The Adaptation Model By Sister Calista Roy

I define my philosophy of nursing within the three nursing domains of person, health, and environment. My goal is to communicate the importance of nursing as a knowledge-based career, depending not only on the nurse fulfilling her role but also on the patient’s compliance. A patient must learn to provide self-care at home in the same capacity as the nurse would provide care in the clinical setting. I discuss various subjects within nursing. I explain why I want to be a nurse, what I believe a nurse’s role is, the different domains of nursing, and where I believe nursing will be in the future. My philosophy demonstrates the interdependence of the nursing domains. You cannot fully evaluate a person without evaluating their health,

Staff nurses have great responsibilities in caring for patients. Often, these nurses experience heavy workload. Heavy patient load and stress contributes to burnout. Why is burnout important to discuss in relation to nurses? Burnout affects the performance of the nurse and the quality of care he or she provides to the patient. Therefore, it is imperative that staff nurses decrease the possibility of burnout and increase or maintain excitement and enjoyment in the field of nursing. If nurses do so, they will find joy in their work and quality of patient care will be increased. Contributors to burnout and

Workload was described to be heavy, stressful, increase in intensity and overtime hours. As a result 25.8% consider resigning, 20.2% consider retiring and 25.6% consider leaving profession. Another problem that was observed at individual level was poor commitment to care. One of the factors that often limited nurses to provide therapeutic care was the change in nurse to patient ratio. As nurses assignments increase with the increase in the number of patients (i.e. 1 nurse to 6-8 patients) the quality of care provided decreases. Nurses’ ability to maintain safe environment became challenging. As part of caring, nurses also showed decreased amount of time spent with their patient. This eventually led to nurses being less satisfied with their current job. Self – efficacy was often low. Nurses felt that they did not have enough knowledge and skills required for professional practice (Newhouse, Hoffman, & Hairston, 2007). This often led into stressful transition and the ability to care for a patient even harder. New graduate nurses often had difficulty maintaining leadership role. They often felt that they did not have the ability to self advocate and raise their voice to be heard by others. They often feared that they would be over heard and that no one would listen to them (Mooney, 2007).

The term environment, as it relates to the metaparadigm perspective, is a multilayered view that can explain the understanding of an individual’s perspective (McEwen & Willis, 2011). More specifically, some may believe the environment related to the nursing profession encompasses any setting in which a therapeutic interaction can occur; that is, a hospital, clinic, nursing home, school, corporation, or home (Tourville & Ingalls, 2003). According to McEwen and Willis (2011), however, this perceived way of identifying the environment only limits its domain by making it fixed, uncompromising, and natural. Although the specific setting in which care disperses is vital to understand the nursing discipline, it is not the only factor influencing the phenomena. Internal and external circumstances are a part of one’s environment, and both play a vital role in identifying and altering one’s perspective and philosophy related to the nursing discipline (McEwen & Willis, 2011). Individuals, such as family members, significant others, and lifelong friends that one interacts with also influence

Implementing a change in practice within these environments can produce anxiety or fear of failure in nurses, leading to a resistance to change. Several studies (Bozak, 2003; Lehman, 2008; Spetz, Burgess & Phibbs, 2012) expounded the need for a concise plan and clear communication between nurses and management when implementing a change of this nature. The use of Lewin’s Change Management theory can support nurses through the transitions and identify areas of strengths and resistances prior to implementing change. Without a framework for guidance, it can be difficult to keep on track.

The profession of nursing is usually described as high-demand job, as well as stressful. The American Association of Critical-Care Nurses believes that nurses can empower their work environments and truly make a difference (AACN, 2016). Although nurses have the ability to join committees and help make changes slowly, there are many factors in the nursing that cannot be changed by nurses. “The global increase in the aged population, the intensity of health care problems, the incidence of chronic illnesses and advanced technology, nurses are faced with a variety of work-related stressors” (Lambert & Lambert, 2008, p. 38). Regardless of nursing communication and social aspects of units, nurses need to accept some stressors as they are and

Hayward, Bungay, Wolff, and Macdonald (2016) performed qualitative interviews on twelve registered nurses averaging sixteen years of experience that represented diverse areas of acute care, to investigate the factors that contribute to turnover. Three themes that influenced the nurses’ decision to leave nursing were challenging workplace environments, limited leadership support, and personal health issues. (Hayward et al.) Furthermore, Hayward et al.’s theme of challenging workplace environments detailed the nurses’ insight on harassment, negative behaviors, and bullying that resulted in nurses’ impaired job performance. Wilson, Diedrich, Phelps, and Choi (2011) investigated the quantitative prevalence of incivility related to the intent to leave nursing by obtaining the results of surveys replicated from the American Academy of

The cost to train new nurses becomes so enormous for hospitals it would be much smarter to figure out why new nurses are leaving and provide tools to assist new nurses with their transition. Looking at reasons NGRN leave their new chosen profession seems simple enough find out what it is that decreases job satisfaction and fix it. One study looked at burnout in new nurses and possible causes, they looked at workplace environment, workplace incivility and empowerment.(Spence Laschinger et al., 2009) They found

     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.

The national nursing shortage is predicted to continue to rise to levels that have not been seen since the 1960’s (Fasoli, 2010). Managers must create an environment that is conducive to employees. The leader needs to promote organizational commitment and retain employees by promoting a positive culture on the unit. Nurses want an environment where they can provide high-quality care to patients and leaders must help facilitate and maintain this environment. Employees also want to feel like their opinions matter to the manager, and they have a say in the future of the unit. Employees do not want to feel like they are not important, or their voices are not being heard.

Nursing shortage refers as a difference between supply and demand of registered nurses (RN) and turnover refers to the loss of an employee due to transfer, termination, or resignation (Huber, 2014). Worldwide, Hospitals are experiencing nursing shortage despite of intervention and innovation attempt. Nursing shortages can lead to longer working hours under stressful situation that can result in fatigue, burnout, medical errors, mistake, and job dissatisfaction which can endanger patients’ safety and quality of care (American Nurses Association, 2015). Hospital leaning toward the profit making is also adding up nursing dissatisfaction. Therefore, visionary leader and manager can help to resolve these issues and promote the friendly working environment to reduce the nursing shortage, turnover, dissatisfaction and safety issues. In this paper, the writer explains the necessary steps that manager and leaders need to take to minimize the nursing shortage based on philosophy of nursing, organizational structure along with the writer’s personal approach finding the solution of the problem.

In a world where there is constant change, and individuals are constantly attempting to adapt and cope with these changes, the human experiences and responses to this process is central to nursing interest, (Meleis, 2012). Today’s global health problems in addition to the politically volatile health care system, and the rising cost of health care seem insurmountable. As nurses,

With the ongoing changes in the healthcare field, nursing workforce retention presents itself as one of the greatest challenges facing healthcare systems today. According to the American Nursing Association, nursing turnover is a multi-faceted issue which impacts the financial stability of the facility, the quality of patient care and has a direct affect on the other members of the nursing staff (ANA, 2014). The cost to replace a nurse in a healthcare facility ranges between $62,100 to $67,100 (ANA, 2014). The rising problem with nursing retention will intensify the nursing shortage, which has been projected to affect the entire nation, not just isolated areas of the country, gradually increasing in its scope from 2009 to 2030 (Rosseter,

Nurse turnover is defined as “the number of nurses changing jobs within an organization or leaving an organization within a given year” (Baumann 2010). Retaining nurses is one of the most important issues in health care as its effects range from challenges in human resource planning, to high costs in financial and organizational productivity (Beecroft et al, 2008), to workgroup processes and morale, to patient safety and quality of care (i.e. patient satisfaction, length of patient stay, patient falls, and medication errors) (Bae et al, 2010). Nursing Solutions Inc (NSI) reported the national average turnover rate for hospitals increased from 13.5% in 2012 to 14.7% last year. Nurses working in Med/Surg had more turnover

The ongoing instability evidenced from the high mobility of qualified nurses in the nursing workforce has raised many questions about the issue of nursing shortage and nurse turnover (Gates & Jones, 2007). The paper below discusses the issues of nursing shortage and nurse turnover. The paper also describes how leaders as well as managers in the nursing fraternity and other leaders can resolve those problems effectively and the different applicable principles, skills, roles of the leader, and theories of leadership and management.