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July 23, 2013

Essay on Nursing Theorist

In the last century nursing has made a phenomenal achievement that it has led to the recognition of nursing as a profession and a separate educational discipline. Contemporary nursing is now more meaning full and significant because of theory-based practice which shifted nursing’s focus from vocation to an organized profession. It was research and theory together which produced nursing science. Nursing theory basically suggests that nursing should be given professional education during which they will study a collection of interconnected subjects which will be applied in their practice. The knowledge may be derived from experimental learning or formal sources such as nursing sources or nursing research. Nursing is a science involving many people environment and process in the context of healthcare.
     In the first half of the twentieth century it has been realized that there is need for knowledge base to guide professional nursing practice and many theoretical work has been contributed by nurses ever since but there is no specific date and place nursing theory took place. Nightingale’s vision was practiced for more than a century and in the past 4 decades theory of nursing was developed more rapidly which made nursing an academic discipline with a substantive body of knowledge. There were four essential concepts common amongst nursing theories which are man, health, environment, and nursing. Nightingale was the first lady who expressed her firm conviction nursing knowledge is different from medical knowledge. According to her nursing is the act of fertilizing the environment of the patient to assist him in recovery. She focused on the changing and manipulating the environment in order to put the patient in the best possible conditions for nature to act. According to Dorothea Orem nursing is the act of assisting others in the provision and management of heath care to improve human functioning at home level of effectiveness. She had a strong health promotion and maintenance focus. She identified three related concept self-care, self-care deficit and nursing system. According to her nursing intervention is needed when individual is unable to perform the necessary self-care activity. Virginia Hendersons thinks that nursing is assisting an individual sick or well in the performance of those activities contributing to health or its recovery (or to peaceful death) that an individual would perform unaided if he had the necessary strength. Medelien Leiningers theory is that Nursing is a learned humanistic and scientific profession and discipline which is focused on human care phenomena and activities in order to assist, support, facilitate  individuals or groups to maintain or regain their well being (or health) in culturally meaningful and beneficial ways, or to help people face handicaps or death. According to her transcultural nursing is a subfield or branch of nursing which focuses on the comparative study and analysis of culture with respect to nursing and health-illness context. Claixta Roy viewed human as biosychosocial beings constantly interacting with the changing environment and who cop with their environment through biosychosocial mechanism. Martha Rogers think that nursing is an art and science that is humanistic and humanitarian. It is directed towards the unitary human and it is concerned with the nature and human development. The goal of nurses is to participate in the goal of change. Hildegard Peplau defined nursing as an interpersonal process of therapeutic interactions between an individual who is sick and a nurse specially educated to respond to the need of health. She identified four phases of nurse orientation, identification, exploitation and resolution. Lydia hall’s concept of nursing is to care, core and cure aspects of patient care where care is the sole function of nurses. Dorothy Johnson’s concept is of behavioral system. She thinks that each individual is pattern and purposeful, repetitive ways of acting that comprises a behavioral system specific to that individual. Jean Watson’s philosophy is that nursing is concerned with promotion of health, preventing illness, caring for the sick and restoring health. Rosemarie Rizzo’s theory is that nursing is a scientific discipline, the practice of which is performing art. Their first goal was to make nursing as a profession and the later was the goal of delivering care to patient as professionals.
     There are four general kind of theoretical work of nursing in history. The first type is nursing philosophy. The first era of nursing theory has contributed in knowledge development by providing direction.  Later era reflects the expansion in human science and its methods. The second theoretical work is of conceptual model. Conceptual model gives meaning and direction to the nursing. The conceptual model comprises the nursing work of the grand theorists and the pioneer of nursing. According to the authors of 2001 conceptual model provides a distinct frame of reference for its adherents that tell them how to observe and interpret the phenomena of interest to the discipline. The theorist of this model include their perspective on each of the meta paradigm concept; person, environment, health and nursing. In 2001, the authors projected the conceptual model of nursing and since then various revisions in the model have been carried out. The conceptual model is used for the rapid progress of a nursing doctoral program and doctoral research. The revised model is the framework for any analysis or evaluation of public, organizational and professional policies, even for nursing-discipline and health services research at either of the four interacting levels: Level 1--efficacy of nursing practice processes; Level 2--effectiveness of nursing practice processes and effectiveness and efficiency of health care delivery subsystems; Level 3--equity of access to effective and efficient nursing practice processes and efficient nursing practice delivery systems, and equity in distribution of costs and burdens of care delivery; Level 4--justice and the social changes and market interventions addressing equity. Nursing model has explicit or implicit grand theories within them which can be observed in Roy’s work. She says that nursing interventions are aimed at promoting physiologic, psychologic, and social functioning or adaption. The third type of nursing theories has derived from work in other discipline related to nursing like nursing philosophies, theories, grand theories or from nursing conceptual models. Orlando gives the best example because her theory is specific to the nurse patient relationship and the nursing process. The forth type is the middle range theory. Middle range theory is more precise and focuses on answering specific nursing practice questions. This theory specifies factors as the age group of patients, the family situations, the health conditions, the location of the patients, and more precisely the action of the nurse.
My theory of nursing fits to the category of theoretical model. Because a theory is set of inter related concepts, definitions and prepositions that present a schematic view of phenomena. It postulates specific relations among concept that takes from a description, explanation, and predictions or prescriptions for actions. Any theory presupposes a more general abstract conceptual system. Since it is derived from other philosophies and conceptual models it is combination of all aspects of nursing theories. The difference between the conceptual model and theory is the level of abstraction; a theory is both more precise and more limited in scope than its present conceptual scheme.
     Based on the difference between conceptual models and theories, different frameworks are required for analysis and evaluation. The accomplishment of the past century has led to the recognition of nursing in both areas which is discipline and profession. Many nurses in history pioneered various cause and challenged the status quo with their creative ideas for the health of people and the development of nursing. The theoretical work has taken nursing to the highly professional level. The emphasis has shifted from the focus on the knowledge of what the nurses know to the focus on what they know and how they utilizes their knowledge. Both the conceptual and theoretical models help to provide knowledge so that to improve practice and identifies the goal of nursing practice. The science and art of nursing theory is one of continuing growth. Nursing knowledge is learnt, used and applied in the nursing practice for the profession and the continued growth of nursing and in academic discipline.



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