Nursing Standards & Nursing Theories

1. Nursing Standards & Nursing Theories Delaune & Ladner Ch 2, Roy Chapter 2

2. Elements of a Profession • Provide service to support social welfare • Possess a specialized body of knowledge • Educate its practioners in institutions of higher learning • Life long commitment • Formulates policy and controls its membership • Practitioners function autonomously • Have a Code of ethics • Have a professional organization that contributes and ensures quality of practice

3. The Nursing Profession • Nursing is both a profession and a practice discipline. • The professional nurse is an occupation that requires extensive education, specialized training and competence. • Nursing services are delivered in variety of settings. • The amount of autonomy and accountability for decisions differs with the practice setting.

4. Another Definition of Nursing • Nursing is concerned with the health and well being of clients/patients. • It involves the delivery of services to promote, maintain, and restore health as well as prevent illness. • Nursing also coordinates services to improve continuity of care.

5. Nursing Is a Science • Science • A process of research and inquiry • empirical knowledge • examination of phenomenon • definition and consensus of terms • model building • theory testing

6. Nursing is not Medicine • Uses a similar body of knowledge • BIO, psych, chem….. • Medicine diagnosis, to cure • Nursing diagnosis to facilitate change • Nursing holistic wellness focus

7. Nursing is a Science • Based on theories • Supported by research • That defines describes and directs practice

8. A Science Is a Process That: • Identifies to categorize and structures in order to understand and manipulate • The statements of science are : • “true” • coherent • logically ordered • focused on definite areas • result in universal statements

9. Two Major Types of Research • Quantitative/ empirical • Observed and measured • Give us numbers, numerical data • Relationships revealed in statistics • Qualitative/Ethics, Esthetics, Personal knowing • Observed and described • Give us stories, narrative data • Relationships revealed in patterns

10. Knowledge development • Combination of scientific and research process • Documentation and analysis of cause and effect • Result is theories that organize and communicate concepts

11. Theory • An idea or set of concepts that describe, organize or explain a phenomenon • Describes relationships between significant constructs within the theory

12. Theories • Evolve • Are tested by research • Contain elements of assumption • Contain agreed upon definitions

13. Theories Roy, Pg 87, Delaune pg 27 • Grand –Give us broad definitions, very abstract, • Man, society. • Meta theories. • Systems, situation producing theory. • Middle range. • Nursing focus, family dynamics, stress, maternal bounding. • Practice – Micro. • goal directed, research related to proper tube feeding.

14. The biological system called man can be assisted in preventing illness by nurses giving immunizations. Meta Grand Middle range Practice Example

15. Theories Often Require Elements of Agreement Example Mathematics 0 X 1 = 0 Agreement 0 Not 1 Chemistry The Ph of Water Is 7.0, Not 10.0

16. Selected Models and Theories • Systems theory – operations, biology • Maslow Needs theory - motivation • Roy adaptation model – nursing

17. Systems Theory • Assumption/agreements • Relationship exists between the whole and its parts • The whole is more than a sum of its parts • A system is goal directed • An open system changes - evolves • Systems have boundaries - open/closed

18. Systems Theory • Input • raw materials • Out put • result of process • Through put • work of the system • Feedback loop – • message that becomes part of input

19. Systems Theory Output Products Decisions Input Knowledge Skills Abilities Raw material Throughput Process Analysis Feedback Evaluation Internal environment External environment

20. Example GI System, Newborn Child, First Feeding • Input - anatomy, food, water. • Through put - digestion. • Out put - waste, energy, water. • Feedback - some food tastes better, digests easier and causes less gas. • Input - anatomy, different foods, new enzymes for digestion.

21. Human Needs TheoryMaslow • Hierarchy • Physiological – food, water • Safety- clothing, shelter • Love, affection,friendship • Esteem- self respect • Self-Actualization –altruism

22. Maslow: Holistic-dynamic Theory • Human needs are organized in hierarchy of prepotency • Prepotency- higher needs emerge as lower ones are satisfied • Needs do not disappear when the are satisfied, they decrease in priority • Can emerge in a different order in different people

23. Nursing Theory Builds Upon and Incorporates Knowledge Form Many of the Other Arts and Science Disciplines

24. Nursing Theory • Provides the foundation and definitions for the development of nursing knowledge. • The accumulation of nursing knowledge knowledge is based upon a combination of research form Nursing and related human research. • Combines research and practice.

25. Nursing Science, Pg. 59 • Focused on the problems and concerns of nursing • Man- person • Bio psycho social spiritual being • Biology • Psychology • Sociology • Culture • Spirituality • Religion

26. Sample Nursing Agreement • Man/person • A biological system • A psychological make up • A social being in a community • Existing in an environment • Is an open system • Has an internal drive • That experiences a series of developmental changes through a life span

27. Definition of Nursing • Science observes, measures, validates • Artists observes, interprets based upon obtained knowledge and chooses an approach

28. Nursing • A practice discipline that incorporates knowledge and techniques from both science and art. • The products of Nursing. • care. • education. • research. • Where a nurse practices can effect how the practitioner defines Nursing.

29. Roy Model of Nursing (Roy Pg. 31-37 Delaune pg. 35) • Scientific Systems Model • Open, complex, holistic, interdependence • Adaptation theory • Humans adapt to maintain integrity, purposeful • Philosophic view • Humanistic, goal directed, • Nursing • provide raw materials to facilitate healthy adaptation

30. Sister Calista Roy A Theoretical System That Analyzes and Prescribes Behavior Related to the Care of Ill or Potentially Ill

31. Roy anchored in Meta theory • System theory • Wholeness • Adaptation • Equilibrium • Environment

32. Discuss the Relationship of Systems Theory to Roy Model. • Based on assumptions of von Bertalanffy’s General Systems Theory • Based on assumptions of Helson’s Adaptation-Level theory • Humanism • Veritivity

33. Veritivity • Principle of human nature that affirms a common purposefulness of human existence, activity and reactivity for the common good and value and meaning of life. Goal directed

34. Discuss the Concepts of Adaptation Model. • Adaptive: Human system has the capacity to adjust effectively to changes in the environment and affects the environment.Promote survival, growth, reproduction & mastery.

35. System (Human) • Set of parts connected to function as a whole for some purpose and through the interdependence of the parts. • Input--Through put--Output--Feedback

36. Chronology of Nursing Theory DevelopmentTable 2-1 Pg. 28 Theories of Nursing Were Developed Beginning in the 1950’s As an Effort to Separate From Medicine and Describe Nursing Essence.

37. First Definitions • Nursing • Health • Client • Environment

38. Some Nursing Facts • 1970 Nursing model became synonymous with Nursing theory • Nursing theory continues to develop

39. Conceptual Framework • Underlying set of ideas:  a set of ideas, principles, agreements, or rules that provides the basis or the outline for something that is more fully developed at a later stage • A group of related concepts. • A model that organizes a group of ideas into a meaningful configuration.

40. Conceptual Framework Con’t • Creates a method of deciding if something is relevant to a discipline. • Relationships are inferred and constructed through logical associations. • More general than a theory.

41. Conceptual Framework: Example • Computer • Technology • Anxiety • Fear • Change - Conflict • Not math fear • Not technology fear • Relationship, presence of anxiety to decreased function • Need for preparation • Teaching - Learning

42. Assessment Diagnosis Planning Implement Evaluate Input Through put Output Feedback Nursing Process & Systems Theory Activities Data collection Data analysis diagnostic statements goals, priorities Perform interventions Compare results, revise plan

43. Selected Nursing Theories Box 2 - 1, Page 84 These are the surviving Models and theories that are currently in common use today. They approach the idea of Nursing from different directions so it has an effect on the assumptions, focus and emphasis. There has yet to be a grand theory of Nursing. I leave this challenge to you.