Theories of nursing

HLTEN508B – Apply reflective practice, critical thinking and analysis in health.

Pre-unit reading and preparation

1. Nursing theorists and theories

1. Henderson – The Nature of Nursing Model

• Introduced The Nature of Nursing Model. She identified fourteen basic needs.
• She proposed that role of the nurse is to assist the patients during when they are sick or well, in recovery and rehabilitation.
• She believed that nursing involves assisting the client in gaining independence as quickly as possible or assisting them to achieve peaceful death if recovery is no longer possible (Theoretical Foundations of Nursing, 2014).

1. Roper – A Model for Nursing Based on a Model of Living

• This model incorporates a life span approach, where the characteristics of the person are considered with respect to prior development, current level of development, and likely future development.
• In combination with the life span approach an independence/dependence category used.
• The model then incorporates a set of twelve activities of living (ADL’s), which represent activities engaged in by individuals whether sick or well.

1. Orem – Self-Care Deficit Theory

• Defined nursing as “The act of assisting others in the provision and management of self-care to maintain/improve human functioning at home level of effectiveness.” (Theoretical Foundations of Nursing, 2014).
• Focuses on activities that adult individuals perform on their own behalf to maintain life, health and well-being.
• Has a strong health promotion and focus.
• Identified 3 related concepts: Self-care, Health and Nursing System

1. Peplau – Theory of Interpersonal Relations

• Defined nursing as “An interpersonal process of therapeutic interactions between an Individual who is sick or in need of health services and a nurse especially educated to recognize, respond to the need for help (Theoretical Foundations of Nursing, 2014).
• Nursing is a “maturing force and an educative instrument”
• Identified 4 phases of the Nurse – Patient relationship

1. Watson – The Philosophy and Science of Caring

• Nursing is concerned with promotion health, preventing illness, caring for the sick, and restoring health.
• She defined caring as a nurturing way or responding the needs of a client. Caring accepts the person as what he/she may become in a caring environment (Theoretical Foundations of Nursing, 2014).

1. Abdellah – Twenty One Nursing Problems

• Established 21 problem areas to guide care and promote the use of nursing judgement.
• Introduced Patient – Centered Approaches to nursing model
• She defined nursing as service to individual and families; therefore the society. Furthermore, she theorized nursing as “an art and a science that moulds the attitudes, intellectual competencies and technical skills of the individual nurse into the desire and ability to help people, sick or well, and cope with their health needs” (Theoretical Foundations of Nursing, 2014).

1. Explain the difference between a theory and a model?

   A theory is a group of related concepts that propose action that guide practice. Theories are composed of concepts, definitions, models, propositions and are based on assumptions. Whereas models, are representations that allow the concepts in nursing theory to be successfully applied to nursing practice. They may demonstrate how theory can be introduced into practice, for example, through the specific methods of assessment.

2. What are the common themes in nursing theorist’s views on caring?

   Four concepts common in nursing theory that influence and determine nursing practice are:

• The person (patient)
• The environment
• Health
• Nursing (goals, roles, functions)

1. What are the age and gender issues facing nurses today?

Nursing in a male-dominated world

Nursing is dominated by females and if often regarded as an oppressed profession. This gendered hierarchy of women in lower roles emphasizes male domination and marginalization of women in society (Cordon, 2014). The unequal power balance between physicians and nurses has resulted in nurses lacking the confidence to question doctors’ decisions and not speaking up in the workplace. Reason for this includes fearing conflict and stress (Cordon, 2014).

Gender discrimination

Nursing, in the past, has been seen as “women’s work” because it is a caregiver role. Due to this, men who enter nursing may face with barriers and discrimination. For example, men who enter the nursing profession may be perceived as more “feminine”. Male nurses may face the perception that they are gay (Cordon, 2014).

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Male nursing students or graduate nurses may also have less male role models in the profession as it is largely dominated by females. While both men and women in the nursing profession can be excellent clinical mentors, the male nurse may have some issues that he cannot comfortably discuss with female colleagues (Cordon, 2014).

1. In the field of health define the following terms:

   a) Best practice – Refers to nursing practices that are based on the “best evidence” available from nursing research. The goal of “best practices” is to apply the most recent, relevant, and helpful nursing interventions, based on research, in real-life practice.

   b) Philosophy – The philosophy of healthcare is the study of ethics, processes and people which establish the maintenance of the health for human beings.

   c) Vision – An aspirational description of what an organization would like to achieve or accomplish in future.

   d) Mission statement – A formal summary of the aims and values of an organization, or individual.

2. How do the following Professional Standards of Practice apply to you as an Enrolled Nurse?

   a) ANMC code of conduct

   These are the principles guiding behaviour between colleagues, between staff and those receiving care. The Department of Health places high importance on maintaining patient confidentiality and protecting privacy and as enrolled nurses we must follow these standards to ensure that all sensitive documents including patient’s case notes are stored in a safe and secure area and discussions of personal information about clients/patients do not occur.

   b) ANMC code of ethics

   It is essential and important, as enrolled nurses, to ensure that the relationship between a patient/client and a health professional is safe, helpful and therapeutic and is always within professional boundaries as determined by the Code of Ethics. Standards include identifying the fundamental moral commitments of the profession, reflection on ethical conduct for professional and self-development and ethical practice.

c) ANMC national Enrolled/Division 2 nurse competency standards

The national competency standards for the enrolled nurse are the core competency standards by which your performance may be assessed to retain your license to practice as an enrolled nurse in Australia. As an enrolled nurse, these core competency standards provide you with the framework for assessing your competence.

d) State/Territory Nurse Regulatory Nurses Act

The state and territory nursing and midwifery authorities (NMRAs) to produce national standards – an integral component of the regulatory framework to help enrolled nurses and midwives deliver safe and competent care. It also keeps the public safe by ensuring the services they will receive are from competent nurses.

e) State/Territory Nursing and Midwifery Regulatory Authority Standards of Practice

The state and territory nursing and midwifery authorities (NMRAs) to produce national standards – an integral component of the regulatory framework to help enrolled nurses and midwives deliver safe and competent care.

f) Scope of Practice decision making framework

The Nursing and Midwifery Board of Australia (NMBA) has endorsed national decision-making frameworks for both nurses and midwives. As enrolled nurses, these two flowcharts will assist us in our professional decision making through a structured and transparent process. It also provides us with and an evidence-based process (approved by the regulatory authority) in our decision-making that we may use in support/defence of our decisions should we be required to provide it.

REFERENCE

i. Theoretical Foundations of Nursing

Virginia Henderson

Bibliography: Theoretical Foundations of Nursing, (2014). Virginia Henderson. [online] Available at: http://nursingtheories.weebly.com/virginia-henderson.html [Accessed 15 Jul. 2014].

ii. Theoretical Foundations of Nursing

Dorothea E. Orem

Bibliography: Theoretical Foundations of Nursing, (2014). Dorothea E. Orem. [online] Available at: http://nursingtheories.weebly.com/dorothea-e-orem.html [Accessed 15 Jul. 2014].

iii. Theoretical Foundations of Nursing

Hildegard E. Peplau

Bibliography: Theoretical Foundations of Nursing, (2014). Hildegard E. Peplau. [online] Available at: http://nursingtheories.weebly.com/hildegard-e-peplau.html [Accessed 15 Jul. 2014].

iv. Theoretical Foundations of Nursing

Jean Watson

Bibliography: Theoretical Foundations of Nursing, (2014). Jean Watson. [online] Available at: http://nursingtheories.weebly.com/jean-watson.html [Accessed 15 Jul. 2014].

v. Theoretical Foundations of Nursing

Faye G. Abdellah

Bibliography: Theoretical Foundations of Nursing, (2014). Faye G. Abdellah. [online] Available at: http://nursingtheories.weebly.com/faye-g-abdellah.html [Accessed 15 Jul. 2014].

vi. Cordon, C.

Structural Inequality and Diversity in Nursing | Minority Nurse

Bibliography: Cordon, C. (2014). Structural Inequality and Diversity in Nursing | Minority Nurse. [online] Minoritynurse.com. Available at: http://www.minoritynurse.com/article/structural-inequality-and-diversity-nursing [Accessed 15 Jul. 2014].

1. Tabbner’s Nursing Care: Theory and Practice

   Tabbner’s Nursing Care 5^th Edition:

   Rita Funnell, Gabrielle Koutoukidis, Karen Lawrence (2009)