nursing

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Theories that are used in everyday nursing practice

Identify at least 2 borrowed theories that you use in everyday nursing practice.

The social exchange theory is defined as “a flow of emotional concern, instrumental aid, information, and/or appraisal (information relevant to self evaluation) between people” (Leahy-Warren, 2007, p. 370). The social exchange theory is constantly utilized in my daily practice as a Maternal Child health nurse. The social exchange theory has four functional dimensions (informational, instrumental, emotional, and appraisal support). Informational support is defined as “information exchanged between individuals or a group that has a positive outcome for the recipient” (Leahy-Warren, 2007, p. 370). Informational support is utilized every minute of my interaction with a mother, especially during new admissions and discharges. Information regarding shaking baby syndrome, baby back to sleep in preventing SIDS, and immunizations are all topics that I pass onto mother’s during our patient-nurse interaction. Instrumental support is defined as “transactions in which direct aid or assistance is given” (Leahy-Warren, 2007, p. 370). This type of support is utilized when assisting my new mothers in breastfeeding or utilizing the breast pump. I am directly assisting my patient in providing nutrition to their newborn. Emotional support is defined as “emotional concern for the recipient” (Leahy-Warren, 2007, p. 370). I continuously provide emotional support to my parents in assisting mom during her labor, newborn transition period, and home-care. Provide emotional support to a new father who may be changing a diaper or feeding his infant for the first time. Appraisal support is defined as “affirmation or expressions of agreement or rightness of some act or point of view” (Leahy-Warren, 2007, p. 370). Appraisal support is utilized when conduction new parent classes and parents are able to interact with one another and other nurses regarding various maternal child health topics.

Social exchange theory deals with the many different types of interactions among patients and their nurses. Social exchange theory deems itself useful in studying the patient-nurse interaction. Patient-nurse interaction in maternal-child health is a unique type of social networking. The goals of the encounter between nurse and patient are derived from the overall goal of nursing practice, health promotion, and disease and injury prevention. Patient-nurse interactions are an exchange process and can be either rewarding or costly for both the patient and the nurse. The patient will expect the nurse to provide a specific set of services and resources. Donohue (2003) found that the exchange theory was instrumental in understanding and explaining patient-nurse practitioner interactions in a women’s health clinic (Donohue, 2003, p. 720).

Patient-nurse interaction is a mutual exchange of resources, and social exchange theory is helpful in describing the how the nurse initiated, maintained and ended the relationship between parents. Social exchange theory is useful in linking variations in patient-nurse interactions and their outcomes. Analyzing what resources are exchanged between the nurse and the patient is a way of measuring potential outcomes. For example, analyzing what information is exchanged is a way to identify potential outcomes in areas of increased maternal knowledge about infant care, increased home safety, prevention of SIDS, adherence to immunizations, and decreased postpartum complications (Leahy-Warren, 2007, p. 371).

The Cultural Diversity and Cultural Bias theory, also known as Critical Race Theory (CRT) in anthropology, has dominated racial scholarship since the 1900’s. “Critical race theory (CRT) challenges the dominant discourse on race and racism as it relates to education by examining how educational theory and practice are used to subordinate certain racial and ethnic groups” (Ford & Airhihenbuwa, 2010, p. 1391). The anthropological theory, CRT, was used as a model to examine cultural competency in healthcare. Anthropological theories such as CRT, cultural deficit, and cultural difference provided a pathway for nursing to establish its own cultural competent theory. Early investigations into cultural competency, utilizing anthropological theories, established the way nurses practice today.

Cultural competency is defined "as a set of congruent behaviors, attitudes, and policies that come together in a system, agency or amongst professionals and enables that system, agency or those professionals to work effectively in cross cultural situations"(Dayer-Berenson, 2009, p. 12). Every day I interact with patients that come from numerous racial and ethnic groups. Many of my patients do not look, act, feel, or respond to interventions or care in the same manner that I do. In my practice I utilize aspects of CRT in providing culturally competent care. In daily practices I must be culturally appropriate in approach and in responses. My goal for my patients is to attain maximum health and well-being, and the only way to meet this goal is to provide culturally competent care.

Do you think that nurse researchers can use non-nursing theories to develop nursing knowledge? Why or why not?

Nurses have borrowed theory from all aspects of the science disciplines and have applied them to nursing situations to derive nursing theory. Two examples of borrowed theories that I utilize in my daily practice are the social exchange theory and the Critical Race Theory (CRT). The implication for using non-nursing theories to develop nursing knowledge is that borrowed theories are potentially useful for understanding the patient-nurse interaction. For example exchange theory could be utilized to investigate the unique dynamics of patients and their expectations in the areas of their nursing care, resources, and overall satisfaction. Nurses can utilize non-nursing theories such as the exchange theory to educate pregnant and postpartum women about issues that concern them and help them access the social support needed for each patient.

The perfect example of a researcher utilizing a non-nursing theory to develop nursing knowledge and a well-used nursing theory is, Leininger. In response to the lack of culturally competent care patients were receiving, Leininger, a fellow nurse established a theory which identified those cultural factors that influenced stress, pain, and an individual’s overall perception of health. Leininger’s Transcultural Nursing theory model was developed utilizing her anthropological roots. Leininger is the first professional nurse in the world to obtain a doctorate in anthropology. Leininger combined her nursing education along with her PhD in anthropology and established a model that provided new knowledge and a new way to practice, in an environment that was rapidly evolving, into a multicultural world. Leininger borrowed theories from her anthropology studies and developed the Transcultural Nursing theory. Leininger utilized anthropology for the cultural aspects, and nursing for the caring components. Nurses should not blindly utilize and adopt non-nursing theories in their practice, but Leininger is a perfect example, of when you systematically review the appropriateness of a borrowed theory it can evolve into a practical nursing theory.


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