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Nursing Concepts and Theory
Conceptual-Theoretical Structure paper
Personal belief about nursing theory and knowledge development process for nursing practice
All nursing theories play an important role in defining nursing and giving the roles that nurses need to play. Originally, the role of nurses was simply to carry out activities as instructed by doctors, however, over the years, this role has been changed to include more responsibilities as the nursing world has evolved. Nursing theories describe, predict and explain the various phenomena in nursing practice and thus create foundations for nursing practice. They also help to generate knowledge in the field of nursing and to point the direction which the field should develop in future. This view is supported by Carper (1978)
who states that nursing theories elaborate nursing practice and create professional boundaries for the profession. Nursing knowledge comes from research that has been conducted on nursing which forms scientific knowledge and experience gained from the practice itself which forms individual knowledge. Other sources of knowledge include tradition, intuition and tacit knowledge. Meta-theories and philosophical perspectives also help to develop knowledge in nursing practice by setting discussions that over time help to answer questions regarding nursing practice and the nature of nursing.
Fawcett's conceptual-theoretical structure
Fawcett's conceptual-theoretical structure provides four steps for development of a conceptual-theoretical model. The first step is selecting and defining concepts followed by development of relational statements. The third step is the development of a set of hierarchical statement and lastly the construction of the map or model Fawcett, 1995.
For example in an attempt to increase the nurse retention in hospitals, the concepts in nursing practice are the demands of nurses, current workload, working conditions, salaries, well-being of patients, quality of life for patients and hospital management policies. The relational statements made would be that if the nurses are given favorable working conditions, less workload and their demands such as increase of salaries and reduction of working hours are met, it is possible to increase the nurse retention rate. Another statement can be made that favorable policies made by the hospital management can help to increase nurse retention. The hierarchical statement would be that when nurses have fewer working hours, better working conditions and better pay, the nurses are able to work more comfortably which leads to improvement in the quality of nursing care in patients which results in a better well-being for patients and an improved quality of life. Thus the conceptual map would be as below.
What is nursing and why is it important to human beings?
Nursing is about dedicating one's life to caring for others sometimes while placing their own health at risk in order to help patients become better or to be comfortable till the end of their life. Nursing is about expressing five core values. The first is human dignity where the nurse treats all patients with honor and respect regardless of their age, sex, health status, origin, religion, etc. The second value is integrity which his basing decisions and actions on an internal framework that is consistent. Third is autonomy where the nurse provides the patient with information to help them making informed health decisions and choices. The fourth value is altruism where the nurse is selflessly concerned with the welfare of their patients. The last value is social justice where the nurse upholds the patient's rights and their dignity. Nursing is important to human beings because it helps them to recover from illness while helping them to proactively maintain a healthy lifestyle during their period of illness by educating them on health related issues, reminding them of the importance of taking medication, providing holistic care to the patient and helping the family deal with the recovery process Rolfe, 1998()
Central reason for existence of nursing
The central reason for existence of nursing is to care and comfort patients as their recover from their illnesses or during their final moments in life. Nurses have a duty to attend to their patients and provide them with holistic care that leads to their physical, spiritual, psychological and social recovery. Nurses help to maintain a level of health and wellness for the patients in order for them to recover from their illness. This involves educating patients on the importance of consistency in medication, administering medication, encouraging and engaging patients in exercises, educating patients on their medical condition and helping them to apply non-pharmacological alternative treatment options. They also help to inform and educate the family on the recovery process of the patient and the role they need to play in the patient's recovery Clark, 2003()
Central belief about the individual person
In nursing, the individual person is the holistic patient to who the nursing activities are directed. This is the patient who is ill or is in the final stages of a disease and requires care and comfort that incorporates holistic care in the physical, psychological, social, and spiritual dimensions. Clients collaborate with nurses and share their signs, symptoms, emotions and feelings to enable the nurse to provide the appropriate care. The individual person has the right to information in an accurate, timely and understandable manner to enable them to make informed decisions. They also have the right to be assisted in reducing the burden of their illness or disease and in weighing the options for treatment that they have. The individual person is striving to adapt to the changes within the external and internal environments as a result of their illness or disease. Therefore the goal of nursing is to help the person adapt to these changes in their environment Zerwekh, 2006()
The environment is the external and internal phenomena surrounding the person. The internal environment constitutes their inner response to the disease or illness such as immune response, emotions and feelings while the external environment is the factors that influence the person's capacity to maintain a balanced or optimum state of health. The environment consists of stimuli which affect the holistic balance in the person and influences their health. Since the person is a holistic individual, the environment is also holistic. The physiological influences include the neurological, cardiovascular, musculoskeletal, immune, reproductive, renal and respiratory system of the person. The ecological influences are the physical surrounding of the person such as shelter, occupation, economic well-being, epidemiological issues and climate. The sociocultural influences include the person's education background, political affiliations, culture, genetic background, and religion. Psychological influences include the person's personality, feelings, emotions and interpersonal relationships Anderson, 2005()
Interaction between the individual and the environment
The interaction of the individual and the environment affects the health of the individual as a result of the individual's attempts to adapt to changes in their environment. Diamond (1999)
states that environmental characteristics influence the behavior of the individual which leads to psychological, physical, spiritual and ecological changes that affect the person's health. Holland (1985)
argues that the interaction between the person and the environment are conceptualized using physical and social variables. The behavioral setting and the people within the environment make great contributions to the interaction between the person and the environment. Therefore all factors in the holistic individual affect the interaction. In the interaction between the person and the environment, there are three main components which are negotiation, participation and evaluation which stimulate the outcome of the interaction.
Health is a dynamic process that takes place in the holistic individual as a result of his or her continuous adaptation to the changes in the environment. In nursing, Springhouse (2002)
argues that health is affected by the interaction between the person and the environment. Therefore, nurses need to assess the health needs of the individual in a holistic manner in order to provide good quality care. These health needs should also be assessed at the individual, family and community levels in order…[continue]
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