Nursing theorists and their influence on current practice

1. Nursing Theorist Overview
Theory guides nursing practice and provides a framework for nurse leadership and healthcare management (McKenna, Pajnikar & Murphy, 2014). All prominent nursing theorists like the individuals covered in the multimedia presentation have influenced nursing practice in some way or another, and all do resonate with me on a personal and professional level. I will incorporate elements of all theorists into my practice in terms of interpersonal communications and attitudes towards health and healing. Of the theorists covered in the presentation, those of Florence Nightingale resonate the most because of her inclusion of environmental factors implicated in patient care. Environmental factors like lighting or ventilation can have a profound impact on perceptions of quality of care, too, which has a strong bearing on the efficacy of the healthcare institution (Sabza & Pirani, 2016). The environmental factors that Nightingale identified as being important to patient care also have a direct effect on physiological responses in some patients, as I have noticed in my own nursing practice. For example, ventilation is a factor implicated in respiratory functions. Some patients are more sensitive to air quality or air temperature, which will be especially critical to those who have issues related to respiratory health or who are receiving specific types of treatments.
Because I have aspirations in nurse leadership, I intend to build on Nightingale’s environmental theories of nursing practice to make critical decisions related to institutional and workplace settings. In fact, Nightingale’s theories are already applicable to my current practice area. I have noticed how patients will respond to changes in their environment, either with beneficial or adverse outcomes. Sudden or constant noises are one of the most noticeable factors impacting patient responses to healthcare interventions. Environmental factors influence the efficacy of some treatment interventions, by creating a sense of comfort in some or initiating a stress response in others. The design of the environment may also be conducive to relaxation, socializing, or resting. Nurses need to be aware of patient needs, with attention paid to cultural variables and other sociocultural issues like gender. Other aspects of Nightingale’s nursing theory that I can immediately apply to my patient care practices center on the responsibility the nurse undertakes to be an active role promoting healing via alterations to the care context.
2. Caring Science
The concept of caring has become embedded in nursing to the point where it is often taken for granted as an implied aspect of service delivery. Therefore, when caring is absent from nursing practice or patient interactions and communications, it can have an adverse impact on health outcomes or on organizational behavior. A lack of official caring practices in the healthcare institution can also lead to workplace dissatisfaction and poor morale among employees (Watson, 2009). Caring has had to be revitalized in nursing theory and education in order to interject the principles of caring, and to show what caring entails. Watson (2009) and the Watson Caring Science Institute (2018) have offered nurse leaders and nurse educators, as well as practitioners, the opportunity to standardize definitions of caring and operationalize standard caring procedures. The theory of human caring embodies my beliefs about the profession of nursing, which is a fundamentally holistic and multidisciplinary practice.
Nursing needs to be grounded in evidence-based practice, and caring is a major component of that approach to healthcare interventions (Watson, 2009). The administration of assessments, tests, and procedures without caring would only achieve a narrow bandwidth of healthcare goals and objectives. Desirable outcomes in patient care go far beyond quantitative outcomes to include the empowerment of patients to take charge of their own health beliefs and practices, to promote psychological growth and healing, and to encourage the integration of social support networks into the overall treatment plan. I have always recognized the importance of cultural contexts, and sociological factors like gender, age, and other variables that will affect behaviors, attitudes, and beliefs, Learning about the patient through active listening, including family members into health-related decisions, and advocating on behalf of patients by communicating with other members of the care team are all parts of a caring-focused nursing practice.
The theory of caring and caring science offers a holistic approach that encourages nurses to be more aware of contextual variables. Nursing that is rooted in caring science can factor in elements of the patient’s religious or spiritual life, leading to what Watson (2009) calls “heart-centered love and caring,” (p. 466). In fact, patient responses to a caring-based approach in my practice has proven that patients need a heartfelt hand, meaningful eye contact, and other signs that the nurse actually cares in addition to being competent.
Caring science also promotes humanistic values in healthcare, which can impact public policy or at least institutional practices. I believe it is most important for nurse leaders to ascribe to Watson’s caring science principles because nursing practice is established at the level of leadership. Nurse leaders who operate more from a position of caring than from a position of financial management create systems of healing in which the objectives of healthcare are to promote wellbeing and psychological harmony.
3. Caring TED Talk
In a world in which scientific understandings of the human body and how to fix it have dominated healthcare discourse and healthcare practices, nurses and physicians are in danger of losing the meaning of their work. Healing is certainly dependent on evidence-based practice. Empirical research has helped nurses and other members of the healthcare team to be more effective for their patients, and more honest about healthcare outcomes. Yet in the pursuit of rigorous scientific knowledge and data-driven healthcare decisions, nurses must not lose the core of their identities and their patients’ needs. In his TED talk entitled “A Doctor’s Touch,” Abraham Verghese admits that doctors and other healthcare practitioners need to re-engage with their patients, with their colleagues, and with themselves. Nurses and physicians need to talk to their patients as human beings, not just as numbers, listening, reading body language, and offering more than just tests and diagnoses. Verghese’s talk invokes Watson’s theory of caring and the approach to nursing that takes caring to the level of science.
Research in fact does show the importance of caring to improving healthcare outcomes, as Verghese and Watson both point out. In my practice too, I have seen how patients smile more when they are working with nurses who do show caring. We as nurses should be caring for patients as if they were members of our social circle instead of being strangers. Taking the approach that we are all members of a human community with universal needs for love and support, we can approach patients in caring ways, changing the nature of nursing practice for the better. The coldness that many patients feel upon entering a clinic or hospital can be transformed into a warm atmosphere more conducive to healing without incurring additional costs. In fact, nurse leaders and hospital administrators need to recognize that the small changes made to staff development practices, leadership, and institutional design end up saving costs related to unnecessary readmissions. Patients that receive genuine caring are more likely to take the necessary emotional and physical steps in their own healing journey. Verghese also points out how doctors often miss important bits of information when they rely only on the results of a test, as opposed to keenly observing patient behavior and body language. The person will reveal subtle cues about their physical and psychological health, and only a caring practitioner will have the eyes and ears to notice.
References
McKenna, H., Pajnkihar, M & Murphy, F. (2014). Fundamentals of Nursing Models, Theories, and Practice. John Wiley.
Sabza, S. & Pirani, A. (2016). Application of Nightingale’s theory in nursing practice. Annals of Nursing and Practice 3(1): 1-3. https://www.jscimedcentral.com/Nursing/nursing-3-1040.pdf
Verghese, A. (2011). A doctor’s touch. TED. https://www.ted.com/talks/abraham_verghese_a_doctor_s_touch?language=en
Watson Caring Science Institute (2018). https://www.watsoncaringscience.org/
Watson, J. (2009). Caring science and human caring theory. Journal of Health and Human Services Administration 31(4): 466-482.