Theoretical Framework in Nursing Process - Outcome Theories

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

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).

Nursing care incorporates not only a compassionate attitude but passion for care of patients. The caring component of nursing cannot be measured, rather dissected through theory within the clarification of what nurses do. Systemically this is all supported through abundant theories and theorist. The nursing profession emphasizes on holistic care which is defined as treatment of the whole person. Within this skill is the admittance of problems that are biomedical but also opportune clarification of the well-being and health of a human that introduces added indicators of disease that are non-visualized (Powers, 2011).

It is undeniable that Maslow is one of the most famous and influential psychologists, whose theory is a base for various motivation theories. Maslow`s Hierarchy of Needs theory explains the drives and the urges that govern human behavior. However, there were many other famous psychologists influencing Maslow during his lifetime; indeed, this fact greatly shaped his professional stance and theory (citation).

In this paper the author provides a real life example of the application of applying Florence Nightingales environmental theory to a practice setting. In an article published in the RN Journals a staff nurse writes about her experience as a floor nurse on an oncology unit and how the surroundings were anything but pleasant. The color of the unit was dark; there was dirty carpeting that lined the unit. Families had nowhere but the hallways to grieve the loss of loved ones and the worrying environment was depressing. This nurse took it upon herself to bring her concerns to hospital administrators; she stepped out on a limb and became the patient family advocate with using the premise of the Florence

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).

The activities include physical and occupational therapy, nutrition counseling, and case management ("Community Health Nursing," 2013).

Kristen M. Swanson’s Caring Theory is the solution in bridging the gap between nursing practice and theory. It offers an explanation of the links between patient well-being and the caring process (Tonges & Ray, 2011). Swanson explained that nurses should be able to demonstrate that they care about their patients, and that caring about their wellbeing is as important as their patients’ current medical problem (Tonges & Ray, 2011).

One nursing theory that has influenced my values and goals as a nurse is Jean Watsons Theory of human caring: Transpersonal Caring as the Fulcrum. Watson believed every person needs an interconnection with others and caring promotes this need. Through caring, a nurse can help the patient have balance and harmony of mind, body, and soul (Cherry & Jacob, 2014).

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).

One could argue, that the evolution of nursing began with Florence Nightingale. She has been awarded the title of the founder of modern day nursing, and many of the practices she implemented in an effort to improve patient care, has molded nursing practice into what is it today. The purpose of this paper is to summarize the credentials and background of Nightingale, review her environmental adaptation theory, and identify sources of her theory. We will also state the major concepts/definitions of the theory as well as provide major assumptions of said theory.

The concept of environment and its integral role in the delivery of nursing care was among the first identified and documented nursing concept since its early days. Florence Nightingale pioneered the profession of nursing and along with it, pioneered the concept of Nursing Theory. Her Environmental Theory was patient focused and incorporated five environmental components needed to promote health. Jarrin (2012) supported that the role of nursing is to promote the best possible environment for the patient to assist in their natural reparative process. It dates back from the time of ancient Greek philosophers and historians, including Plato, Hippocrates, and Aristotle, whose works are studied by Nightingale in her early years. According to Rahim (2013), as considered as the profession’s first nurse theorist, Florence Nightingale provided the essential foundation in environmental theory. She believed that some laws of nature, when applied and integrated into nursing care, can assist individuals in restoring their health during their illness, and, in those who are already healthy, promote health and prevent illness.

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 purpose of this paper is to provide an introduction, purpose, and rational for selecting a nursing theory. I will describe the theory by identifying the purpose, concepts/definitions, relationships/structure, and assumptions. I will use the Chinn & Kramer evaluation criteria to critique this chosen theory. Finally I will describe a plan for implementing the theory into my practice setting, identifying any barriers and challenges.

Nightingale believed health of the patient was a process affected by nursing, the environment, and human conditions (Torres, 1985, p. 41). Filth, vermin, dirty water, stagnant air, and raw sewage were a breeding ground for diseases and infection. With conditions such as these even a healthy person in a poor environment would soon experience a decline in health. Nightingales theory showed how the environment could inhibit or promote health for man.