TFN 2

Florence Nightingale

first nursing theorist. “The Lady with the Lamp”. She was a statistician

Derbyshire, England

Where Florence was born and raised

Institute of Saint Vincent de Paul in Alexandria, Egypt

Where Florence trained in nursing

38 nurses

Led how many nurses in 1854

Pie chart

What was Florence credited with inventing

Crimean War

Broke out when Florence was 34 years old. War Russia vs Turkey (Britain and France)

Nursing for Florence

an act of utilizing the environment of the patient to assist him in his recovery. activities that promote health that can be done by anyone.

Environmental Theory

external influences and conditions can prevent, suppress or contribute to disease or death. Retain the patients own vitality by meeting his basic needs through control of the environment

Physical, Psychological, Social

Types of Environment identified by Florence

Physical Environment

Consists of physical elements. Influence the social and psychological environments

Psychological Environment

requires various activities to keep the mind active

Social Environment

a person’s home or hospital room as well as the total community

Ventilation and Warming

keep the air he breathes as pure as the external air, without chilling. Concerned about “noxious air” or “effluvia”. Temperature not too warm or too cold

Light

Direct sunlight. “quite real and tangible effects upon the body”

Noise

patients should never be waked intentionally or accidentally. Nurses’ responsibility is to assess and stop different kinds of noise

Health of House and Cleanliness of the Area

Cleanliness of the area affects the person inside. Importance of the health of houses as being closely related to the presence of the environmental factors

Variety

Changes in the environment such as decorations to avoid monotony

Bed and Bedding

Beddings regularly changed and comfortable. Bed in the lightest part of the room near the window

Personal Cleanliness

Keep pores free from obstructing excretions. Every nurse ought to wash her hands frequently

Nutrition & Food intake

nurse should be conscious of patients’ diets and remember how much food and what to have

Observation of the sick

What to observe and how to observe any changes in the condition be it positive or negative

Chattering hopes & advices

Avoid the practice of attempting to cheer the sick by making light of their danger and making false promises, giving false hope.

Social Considerations

importance of looking beyond the individual to the social environment in which they lived.

Environment for Florence

should be altered to improve conditions so that the natural laws would allow healing to occur. Poor or difficult environments led to poor health and disease

Health by Florence

“Not only to be well, but able to maintain well-being by using power we have to the fullest extent.” Maintenance of health through prevention of disease by environmental control and social responsibility

Person by Florence

Defined in relation to their environment and the impact of the environment upon them

Notes on Nursing: What it is and what it is not

Book that was written by Florence

Caring

is the essence of nursing and connotes responsiveness between the nurse and person

Jean Watson’s theory that was published in 1988

Nursing: Human Science and Human Care

Theory of Caring

A relational caring for self and others. Caring is the essence of nursing. Foundation for our professional nursing practice environment.

Transpersonal Caring Relationship

Going beyond ego to higher “ spiritual” caring created by “Caring Moments. Inner Harmony (equanimity)

Caring Occasion/Moment

Two people, each with their own “phenomenal field”/background come together in a human-to-human transaction that is meaningful, authentic, intentional. Sharing human experience that expands each person’s worldview and spirit

Human Being by Watson

a valued person in and of themselves to be cared for, respected, nurtured, understood, and assisted. human is viewed as greater than and different from the sum of his or her parts

Health by Watson

high level of overall physical, mental, and social functioning, a general adaptive-maintenance level of daily functioning. absence of illness

Environment/Society by Watson

nurses have existed in every society, and that a caring attitude is transmitted by the culture of the nursing profession as a unique way of coping with its environment.

Caritas Processes

an evolution of carative factors meant to provide a more contemporary and dynamic framework for nursing care. They are not merely a list but are presented as interrelated and evolving processes.

Intrapersonal-interpersonal need

self-actualization

Psychosocial needs

need for achievement, affiliation

Psychosocial needs

the need for activity-inactivity, sexuality

Biophysical needs

the need for food and fluid, elimination, ventilation

Theory of Bureaucratic Caring

a dialectical relationship (thesis, antithesis, synthesis) between the human (person & nurse) dimension of spiritual ethical caring and the structural (nursing, environment) dimensions of the bureaucracy or organizational culture (technological, economic, political, legal and social)

Marilyn Anne Ray

Proponent of theory of Bureaucratic Caring

Caring

Complex, transcultural, relational process, grounded in an ethical, spiritual context. relationship between charity and right action, between love as compassion is response to human suffering and need, and justice or fairness in terms of what ought to be done

Spiritual-Ethical Caring

The ethical imperatives of caring that join with the spiritual and relate to our moral obligation to others. facilitation of choices for the good of others

Educational

Formal and informal educational programs. forms of teaching and sharing information.

Physical

physical state of being including biological and mental patterns and their interrelatedness.

Socio-cultural

Social interaction and support. Understanding interrelationships, involvement, and structures of cultural groups, community and society

Legal

Responsibility and accountability. Rules and principles to guide behaviors, such as policies and procedures

Technological

nonhuman resources such as the use of machinery to maintain the physiological well-being

Economic

Allocation of scarce resources: money and services. Caring as an interpersonal resource

Political

Patterns of communication and decisions in the organization. Role and gender stratification. Uses of power, prestige, and privilege

Nursing/Caring by Marilyn

holistic, transcultural and relational, spiritual and ethical caring that seeks the good of self and others

Love

foundation of spiritual caring, calls forth a responsible ethical life

Person/Cultural Being by Marilyn

pattern of meaning for individuals, families and communities

Health by Marilyn

social organization of health and illness determines how persons are recognized as sick or well, how health or illness is presented and the way health is interpreted by the individual

Environment/Culture of Organization

complex spiritual, ethical, ecological and cultural phenomenon. embodies the elements of the social structure and spiritual and ethical caring patterns of meaning

Theoretical Assertion of Marilyn

the essential construct and consciousness of nursing. viewed as love and bureaucratic. meaning of caring is love and is highly differential depending on its context structures

Application in Practice of Bureaucratic Caring

can transform the workplace into moral communities within the culture of humanistic, social, economic, political and legal values

Application in Education of Bureaucratic Caring

useful to nursing education because of its broad focus on caring and complexity sciences in nursing. Used as an organizing framework for curricula

Application in Research of Bureaucratic Caring

developed a phenomenological-hermeneutical approach (caring inquiry). been adopted by many researchers for the humanistic approach. study the human experience in health situations

Patricia Benner

Caring, Clinical Wisdom, and Ethics in Nursing Practice
Novice to Expert; Excellence and Power in Nursing Practice

Novice to Expert Theory

Patricia Benner published what theory in 1982

Dreyfus model of Skill Acquisition

A five-stage model of the mental activities involved in direct skills acquisition mode. Benner’s Theory is based on this model

Philosophy of Benner

Experience and mastery are required to bring a skill to a higher level. Not how to do nursing but how do nurses learn to do nursing. Practical application to complex situations rather than theories and models

Beginner

Learning the job means learning the rules and routine. Lack of a sense of control and responsibility

Competence

Seeing and connecting similarities, Developing strategic knowledge, Contingency planning

Proficiency

Personal responsibility, Responding instinctively and intuitively, Learning from outside sources

Expert

Extensive knowledge and Automaticity of behavior

Novice

Beginner with no experience, Taught general rules to help perform tasks

Advanced Beginner

gained prior experience in actual situations to recognize recurring meaningful components. Applies to most newly graduated nurses

Competent Practitioner

2-3 years experience, Coordinates several tasks simultaneously, Consistent, predictable, and able to manage time, Begins to recognize patterns.

Proficient Practitioner

applies to nurses with 3-5 years experience, Views patient holistically, Focuses on long-term goals

Expert

No longer relies on principles, rules or guidelines. intuitive grasp of clinical situations and patients needs automatically

Nursing by Benner

A caring relationship. “Caring is primary because caring sets up the possibility of giving help and receiving help.” guided by the moral art and ethics ofcare and responsibility

Person by Benner

A person is a self-interesting being, gets defined in the course of living a life. an effortless and non-reflective understanding of the self in the world

Health by Benner

defined as what can be assessed

Well-being

human experience of health or wholeness

Illness

human experience of loss or dysfunction

Environment/Situation

“Personal interpretation of the situation is bounded by the way the individual is in it. Each person’s past, present, and future, which include your own personal meanings, habits, and perspectives influence the current situation

Kari Martinsen

Norwegian nurse and philosopher

Compassion

one of the basic values of nursing care

Philosophy of Caring

Taking care of other people. question the policy of objectifying patients by focusing on the technology of care and diseases, rather than the patient. Social aspects of care were equal to the technical aspects

Philosophy and Nursing: A Marxist and Phenomenological Contribution (1975)

Kari Martinsen’s Thesis

Care by Martinsen

forms not only the value base of nursing, but is a fundamental precondition for our lives. directed outward toward the situation. can bring the patient to experience the meaning of love and mercy;

relational, practical, moral simultaneously

Trinity of care

Clinical Observation

the exercises of professional judgment in practical, living contexts

Sovereign Life Utterances

phenomena that accompany the Creation itself. exist as pre-cultural phenomena in all societies. present as potentials. beyond human control and influence (openness, mercy, trust, hope, love)

Untouchable Zone

zone that we must not interfere with in encounters with the other and encounters with nature

Openness

In caring, the untouchable zone is united with its opposite, in which closeness,vulnerability, and motive have their correct place

Katie Eriksson

pioneers of caring science in the Nordic countries. Finland-Swedish minority in Finland and her native language is swedish

Patient Care Process

Erikssons doctoral dissertation in Pedagogy

Caritas

love and charity. by nature unconditional love. fundamental motive of caring science and motive for all caring

Caring Communion

form of intimate connection that characterizes caring. requires meeting in time and space, an absolute, lasting experience.

Faith, Hope, Love, Tending, Playing, Learning

Caring elements of Eriksson

Caring Ethics

The core of nursing ethics. Comprises the ethics of caring. deals with the basic relation between the patient and the nurse. the approach we have toward the patient

Nursing Ethics

deals with the ethical principles and rules that guide my work or my decisions

Ethical Caring

is what we actually make explicit through our approach and the things we do for the patient in practice

Dignity

Constitutes one of the basic concepts of Caritative caring things

Absolute Dignity

granted the human being through creation. involves the right to be confirmed as a unique human being

Relative dignity

influenced and formed through culture and external contexts