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A Reaction Paper On

NURSING THEORIES

Submitted by: MONALIZA P. DE LEON

NEED THEORY and DEFINITION OF NURSING


Virginia Henderson

Virginia Hendersons very own definition of nursing and theory explains nursing in a very different way. In her definition she said The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will, or knowledge, and to do this in such a way as to help him gain independence as rapidly as possible. She must in a sense, get inside the skin of each of her patients in order to know what he needs.

Her definition emphasizes what our duty, as nurses, are- it is to help our clients gain independence as quickly as possible to promote continuity of healing even after hospitalization, it is to help our clients attain their optimum health by providing their basic needs. Her theory has 4 major concepts the individual, the environment, the health and nursing. According to Henderson, individuals have basic needs which are components of health. For the individual, mind and body are inseparable and interrelated, and the individual considers the biological, psychological, sociological, and spiritual components. In this theory, the patient is a sum of parts with biophysical needs and is not just a type of client or a consumer. The theorys definition of health is based on an individuals ability to function independently. Basic nursing care involves providing conditions so that the patient can independently perform the fourteen components.

As nurses, we need to advocate the promotion of health, prevention and curing of diseases. We need to do anything we can for others as if their bodies are ours , as if we are what they are if they have the will , the strength and the knowledge. But we should always keep in mind that it is always better to make the patient INDEPENDENT from us as soon as possible.

SELF-CARE DEFICIT THEORY


DOROTHEA OREM

Practicing a healthy lifestyle should be the central focal point for every individual. With every person of the society aiming to be healthy, the whole community will be healthy as well. Self-care plays an important element when discussing healthy lifestyle. According to Orem, self-care composed all activities that an individual initiates himself to ensure his health and well-being. These activities may range from taking physical care by ensuring sufficient intake of air, food, water, elimination, to taking care of mental health by creating a balance between rest time and activity. However, when an individual fails to take care of his well being on his own behalf and needs medical assistance, this is considered as self care deficit. Self-care deficit paved the way for various nursing theories and highlights the importance of the role that nurses play in the community. Orem states that nursing is a helping service and its goal is to overcome human limitations and to make certain that the patient is provided with assistance to cope up with his illness or injury until he recovers from it. When an individual demonstrates inability to cope up with his physical or mental instability, nurses render him the required assistance, methods, and techniques. The nurse comes into the picture helping that individual to attain his optimum level of health. Orem identifies five methods for the nurse to help the patient in the community. These methods include acting or doing for patient, guiding the patient, supporting one another, providing an environment to promote personal development and providing health teaching. Through these methods, a nurse can help the patient and assist him until he can already take care of himself.

SYSTEMS MODEL
BETTY NEUMAN

"Health is a condition in which all parts and subparts are in harmony with the whole of the client. --Betty Neuman

In Neumans model, human being is viewed as an open system that interacts with both internal and external environment, forces and stressors. The internal environment exists inside the client system and the external environment exists outside the client system. Because of these interactions, the human is in a constant and dynamic change moving towards system stability or towards illness or varying disease. The Neumans system model has two major components- stress and reaction to stress. The client in the Neumans system model is viewed as an open system in which repeated cycles of input, process, out put and feed back constitute a dynamic organizational pattern. The client may be an individual, a group, a family, a community or an aggregate. In the development towards growth and development open system continuously become more differentiated and elaborate or complex. As they become more complex, the internal conditions of regulation become more complex. Exchange with the environment are reciprocal, both the client and the environment may be affected either positively or negatively by the other. The system may adjust to the environment or to itself. The ideal is to achieve optimal stability. As an open system, the client system has to seek or maintain a balance among the various factors, both with in and outside the system, that seek to disrupt it.

CORE, CURE, CARE THEORY


LYDIA HALL

Lydia Halls theory of core, cure, and care theory can be easily integrated into practice. The core aspect of her theory describes the person that nursing care is directed towards and the individuals behavior due to their feelings and value system. The cure component is the attention given to patients by medical practitioners. These include interventions or actions that can be used to treat or cure the illness or disease that the individual may be suffering from. The last element, care, is about nurturing the patient and providing comfort measures. This also includes providing health teaching. An example used to integrate Lydia Halls theory will be a patient that has just found out that he has diabetes mellitus.

Lydia Halls Care Cure Core model suggests that patients have three needs of care: the physical, the medical, and the social needs. According to Lydia Hall, patients should only be cared by professional nurses who can take whole responsibility on care and teaching of their patients.

CONSERVATION THEORY
MYRA LEVINE

"Ethical behavior is not the display of one's moral rectitude in times of crisis; it is the dayto-day expression of one's commitment to other persons and the ways in which human beings relate to one another in their daily interactions." - Levine, Myra

Nothing is permanent except change. It is a given fact that every organism has to adapt to change in order to survive. Adaptation is the process whereby the patient maintains integrity within the realities of the environment. Conservation, on the other hand, is a product of adaptation. The core, or central concept, of Levines theory is conservation. When a person is in a state of conservation, it means that individual adaptive responses change productively, and to the least expenditure of effort, while preserving optimal function and identity. Conservation is achieved through successful activation of adaptive pathways and behaviors that are appropriate for the wide range of responses required by functioning human beings. Myra Levine described the Four Conservation Principles. These principles focus on conserving an individual's wholeness. She advocated that nursing is a human interaction and proposed four conservation principles of nursing which are concerned with the unity and integrity of individuals.

THE HELPING ART OF CLINICAL NURSING


ERNESTINE WIEDENBACH

In this theory, it is said that every individual has his or her needs. This is something that is very evident in life. Every one of us has our own limitless needs that has to be fulfilled, that has to be met and that is a NORMAL part of living. On the other hand, help must be used by an individual so that he or she can enhance and extend his capabilities. By combing these (need and help), Ernestine Wiedenbachs theory was made. Ernestine believes that there are four main elements of clinical nursing- philosophy, practice, purpose and art. She said that nursing exists because there are patients who need help. The nurses philosophy is her attitude towards life. Practice pertains to actions that are needed to be done to meet the patients need for help. Purpose is what the nurse wants to accomplish through what she practice and lastly, art is the APPLICATION of knowledge and skills to achieve the desired outcome. Every clinical nurse should have all these elements to meet every patients needs. Nurses should identify patients need for help and do everything to help the patient attain his or her needs.

ADAPTATION MODEL
SISTER CALLISTA ROY

Nursing is a science and practice that expands adaptive capabilities and enhances person and environmental transformation. Sister Callista Roy

Sister Callista Roys adaptation model is a lot like Myra Levines theory which focuses on humans ability to adapt. Humans are holistic adaptive systems which have parts hat function in unity for a purpose. In her theory, Callista Roy stated that a persons adptive level is constantly changing and depends on the focal, contextual and residual stimuli. Focal stimulus is the internal and external stimulus encompassing human system; this goes along with Betty Neumans model too. Another is the Contextual stimulus which is composed of all the other stimuli present in a situation that contributes to the effect of focal stimulus. The last stimulus is the residual stimulus which is composed of stimulus present within and without the human system which affects the current situation. Her very own definition of nursing means that it is the duty of nurses to aid their patient in adapting to changes and interact to the environment to promote health- a state of well-being, quality of life and dying with dignity.

NURSING PROCESS THEORY


IDA JEAN ORLANDO

Nursing is a distinct profession that functions autonomous. Ida Jean Orlando

Ida Jean Orlando focuses on the nursing process. She stated that there are three elements that compose a nursing situation the client behavior, the nurse reaction and the nurse actions. The client behavior is an observable or non observable behavior that tells something about the clients problems and needs. The nurse reaction is the nurses perceptions, thoughts and feeling about the situation or the clients behaviors and the nurses actions are the actions or interventions to do something or help the client about his/ her problem or need.

As nurses, it is our job to find out the meaning of an individuals immediate need for help and to see to it that the individuals need for help is met. Orlando's Deliberative Nursing Process Theory focuses on the interaction between the nurse and patient, perception validation, and the use of the nursing process to produce positive outcomes or patient improvement. Orlando's key focus was to define the function of nursing. Her theory is widely used because it is clear, concise and easy to use.

CHANGE THEORY
KURT LEWIN

Behavior is a dynamic balance of forces working on opposing directions. Kurt Lewin

This is one of the non-nursing theories that I liked most. Kurt Lewins theory shows how a change in ones behavior is made. His model, the unfreeze-change-refreeze model, tells that in order for a change in ones behavior one must first understand what can cause the change the driving forces, the restraining forces and the equilibrium. For a change to happen, one must first unfreeze his behavior. He should let go of the way he or she have always done it. To do so, on must increase the driving force, decrease the restraining force or, combine the two methods. After unfreezing, the next step is to start the process of changing, once youve applied and got used to the change that youve made, its time to refreeze the habit or behavior. This method is like adjusting and changing your undesired, unproductive habits into a desired, productive and useful habit. In this way, a nurse can improve himself or herself easily. Nurses will be able to adapt and take up new and better practices easily taking up lesser time because of these provided steps.

DEVELOPMENTAL THEORY
ERIK ERICKSON

This theory of Erik Erickson focuses on the psychological development of human beings. It provided a psychological developmental stage in human life that will enable a nurse to understand every individual he or she is taking care of. If a nurse will understand this theory, shell be able to identify why certain individual behaves or acts that way and understanding our patients is the first thing we should do to be able to really help them. Also by knowing this theory, well know how to respond to different types of patients with different types of problems. In example, a nurse would know how to act in front of a child which differs from how he or she will act in front of an elderly. Next, nurses can gather information about patients by using Erikson's theory and provide patient centered care. Nurses being familiar with Erikson's Development Theory can "...help in analyzing patient's symptomatic behavior in the context of traumatic past experiences and struggles with current developmental tasks". Nurses can help identify inpatients faulty behavior based on past experiences and stages and help them seek psychological assistance such as a counselor. Nurses can help patients who are having difficulty with developmental phases by providing care directed to the appropriate stage.