TFN: Travelbee, Fitzpatrick, Benner

Human-to-Human Relationship Model

Theory of Travelbee

Interpersonal Aspects of Nursing
Intervention in Psychiatric Nursing: Process in the One-to-One Relationship

Published books of Travelbee

1 - The inaugural meeting or original encounter
2 - Visibility of personal identities/emerging identities
3 - Empathy
4 - Sympathy
5 - Establishing mutual understanding and contact/rapport

According to Travelbee, what are the 5 phases of interaction process

Original Encounter

According to Travelbee, this is described as the first impression by the nurse of the sick person and vice-versa. The nurse and the patient see each other in stereotyped or traditional roles

Emerging Identities

According to Travelbee, this is described by the nurse and patient perceiving each other as unique individuals. At this time, the link of relationship begins to form

Empathy

According to Travelbee, this refers to the ability to share in the person's experience. Travelbee proposed that two qualities of that enhance the empathy process are similarities of experience and the desire to understand another person

Sympathy

According to Travelbee, this refers when the nurse wants to lessen the cause of the patient's suffering, it goes beyond empathy. The nurse should use a disciplined intellectual approach together with therapeutic use of self to make helpful nursing actions

Rapport

According to Travelbee, this refers as nursing interventions that lessens the patient's suffering. The nurse and the sick person are relating as human being to human being

Health

According to Travelbee, this is measured by subjective and objective health

Environment

According to Travelbee, its definition was not clearly defined in this theory. She defined human conditions and life experiences encountered by all men as sufferings, hope, pain and illness. These conditions are associated to the environment

Illness

According to Travelbee, this is a category and classification, both objective and subjective criteria

Objective criteria

According to Travelbee, these are determined by the outward effects of illness on the individual

Subjective criteria

According to Travelbee, this refer to the way in which a human being perceives himself or herself as ill

Suffering

According to Travelbee, this is a feeling of displeasure which ranges from simple transitory mental, physical, or spiritual discomfort to extreme anguish, and those phases beyond anguish, namely, the malignant phases of despairful 'not caring', and the terminal phase of apathetic indiferrence

Pain

According to Travelbee, this pain itself is not observable - only its effects are noted. The experience of pain is unique to each indiviual

Hope

According to Travelbee, this is a mental state characterized by the desire to gain an end or accomplish a goal combined with some degree of expectation that what is desired or sought is attainable. It is related to dependence on others, choice, wishing, trust and perseverance, and courage and is future oriented

Nursing

According to Travelbee, this is defined as "an interpersonal process whereby the professional nurse practitioner assists an individual family, or community to prevent of cope with the experience of illness and suffering and, if necessary, to find meaning in these experiences

Life Perspective Rhythm Model

Theory of Fitzpatrick

Advanced Practice Psychiatric Nursing: Integrating Psychotherapy, Psychopharmacology, and Alternative/Complementary Approaches
Theories Guiding Nursing Research and Practice: Making Nursing Knowledge Development Explicit
Nursing Concept Analysis: Application to Research and Practice

Published books of Fitzpatrick

Wholeness
Openness
Unidirectionality
Pattern and Organization
Thought and Sentience

In Fitzpatrick's theory, nursing focuses on a set of basic assumptions that describes the life process in human beings

Martha Roger's Theory of Human Beings

In Fitzpatrick's theory, she conceptualized her model from

differentiation, organizing, and order life's reality

Martha Roger's Theory of Human Beings correlates human development as the basis for

Person

According to Travelbee, this includes both self and others; seen as a open system, a unified whole characterized by a basic human rhythm

Health

According to Travelbee, this is a dynamic state of being that results from the interaction of person and the environment

Nursing

According to Travelbee, this is a developing discipline whose central concern is the meaning attached to life (health)

From Novice to Expert: Excellence and Power in Clinical Nursing Practice

Theory of Benner

From Novice to Expert: Excellence and Power in Clinical Nursing Practice
Nursing Pathways for Patient Safety
The Primary of Caring

Published books of Benner

Nursing

According to Benner, this is described as an "enabling condition and concern" which shows a high level of emotional involvement in the nurse-client relationship

Person

According to Benner, this is a self-interpreting being, that is, the person does not come into the world pre-defined but gets defined in the course of living a life

role of the situation
role of the body
role of personal concerns
role of temporality

According to Benner, these are the major aspects of understanding that the person must deal with as:

Embodiment

According to Benner, this is the capacity of the body to respond to meaningful situations

1 - unborn complex
2 - habitual skilled body
3 - projected body
4 - actual projected body
5 - phenomenal body

According to Benner, what are the 5 dimensions of the body

Health

According to Benner, this is focused on the lived experience of being healthy and ill; what can be assessed

Well-being

According to Benner, this is the human experience of health or wholeness

Environment

According to Benner, she used the term "situation" instead, because it suggests a social environment with social definition and meaning

1 - Novice
2 - Advanced beginner
3 - Competent
4 - Proficient
5 - Expert

According to Benner, what are the 5 levels of skills acquisition and skill development

1 - Novice

According to Benner, the person has no background experience
of the situation in which he or she is involved. Context-free rules and objective attributes must be given to guide performance. There is difficulty discerning between relevant and irrelevant aspects of a situation.

2 - Advanced beginner

According to Benner, the person can demonstrate marginally acceptable performance, having coped with enough real situations to note, or to have pointed out by a mentor, the recurring meaningful components of the situation. Most newly graduated nurses are at this level.

3 - Competent

According to Benner, the through learning from actual practice situations and by following the actions of others, the advanced
beginner moves to this level. Consistency, predictability, and time management are important in competent performance. This stage is most pivotal in clinical learning, because the learner must begin to recognize patterns and determine which elements of the situation warrant attention and which can be
ignored.

4 - Proficient

According to Benner, the nurses at this level demonstrate a new ability to see changing relevance in a situation, including recognition and implementation of skilled responses to the situation as it evolves. They no longer rely on preset goals for organization, and they demonstrate increased confidence in their knowledge and abilities

5 - Expert

According to Benner, nurse as having an intuitive grasp of the situation and as being able to identify the region of the problem without losing time considering a range of alternative diagnoses and solutions; “knows the patient,”

1 - a clinical grasp and resource-based practice
2 - embodied know-how
3 - seeing the big picture
4 - seeing the unexpected

According to Benner, the key aspects of expert practice include the following

Aspects of a situation

According to Benner, this is the recurring meaningful situational
components recognized and understood in context because the nurse has previous experience

Attribute of a situation

According to Benner, this is the measurable properties of a situation that can be explained without previous experience in the situation

Competency

According to Benner, this is “an interpretively defined area of skilled performance identified and described by its intent, functions, and meanings”

Domain

According to Benner, this is an area of practice having a number of competencies with similar intents, functions, and meanings

Exemplar

According to Benner, this is an example of a clinical situation that conveys one or more intents, meanings, functions, or outcomes easily translated to other clinical situations

Experience

According to Benner, this is not a mere passage of time, but an active process of refining and changing preconceived theories, notions, and ideas when confronted with actual situations; it implies there is a dialog between what is found in practice and what is expected

Maxim

According to Benner, this is a cryptic description of skilled performance that requires a certain level of experience to recognize the implications of the instructions

Paradigm case

According to Benner, this is a clinical experience that stands out and alters the way the nurse will perceive and understand future clinical situations; it also create new clinical understanding and open new clinical perspectives and alternatives.

Salience

According to Benner, this describes a perceptual stance or embodied knowledge whereby aspects of a situation stand out as more or less important