Nursing Theory Application

Nursing Theory Application Case Study Overview from the viewpoint of a new EMT -- Patient was a 78-year-old mail presenting breathing difficulties. Patient had early stage cancer with a DRN bracelet and note. Patient's wife was aware of the DNR, but her natural reaction was to try to save her husband. The call, then, was more to assure the wife than the husband, who accepted the situation but was still distressed.

Nursing Theory Applied -- "Nursing as Caring" was developed by Boykin and Schoenhofer in the 1980s when looking at the dimensions of caring and how it applied to the overall patient/health care paradigm. In general, the theory is a framework that guides and acts as a tool box when dealing with common issues in modern health care.

The central dimensions of the theory is that caring is what makes humans 'human,' that caring is a moment to moment and uniquely individual model that is required within health care, and that the medical professional's own personhood and empathy are developed through a caring model (Cardinal Stritch University, 2010). Borrowed Theory Applied -- In primitive cultures, the process of dying is accepted as a natural part of the rhythm of being human and revered.

In the modern developed world, death is feared and those who are dying are often institutionalized and removed from general society, often rather than allowing one to die with dignity everything "possible" even if uncomfortable and invasive is done to keep the loved one alive -- not for the patient, but for the living.

Elizabeth Kubler-Ross believes the opposite, that grief and loss are transformative and that a person's stage of dying is a natural outgrowth of life (Kubler-Ross, 2007) Analysis of Theory and Evaluation- In the presented case study there are certainly elements that fit both Kubler-Ross and The Theory of Nursing as Caring. In fact, the two have a great deal in common in their basis on the paradigm of individual empathy and caring for the patient. However, because of the patient's decision for DNR, Kubler-Ross may be slightly more relevant.

Kubler-Ross' theory was developed as a response to the view that death and dying were processes to be feared and hidden within modern society. The overall purpose of the theory is that patients are unique individuals with unique and important rights to decide the circumstances of their death -- even if that means heroic and medically possible efforts are refused (Kubler-Ross, On Death and Dying, 2013). Within the nursing model, this may seem anathema to many ethical principles of aiding and doing no harm.

However, in other ways, the ideals of patient-centered care are critical to the modern nursing profession. At the very heart of both KR and medical ethics are the notions of autonomy (allowing a rational individual to make uncoerced and individual decisions), beneficence (do no harm, but also do not cause the patient pain and discomfort that will only prolong illness, not cure it), and paternalism (that of respecting the individual's choice and opportunities) (Kubler-Ross, (Rai, 2009).

Kubler-Ross, though, states that the grief stages, "have evolved since their introduction, and they have been very misunderstood over the past three decades. They were never meant to tuck messy emotions into neat packages. They are responses to loss that many people have, but there is not a typical response to loss. There is no typical loss. Our grief is as individual as our lives" (Kubler-Ross, On Grief and Grieving, 2007). Thus, the overall concept is broad in scope and narrow in application.

Family, friends and medical professionals should, of course, attempt.