1st Sem - TFN Midterms

Lydia E. Hall

CARE, CORE, and CURE

Faye Glenn Abdellah

21 Nursing Problem

Virginia Henderson

Need Theory. First Lady of Nursing,” “The Nightingale of Modern Nursing,” and the “Nurse’s Nurse.”

Hall’s definition of Person

The individual human who is 16 years of age or older and past the acute stage of long-term illness. Unique, capable of growth and learning, and requiring a total person approach. The source of energy and motivation for healing is the individual care recipient, not the health care provider.

Hall’s definition of Environment

Any actions taken concerning this are to assist the individual in attaining a personal goal.

Loeb Center’s Concept

focuses on providing an environment that is conducive to self-development.

Hall’s definition of Health

Can be inferred as a state of self-awareness. A dynamic state; not just the absence of disease but progress toward selfactualization.

Hall’s definition of Nursing

Identified as participating in the care, core, and cure aspects of patient care. Focuses mainly on the care aspect while supporting the core and cure components.

Care

The role of nurses, focusing on performing the task of nurturing patients. Defines a primary role of nurses, where the nurse gives hands-on bodily care to the patient’

Nurturing

factors that make up the concept of mothering (care and comfort of the person) and provide teaching-learning activities

Core

Centers entirely on the patient. Nurses help patients put their feelings about their illness and its impact into words. Focuses on the patient’s emotional, social, spiritual, and intellectual needs within the context of their family, community, and the world

Cure

Medical side of nursing. Specifically administering treatments and managing medications. Treating an illness or disease requires a team approach

Abdellah’s definition of Person

Recipients of nursing: Family and Society

Abdellah’s definition of Health

the purpose of nursing services.

Abdellah’s definition of Environment

Included in “planning for optimum health on local, state, national, and international levels” the focus of nursing service is clearly the the focus of nursing service is clearly the individual..

Abdella’s definition of Nursing

Based on an art and science. Use of the problem-solving approach with key nursing problems related to the health needs of people

21

how many nursing problem theory? (abdellah)

Henderson’s definition of Person

Requires help toward achieving independence and completeness or wholeness of mind and body. A complete and independent being with biological, sociological and spiritual components

14

how many fundamental’s needs theory

Henderson’s definition of Environment

“the aggregate of the external conditions and influences affecting the life and development of an organism.”

Henderson’s definition of Health

Equated help with INDEPENDENCE. that margin of mental physical vigor that allows a person to work most effectively and to reach his highest potential level of satisfaction in life

Henderson’s definition of Nursing

The function of the nurse is to assist the individual, sick or well, in the performance of activities contributing to health or its recovery. “independence in the satisfaction of the human being's 14 fundamental or basic needs.

Hildegard E. Peplau

Theory of Interpersonal Relations. Known as the “Mother of Psychiatric Nursing” and “Nurse of the Century.” She was the first nursing theorist to publish a major nursing theory after Florence Nightingale.

Peplau’s definition of Person

An organism that “strives in its own way to reduce tension generated by needs”

Peplau’s definition of Health

Defined as “a word symbol that implies forward movement of personality and other ongoing human processes in the direction of creative, constructive, productive, personal, and community living.”

Peplau’s definition of Environment

Encourages nurses to consider the patient’s “culture” and “mores” when the patient adjusts to the hospital routine. Existing forces outside the organism and in the context of culture.

Peplau’s definition of Nursing

A therapeutic and healing art. A “significant therapeutic, interpersonal process” that functions cooperatively with others to make health possible.

ORIENTATION PHASE

The nurse and patient meet as two strangers • The individual has a “felt need” and seeks professional assistance • The nurse helps the individual to recognize and understand their problem and determine the need for help.

IDENTIFICATION PHASE

Patient identifies with those who can help him/her • The nurse permits exploration of feelings to aid the patient in undergoing illness as an experience that reorients feelings and strengthens positive forces in the personality and provides needed satisfaction

EXPLOITATION PHASE

Patient attempts to derive full value from what he/she is offered through the relationship • Patient may make minor requests or display attention-getting techniques • The nurse can project new goals to be achieved through personal effort and power shifts from the nurse to the patient as the patient delays gratification to achieve the newly formed goals.

RESOLUTION PHASE

Termination of the professional relationship. Patient gradually puts aside old goals and adopts new goals • Patient frees himself from identification with the nurse

Stranger

Greets the patient with respect and acceptance, building a foundation of trust

Resource Person

Provides clear, relevant information to help the patient understand their condition and care.

Teacher

Guides learning about health, treatment, and self-management.

Leader

Encourages participation, decision-making, and cooperation in the care process.

Surrogate

Acts as a substitute figure (e.g., parent, sibling, or confidant) to meet emotional needs temporarily.

Counselor

Listens, supports, and helps the patient explore feelings to promote self-awareness and coping.

Ida Jean Orlando

Deliberative Nursing Process Theory. Authored The Dynamic Nurse-Patient Relationship: Function, Process and Principles of Professional Nursing Practice (1961).

Orlando’s definition of Person

Considers the person as a “human being” – a unique individual behaving verbally and non-verbally. Humans in need are the focus of nursing practice

Orlando’s definition of Health

A person experiences this when their needs are met and they are free from discomfort. An unmet need creates a deficit in this (helplessness), which serves as the exact initiator that necessitates nursing intervention.

Orlando’s definition of Environment

did not define this in her theory. She did not evaluate how physical surroundings, cultural settings, families, or broader community groups impact the patient. She only focused on the patient’s immediate need, chiefly the relationship and actions between the nurse and the patient

Orlando’s definition of Nursing

It must be carried out through a disciplined, interactive process where the nurse validates perceptions with the patient before taking action. A unique, independent profession separate from medicine

Deliberative Nursing Process

nurse helps patients meet perceived needs that the patient cannot meet for themselves. identifying client behaviors, nurse’s reactions, and nursing actions to take.

Presenting Behavior

This is the patient’s problematic situation. • Considered the stimulus, causes an automatic internal response in the nurse, which in turn causes a response in the patient.

Distress

When the patient experiences a need that cannot be resolved, a sense of helplessness occurs.

Immediate Reaction

Perceptions stimulate automatic thought, and each thought stimulates an automatic feeling, causing the patient to act. • The immediate reaction reflects how the nurse experiences their participation in the nurse-patient relationship

Nurse’s Reaction

The patient’s behavior stimulated a nurse’s reaction, which marks the beginning of the nursing process

Nurse’s Action

When the nurse acts, an action process transpires.

nursing process

This action process by the nurse in a nurse-patient contact. The nurse decides on appropriate action to resolve the need in cooperation with the patient. This action is evaluated after it is carried out.

Automatic Nursing Actions

These are nursing actions decided upon for reasons other than the patient’s immediate need.

Deliberative Nursing Actions

These are actions decided upon after ascertaining a need and then meeting this need.

Assessment

The nurse uses a nursing framework to collect both subjective and objective data about the patient. The nurse completes a holistic assessment of the patient’s needs

Diagnosis

This stage uses the nurse’s clinical judgment about health problems. can then be confirmed using links to defining characteristics, related factors, and risk factors found in the patient’s assessment.

Planning

Each problem is given a specific goal or outcome, and each goal or outcome is given nursing interventions to help achieve the goal. Addresses each of the problems identified in the diagnosis.

Implementation

This is the stage wherein the nurse begins utilizing the nursing care plan to carry out essential nursing interventions.

Evaluation

The nurse looks at the patient’s progress toward the goals set in the nursing care plan. Changes can be made to the nursing care plan based on how well (or poorly) the patient is progressing toward the goals.

Joyce Travelbee

Human-to-Human Relationship Model

Travelbee’s definition of Person

A unique irreplaceable individual – a one-time being in this world – like yet unlike any person who has ever lived or ever will live. a unique, irreplaceable individual who is in continuous process of becoming, evolving and changing

Subjective Health

an individually defined state of well being in accord with self-appraisal of physical-emotional-spiritual status

Objective Health

absence of discernible disease, disability or defect as measured by physical examination, laboratory tests and assessment by spiritual director or psychological counselor

Travelbee’s definition of Environment

Defined human conditions and life experiences encountered by all men as suffering, hope, pain, and illness.

Illness

a category and classification

Subjective criteria

refer to the way in which a human being perceives himself or herself as ill

Objective criteria

are determined by the outward effects of illness on the individual

Travelbee’s definition of Nursing

An interpersonal process whereby the professional nurse practitioner assists an individual, family, or community to prevent or cope with the experience of illness and suffering, and if necessary, to find meaning in these experiences

Nurse-Patient Interaction

Refers to any contact between a nurse and an ill person

Therapeutic Use of Self

Ability to use one’s personality consciously and in full awareness in an attempt to establish relatedness and to structure nursing intervention

Original Encounter

First impressions. The nurse and patient see each other in stereotyped or traditional roles

Emerging Identities

Involves perceiving each other’s uniqueness. The link of the relationship begins to form

Empathy

Refers to the ability to share in the person’s experience (feeling with someone).

Sympathy

When the nurse wants to lessen the cause of the patient’s suffering (feeling for someone).

Rapport

Described as nursing interventions that lessen the patient’s sufferinga harmonious, trusting connection built between a nurse and a patient through mutual respect, empathy, acceptance, and active communication.

Margaret A. Newman

Health As Expanding Consciousness. emphasizes pattern recognition and transformation. focuses on recognition of the evolving person–environment pattern; health includes disease and is understood as expanding consciousness.

Martha E. Rogers

Science Of Unitary Human Beings. emphasizes human– environmental field patterning. views human beings and environments as irreducible, pandimensional energy fields in continuous mutual process; nursing promotes harmonious patterning and well-being.

Rosemarie Rizzo Parse

Human Becoming Theory, emphasizes meaning, choice, and true presence. focuses on humanuniverse, personal meaning, rhythmic patterns, freedom, and cotranscending with possibilities; nursing is lived through true presence.

Newman’s definition of Person

A unitary, open being continuously interconnected with the universe and engaged in an evolving pattern of the whole. • The person cannot be understood by separating the individual into isolated parts. • Consciousness includes cognitive and affective awareness as well as the interconnected processes of the entire living system. • Each person expresses a unique life pattern through relationships, choices, movement, and experiences.

Newmans’s definition of Health

the pattern of the whole and includes both disease and non-disease. Illness does not necessarily mean loss of wholeness; it may be a manifestation of the person’s total evolving pattern. a transformative process toward more inclusive consciousness. Pattern recognition enables the person to perceive alternatives and discover new possibilities for action.

Newman’s definition of Environment

Individual patterns interact with family, community, and the wider universe. the larger whole within which individual consciousness exists and evolves.

Newman’s definition of Nursing

helps the person recognize relationships and recurring life patterns. centers on caring relationships and recognizing the person through patterns.

Central theory

health is the expansion of consciousness

Roger’s definition of Person

is a unitary human being, an irreducible, indivisible, pandimensional being identified by pattern. The whole has characteristics that cannot be predicted by studying individual parts alone. • Human beings are open systems and are continuously changing. • Each human field has a unique pattern that manifests the person’s identity and life process.

Roger’s definition of Health

is an expression of the life process and of the continuously changing human and environmental field pattern. Pattern manifestations may be experienced as illness, disease, or well-being

Roger’s definition of Environment

is an irreducible, pandimensional energy field that is integral with the human field.

Roger’s definition of Nursing

both a science and an art concerned with people and the world in which they live. • Its purpose is to promote health and well-being through understanding human environmental field patterns. • Professional practice promotes harmonious interaction between human and environmental fields.

Integrality

the continuous mutual process of human and environmental fields; neither can be understood as separate from the other

Resonancy

continuous change in wave patterns from lower-frequency, longer-wave patterns toward higher-frequency, shorter-wave patterns.

Helicy

continuous, innovative, unpredictable, and increasing diversity of human– environmental field patterns.

HUMANUNIVERSE

Parse views person and environment as inseparable and irreducible; she uses this term to emphasize their unity. is indivisible, unpredictable, everchanging, and continuously cocreating reality. Human beings freely choose meanings and ways of becoming within their situations.

LIVING QUALITY

is defined by the person—not by the nurse or by an external standard of normality. • It reflects the person’s lived experience, priorities, hopes, values, and meanings in the emerging now. • Health-related experiences therefore must be understood from the individual’s own perspective.

Parse’s definition of Nursing

is a science whose practice is a performing art, lived through relationships with persons, families, groups, and communities. • The nurse practices true presence being genuinely available and attentive to moment-to-moment changes in meaning. The nurse does not impose what the patient should value, but respects freedom, dignity, and personal choice.

Meaning

people give and take meaning through speaking, silence, movement, stillness, values, hopes, and day-to-day living. personally chosen.

Rhythmicity

people live unique, continuously changing patterns of relating with others, ideas, objects, and situations.

Transcendence

people move beyond the present toward new possibilities, hopes, dreams, and ways of becoming.