Critical Thinking and Theory

Dorothea Orem Hildegard Peplau Myra Levine Jean Watson Educational Background Nursing diploma, Providence Hospital School of Nursing. Bachelor of Science- Catholic University of America-1939, Master of Science in Nursing Education-1945. Graduated Pottstown, Pennsylvania Hospital School of Nursing-1931. B.A. in interpersonal psychology- Bennington College, Vermont-1943, M.A. in psychiatric nursing- Teachers College, Columbia-1947, Ed.D in curriculum development-Columbia University-1953. Diploma in Nursing, Cook County School of Nursing- 1944. Bachelor of Science in Nursing -University of Chicago-1949, Master of Science in Nursing- Wayne State University-1962. University of Colorado at Boulder-1964, M.S.

in psychiatric and mental health nursing-1966, Ph.D. in educational psychology and counseling-1973. Philosophy of Nursing Humans participate in ongoing interchange and communication between themselves and their environments to function and stay alive. Peplau considered Nursing as therapeutic, meant to help a sick individual in need of health care. Holistic perspective, believing environment plays a key role in 'wholeness'. Caring represents the core of nursing and implies responsiveness among patient and nurse; the nurse co-participates towards the recovery of the person.

Definition of Nursing Orem defined nursing as an art from through which the nurse offers specialized assistance to persons with disabilities making ordinary assistance essential for meeting the needs of self-care. Nursing under Peplau's perspective is an interpersonal process that encompasses interaction among two or more persons sharing a common aim. Nursing should promote 'wholeness' and entails engagement in 'human interactions'. Caring along with nursing has existed throughout the ages in each society. Caring for others is natural. However, a caring attitude does not come from genes.

It is transmitted via culture of profession. Goal/Purpose of Theory The Self-Care Deficit Nursing Theory: To encourage patients to be as independent as possible and promote self-care. Theory of Interpersonal Relations: The nurse through interactions, develops a care model suited to the needs of the individuals, aiming for a common goal of health. The Conservation Model: Nursing's role in conservation is to assist an individual with the process of "keeping together" the total individual via the minimum amount of effort.

Theory of Human Caring: Nursing concerns the promotion of health, the prevention of disease, caring for the sick, and restoration of health. The goal is health promotion, and treatment of diseases through caring. Nursing often involves care and empathy towards the patient and the process. Theoretical pioneers like Dorothea Orem, Hildegard Peplau, Myra Levine, and Jean Watson have provided nurses with the ability to understand the needs of patients through insightful critical thinking and varied perspectives.

Although their contributions have been momentous and inspiring, the first nursing theorist to truly change how nurses interact with patients was Florence Nightingale. Recognized as the philosophical founder of modern secular nursing, she was the first to focus on the collective and the individual needs of nursing and apply her knowledge via theory. Her philosophy of nursing meant integration and balance of concerns from human and non-human to inner and outer.

By examining the four nursing theorists and comparing their philosophy of nursing with Nightingale's, the selection of which theorist is most congruent with Nightingale will be selected. Dorothea Orem created The Self-Care Deficit Nursing Theory. The theory emphasizes the duty of the nurse to encourage independence from the patient so the patient can generate a level of self-care that will help towards a positive health outcome. Although the original theory was split into three theories, the overall message of Orem's theory is to enable independence in patients.

Self-care is at the center of the theory and is defined as: Self-care is not limited to a person providing care for himself; it includes are offered by others on behalf of the person (dependent care). Care may be offered by members of the family or outsides until a person is able to perform self-care. Self-care is purposeful and contributes to human structural integrity, functioning, and development (Meleis, 2012, p. 280).

When compared to the other theories, including Nightingale's, the theory is vastly different from the others as it places some of the responsibility of a positive health outcome on the patient. Furthermore, by splitting the original theory into three, it adds complexity to the perspective making it more difficult to understand the original or updated goal.

For example, the first theory, the theory of self-care, focuses on self-care as a means of maintaining life, keeping the psychic and physical functions continuing, and maintaining a person's health integrity to sustain good health. This theory harkens back to Orem's original theory, but does not go into detail on how to enable self-care within the patient. The second theory, self-care deficit, gives the most comprehensive element, but fails to deliver a clear and concise understanding of the theory.

For instance, it has a central idea expressed through two sets of presuppositions. The first set involves the individual's capability to engage and manage in offers dependent care and self-care as well as take actions to manage/maintain functioning and health. The second encompasses understanding what society can offer to help the individual in a state of dependency become more independent (Meleis, 2012). The extra layers seem to take away from the overall meaning of the theory. The third theory of Orem's original theory is the theory of nursing systems.

The framework involves an understanding that experienced nurses offer intentional care for patients needing dependent care. Such splitting of theory creates unnecessary confusion and is very different from the simplicity offered in Nightingale's philosophy of nursing. Hildegard Peplau's Interpersonal Relations Theory, is one that revolves around the interpersonal process. For the nurse to perform his or her duty, she or he must understand the meaning of a patient's experience for nursing to function as a therapeutic, educative, and maturing force (Fawcett & Desanto-Madeya, 2013).

Expressed as 'phases' Peplau stressed the nature of this theory as interpersonal connections. "These phases represent a relative concrete and specific taxonomy. The Theory of Interpersonal Relations is a middle-range descriptive classification theory. The focus of the theory is on interaction phenomena and intra and interpersonal phenomena" (Fawcett & Desanto-Madeya, 2013, p. 383). Such a theory does not relate with Nightingale's environmental theory, because of the focus on relationships.

Still, the theory allows for a better recognition of the needs and experiences of the patient that can allow for growth and development for the nurse. Another singular and one-dimensional theory that focuses on an aspect of nursing is Jean Watson's Theory of Human Caring. Caring to Watson is not inherent because of a person's genes, but rather, the caring attitudes express within the culture (Watson, 2008).

Although it is important to care for the wellbeing of the patient, and can serve as a main motivator for delivery quality patient care, it does not seem to take into account the kind of influences that Nightingale discusses in her theory. The theory itself feels as though it is not an effective means of understanding what the needs of the patient are. For example, the instillation of faith and hope is part of the theory.

However, there is no real discussion on how to instill faith and hope in a patient. The theory simply states that by being authentically present, it can enable and sustain the deep belief system as well as subjective life-world of self (Watson, 2008). It seems to rely too much on abstract thoughts to truly give compelling insight. The last theory is Myra Levine's The Conservation Model. This theory seems most congruent to Nightingale's environmental theory because it aims to provide an understanding in.