Nursing Theory

Practicum Reflective Journal
Nursing Theory
My intended area of practice is the primary care of adults across their lifespan. Therefore, lifespan theory was chosen as the theoretical foundation for this practicum. Lifespan theories provide a framework for describing the optimization of the whole person across various functional domains during the course of their life. It integrates the biological, psychological, and social components of the development of the person, while taking into account cultural aspects that affect their development (Gilleard and Higgs, 2015).
Like Course Health Development is a framework within lifespan theory that focuses on health development over the life of the individual (Bates, et al, 2018). This theory holds that nurses touch people in every point of their lifespan and that understanding how patient characteristics change as they age offers the opportunity to engage in primary prevention during the early stages of the aging process (Bates, et al, 2018).
Life Course Theory is another related theory that explains health and disease expanding across different populations, and over time with a focus on improving outcomes for patient as they age (Cheng and Solomon, 2014). These theories will form the key component of my practicum experience, and my intended practice of nursing care.
Goals and Objectives
The goals and objectives of this practicum were developed from the seven domains of practice. My goal for this course was to see as many different types of patients as possible across a range of lifespan points in their development. I wished to provide a helping role, emotional and informational support, diagnostic and monitoring support, and to ensure practice across all seven domains.
Refection
I feel that I goals I set out to accomplish in my practicum. My practicum involved working primary care setting where I saw a number of patients in various stages of their lifespan. I saw patients that had a number of disease conditions such as hypertension, GERD, COPD, arthritis, and other chronic conditions. I also saw cases such as otitis media, bronchitis, UTIs, and other forms of acute cases. The practicum involved over 150 hours and 100 patients over a two-month period. I was able to assist in all seven domains nursing practice and see how lifespan theories can be applied in a practical clinical setting.
Upon reflecting on my experience, many of the patients who came in with chronic conditions could reduce their effects by making lifestyle changes now. However, preventative measures been taken earlier in life, many of these chronic conditions would never have developed. Early education and encouragement to make healthy lifestyle choices and a significant impact on the rate of decline due to age-related diseases as a person ages. This is lifespan theory and practice.
The acute cases were often an emergency, or crisis mode when they came in. One of the first things that needed to be done was to reassure them that everything was going to be okay. The chronic patient took considerably more time to manage than acute cases. They require education, and encouragement to enact the lifestyle changes that were suggested to help manage their diseases. Many times, they would come back for repeat appointments and it was easy to tell that they had not changed anything. By the time they have aged, many of their lifestyle choices are habitual. This emphasizes the importance of instilling good habits and lifestyle choices at an early age. Many of them could be under much better management if they were willing to take the advice that you have to offer.
I feel that I met all of my practicum goals and learned how to apply lifespan theory to the clinical setting and daily practice. It involves educating each patient about their condition and what they can do to management it. This applied to acute cases as well as chronic ones. For the acute cases, education would help them get relief faster and possibly prevent another outbreak from occurring in the future. However, for the chronic ones, convincing them to make changes was difficult. They would not see the results of these changes as quickly as the acute cases. They may have to make these lifestyle changes and wait some time to see any measurable results. This makes them more likely to give up because they do not feel that there is anything they can do.
I found that empowerment is the most valuable treatment one can give those with chronic and acute diseases. They need to note that there is something they can do to improve their lives and make their condition better. Even though this may give them hope when they are in your office, it is apparent that they do not have the support needed to implement these changes. This borrows under the category of the Health Belief Model (Boston University School of Public Health, 2018). and the readiness of the person to make the changes that you suggest. Until the person is ready to make the changes themselves, there is little that you can do to help them, other than biological treatment of their disease.
In the final analysis, I found that the Lifespan Theory is closely related to the Health Belief Model. Many of the patients that I saw did not believe that they can make changes that would result in an improved outcome. In terms of patient load, chronic patients took up much more time per visit, enterprise a major portion of the caseload. This further supports the need for early education and the development of a healthy lifestyle early in life before destructive patterns become set. My overall impression of my practicum is that I met my goals and had the opportunity to see these theories and practice.
References
Bates, R., Blair, L., Schlegel, E., McGovern, C., Nist, M., Sealschott, S. & Acrcoleo, K. (2018). Nursing Across the Lifespan: Implications of Lifecourse Theory for Nursing Research. Journal of Pediatric Health Care,32(1), 92–97.
Boston University School of Public Health (2018). The Health Belief Model. Retrieved from http://sphweb.bumc.bu.edu/otlt/MPH-Modules/SB/BehavioralChangeTheories/BehavioralChangeTheories2.html
Cheng, T. & Solomon, B. (2014). Translating Life Course Theory to Clinical Practice to Address Health Disparities. Maternal and Child Health Journal, 21(1): 92-97.
Gilleard, C. & Higgs, P. (2015). Connecting Life Span Development with the Sociology of the Life Course: A New Direction. Sage Journals. Retrieved from https://journals.sagepub.com/doi/full/10.1177/0038038515577906