MOUNT VERNON NAZARENE UNIVERSITY DEPARTMENT OF NURSING Philosophy Mount Vernon Nazarene University is an intentionally Christian, liberal arts university within the Wesleyan evangelical tradition

Subject:NursingPrice:14.86 Bought3

Share With

MOUNT VERNON NAZARENE UNIVERSITY DEPARTMENT OF NURSING Philosophy Mount Vernon Nazarene University is an intentionally Christian, liberal arts university within the Wesleyan evangelical tradition. The University commits to academic excellence inspiring students to achieve their highest potential spiritually, intellectually, socially, and physically as they prepare for careers and service to God and humankind. The faculty members of the Nursing Department support the philosophy of Mount Vernon Nazarene University. Faculty members believe in a holistic approach to faith and learning. Our Christian faith serves as the underpinning for the program and directs our vision, mission and practices. Belief in a sovereign God guides the Department’s philosophy statement. Advancement of nursing knowledge occurs through empirical testing, personal, ethical and aesthetic knowing. All truth, both objective science and subjective experiential truth comes from God. The faculty believes students must take part in the pursuit of knowledge and are responsible for actively engaging in their education. Nurses have a specialized body of knowledge. Even so, best nursing practice combines knowledge of behavioral and natural sciences and the humanities with nursing science to best care for patients. Learning is a lifelong endeavor. Continued learning is essential to safe quality nursing practice. The principle concern of nursing is advocating for the health care needs of people and communities. Advocacy can take place through providing direct care for patients, coordinating care among members of the interdisciplinary health care team, speaking for equality in resource allocation, and by political activism aimed at improving health care delivery and access for all. Nurses must also take part in developing and encouraging future nurses toward excellence in and advancement of the profession. Within the context of promoting, restoring and maintenance of health, the Christian nurse is responsible for being a steward of the environment. Evidence for best practice guides actions targeted toward environmental stewardship, health care advocacy and nursing care. Students need to develop excellent communication with other members of the health care team to best meet health care goals. Spiritual care is primary to the health of individuals and society. The nurse must foster personal spiritual growth to efficiently guide patients in spiritual wholeness. Christian nurses receive power from the Holy Spirit to achieve the goals of Christian nursing practice. Godly living is essential to advancing spiritual growth. The Nursing Department believes Christian nursing practice is an intentional act requiring spiritual discipline and a desire to minister to others as a response to God’s grace. The faculty members help students to grow in Christ by role-modeling godly living and Christian values in the practice of nursing. Through Christian nursing education students receive an invitation to enter Christian nursing practice which can result in a fulfilling, professional nursing career. Conceptual Framework Service and obedience to God are central to the practice of Christian nursing; therefore our faith in God serves as the underpinning for the nursing program. A biblical view of nursing forms the basis for the Nursing Department’s conceptual framework. The framework is organized around seven concepts and four sub-concepts that guide professional nursing practice. The Christian nursing framework developed by Shelly and Miller (1999) serves as the basis for the seven concepts (God, truth, persons, environment, health, nursing, and spiritual care). The biblical worldview describes the concepts of concern for nursing. Included are sub-concepts of Godly living, evidence-based nursing, comfort care, and communication to highlight their importance in nursing practice. The conceptual framework’s design includes a view of Christian nursing concepts found under the umbrella of God and a biblical worldview. Christian nurses, through the power of the Holy Spirit, have the ability to meet the health care needs of the community through the ministry of nursing. The concepts of truth and spiritual care come from the Christian nurses’ relationship to God. We know who God is through the truth of the Holy Scripture, and rely on that truth for direction for nursing care of patients, and personal spiritual growth. The concepts of concern for nurses (person, health, environment and nursing) make up the rest of the major ideas in the framework. This framework aids students in identifying patterns of potential and actual health problems of concern to nursing. The faculty view Godly living, evidence-based nursing, comfort care, and communication as qualities essential to Christian nursing practice. These qualities are dynamic and serve to further define the practice of nursing. Conceptual Definitions Concepts and Sub-concepts God: The faculty affirms the belief of a sovereign God and that He is the creator of everything (1Corinthians 8:5-6). The triune God is Father, Son and Holy Spirit (Galatians 4:4-6; John 14: 25-27). We believe in Jesus Christ the Son of the Living God, who died for our sins and was resurrected on the third day. Through this resurrection we receive salvation from sin and everlasting life through the blood Revised 6/13 of Christ Jesus (John 6:43; John 14:6). As members of the body of Christ we receive the gift of the Holy Spirit to guide us in obedience to His will (Acts 2:4; John 14:25). Godly Living: We affirm Godly living as a basis for delivery of Christian nursing practice. We approach the practice of Christian nursing not only as a science and an art, but as a response to God’s grace toward us, from which we receive power through the Holy Spirit to holistically care for others. The faculty helps students to grow in Christ by role modeling Godly living and Christian values in their nursing practice. Truth: Nursing knowledge comes about through empirical testing, personal, ethical and aesthetic knowledge (Carper, 1978). All truth, both objective science and subjective experiential truth, comes from God. Evidence-Based Nursing: Nurses deliver care to others based on evidence learned through empirical testing, personal, ethical and aesthetic knowledge. Professional nurses decide how to provide patient care by analyzing available data. Interpreting and analyzing data is essential to decision-making. Nurses use a framework to assess patients, plan interventions based on evidence, carry out interventions according to accepted standards of nursing care and evaluate the outcomes of such actions. Evidence based nursing is always aware and respectful of human dignity and cultural values of both patients and nurse. Professional nurses take part in new knowledge development through research and theory construction. Academic Excellence: Nurses are expected to continually seek opportunities to increase knowledge and scholarship. We recognize that nursing is a field which changes rapidly. As such, nurses must endeavor to acquire, maintain, and pursue their expertise. Persons: People are created in the image of God (Genesis 1:27) to have a relationship with God (Deuteronomy 6:4-6), through the person of Jesus Christ (Matthew 22:37-39). As people created of God’s love, we affirm each person should be honored and served with dignity regardless of social, mental or physical status. People are physiological, psychological, sociocultural, and spiritual beings. These characteristics are present within various developmental stages and have a wide range of potentials. The spiritual part of the person is always developing. This spiritual self permeates all other characteristics by supporting optimal health, even if the person does not recognize it. The spirit controls the mind and the mind consciously or unconsciously controls the body (Neuman, 1995). Spiritual needs of the person include the need to develop trusting relationships with God and others, recognition of the need for forgiveness and to forgive, and the need for meaning, hope and purpose in life. Environment: The environment includes all creation, both physical and spiritual. God created the environment, but the environment remains separate from God. Included in this definition is the place in which nursing occurs. God entrusted human beings as stewards of the environment; therefore nurses show support for environmental health and protection. The environment has significant impact on the health status of the individual and communities. Health: From a Christian worldview, health is the ability to function in harmony with God, self, others and the environment. Inherent is the ability to forgive and receive forgiveness, to love others and accept love, and experience a sense of meaning and purpose in life. Multiple dimensions of heath exist including the physical, psychological, sociological, spiritual and cultural features. Nursing: Nurses help people and communities respond to actual or potential changes in health status. Nursing has a unique body of knowledge gained through empirical testing, personal, ethical and aesthetic knowing. Christian nursing is holistic and includes caring for the physical, psychological, sociological, spiritual and cultural dimensions of the person. Nurses speak for health of people and communities. The role of patient advocate happens through multiple venues. Nurses advocate by providing direct care for patients, coordinating care among members of the interdisciplinary health care team, speaking for equality in resource allocation, and by political activism aimed at improving health care delivery and access. The nurses’ role in education is essential. Nurses have a responsibility to educate and mentor future nurses. In addition, nurses educate patients and the public about issues which impact the health of people and the community. The act of Christian nursing is not merely a response to human need and suffering, but is a direct response to God’s grace toward us. We have the ability to care for others through the power and wisdom given to us through the Holy Spirit. Comfort Care: The nurse provides comfort to patients and strives to lessen human suffering. Caring, for the Christian nurse is an act of faith based on a response to God’s grace. Nurses provide compassionate care for the whole person with the aim of promoting health and providing comfort to all who suffer. Assessment of patient needs from a holistic framework, including cultural values is essential in the delivery of comfort care. Caring nurses center their focus on patients even to the extent of sacrificing self. Comfort care requires the nurse to be fully “present” with the patient, and includes providing for physical, Revised 6/13 psychological, emotional and spiritual well-being. The Christian nurse provides comfort, hope and compassionate presence even to those for whom recovery will not be possible. A Christian nurse can provide care as an expression of Godly living. Communication: Communication is essential to effective nursing practice. The nurse must achieve excellence in written, verbal and nonverbal communication to address adequately the needs of patients. Communication among members of the interdisciplinary health care team, those who have the responsibility for public policy making, and patients who need health care information is central to nursing practice. Nurses must have skills in getting and discriminating among vast amounts of health care information with the aim of deciding care from the best sources of information available. Written and verbal communication skills are essential to getting health care information to others. Spiritual Care: As Christian nurses we affirm spiritual care as primary to the health of individuals and society. The nurse and patient need spiritual care. Even so, we are aware of, and respect spiritual beliefs that differ from our own. We believe that spiritual distress permeates all dimensions of a person’s health and society; therefore we help others recognize a need for God according to their openness to receive spiritual care. We share our commitment to Christ by living out a life of service to others. Program Objectives 1. God/Godly Living: Apply biblical principles to professional nursing practice. Affirm Godly living as a basis for delivery of nursing care from a biblical perspective. 2. Truth: Provide holistic nursing care based on evidence gained through empirical testing, personal, ethical, and aesthetic knowledge. 3. Evidence-Based : Analyze subjective and objective data for scientific merit. 4. Academic Excellence: Demonstrate academic responsibility in current curriculum. Recognize the ongoing need to increase knowledge and scholarship. 5. Persons: View each person as created in the image of God, therefore worthy of respect and dignity. 6. Environment: Recognize the influence of the environment on the health of individuals and communities. 7. Health: Convey a Christian worldview of health as the ability to function in harmony with God, self, others and the environment. 8. Nursing: Deliver nursing care aimed at helping people and communities in their response to actual or potential health problems. 9. Comfort Care: Provide compassionate care for the whole person with the aim of promoting optimal health and providing comfort to all who suffer. 10. Communication: Communicate effectively with individuals, families, communities and members of the healthcare team through verbal, nonverbal and written communication 11. Spiritual Care: Affirm spiritual care as primary to the health of individuals and society. Leveled Student Outcomes God/Godly Living: Apply biblical principles to professional nursing practice. Affirm Godly living as a basis for delivery of nursing care from a biblical perspective. • Level 1: Develop integrity and professionalism as the basis for the delivery of nursing care. Identify personal beliefs and values and their impact on nursing care. • Level 2: Demonstrate respect for individuals with different beliefs and values. Provide care with professionalism and integrity. • Level 3: Assimilate biblical principles into nursing care. Truth: Provide holistic nursing care based on evidence gained through empirical testing, personal, ethical, and aesthetic knowledge. • Level 1: Acquire knowledge of empirical sciences and recognize ethical issues in the practice setting. • Level 2: Demonstrate knowledge of the empirical sciences, personal experience, and ethical reasoning in the practice setting. Analyze ethical issues identified in the practice setting. • Level 3: Apply knowledge of the empirical sciences, personal experiences, and ethical practices to provide care. Respond to ethical dilemmas from a Christian worldview. Evidence-Based: Analyze subjective and objective data for scientific merit. • Level 1: Gather subjective and objective data and incorporate evidence from taxonomies such as North American Nursing Diagnostic Association (NANDA), Nursing Intervention Classifications (NIC), and Nursing Outcomes Classifications (NOC) into nursing practice. Review evidence-based research. Revised 6/13 • • Level 2: Analyze subjective and objective data to plan care. Examine and critique research. Plan care through the use of NANDA, NIC, and NOC. Use critical thinking in the delivery of patient care, demonstrating the ability to see alternative viewpoints and treatment options, make decisions based on evidence. Level 3: Analyze data gathered and best evidence. Apply sound clinical judgments in delivery of patient care demonstrating the ability to see alternative viewpoints and treatment options, make decisions based on evidence. Implement care through the use of NANDA, NIC, and NOC. Academic Excellence: Demonstrate academic responsibility in current curriculum. Recognize the ongoing need to increase knowledge and scholarship. • Level 1: Recognize the ongoing need to increase knowledge and demonstrate desire for continued learning. • Level 2: Seek opportunities for continued learning and professional growth. • Level 3: Engage in the pursuit of scholarly activities in preparation for lifelong learning and service Persons: View each person as created in the image of God, therefore worthy of respect and dignity. • Level 1: Acknowledge and incorporate confidentiality and privacy in nursing care. Recognize developmental stages and cultural diversity when planning patient care. Identify the roles and relationships of patients. • Level 2: Deliver developmentally and culturally responsive care to patients and families. Promote dignity by adhering to the principles of privacy and confidentiality. Analyze the roles and relationships of patients and families. • Level 3: Advocate effectively for the dignity and worth of patients and colleagues. Promote health roles and relationships of patients, families, and populations. Environment: Recognize the influence of the environment on the health of individuals and populations. • Level 1: Recognize environmental hazards and maintain safety during delivery of care. • Level 2: Intervene to create optimal environment for patient healing. Promote patient safety. • Level 3: Anticipate and prevent environmental threats. Ensure patient safety. Health: Convey a Christian worldview of health as the ability to function in harmony with God, self, others and the environment. • Level 1: Assess patient to promote, maintain, or restore healthy living. Deliver fundamental patient teaching on health promotion and disease prevention. • Level 2: Provide opportunities for optimum patient health by integrating health promotion activities aimed at risk reduction. • Level 3: Improve the health of patients and populations through an interdisciplinary approach to health promotion and disease prevention. Nursing: Deliver nursing care aimed at helping people and populations in their response to actual or potential health problems. • Level 1: Acquire critical thinking skills to create, implement, and evaluate holistic nursing plans of care. Follow established standards and guidelines when providing care. Identify principles of prioritization and delegation. • Level 2: Utilize critical thinking while providing holistic nursing care according to established standards and guidelines. Articulate concepts of delegation and prioritization. • Level 3: Apply sound clinical judgment to plan and provide holistic nursing care. Evaluate established nursing standards and care guidelines. Delegate and prioritize effectively. Comfort Care: Provide compassionate care for the whole person with the aim of promoting optimal health and providing comfort to all who suffer. • Level 1: Assess comfort and provide nonpharmacologic nursing therapeutics to relieve the suffering of patients. Demonstrate empathy. • Level 2: Assess comfort and discern between pharmacologic and nonpharmacologic therapeutics to provide the most effective interventions to decrease suffering. Demonstrate empathy. • Level 3: Anticipate the comfort needs of patients and perform interventions to relieve suffering. Demonstrate empathy. Communication: Communicate effectively with individuals, families, populations, and members of the healthcare team through verbal, nonverbal and written communication • Level 1: Communicate clearly and therapeutically with patients and nursing staff. Document basic assessment and patient care. • Level 2: Demonstrate assertive and therapeutic communication with patients, families, and the health care team. Documents assessment and care according to nursing standards. Revised 6/13 • Level 3: Collaborate effectively with patients, families, populations, and the health care team. Provide effective therapeutic communication. Documents ongoing assessment and care according to established agency policies and nursing standards. Spiritual Care: Affirm spiritual care as primary to the health of individuals and society. • Level 1: Assess and begin to meet the spiritual needs of patients. • Level 2: Deliver spiritual care with sensitivity to the patient’s beliefs. • Level 3: Collaborate with the patient and health care team to promote healthy spirituality. Revised 6/13 Week 4 Discussion Forum is posted. There are 4 questions for you to answer. Please use APA format. Please write on a word document (NO COVER PAGE NECESSARY) and upload the file to the discussion forum. You should include references as appropriate. You do not need to respond to your peers this week unless you would like to. Please post your discussion by Sunday at 11:59pm. Let me know if you have questions. Have a great week! Prof Maglott. Nursing Conceptual Models Work Sheet-Chapters 7-13 Theorist Background Metaparadigm Theory Name Concepts Likes/Dislikes Application to Practice. Rationale Dorothy Person Johnson Environment Health Nursing Imogene King Person Environment Health Nursing Martha Person Rogers Environment Health Nursing Sister Callista Person Roy Environment Health Nursing Betty Person Neuman Environment Health Nursing Myra Estrin Person Levine Environment Health Nursing Dorothea Person Orem Environment Health Nursing Devotional Pray all the time, Pray without ceasing Just as our physical lives are sustained by breathing, our spiritual lives should be maintained by praying. Ephesians 6:18 And pray in the Spirit on all occasions with all kinds of prayers and requests. With this in mind, be alert and always keep on praying for all the Lord’s people. I Thessalonians 5:17-18 17 pray continually, 18 give thanks in all circumstances; for this is God’s will for you in Christ Jesus. Nursing Models Analyze and Critique Objectives Johnson, King, Rogers, Roy, Neuman, Levine, & Orem 1. 2. 3. 4. Explore each model and the theoretical framework Critique the models. Discover application of the models to nursing practice. Reflect on each model-likes/dislikes. Can you utilize in your nursing practice? Rationale. 1. Place the reflection worksheet in the Week 2 dropbox by Sunday night end of week 2 @ 23:59pm. Critique and Analyze O What is the historical context of the theory O What are the basic concepts and relationships O O O O presented by the theory What major phenomena of concern to nursing are presented To whom does this theory apply By what method can this theory be tested Does this theory direct critical thinking in nursing practice Critique and Analyze O Does this theory direct therapeutic nursing interventions O Does this theory direct communication in nursing practice O Does this theory direct nursing actions that lead to favorable outcomes O How contagious is this theory Dorothy Johnson General Info ? Patterned after a Systems Model ? 4 major concepts ? Roots in behavioral sciences (psychology, sociology). ? Based on Nightingales beliefs ? Nursing Goal: to help people prevent or recover from disease or injury ? Patterns of behavior are reactions to stressors ? Self-maintaining and self-perpetuating as long as internal and external are orderly, if conditions and resources are not there, dysfunctional behavior results ? Instability in the behavioral system results in a need for nursing intervention ? Goal is to maintain or restore behavioral system balance Johnson’s Subsystems O Achievement subsystem O Affiliative or attachment subsystem O Aggressive or protective subsystem O Dependency subsystem O Sexual subsystem O Eliminative subsystem O Ingestive subsystem Nursing Process ? Assessment – gather info from subsystems, ? ? ? ? environmental factors, behaviors Planning – internal subsystem problems or intersystem problems Implementation - restore, maintain, or attain balance Evaluation – attainment of goal of balance? Ultimate goal: restoration, maintenance, or attainment of balance/stability in the patient's behavioral system. Metaparadigm O Person O Environment O Health O Nursing Basic Assumptions ? Assumption ? A person is a system of behavior characterized by repetitive, predictable, and goal-directed behaviors that always strive toward balance. ? Propositions ? Primary relationships between: ? Person and Environment ? Person, Health, and Environment ? Person, Nursing, and Health ? Balance is essential for effective and efficient functions of the person Johnson’s Critique ? Simplicity – clear & well defined ? Generality – applies to most illnesses and individuals ? Empirical Precision– terms used consistently for research ? Derivable Consequences– used for practice, research and education, defines the profession-focus should be on person and not disease. Application - Article ? Johnson - AIDS ? How was Johnson’s model applied? What were the results? ? Can find AIDS article in the resource folder for week 2. Reaction/Response …Journey… Likes Dislikes Application to Current Practice? Imogene King King’s Questions O What is the scope of practice of nursing? O What kind of settings do nurses perform their functions? O Are the current goals of nursing similar to those of the past half century? O What are the dimensions of practice that have given the field of nursing a unifying focus over time? Basic Assumptions O Individuals-Nursing focus is the care of human beings O Concepts: perceptions-space and time, values, body image, growth & development, and the rights of the patient O Goal of Nursing is the health care of individuals and groups O Humans are open systems that interact with their environment O Interacting systems: Personal, Interpersonal, Social. Nursing Process O Assessment – understanding patient perceptions, communication, interaction O Planning – decision about goals O Implementation – transactions made O Interactions vs. Transactions O Evaluation – were goals attained? Metaparadigm O Person O Environment O Health O Nursing King’s Critique O Simplicity – Complex, but understandable. 10 major concepts. O Generality – Are there limitations? What? What was King’s response to the limitations? O Empirical Precision – Research utilized O Derivable Consequences – Continues to be used to provide quality, theory-based patient care in practice settings around the world. Reaction/Response …Journey… Likes Dislikes Application to Current Practice? Application - Articles ? King-Practice Setting Application Articles ? How was King’s model applied? What were the results? ? Can find 4 King articles in the resource folder for week 2. Martha Rogers Martha Rogers Cont. General Info O Energy Field – human beings and the environment O Universe of Open Systems – human and environment O Pattern – dynamic process of life for the human Metaparadigm O Person O Environment O Health O Nursing Basic Assumptions O “Man and environment are continuously exchanging matter and energy with one another” O “The nurse is an environmental component for the individual receiving services” Nursing Process O Assessment – identify patterns O Planning – consider patterns O Implementation – human field patterning O Evaluation – appraisal process, determine dissonance Roger’s Critique O Simplicity - abstract and complex O Generality - broad O Empirical Precision – other theories can be derived from it O Derivable Consequences – is useful in practice, education, and research Case Study O Charlie is 56 and has a 30 yr. hx of smoking 2 packs a day of cigarettes. He is seeing an NP, Sandy for the first time after being diagnosed with COPD. Pattern appraisal begins with eliciting the client’s description of his experience with this disease, his perceptions of his health, and how the disease is expressed. O He states having a productive cough worse in the morning, gets short of breath whenever he is physically active, and always feels tired. Through specific questions, the NP discovers that he has experienced a change in his sleep patterns and nutritional intake. He is sleeping for shorter periods and eating less. She also learns that his wife smokes, has cats, and is not willing to change her ways. During this appraisal, the NP seeks to discover what is important to Charlie and how he defines healthy. O Mutual patterning involves sharing knowledge and offering choices. Upon completion of the appraisal, the NP summarizes what she has been told and how she understands it (looking for dissonance). The NP provides information about the disease and suggestions that will increase his comfort. Noninvasive interventions such at breathing retraining, high protein diet, eating smaller meals, sleeping with head elevated, and using progressive relaxation at bedtime. She also recommends a HEPA filter/humidifier for the environmental affects. O Because Charlie has expressed a desire to quit smoking, the NP suggests that he use forms of centering, such as guided imagery and meditation to supplement the nicotine patches. At the end of the visit, Charlie states that he feels better knowing that he has the power to change some things about his life. How was Roger’s Theory Applied? Reaction/Response …Journey… Likes Dislikes Application to Current Practice? Sister Callista Roy Most widely used framework in nursing practice General Info O Levels of life processes: integrated – compensatory – compromised O Coping mechanisms – innate and acquired Metaparadigm O Person O Environment O Health O Nursing Basic Assumptions O Persons are inseparable from their environment O Adaptation occurs when the person responds positively to the environmental changes O The major task of a person is to adapt to environmental stimuli to achieve survival, growth, development, and mastery O Adaptation enables the person to find meaning and purpose in live and to become an integrated whole O A person continually experiences environmental stimuli O A response is made O Ineffective responses fail to achieve goals of adaptation O Nursing assists the person’s adaptation effort by managing the environment Nursing Process O Assessment – behavior and stimuli O Diagnosis – based on adaptive state and set goals O Implementation – interventions to manage stimuli and promote adaptation O Evaluation – achievement of adaptive goals Roy’s Critique O Simplicity – clear and well defined O Generality – broad in scope O Empirical Precision – well researched O Derivable Consequences – used extensively Reaction/Response …Journey… Likes Dislikes Application to Current Practice? Betty Neuman http://www.neumansystemsmodel.org General Info O Focus on: the client system in relationship to environmental stressors O Wellness of the client system and the client system’s reaction to stress O Lines of Defense – flexible line, normal line, and lines of resistance O Environmental Stressors Metaparadigm O Person O Environment O Health O Nursing Basic Assumptions O Each client system is unique O Each person is born with a spiritual energy force or ‘seed’. O When the cushioning effect of the flexible line of defense is no longer capable of protecting the client system against an environmental stressor, the stressor breaks through the normal line of defense. At this point, the interrelationships of the physiological, psychological, sociocultural, developmental, and spiritual variables determine the nature and degree of the system’s reaction to the stressor (Fawcett). Nursing Process O Nursing Diagnosis Category: Assessment & Diagnosis O Nursing Goals: Planning & Implementation O Nursing Outcomes: Implementation & Evaluation Neuman’s Critique O Simplicity – complex yet easy to understand O Generality - broad O Empirical Precision – guides research O Derivable Consequences – cane be used to generate more theory, promotes nursing as a profession Application - Articles O Neuman – MS O How was assessment and levels of prevention applied? O Neuman – Diabetes O How was Neuman’s Model used with a Diabetic patient? O Neuman – Infants & Tobacco O What was the study about? How was Neuman’s model used? O Neuman – Public Health O How does Neuman’s model ‘fit’ with public health nursing? Reaction/Response …Journey… Likes Dislikes Application to Current Practice? Myra Estrin Levine General Info O Conservation – complex systems O Wholeness – exploring the whole to understand the whole O Adaptation – conservation is the outcome of adaptation Metaparadigm O Person O Environment O Health O Nursing Basic Assumptions O “Every self-sustaining system monitors its own behavior by conserving the use of resources required to define its unique identity” O The goal of conservation is health Nursing Process O Assessment – observation, orgasmic responses to illness O Planning – validation and hypothesis O Implementation – testing the hypothesis O Evaluation – observation of the response to the interventions Self Reflection O What do you think about Levine’s view that the nurse should use the steps of the scientific method for establishing guidelines of patient care rather than the standard nursing process? O Do you think that this approach allows the nurse to meet the standards of care practice requirements for assessment, planning, implementation, and evaluation? Critique O Simplicity – clear and simple O Generality – easily generalizable O Empirical Precision – consistently defined O Derivable Consequences - used in practice and research Reaction/Response Likes Dislikes Application to Current Practice? Dorothea Orem General Info 1. Self care What the person requires 2. Self care deficit Limitations in meeting requirements 3. Nursing systems Actions and knowledge Self Care Agency Nursing Systems Self Care Deficit Self Care Requisite Therapeutic Self care demand Metaparadigm O Person O Environment O Health O Nursing Basic Assumptions O Self care is a part of life O Self care is learned O Self care abilities are influenced by age, developmental state, experiences, and sociocultural background O Nurses assess the abilities of the patient to meet or not meet their self care needs Nursing Process O Assessment – Diagnostic operations O Diagnosis/Planning – Prescriptive operations O Implementation – Regulatory operations O Evaluation – Control operations Orem Critique O Simplicity – 3 theories and 8 concepts O Generality – nurses in nursing practice O Empirical Precision – the concepts can be measured O Derivable Consequences – focus is nursing, used in curriculum Reaction/Response …Journey… Likes Dislikes Application to Current Practice? Lecture Application Activity Week 2 O Read Case Study O Answer the 3 questions O Place in dropbox Ms. Davila, age 64 is under the care of a home health agency. Because of rheumatoid arthritis, she has been mostly homebound for 6 years. The home health care was begun at the time of her diagnosis with type II diabetes mellitus 3 years ago. She is pleased to report that she has never been hospitalized – even for the birth of their 2 children. Since age 50, she has had her share of health problems, including osteoporosis, intense arthritic pain and impaired mobility, diabetes, anemia, and a weight problem. She experiences a lot of pain in her legs and uses a wheelchair. When she does walk, she prefers to be barefoot. She needs assistance most days with bathing and grooming. Her breathing is normal. She has no skin problems. Her blood sugar tests are usually somewhat elevated, but her diabetes continues to be managed by diet alone. She is 5 feed tall and weights 180 pounds. Weight has never been viewed as a liability in her Hispanic upbringing. Good times are always associated with eating. She has not experienced any elimination problems. Ms. Davila dropped out of school midway through high school to get married. Now, as a widow, she relies mostly on Social Security income and receives health care through Medicare. Her daughter and grandchildren live in the nearby city. 1. For the patient in the case study, how are they in each of these categories of self-care requisites? This is similar to an assessment. Air Water Food Elimination Activity and Rest Solitude and Social Interaction Hazards Developmental Health Deviation 2. Out of the requisites, what are the therapeutic self-care demands? What areas need care and/or what kind of care? 3. Which of the 3 nursing actions would be helpful for this person? (Wholly compensatory, partially compensatory, supportive-educative). Explain. Week 2 Discussion Forum O Develop a patient case study utilizing Imogene Kings interacting systems framework and theory of goal attainment. O The case study should be applicable to the patient population in your current practice area. Develop a plan of care for the patient in the case study using King's nursing theory as the basis of your practice. O Review the 6 other Conceptual Models/Theories chapters 7-13. Select 1 Model to Compare and Contrast with Kings Interacting Systems Framework and Theory of Goal Attainment. How would you apply the selected model to your case study/plan of care. O O O O What are the Similarities vs. Differences for each Model. How would the nurse apply the Nursing Process differently or the same based on each model/theory? Share your case study, plan of care, and compare/contrast reflection with your peers in the discussion forum. O You will not be able to view your peer's discussion postings until you have posted your initial response (case study & care plan; compare/contrast). Review 2 peer’s response’s and provide feed back to their discussion posting. Place Week 2 Application Activity (3 questions response) in dropbox by end of Week 2 Sunday at 23:59pm. O Place Week 2 Worksheet in dropbox by end of Week 2 Sunday at 23:59pm. O O Self Care