Background of nursing study (Nursing Autobiography)
The individual is a nurse practitioner who runs a primary Care Centre serving a clinically underserved population in an underdeveloped area. The individual addresses the metaparadigms of nursing by focusing on person and health, thus maintaining the individual’s self-concept and ensuring that patients are receiving the care they need. This ensures a link in between the desire and the requirement of the patient. The individual has to act in the utmost interest of the patients depending upon own proficiency. Critical thoughts and good judgment is the requisites that every nurse must acquire in order to care for the patients and prioritizing the needs of the patients (Chitty, K., 2009).
Four Metaparadigms of nursing
Metaparadigm is a framework of hypotheses and ideas that gives concept in functioning of a discipline. Nursing paradigm governs four basic concepts that cover the patient as an entire entity, the health and well-being of the patient, the environment and the responsibilities of nursing (Geiger, J. F. and Salas-Lopez, D., 2010). These paradigms ensure a holistic vision of care in which the well-being of the person and medical fitness related to four interrelated components. These are:
• Personal Component - focuses on receiving care though this also includes family members are other people important to the patient, this also includes spiritual and social necessities along with health and governs how the person interrelate with his or her physical and social position. This ensure in empowering the person to manage healthiness and well-being with dignity and self-maintenance as well as optimistic individual connections.
• Environment component; focuses on the surroundings of the patient that are affecting. These include both external and internal influences that are affecting health and wellness of the person and interaction with other people like family, friends or peer. The other affecting parts of the environment are economic conditions, geographical setting, culture, societal connections and technology. This concept ensures that the person can alter his or her environment to progress health condition.
• Health component - it governs the extent of well-being and access to health care. The health constituent portrays a whole component with several dimensions in a continuous state of movement. This governs the lifespan and genetic component of the person and the ways in which bodily, intellectual, societal, emotional, and spiritual well-being incorporated to achieve utmost fitness benefits. The theory states that these factors control the person’s state of fitness.
• Nursing component - this governs in delivering maximum health outcome to a patient by means of a shared relationship in a protected and loving environment. This concept governs the principles of knowledge, relationship, skills, expert judgment and communiqué to carry the tasks in achieving the best outcome in patient’s health. This ensures an utmost degree of service and incorporates with other metaparadigms to ensure patient well-being (Geiger, J. F. and Salas-Lopez, D., 2010).
Employing the paradigms in professional practice
All nurses must abide by the paradigms in professional practice to ensure patient safety, quality care and in building a sound environment, which enables maximum outcome in patient’s health and well-being. This ensures in building a safer health system (Chitty, K., 2009). All these ensure health care must be safe so it is the individual responsibility of the caregiver to do no harm to the patient, must be effective governing the modern technology and collaboration. This health care needs to be effective and patient centered considering the culture, social perspective and the specific needs of the patient with due respect governing sovereignty. The health care must be timely, efficient and must be equitable where race gender or ethnicity never prevents any person from receiving quality care.
Major concepts unique in professional practice
Caring is the major concept in nursing that helps in developing several theories of caring. According to Jean Watson, caring comprises compassionate care, orientation of human science, process of human caring its phenomena and experiences. Transpersonal care involves unity of life and correlations that move in concentric encircles of caring from person to others, to neighborhood and to world. Caring science acknowledges enquiry covering insightful, personal, and interpretative as well as purpose and experimental aspects of caring. The philosophy of Nightingale includes all the four metaparadigms but gives emphasis on patient and the environment and ensures altering the environment to hasten patient recovery (Chitty, K., 2009). According to Henderson, the art of nursing is to assist the individual sick or well in performing those activities in contribution to health and recovery or to a peaceful death. The other major concept is caring, which is the soul of nursing, fundamental, central and is the united focal point of nursing. The major focus of nursing is to help the patient in achieving a higher degree of synchronization within intellect, body and spirit.
Practice Specific Concepts
Apart from the transcultural theory that has been proposed and suggested by Leininger, the author strongly feels that mention must be made of two more practice-specific concepts associated with provision of healthcare services. These are Betty Neuman’s System Model concept and Dorothea E. Orem’s Self-Care theory.
The Neuman Systems Model perceives the customer as an open framework which reacts to stressors in nature. The customer variables are physiological, mental, sociocultural, formative, and otherworldly. The customer framework comprises of a fundamental or center structure that is ensured by lines of resistance (Sare, V. M., & Ogilvie, L., 2010). The typical level of wellbeing is recognized as the ordinary line of safeguard that is ensured by an adaptable line of resistance. Stressors are in-between and extra-personal in nature and emerge from the inner, outside, and made situations.
At the point when stressors get through the adaptable line of safeguard, the framework is attacked and the lines of resistance are initiated and the framework is depicted as moving into ailment on a wellbeing sickness continuum. On the off chance that satisfactory vitality is accessible; the framework will be reconstituted with the ordinary line of safeguard restored at, underneath, or over its past level.
Nursing mediations happen through three avoidance modalities. Essential counteractive action happens before the stressor attacks the framework; optional aversion happens after the framework has responded to an attacking stressor; and tertiary avoidance happens after the framework has responded to an attacking stressor; and tertiary anticipation happens after auxiliary counteractive action as reconstitution is being made.
Orem built up the Self-Care Deficit Theory of Nursing, which is made out of three interrelated speculations: (1) the hypothesis of self-care, (2) the self-care deficiency hypothesis, and (3) the hypothesis of nursing frameworks. Nursing is as workmanship through which the expert of nursing gives particular support to persons with incapacities which makes more than customary help important to address issues for self-care. The medical attendant likewise astutely takes an interest in the therapeutic care the individual gets from the doctor. Environment has physical, concoction and natural highlights. It incorporates the family, culture and group. Wellbeing is "in effect fundamentally and practically entire or sound." Also, wellbeing is an express that envelops both the strength of people and of gatherings, and human wellbeing is the capacity to consider one's self, to symbolize experience, and to correspond with others. Self-consideration is the execution or practice of exercises that people launch and perform all alone sake to look after life, wellbeing and prosperity.
Self-care organization is the human's capacity or energy to take part in self-mind and is influenced by fundamental molding elements. Essential molding components are age, sexual orientation, formative state, wellbeing state, sociocultural introduction, human services framework elements, family framework variables, examples of living, natural components, and asset sufficiency and accessibility. Helpful Self-consideration Demand is the totality of self-consideration activities to be performed for some length of time to meet known self-care requirements by utilizing substantial routines and related arrangements of activities and operations (Sare, V. M., & Ogilvie, L., 2010).
Self-care Deficit outlines when nursing is required. Nursing is obliged when a grown-up (or on account of a ward, the guardian or watchman) is unequipped for or restricted in the procurement of constant powerful self-care). Nursing Agency is a complex property or characteristic of individuals taught and prepared as medical attendants that empowers them to act, to know, and to help other people meet their restorative self-consideration requests by practicing or building up their own self-care office. Nursing System is the result of a progression of relations between the persons: real attendant and genuine customer. This framework is initiated when the customer's remedial self-consideration interest surpasses accessible self-care office, prompting the requirement for nursing.
List of Propositions in connection with the practice concepts
Based on the above mentioned concepts and theories highlighted in the study, the following five propositions have been made:
Individuals ought to act naturally dependent and in charge; they could call their own consideration and others in their family requiring consideration.
Individuals are separate people and hence, their nursing and healthcare needs need to be assessed uniquely.
Nursing is a manifestation of activity – collaboration between two or more persons.
Effectively meeting widespread and advancement self-care imperatives is a critical part of essential consideration avoidance and sick wellbeing.
An individual's learning of potential wellbeing issues is essential for advancing self-care practices.
Theories and philosophies of nursing consistent with these concepts
Besides the above-mentioned theories there are several other theories and philosophies of nursing, such as Peplau in 1952 states’ nursing is a curative interpersonal process. Nursing identifies the needs frequently called as Henderson’s fourteen basic needs covering various needs such as breathing, proper drinking and eating, normal physiological functioning, communicating with others expressing emotions, desires, fears and views and having a normal learning, intellectual and curiosity in developing normal health (Lorentz, M. and Madeline, M., 2008). The other theories includes Abedellah of 1960 that addresses nursing care for the person as a whole to meet the bodily, emotional, societal and rational needs of the client and family. Orlando describes client as an individual, with certain needs, when achieved reduces distress and enhance sufficiency or develops well-being. According to Johnson, in 1968, the aim of nursing is to reduce potential stresses so that the patient can move about more effortlessly through revival.
Concepts of transcultural nursing and health promotion
Essential component of modern nursing is transcultural nursing developed by Madeleine Leninger. The increasing multi-cultural population in various countries faces a major challenge in providing personalized or holistic care to patients (Lorentz, M. and Madeline, M., 2008). Nurses need to acquire understanding and skills in cultural competency. These need to recognize respect and appreciate the individualism and diversity of viewpoints, morals, religion and culture among the different population of patients. This ensures care or nursing are in harmony with individual or group’s cultural values practices and beliefs. One of the most important health promotion models is Purnell and Paulanka Model that recognizes bio-cultural ecosystem and work force problems. This not only recognizes diversity among patients but the team members are also from various cultures and helps in understanding the various cultures among health care providers. This provides a framework to recognize inborn concepts and distinctiveness of new culture.
Research supporting these theories
Various researches (Sare, V. M., & Ogilvie, L., 2010) carried out for some years all over the world to ensure nurses in practicing transcultural nursing proficiently and their caring performances must be rooted in the knowledge and discipline of transcultural nursing. These implement in developing of standards that can serve as a guideline for education, learning, practicing and research of transcultural nursing competency.
Integrating role and change theory in professional practice and organization
The integrating role in advanced practice nursing is to incorporate theory into practice while providing patient care or working as consultants or leaders and assisting and manipulating change of systems. The Integrated Theory of Health Behavior states that health behavior change can be improved by developing knowledge, viewpoints, growing own ruling skills and abilities and thereby increasing social facilities (Sare, V. M., & Ogilvie, L., 2010). Using a theoretical perception improves evaluations and directing the use of excellent practice interference leads improvement in patient outcome. Organizations change to foresee, adapt or act in response to the changes in their surroundings or to find improved ways to fulfill their mission. Organizations in health service often change with unlock statements about unavoidability, rising pace and requirements for change.
Chitty, K. (2009). Professional Nursing. Missouri: Elsevier and Saunders.
Geiger, J. F. and Salas-Lopez, D. (2010). Developing Culturally Competent Nursing. Journal of Healthcare Management, 13(2), 190-204.
Lorentz, M. and Madeline, M. (2008). Transcultural Nursing. Michigan: Tucker Publications.
Sare, V. M., & Ogilvie, L. (2010). Strategic Planning for Nurses. London: Harvester Wheatsheaf.