Sister Calista Roy

Since the beginning of nursing as a profession, Nightingale made us look at the environment as an integral part of the healing process. Many theorists after her expanded upon this aspect, none so adamantly as Martha E. Rogers. Rogers elaborates on the holistic approach with her conceptual model/theory. Rogers’ science of unitary human beings is an indispensable research tool that relates to all South University Framework Pillars. Its historical significance only validates its invaluable quality. Rogers’ ideas are still functional today through the Commission of Collegiate Nursing Education professional core competencies, care plans, clinical application, current individualized healthcare, and healthcare of populations.

To achieve positive and sustainable health outcomes it is important to understand the relationships between the subjects of person, environment, health, and nurse. People are unique and they prioritize their values differently. People are constantly seeking to define their truths and their purpose. These unique perspectives of the world guide the actions of everyone. There is a constant interaction between people and their environment. People and their environment both impact the wellbeing of each other. Health is multifaceted. Health is the culmination of physical, physiological, psychological, social, and spiritual status. These aspects of health are interconnected. Absolute health may never be achieved. However, nurses work to progress their

Nursing theories play an integral role in guiding practice, education, and research. Many different theoretical perspectives are maintained in the field of nursing due to the diversity of the field, no single theory is able to account for all nursing knowledge. The purpose of this paper is to compare and contrast two nursing theories that have produced a profound impact on nursing practice. The theories being compared are Dorothea Orem’s Self Care Deficit Nursing Theory (SCDNT) and Sister Callista Roy’s Adaptation Model (RAM). Both theorists have profoundly influenced nursing science, research, practice, and education. Similarly, both of these theories fall into the category of Grand nursing theories which are the most complex theory level and explain broad areas of the discipline, as well as being the broadest in scope (McEwen & Wills, 2014).

Roy believes nursing as a key player to help patients to develop coping mechanism and positive outcome from the constant stimuli exposure. Roy’s goal is for the patient to achieve adaptation leading to optimum health, well-being, quality of life, death with dignity, and finding in life by participating in their own care (Roy & Andrews, 1999.)

     Other major developments of the model in the 1999 textbook include: expanding the adaptive modes to include relational persons as well as individual persons and describing adaptation on three levels of integrated life processes, compensatory processes, and compromised processes. Roy has also outlined a structure for nursing knowledge development based on the Roy Adaptation Model and provided examples of research within this structure. Roy remains committed to developing knowledge for nursing practice and continually updating the Roy Model as a basis for this knowledge development.

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.

Nursing has developed into a profession, in which many theories have been developed and presented in order to lend guidance for purposeful and meaningful practice. In general, nursing theories are based on four concepts that collectively make up the nursing metaparadigm: person, environment, health, and nursing. These four concepts represent a commonality in the nursing profession (Tourville & Ingalls, 2003). This paper will

This can also be seen from a viewpoint of a nurse entering a clinical setting in which they possess little to no experience with that patient population. The second stage in this model is advanced beginner the nurse has begun to understand the basic concepts of the new clinical setting. In this stage the advanced beginner can adapt to situations by using past experience to apply to clinical situations.

A metaparadigm is a concept that is extremely general, one that serves to define an entire world of thought. The metaparadigm of nursing is comprised of four parts: person, health, nursing and environment. This concept is important to nursing theory, because those are the key areas of focus when it comes to patient care. In this metaparadigm, the ‘person’ can refer to the patient, the patient’s family members, friends, communities, and groups. The nurse’s goal when dealing with the ‘person’ is to nurture the patient and empower him or her to manage their own health to the best of their abilities. The next part of the metaparadigm is ‘health’. It generally addresses the person’s state of well-being and their availability to healthcare. The other metaparadigm ‘environment’ includes factors that affect individuals internally and externally. A positive therapeutic interaction creates an environment that is essential for patient recovery. The final concept in the metaparadigm of nursing is ‘nursing’. In general, this refers to any hands-on medical treatment from nurse to patient.

The Environmental Theory by Florence Nightingale defined Nursing as “the act of utilizing the environment of the patient to assist him in his recovery” (Alice Petiprin, 2014). It involves the nurse’s initiative to make environmental settings appropriate to aid in the recovery of the patient’s health. According to Nightingale all external factors are somehow associated with the patient and affects their life physically, mentally, and socially (Alice Petiprin, 2014).

According to Roy, the Nurse using the Nursing Process, promotes adaptation responses during health and illness to free energy from ineffective or inadequate responses to increase health and wellness. Goals, mutually agreed on and prioritized, are proposed to meet the global goals of: survival/growth and promotion/reproduction of race/society/attaining full potential or mastery of self. The nurse uses activities to increase adaptive and decrease ineffective responses during illness and health. These activities alter or manipulate the client's focal, contextual and residual stimuli and expand his repertoire of effective coping mechanisms. Nursing focuses on the person as a biopsychosocial being at some point along the health-illness continuum. In contrast, medicine focuses on biological systems and the patient's

American Nurses Association defines nursing as “the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and population”( Potter,P.,& Perry, A. 2005,1-5). Thus making nursing dynamic and ever changing. However, when nursing

Florence Nightingale developed the environmental model theory of nursing. Nery, (2015) states that Florence Nightingale’s environmental theory of nursing, “focus primarily on the environment, interpreted as all external conditions and influences that affect the life and development of an organism, that are able to prevent, suppress or contribute to disease and death.” The four metaparadigm concepts of this theory consist of person, environment, nursing, and health. Within this theory, the patient is being cared for by the nurse, has been influenced by the environment, and has reparative powers (“Nursing Theories, 2011). Nightingale’s theory does not have a clear definition of the person; however, it can be inferred that the person correlates “in relation to the environment and the impact of the environment on the person’s health status” (Butts & Rich, 2018). The highlight of Nightingale’s theory is the environment. Both the external and internal environment needs to be in sanitary conditions. The environment concept of this theory contains “physical, psychological, and social” factors (“Nursing Theories, 2011). The goal of the nurse is the control the patient’s environment to achieve ideal health for the patient. Nightingale’s theory did not define health; however, she stated that nature itself can heal ailments (Butts & Rich, 2018). Nightingale (1859) stated that health is ‘not only to be well, but able to use well every power we have to use it.”

The theorist Betty Neuman explains how the whole system affects the patient’s health and shows how the nurses are responsible for the social, mental, spiritual, physical and emotional state of the patient and not only the physical aspect. With the theory nursing students, nurses and other professionals are able to provide effective systematic nursing care to their patient using the system model. Furthermore, her ideas give the importance on how to give the right care through a stressful situations and gives knowledge and development to the science of nursing. She also to coping with unexpected situations through three prevention levels which are the primary prevention, secondary prevention, and the tertiary prevention. Generally, I choose this model because I see how it depicts the nurse as an active participant with the patient and as a concerned with all the variables affecting the patients response to stressors. The Betty Neuman theory reflects health

Being the daughter of a Licensed Vocational Nurse and the eldest of seven children, Sister Callista Roy learned the importance of selflessness, caring and the importance of really knowing and caring for others. A scholar with a degree in sociology as well as nursing, and her involvement as a Sister in the church showed a true dedication of service of others. (Parker & Smith, 2010, p. 168). The Adaptation Model looks at a patient’s health through the lens of adaptation, being able to change based on environmental factors whether they are internal or external Shah, M. (2015). Compare and Contrast of Grand Theories: Orem’s Self-Care Deficit Theory and Roy’s Adaptation Model. International Journal of Nursing Didactics, 5(01), 39-42. doi:http://dx.doi.org/10.15520/ijnd.2015.vol5.iss01.28.39-42. This model was developed while completing her Master’s Degree influenced by Dorothy