focus of patient care, and the metaparadigm is designed to differentiate nursing from other specialties (Alligood, 2014). It is this use of theories that makes nursing a profession and guides professional nursing practice, research, and education (Alligood, 2014).

Hart and Mareno (2013) wrote in their article, Cultural challenges, and barriers through the voices of nurses, nurses are being tested in today 's healthcare environment to provide culturally competent care to their patients which consist of a diverse population. Nurses, according to Hart

The gap within multicultural health care has thus far led to racism, stereotyping, and discrimination. Furthermore, healthcare leaders have not identified what intervention is appropriate to close the gap on cultural competence. Wilson, Sin, & Conlon, (2010, p. 361) states, “it is important to recognize that certain organizational factors may act as constraints on the ability of individuals to engage.” However, administrators and other leaders that are involved with healthcare disparities have created multiple platforms to access care but have not leveraged the cultural differences.

Cultural competence is the knowledge, skills, and attitudes of the individual health care professionals when they treat individual patients who are from different race, ethnicity, and religion and diverse backgrounds. In the U.S, some patients receive equal treatment in the health care facilities, but others receive unequal treatment because they are from diverse backgrounds. In the article, “Cultural Clues” Melissa Hansen focuses on the importance of culturally competent workforce- (nurses, technicians, and doctors) who can recognize cultural differences to allow effective communication with patients. The culturally competent health care workers also include the community health workers- (community health promoters, village health workers, and lay health advisers). In fact, the lack of understanding between the healthcare workers and patients is resulting in an estimated one-third of patients who do not adhere to prescribed medication regimens. This condition leads not only to serious complication and more hospitalizations, but also is costing the U.S. health system an estimated $100 billion to $290 billion every year (Hansen 22). Necessarily, the health care workforce needs to improve this state to reduce disparities.

Healthcare managers are responsible for ensuring that their organization has a plan or strategy that is geared toward eradicating health inequality through cultural competency. Best practices are of utmost importance in assuring cultural proficiency. Buchbinder and Shanks (2012) outlined these practices in their textbook Introduction to Healthcare Management: a diverse workforce, leadership and organizational culture that fosters cultural competence as well as human resource policies which do the same, appropriate training/education for all employees, linguistic services and materials, systems capable of tracking data with regards to health outcomes, and responding to and engaging the community (p. 321). Additionally, a Commonwealth Fund study provided a list of actions that diversity leadership should adhere to in accordance with the National Standards on Culturally and Linguistically Appropriate Services (CLAS) standards. Aside from employing a culturally diverse staff and patient services and regular re-evaluations of goals, healthcare leaders engage and report their progress to diversity goals the community (Dreachslin, 2008). Inasmuch as cultures change and evolve, it is suggested that cultural competence training be an ongoing process and that organizational policy and strategic plans be reassessed periodically for effectiveness (Buchbinder & Shanks, 2012). Time, revenue, and energy spent in interventions that do not bring the desired results is not

The nursing profession has progressed greatly since it roots with Florence Nightingale, moving from reliance upon total medical direction for providing basic care and “the first duty of the nurse it that of obedience-absolute fidelity to his orders, even if the necessity of the prescribed measures is not apparent, you have no responsibility beyond that of faithfully carrying out the directions received” (Jennifer C. Telford), into an autonomous practice with its own nursing theory practices, models, and interventions.

My experience interacting with minorities and medically underserved individuals has taught me cultural competence by gradually learning the capacity to understand other people’s experiences and sufferings in a way I never had before. By working in family and free health clinics, and volunteering as an EMT and a hospice aide, I have personally seen some of the health disparities found in our world. I have witnessed how a lack of insurance, monetary income, or health education affects one’s decision to attain primary health care. Furthermore, my experiences with emergency medicine teams serving culturally diverse communities have helped me to be able to see how healthcare professionals handle crises while not losing the ability to think logically and rationally when striving to treat people’s illnesses, instead of focusing on their

Health disparities are at the root of public health crises; there are billions of dollars being allocated for initiatives and operations with the aim at improving the quality of life and combating health disparities within at-risk, vulnerable, and minority populations. Race relations and how it is impacted by American culture, history and policy presents a risk factor for negative health outcomes for some. NCORE will be an environment where I can be a part of the dialogue, and where I can learn the skills needed to be active and operate public health professional within a cultural context. Cultural humility and competence are very important when planning and piloting public health programs aimed at targeted audiences such as persons of color and people

It takes a combination of theories to make healthcare organizations function at a quality standard. Providing the patients with the best care possible is always the goal for any healthcare organization. It takes, not only the nurses, but all the staff of the organization to achieve this goal. Non-nursing theories exist to help guide all staff and provide an optimal work environment to allow quality care to be given to the patient. In this paper, some non-nursing theories will be examined and the importance of each one will be ranked according to this nurse.

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

Nurses often feel a conflict between the ideals of the profession and the reality of the job.  Deheny (2001) writes “demands and expectations of the role are greater than the resources or number of hours in the day to accomplish what nurses would define as quality nursing care” (para. 1).  Also, the use of advanced technology can create emotional withdrawal from the patient as the nurse focuses more on the machines than the person.  These factors increase job dissatisfaction and emotional burnout.  To articulate one’s personal philosophy requires examining the values and beliefs that define a person. Masters (2014) writes, “the overall purpose of personal philosophy is